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Question 1

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma . Which would the nurse expect to note specifically in this disorder?
A.increased calcium levels
B. Increased white blood cells
C. Decreased blood urea nitrogen level
D. Decreased number of plasma cells in the bone

Answer 1

A. Increased calcium levels

Question 2

The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan?
A.encourage fluids
B. Providing fluids
C. Coughing and deep breathing
D. Monitoring the red blood cell count

Answer 2

A. Encourage fluids

Question 3

The nurse should plan to implement which intervention in the care of a client experiencing neutropenia as a result of chemotherapy ?

A.restrict all visitors
B. Restrict fluid intake
C. Teach the client and family about the need for hand hygiene
D. Insert an indwelling catheter to prevent skin breakdown

Answer 3

C. Teach the client and family about the need for hand hygiene

Question 4

The home health nurse is caring for a client with cancer who is complaining of acute pain. The most appropriate determination of the clients pain should include which assessment ?

A. The clients pain rating
B. Nonverbal cues from the client
C. The nurses impression of the clients pain
D. Pain relief after appropriate nursing intervention

Answer 4

A. The clients pain rating

Question 5

The nurse is conducting a history and monitoring laboratory values on a Client with multiple myeloma. What assessment findings should the nurse expect to note ?? SATA

A. Pathological fracture
B. Urinalysis positive for Bence Jones protein
C. HGB level of 15.5
D. Calcium level of 8.6
E. Serum creatinine level of 2.0

Answer 5

A. Pathological fracture

B. Urinalysis positive for Bence Jones protein

E. Serum creatinine level of 2.0

Question 6

As part of chemotherapy education the nurse teaches the female client about the risk for bleeding and self care during the period of greatest bone marrow suppression. The nurse understands that further teaching is needed if the client makes which statement?

A. “I should avoid blowing my nose”
B. “I may need a platelet transfusion if my platelet count is to low”
C. “ Im going to take aspirin for my headache as soon as i get home”
D. “ i will count the number of pads and tampons i use when menstruating “

Answer 6

C. “ Im going to take aspirin for my headache as soon as i get home”

Question 7

The nurse is instructing a client with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the client ?

A. Administer the iron at mealtimes
B. Administer the iron through a straw
C. Mix the iron with cereal to administer
D. Add the iron to apple juice for easy administration

Answer 7

B. Administer the iron through a straw

Question 8

Laboratory studies are performed for a client suspected to have iron deficiency anemia. The nurse reviews the lab results , knowing that which result indicates this type of anemia?

A. Elevated HGB levels
B. Decreased reticulocyte count
C. Elevated Red blood cells count
D. Red blood cells that are microcytic and hypochromic

Answer 8

D. Red blood cells that are microcytic and hypochromic

Question 9

The nurse is providing dietary teaching for a client who underwent a partial gastrectomy to treat gastric cancer about food high in vitamin B12. The nurse would instruct the client to include which foods items in the diet that are high in this vitamin? SATA

A. Milk
B. Fish
C. Beef
D. Apples
E. Turkey
F. Bananas

Answer 9

A. Milk
B. Fish
C. Beef
E. Turkey

Question 10

The nurse provides home care instructions to a client with systemic lupus erythematosus and tells the client about methods to manage fatigue which statement by the client indicates a need for further instruction?

A. “I should take hot baths because they are relaxing”
B. “I should sit whenever possible to conserve my energy “
C. “ i should avoid long periods of rest because it can cause joint stiffness”
D. “ I should do some exercise , such as walking when im not fatigues”

Answer 10

A. “I should take hot baths because they are relaxing”

Question 11

A client develops an anaphylactic reaction after receiving morphine. The nurse should plan to institute which actions ? SATA

A. Administer oxygen
B. Quickly assess the clients respiratory status
C. Document the event , interventions, and clients response
D. Leave the client and contact PCP
E. Keep the client supine regardless of blood pressure readings
F. Start IV infusion of D5W and administer 500 ml bolus

Answer 11

A. Administer oxygen
B. Quickly assess the clients respiratory status
C. Document the event , interventions, and clients response

Question 12

The client with AIDS is diagnosed with cutaneous Kaposi syndrome. Based on this diagnosis the nurse understands that this has been confirmed by which finding?

A. Swelling in genital area
B. Swelling in lower extremities
C. Positive punch biopsy of the cutaneous lesions
D. Appearance of reddish-blue lesions noted on the skin

Answer 12

C. Positive punch biopsy of the cutaneous lesions

Question 13

Which patient is at greatest risk for developing IDA?

A. A 6 year old African America boy with no health problems
B. A 15 Year old African American pregnant female
C. A 52 year old Mexican American female with HTN
D. A 72 year old Caucasian male with cardiac disease

Answer 13

B. A 15 Year old African American pregnant female

Question 14

When a patient with vitamin B12 deficiency is counseled about diet , what statement by the patient indicates an understanding of the cause of the anemia ?

A. “I know i need to eat more fruits and vegetables”
B. “ I have to cute out all fried food in my diet”
C. “ I have been eating more organic foods
D. “ I have been having beef or fish at least once a day”

Answer 14

D. “ I have been having beef or fish at least once a day”

Question 15

The nurse understands that it is essential for the patient to have which blood test before initiating folic acid supplementations?

A. Vitamin B12 level
B. Pregnancy test
C. CBC
D. Liver enzymes

Answer 15

A. Vitamin B12 level

Question 16

Which activity should be avoided in a patient with sickle cell anemia?

A. Driving to the beach 3 hours away
B. Going to concert
C. Running in a 5 k race
D. Carpentry work

Answer 16

C. Running in a 5K race

Question 17

When comparing osteoarthritis to RA the nurse recognizes which of the following statements to be true ? SATA

A. Osteoarthritis pain tends to get worse with activity, but RA gets better with activity
B. Both RA and osteoarthritis are autoimmune diseases
C. Patients with RA are at risk for developing extra-articular manifestations such as eye inflammation, lung disease, whereas osteoarthritis affects only joints and surrounding structures.
D. Patients with osteoarthritis typically have morning stiffness lasting less than 30 mins hour, where as RA patients typically complain of morning stiffness lasting longer than 30 mins
E. Both RA and osteoarthritis affect joints in a symmetrical pattern.

Answer 17

A. Osteoarthritis pain tends to get worse with activity, but RA gets better with activity

C. Patients with RA are at risk for developing extra-articular manifestations such as eye inflammation, lung disease, whereas osteoarthritis affects only joints and surrounding structures.

D. Patients with osteoarthritis typically have morning stiffness lasting less than 30 mins hour, where as RA patients typically complain of morning stiffness lasting longer than 30 mins

Question 18

The nurse knows which of the following statements regarding laboratory values and RA are true ? SATA

A. Patient with a positive rheumatoid factor definitely have RA
B. An elevated CRP is indicative of inflammation but is not specific only for RA
C. Certain DMARD therapies may cause lab abnormalities such as elevated liver enzyme, thrombocytopenia, leukocytopenia

D. Approximately 25-30% of patients who have RA do not have a positive rheumatoid factor
E. Patients with RA have elevated cardiac enzymes due to pharmacological therapy

Answer 18

B. An elevated CRP is indicative of inflammation but is not specific only for RA
C. Certain DMARD therapies may cause lab abnormalities such as elevated liver enzyme, thrombocytopenia, leukocytopenia
D. Approximately 25-30% of patients who have RA do not have a positive rheumatoid factor

Question 19

The nurse should recognize which patient to be at highest risk for developing SLE?

A. A 10 Year old Hispanic female
B. An 18 y,o African American male
C. A 30 y.o African American female
D. A 50 year old Caucasian male

Answer 19

C. A 30 y.o African American female

Question 20

A nurse is screening patients for their risk of developing HIV. The nurse should consider which patient at greatest risk ?

A. African American man
B. Asian women
C. Caucasian man
D. Latino Women

Answer 20

A. African American man

Question 21

Which of the following statements regarding viral replication is correct ?

A. Endotoxin and or exotoxin is required for viral proliferation
B. The virus must use host white blood cells for viral proliferation
C. Pathogenic replication is facilitated by the administration of antivirals
D. The virus replicated by preventing phagocytosis by white blood cells.

Answer 21

B. The virus must use host white blood cells for viral proliferation

Question 22

A nurse is caring for a patient in the ED. The patient asks for an HIV test. The nurse explains that a screening test can provide quick results and determine whether more testing is necessary. The test is an ?

A. CD4 + count
B. ELISA
C. Rapid Test
D. Viral Load

Answer 22

C. Rapid Test

Question 23

The nurse understand e that which of the following are correct statements about the HIV disease ? SATA ?

A. HIV disease progresses in stages ; HIV disease is dx by determining viral load
B. A CD4+ count of 500 calls or more indicated HIV not aids
C. The western blot test is diagnostic for HIV disease
D. A CD4+ count of 200 or less increases the chances for opportunistic opportunities
E. ART is started immediately after diagnosis if the CD4+ count is less than 200 cells.

Answer 23

C. The western blot test is diagnostic for HIV disease

Question 24

A patient states that she has recently been treated for gonorrhea, her last HIV test was 18 months ago. When you review the orders, you notice that an HIV test has been ordered. What do you do?

A. Explain that the test has been ordered and that she can opt out
B. No discussion is necessary ; just do the test
C. Obtain her written consent before the test
D. Provide protest counseling before getting consent

Answer 24

A. Explain that the test has been ordered and that she can opt out

Question 25

A patient newly diagnosed with HIV as about community support groups . What should the nurse do?
A. Contact psychiatry for an evaluation of depression
B. Provide a list of groups in a neighboring community
C. Request a referral to the social work dept
D. Suggest the patient contact the physician

Answer 25

B. Provide a list of groups in a neighboring community

Question 26

The nurse understands that an important lab assessment parameter for a patient with cancer has metastasized to bone is which of the following ?

A. WBC
B. Calcium level
C> Glucose level
D. Sodium/potassium level

Answer 26

B. Calcium level

Question 27

What is the most specific method of diagnosing a malignancy ?

A. Serum lab test
B. MRI
C. CT scan
D. Biopsy

Answer 27

D. Biopsy

Question 28

The nurse understands that the patient receiving chemotherapy prior to definitive excision is receiving which type of treatment?
A. Secondary treatment
B. Adjuvant therapy
C. Neoadjuvant therapy
D. Primary treatment

Answer 28

C. Neoadjuvant therapy

Question 29

Which statement by the patient indicates that teaching about chemotherapy was effective ?

A. “ i know everyone loses their hair with chemo”
B. “ i know it is important that i monitor my temp”
C.” I know i should eat whatever i want so that i dont lose weight while on chemo”
D. “ I understand that i can skip a chemo treading if i dont feel well “

Answer 29

B. “ i know it is important that i monitor my temp”

Question 30

Which nursing action is indicated for the patient with thrombocytopenia ?

A. Avoid IM injections
B. Encourage the patient to drink plenty of fluids
C. Place the patient on isolation precautions
D. Encourage frequent rest periods

Answer 30

A. Avoid IM injections

Question 31

The nurse correlates which diagnostic results as increasing the risk for infection in the patient with leukemia?

A. WBC 11
B.ANC 500 mm
C. HGB 8.6
D. Platelets 112,000

Answer 31

B.ANC 500 mm

Question 32

A patient with lymphoma is beginning the induction chemotherapy regimen. Which information is most essential for the nurse to include in the treatment plan?

A. Advance directives
B. Bleeding precaution
C. Importance of frequent rest periods
D. Neutropenic precautions

Answer 32

D. Neutropenic precautions

Question 33

A nurse is planning care for a client who has a HGB of 7.5 and hct 21.5% . Which of the following actions should the nurse include in the plan of care ?
SATA

A. Provide assistance with ambulating
B. Monitor Oxygen sat
C. Weigh the client weekly
D. Obtain Stool specimen for occult blood
E.Schedule rest periods

Answer 33

A. Provide assistance with ambulating
B. Monitor Oxygen sat

D. Obtain Stool specimen for occult blood
E.Schedule rest periods

Question 34

A nurse is teaching a client who has a new prescription for ferrous sulfate. Which f the following information should the nurse include in the teaching ?

A. Stools will be dark red
B. Take with a glass of milk if gastrointestinal distress occurs
C. Food high in vitamin C will promote absorption
D. Take for 14 days

Answer 34

C. Food high in vitamin C will promote absorption

Question 35

A nurse is providing d/c teaching to a client who has gastrectomy for stomach cancer. Which of the following information should the nurse include in the teaching? SATA

A. You will need monthly injections of v12 for the rest of your life
B. Using the nasal spray form of vitamin b12 on a daily basis can be an option
C. An oral supplement of Vb12 taken on daily bases can be an option
D.you should increase your intake of animal proteins , lugemes , and dairy products to increase vitamin B12 in your diet
E. Add soy milk fortified with vb12 to your diet to decrease the risk of pernicious anemia

Answer 35

A. You will need monthly injections of v12 for the rest of your life
B. Using the nasal spray form of vitamin b12 on a daily basis can be an option

Question 36

A nurse is completing an integumentary assessment of a client who has anemia,. Which of the following findings should the nurse expect ?
A. Absent turgor
B. Spoon shaped nails
C. Shiny, hairless legs
D. Yellow mucous membranes

Answer 36

B. Spoon shaped nails

Question 37

A nurse in a client receives a phone call from a client seeking information about a new prescription for erythropoietin, which of the following information should the nurse review with the client ?
A. The client needs an ESR test weekly
B. The client should have their HGB checked twice a week
C. O2 sat levels should be monitored
D. Folic acid production will increase

Answer 37

B. The client should have their HGB checked twice a week

Question 38

A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. The client reports having N/D. Their temp is 100.6 orally. The client is concerned about the possibility of having HIV . Which of the following actions should the nurse take ? SATA
A. Perform physical assessment
B. Determine when manifestations began
C. Teach the client about HIV transmission
D.draw blood for HIV testing
E. Obtain a sexual History

Answer 38

A. Perform physical assessment
B. Determine when manifestations began
E. Obtain a sexual History

Question 39

A nurse is caring for a client who is suspected of having HIV. The nurse should identify that which of the following diagnostic test and lab values are used to confirm HIV infection ? SATA

A. Western blot
B. Indirect immunofluoroescence assay
C. CD4+ T-lymphocyte count
D. HIV RNA quantification test
E. CSF

Answer 39

A. Western blot

B. Indirect immunofluoroescence assay

Question 40

A nurse is providing teaching for a client who has stg 3 HIV disease . Which of the following statements by the client should indicate to the nurse an understanding of the teaching ?
A. “I will wear gloves while changing the pet litter box “
B. I will rinse raw fruits with water before eating them “
C. “ i will wear a mask when around family members who are ill”
D. “ i will cook vegetables before eating them “

Answer 40

D. “ i will cook vegetables before eating them “

Question 41

A nurse is assessing a client for HIV . The nurse should identify that which of the following are risj factors associated with this virus ? SATA
A. Perinatal exposure
B. Pregnacy
C. Monogamous sexpartner
D. Older adult women
E. Occupational exposure

Answer 41

A. Perinatal exposure

D. Older adult women
E. Occupational exposure

Question 42

A nurse i providing teaching for a client who has stage 2 HIV disease ad is having difficulty maintaining a normal weight. Which of the following stamens by the client should indicate to the nurse an understanding of the teaching?

A. “ i will choose a diet high in fat to help gain weight “
B. “ i will be sure to eat 3 large meals daily”
C. “I will drink up to 1 liter of liquid each day”
D. “ i will add high protein foods to my diet “

Answer 42

D. “ i will add high protein foods to my diet “

Question 43

A nurse is reviewing the plan of care for a client who has SLE the client reports fatigue joint tenderness swelling and difficulty urinating. Which of the following lab findings should the nurse anticipate ? SATA

A. Positive ANA titter
B. Increased HGB
C. 2 + urine Protein
D> increased serum C3 and C4
E. Elevated BUN

Answer 43

A. Positive ANA titter
C. 2 + urine Protein
E. Elevated BUN

Question 44

Nurse is teaching a client who has SLE about self care. Which of the following statements indicates understanding of the teaching?

A.” I should limit my time to 10 min in the tanning bed”
B. “ i will apply powder to Any skin rash
C. I should use mild hair shampoo”
D. I will inspect my skin once a month for rashes

Answer 44

C. I should use mild hair shampoo

Question 45

A nurse is discussing gout with a client who is concerned about developing disorder. Which of the following findings should the nurse identify as risk factors for this disease (SATA)
a. Diuretic use
B. Obesity
C. Deep sleep deprivation
D.Depression
E. Cardiovascular disease

Answer 45

a. Diuretic use
B. Obesity

E. Cardiovascular disease

Question 46

A nurse is assessing a client who has a new diagnosis of SLE. Which of the following findings should the nurse expect ?
A. Weight gain
B. Petechiae on thighs
C. Systolic murmur
D. Alopecia

Answer 46

D. Alopecia

Question 47

A nurse is caring for client who has SLE and is experiencing an episode of Raynaud’s phenomenon which of the following findings should the nurse anticipate ?
A. Swelling of the joints of the fingers
B. Pallor of toes with cold exposure
C. Feet that become reddened with ambulating
D. Client report intense feeling of heat in the fingers

Answer 47

B. Pallor of toes with cold exposure

Question 48

A nurse is working in an outpatient clinic is assessing a client who has RA . The client reports increased joint tenderness and swelling. Which of the following findings should the nurse expect ?
SATA

A. Recent influenza
B> decreased ROM
C. Hyper salivation
D. Increased BP
E.Pain at rest

Answer 48

A. Recent influenza
B. Decreased ROM
E. Pain at rest

Question 49

A nurse is teaching a client who has new dx of RA . Which of the following statements should the nurse include in the teaching?

A. “You can experience morning stiffness when you get out of bed”
B. “You can experience abdominal pain”
C. “ you can experience weight gain”
D. “ you can experience low blood sugar”

Answer 49

A. “You can experience morning stiffness when you get out of bed”

Question 50

A nurse is caring for a client who has RA. Which of the following LAb test are used to diagnose the disease ? SATA
A. Urinalysis
B. ESR
C. BUN
D. ANA titter
E. WBC count

Answer 50

B. ESR
D. ANA
E. WBC