NUR 211 FINAL EXAM QUESTIONS AND
ANSWERS GRADED A+ 2025/2026
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory work.
Which finding should the nurse report to the provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 - ANS A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit level of 30%
is an expected finding, as is a slightly elevated white blood cell count. A sodium of 147, although
slightly high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often
shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When
the client requests pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication - ANS A. Give the client pain
medication it it is time for another dose.
Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours of IV
opioid analgesics. Even if the client is addicted and drug seeking, he or she is still in extreme
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,pain. If the client can receive another doe of medication, the nurse should provide it, The other
options are judgmental and do not address the client's pain. Giving placebos is unethical.
A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to
start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution - ANS A. 0.45% normal saline
Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a hypotonic
solution such as 0.45% normal saline. ).9% normal saline and lactated ringers solution are
isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis. What intervention by the
nurse takes priority?
A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line - ANS A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would come first. The main
problem in a sickle cell crisis is tissue and organ hypoxia, so providing oxygen helps halt the
process.
A client has a sickle cell crisis with extreme lower extremity pain. What comfort measure does
the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. - ANS C. Keep the lower extremities warm
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow and
ischemia, leading to pain. Due to decreased blood flow, the clients legs will be cool or cold. The
UAP can attempt to keep the clients legs warm. Ice and elevation will further decrease
perfusion. Elastic bandage wraps are not indicated and may constrict perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her child also has the disease.
What response by the nurse is best?
A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days. - ANS B. I can see you
are upset. I can stay here with you awhile if you like.
The best response is for the nurse to offer self, a therapeutic communication technique that
uses presence. Attempting to assign blame to both parents will not help the client feel better.
There is genetic testing available, so it is inaccurate to state there is no way to know who will
have the disease. Stating that good treatments exist belittles the client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to the clinic
reporting an increase in fatigue. What laboratory result should the nurse report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 - ANS D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this extreme elevation could
indicate leukemia, a complication of taking hydoxyurea. The nurse should report this finding
immediately. Alternatively, it could indicate infection, a serious problem for clients with SCD.
Hematocrit and hemoglobin levels are normally low in people with SCD. The potassium level,
while slightly low, is not worrisome as the WBCs.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A nurse working with clients with sickle cell disease teaches about self-management to prevent
exacerbations and sickle cell crisis. What factors should clients be taught to avoid? (Select all
that apply)
A. Dehydration
B. Exercise
C. Extreme stress
D. High altitudes
E. Pregnancy - ANS A,C,D,E
Several factors cause RBCs to sickle in SCD, including dehydration, extreme stress, high altitudes,
and pregnancy. Strenuous exercise can also cause sickling, but not unless it is very vigorous.
The nurse is teaching a client who has sickle cell disease and was admitted for splenomegaly
and abdominal pain. Which instruction does the nurse include in the clients discharge teaching?
A. Avoid drinking large amounts of fluids
B. Eat six small meals daily instead of large meals
C. Engage in aerobic 3 days a week
D. Receive a yearly influenza vaccination - ANS D. Receive a yearly influenza vaccination
Abdominal pain and a palpable spleen could indicate blood trapped in the spleen. Over time,
the spleen may become nonfunctional, which the client at risk for infection. An annual influenza
vaccination helps prevent infection. A client with sickle cell disease should not become
dehydrated or engage in strenuous physical activity because this could precipitate a crisis. Eating
smaller meals has no impact on sickle cell disease of infection.
The nurse is caring for a client during a sickle cell crisis. Which intervention does the nurse
implement for the client?
A. Administer acetaminophen as needed
B. Administer intravenous fluids to keep the vein open
C. Keep the room temperature at 80F
D. Transfuse red blood cells (RBCs) - ANS C. Keep the room temperature at 80 F
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
ANSWERS GRADED A+ 2025/2026
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory work.
Which finding should the nurse report to the provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 - ANS A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit level of 30%
is an expected finding, as is a slightly elevated white blood cell count. A sodium of 147, although
slightly high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often
shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When
the client requests pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication - ANS A. Give the client pain
medication it it is time for another dose.
Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours of IV
opioid analgesics. Even if the client is addicted and drug seeking, he or she is still in extreme
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,pain. If the client can receive another doe of medication, the nurse should provide it, The other
options are judgmental and do not address the client's pain. Giving placebos is unethical.
A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to
start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution - ANS A. 0.45% normal saline
Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a hypotonic
solution such as 0.45% normal saline. ).9% normal saline and lactated ringers solution are
isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis. What intervention by the
nurse takes priority?
A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line - ANS A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would come first. The main
problem in a sickle cell crisis is tissue and organ hypoxia, so providing oxygen helps halt the
process.
A client has a sickle cell crisis with extreme lower extremity pain. What comfort measure does
the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. - ANS C. Keep the lower extremities warm
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow and
ischemia, leading to pain. Due to decreased blood flow, the clients legs will be cool or cold. The
UAP can attempt to keep the clients legs warm. Ice and elevation will further decrease
perfusion. Elastic bandage wraps are not indicated and may constrict perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her child also has the disease.
What response by the nurse is best?
A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days. - ANS B. I can see you
are upset. I can stay here with you awhile if you like.
The best response is for the nurse to offer self, a therapeutic communication technique that
uses presence. Attempting to assign blame to both parents will not help the client feel better.
There is genetic testing available, so it is inaccurate to state there is no way to know who will
have the disease. Stating that good treatments exist belittles the client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to the clinic
reporting an increase in fatigue. What laboratory result should the nurse report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 - ANS D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this extreme elevation could
indicate leukemia, a complication of taking hydoxyurea. The nurse should report this finding
immediately. Alternatively, it could indicate infection, a serious problem for clients with SCD.
Hematocrit and hemoglobin levels are normally low in people with SCD. The potassium level,
while slightly low, is not worrisome as the WBCs.
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, A nurse working with clients with sickle cell disease teaches about self-management to prevent
exacerbations and sickle cell crisis. What factors should clients be taught to avoid? (Select all
that apply)
A. Dehydration
B. Exercise
C. Extreme stress
D. High altitudes
E. Pregnancy - ANS A,C,D,E
Several factors cause RBCs to sickle in SCD, including dehydration, extreme stress, high altitudes,
and pregnancy. Strenuous exercise can also cause sickling, but not unless it is very vigorous.
The nurse is teaching a client who has sickle cell disease and was admitted for splenomegaly
and abdominal pain. Which instruction does the nurse include in the clients discharge teaching?
A. Avoid drinking large amounts of fluids
B. Eat six small meals daily instead of large meals
C. Engage in aerobic 3 days a week
D. Receive a yearly influenza vaccination - ANS D. Receive a yearly influenza vaccination
Abdominal pain and a palpable spleen could indicate blood trapped in the spleen. Over time,
the spleen may become nonfunctional, which the client at risk for infection. An annual influenza
vaccination helps prevent infection. A client with sickle cell disease should not become
dehydrated or engage in strenuous physical activity because this could precipitate a crisis. Eating
smaller meals has no impact on sickle cell disease of infection.
The nurse is caring for a client during a sickle cell crisis. Which intervention does the nurse
implement for the client?
A. Administer acetaminophen as needed
B. Administer intravenous fluids to keep the vein open
C. Keep the room temperature at 80F
D. Transfuse red blood cells (RBCs) - ANS C. Keep the room temperature at 80 F
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
