NRSG 3420 Exam 1Exam questions
2026 Exam Questions and verified
Answers
medical management of sickle cell anemia - CORRECT ANSWERS hematopoietic stem cell
transplant (HSCT) - may cure SCD but is not readily available due to lack of compatible donors or due to
severe organ damage that may be already present in patient
pharmacologic therapy:
- hydroxyurea (increases levels of fetal hemoglobin decreasing formation of sickled cells)
- folic acid supplements (maintain the amount needed for increased erythropoiesis to counteract the
effects of hemolysis)
- infections are common and can lead to crisis: immunization
- transfusion therapy (caution with repeat blood transfusions - pt can develop antibodies to donor
blood, hemolytic transfusion reactions may mimic the s/sx of sickle cell crisis
- supportive therapy (pain management, aspirin, NSAIDS, PCA, hydration, oxygen therapy)
cancer & thrombocytopenia - CORRECT ANSWERS many chemotherapy agents cause some
degree of myelosuppression (depression of bone marrow function), resulting in:
- leukopenia
- neutropenia
- anemia
- thrombocytopenia
- increased r/o infection and bleeding
,is predictable:
- pts usually reach point at which blood counts are lowest 7 to 14 days after chemo
- during 2 weeks, nurses anticipate associated toxicities, especially a fever associated with neutrophil
count less than 1500 cells/mm3
- frequent monitoring of CBC is essential
- pts are educated on strategies to protect against infection, injury, and blood loss
- erythropoetin (EPO) stimulated RBC production, decreasing the symptoms of treatment-induced
chronic anemia and reducing the need for blood transfusions
- interleukin 11 (IL-11) (oprelvekin) stimulates the production of megakaryocytes (precursors to
platelets) and can be used to prevent and treat severe thrombocytopenia but has had limited use
because of toxicities
thrombocytopenia - CORRECT ANSWERS abnormally low platelet levels
<20,000 - petechiae, gingival bleeding, excessive menstrual bleeding, excessive bleeding after
surgery/dental extractions
<5,000 - fatal CNS, or GI hemorrhage
management of thrombocytopenia - CORRECT ANSWERS treat underlying condition
monitor for factors increasing risk of bleeding (elevated INR/PT/aPTT, decreased fibrinogen, use of
medications)
assess for and instruct patient/family on s/sx of bleeding (petechiae, bleeding, decrease HgB/HcT, frank
or occult blood in body fluids, altered mental status, tachycardia)
, minimize risk of bleeding:
- use soft toothbrush, electric razor for shaving, keep lips moisturized, maintain fluid intake of at least 3
L q24 hrs
- avoid rectal temp, avoid IM injections (use smallest needle possible)
- apply direst pressure to venipuncture site for at least 5 min
- avoid aspirin
- caution against forceful nose blowing
preventing hemorrhage post-op - CORRECT ANSWERS hemorrhage is an uncommon yet
serious complication of surgery that can result in hypovolemic shock and death.
patient presents with hypotension; rapid, thready pulse; disorientation; restlessness, oliguria; and cold,
pale skin; concentrated urine; air hunger (looking to catch breath)
assessment and identification of at-risk individuals, monitoring
nursing management of transfusion reactions - CORRECT ANSWERS - stop the transfusion,
maintain the IV line with NS through new IV tubing (given at slow rate)
- assess pt carefully; comparing the VS with baseline, respiratory status, changes in mental status,
jugular vein distention, back pain or urticaria
- notify primary provider of assessment findings
- notify blood bank and send blood container/tubing to blood bank for repeat typing and culture
2026 Exam Questions and verified
Answers
medical management of sickle cell anemia - CORRECT ANSWERS hematopoietic stem cell
transplant (HSCT) - may cure SCD but is not readily available due to lack of compatible donors or due to
severe organ damage that may be already present in patient
pharmacologic therapy:
- hydroxyurea (increases levels of fetal hemoglobin decreasing formation of sickled cells)
- folic acid supplements (maintain the amount needed for increased erythropoiesis to counteract the
effects of hemolysis)
- infections are common and can lead to crisis: immunization
- transfusion therapy (caution with repeat blood transfusions - pt can develop antibodies to donor
blood, hemolytic transfusion reactions may mimic the s/sx of sickle cell crisis
- supportive therapy (pain management, aspirin, NSAIDS, PCA, hydration, oxygen therapy)
cancer & thrombocytopenia - CORRECT ANSWERS many chemotherapy agents cause some
degree of myelosuppression (depression of bone marrow function), resulting in:
- leukopenia
- neutropenia
- anemia
- thrombocytopenia
- increased r/o infection and bleeding
,is predictable:
- pts usually reach point at which blood counts are lowest 7 to 14 days after chemo
- during 2 weeks, nurses anticipate associated toxicities, especially a fever associated with neutrophil
count less than 1500 cells/mm3
- frequent monitoring of CBC is essential
- pts are educated on strategies to protect against infection, injury, and blood loss
- erythropoetin (EPO) stimulated RBC production, decreasing the symptoms of treatment-induced
chronic anemia and reducing the need for blood transfusions
- interleukin 11 (IL-11) (oprelvekin) stimulates the production of megakaryocytes (precursors to
platelets) and can be used to prevent and treat severe thrombocytopenia but has had limited use
because of toxicities
thrombocytopenia - CORRECT ANSWERS abnormally low platelet levels
<20,000 - petechiae, gingival bleeding, excessive menstrual bleeding, excessive bleeding after
surgery/dental extractions
<5,000 - fatal CNS, or GI hemorrhage
management of thrombocytopenia - CORRECT ANSWERS treat underlying condition
monitor for factors increasing risk of bleeding (elevated INR/PT/aPTT, decreased fibrinogen, use of
medications)
assess for and instruct patient/family on s/sx of bleeding (petechiae, bleeding, decrease HgB/HcT, frank
or occult blood in body fluids, altered mental status, tachycardia)
, minimize risk of bleeding:
- use soft toothbrush, electric razor for shaving, keep lips moisturized, maintain fluid intake of at least 3
L q24 hrs
- avoid rectal temp, avoid IM injections (use smallest needle possible)
- apply direst pressure to venipuncture site for at least 5 min
- avoid aspirin
- caution against forceful nose blowing
preventing hemorrhage post-op - CORRECT ANSWERS hemorrhage is an uncommon yet
serious complication of surgery that can result in hypovolemic shock and death.
patient presents with hypotension; rapid, thready pulse; disorientation; restlessness, oliguria; and cold,
pale skin; concentrated urine; air hunger (looking to catch breath)
assessment and identification of at-risk individuals, monitoring
nursing management of transfusion reactions - CORRECT ANSWERS - stop the transfusion,
maintain the IV line with NS through new IV tubing (given at slow rate)
- assess pt carefully; comparing the VS with baseline, respiratory status, changes in mental status,
jugular vein distention, back pain or urticaria
- notify primary provider of assessment findings
- notify blood bank and send blood container/tubing to blood bank for repeat typing and culture
