NSG 312 EXAM 2 QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026
Early symptoms of anemia - Answers -weakness
-fatigue
-pallor
-changes in tongue color and texture
-changes in nail color, texture, and strength
-nausea and vomiting
Later signs of anemia - Answers -shortness of breath
-tachycardia
-dizziness
-chest pain
-altered LOC
Causes of anemia - Answers -hypoproliferative
-hemolytic
-bleeding
Hypoproliferative - Answers -defect in production of RBC
-caused by... iron deficiency, via b12 deficiency, folate deficiency, decreased erythropoietin
production, cancer, bone marrow damage
Hemolytic - Answers -excess destruction of erythrocytes
-caused by altered erythropoiesis or direct injury to the erythrocyte (sickle cell)
Bleeding - Answers -not enough RBC due to loss through bleeding
Sickle cell disease - Answers -gene results in production of defective hemoglobin molecule that causes
erthryocyte to change shape when exposed to 02
What does the sickle cell shape cause - Answers -RBC to stick to sides of vessels, causing lack of blood
flow
-when blood flow decreased, inflammation and infarction can occur
Nursing interventions for sickle cell - Answers -hydroxyurea (chemo agent that is only FDA approved
tx)
-pain control
-O2 supplementation
-prevent complications
-folic acid supplements
-coping skills
-infection prevention
PT education for sickle cell disease - Answers -education about disease prevention
-s/s of emergency and when to seek care
-pain tx
education about disease prevention (SCD) - Answers -high altitudes worsen sx
-no smoking! COPD (worsening sx)
-avoid triggers (cold weather, overexertion, stress)
when to seek care (SCD) - Answers -severe chest pain, difficulty breathing
-swelling hands/feet; severe pain
-weakness, facial dropping, confusion, trouble speaking
-severe fatigue, rapid heart rate, pale skin
Pain tx (SCD) - Answers -pain biggest reason for hospitalization
-nonpharmacological interventions
-opiod and NSAID management for worse pain
What is one big thing that sickle cell diseases causes - Answers -vision problems
Polycythemia - Answers -increased RBC
-hematocrit level >50% in females nad >55% in males
Polycythemia Vera (primary) - Answers -Myeloproliferative cancer caused by a gene mutation that
begins in bone marrow
-bone marrow is hyper cellular (RBC, WBC, and platelets are all high)
Assessment findings of polycythemia vera - Answers -headache, dizziness, vision changes
-TIA
-abd discomfort/pain; splenomegaly
, -ruddy complexion, angina, dyspnea, HTN, thromophlebitis
-fatigue
-pruititus due to histamine being released from increased # of basophils
-elevated uric acid levels resulting in gout and renal stone formation
DX of polycythemia vera - Answers -mutation in JAK2 gene
-more at risk for clots (stroke, MI, DVT < PE
Secondary polycythemia - Answers -Excessive production of erythropoietin caused by reduced
amounts of oxygen, cyanotic heart disease, and cancers that cause increased erythropoietin (renal cell
carcinoma)
nursing interventions/pt education for neutropenia - Answers -increased risk for infection (must
monitor closely and take precaution)
-perform hand hygiene when entering & leaving room
-put on gloves, gown, and mask before entering room and remove before leaving
-pt may leave room with mask
-no fresh fruit or flowers allowed in room
-tx depends on cause but may have to stop cause temporarily (ie. stopping chemo)
Leukemia - Answers -cancer of the blood caused by unregulated increase of leukocytes (WBC) in the
bone marrow eventually leaving little room for normal cell production
-types classified on stem cell involved and Time takes for sx to evolve
Acute leukemia - Answers -quick onset of sx usually within few weeks
-death can occur within weeks to months without aggressive tx
Chronic leukemia - Answers -sx evolve over months to years
-progression of disease can lsat for years
Causes of leukemia - Answers -exact cause unknown
-risk factors: radiation exposure, genetic disorders, viral infections, bone marrow damage from pelvic
radiation, previous chemo tx
Leukemia nsg interventions - Answers -Prevention of infection and bleeding
-oral care (mucositis common)
-improve/maintain nutritional intake (low microbial diet)
-monitor fluid and electrolytes
-pain control (acetaminophen for fevers, massage, relaxation, music therapy
-psychosocial important
pt education for leukemia - Answers low microbial diet (no fruits, veggies, sushi, lunch meat, etc)
Myelodysplastic syndromes (MDS) - Answers -group of clonal disorders of the myeloid stem cell that
causes dysplasia (abnormal development) in or or more type cells
-cause low blood cell count (can develop to acute leukemia)
-blood marrow produce high number of cells but they die prematurely before going to circulation
Risk factors of Myelodysplastic syndromes (MDS) - Answers -genetic syndromes (down syndrome!!!,
trisomy 18, neurofibromatosis type 1)
-mainly diagnosed in older adults
Lymphoma - Answers accumulation of cancerous lymph cells, tumors in lymph nodes and organs of
lymph system
Hodgkin lymphoma - Answers -rare but more curable
-one node origin (reed-stern berg cell)
-usually start as enlarged lymph node in neck
Hodgkin lymphoma risk factors - Answers -cause unknown
-age
-certain viral infection (HIV, HPV)
-family hx
-being exposed to cytotoxic agents
-long term immunosuppressive therapy
-veterans exposed to herbicide agent orange in vietnam
tx of Hodgkin lymphoma - Answers chemo
complications of Hodgkin lymphoma - Answers -infertility
-organ dysfunction (endocrine)
-increaesd risk of future cancers
-risk of infection
Early symptoms of anemia - Answers -weakness
-fatigue
-pallor
-changes in tongue color and texture
-changes in nail color, texture, and strength
-nausea and vomiting
Later signs of anemia - Answers -shortness of breath
-tachycardia
-dizziness
-chest pain
-altered LOC
Causes of anemia - Answers -hypoproliferative
-hemolytic
-bleeding
Hypoproliferative - Answers -defect in production of RBC
-caused by... iron deficiency, via b12 deficiency, folate deficiency, decreased erythropoietin
production, cancer, bone marrow damage
Hemolytic - Answers -excess destruction of erythrocytes
-caused by altered erythropoiesis or direct injury to the erythrocyte (sickle cell)
Bleeding - Answers -not enough RBC due to loss through bleeding
Sickle cell disease - Answers -gene results in production of defective hemoglobin molecule that causes
erthryocyte to change shape when exposed to 02
What does the sickle cell shape cause - Answers -RBC to stick to sides of vessels, causing lack of blood
flow
-when blood flow decreased, inflammation and infarction can occur
Nursing interventions for sickle cell - Answers -hydroxyurea (chemo agent that is only FDA approved
tx)
-pain control
-O2 supplementation
-prevent complications
-folic acid supplements
-coping skills
-infection prevention
PT education for sickle cell disease - Answers -education about disease prevention
-s/s of emergency and when to seek care
-pain tx
education about disease prevention (SCD) - Answers -high altitudes worsen sx
-no smoking! COPD (worsening sx)
-avoid triggers (cold weather, overexertion, stress)
when to seek care (SCD) - Answers -severe chest pain, difficulty breathing
-swelling hands/feet; severe pain
-weakness, facial dropping, confusion, trouble speaking
-severe fatigue, rapid heart rate, pale skin
Pain tx (SCD) - Answers -pain biggest reason for hospitalization
-nonpharmacological interventions
-opiod and NSAID management for worse pain
What is one big thing that sickle cell diseases causes - Answers -vision problems
Polycythemia - Answers -increased RBC
-hematocrit level >50% in females nad >55% in males
Polycythemia Vera (primary) - Answers -Myeloproliferative cancer caused by a gene mutation that
begins in bone marrow
-bone marrow is hyper cellular (RBC, WBC, and platelets are all high)
Assessment findings of polycythemia vera - Answers -headache, dizziness, vision changes
-TIA
-abd discomfort/pain; splenomegaly
, -ruddy complexion, angina, dyspnea, HTN, thromophlebitis
-fatigue
-pruititus due to histamine being released from increased # of basophils
-elevated uric acid levels resulting in gout and renal stone formation
DX of polycythemia vera - Answers -mutation in JAK2 gene
-more at risk for clots (stroke, MI, DVT < PE
Secondary polycythemia - Answers -Excessive production of erythropoietin caused by reduced
amounts of oxygen, cyanotic heart disease, and cancers that cause increased erythropoietin (renal cell
carcinoma)
nursing interventions/pt education for neutropenia - Answers -increased risk for infection (must
monitor closely and take precaution)
-perform hand hygiene when entering & leaving room
-put on gloves, gown, and mask before entering room and remove before leaving
-pt may leave room with mask
-no fresh fruit or flowers allowed in room
-tx depends on cause but may have to stop cause temporarily (ie. stopping chemo)
Leukemia - Answers -cancer of the blood caused by unregulated increase of leukocytes (WBC) in the
bone marrow eventually leaving little room for normal cell production
-types classified on stem cell involved and Time takes for sx to evolve
Acute leukemia - Answers -quick onset of sx usually within few weeks
-death can occur within weeks to months without aggressive tx
Chronic leukemia - Answers -sx evolve over months to years
-progression of disease can lsat for years
Causes of leukemia - Answers -exact cause unknown
-risk factors: radiation exposure, genetic disorders, viral infections, bone marrow damage from pelvic
radiation, previous chemo tx
Leukemia nsg interventions - Answers -Prevention of infection and bleeding
-oral care (mucositis common)
-improve/maintain nutritional intake (low microbial diet)
-monitor fluid and electrolytes
-pain control (acetaminophen for fevers, massage, relaxation, music therapy
-psychosocial important
pt education for leukemia - Answers low microbial diet (no fruits, veggies, sushi, lunch meat, etc)
Myelodysplastic syndromes (MDS) - Answers -group of clonal disorders of the myeloid stem cell that
causes dysplasia (abnormal development) in or or more type cells
-cause low blood cell count (can develop to acute leukemia)
-blood marrow produce high number of cells but they die prematurely before going to circulation
Risk factors of Myelodysplastic syndromes (MDS) - Answers -genetic syndromes (down syndrome!!!,
trisomy 18, neurofibromatosis type 1)
-mainly diagnosed in older adults
Lymphoma - Answers accumulation of cancerous lymph cells, tumors in lymph nodes and organs of
lymph system
Hodgkin lymphoma - Answers -rare but more curable
-one node origin (reed-stern berg cell)
-usually start as enlarged lymph node in neck
Hodgkin lymphoma risk factors - Answers -cause unknown
-age
-certain viral infection (HIV, HPV)
-family hx
-being exposed to cytotoxic agents
-long term immunosuppressive therapy
-veterans exposed to herbicide agent orange in vietnam
tx of Hodgkin lymphoma - Answers chemo
complications of Hodgkin lymphoma - Answers -infertility
-organ dysfunction (endocrine)
-increaesd risk of future cancers
-risk of infection
