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MCA 2 HEMATOLOGY EXAM | LATEST UPDATE |
COMPREHENSIVE PRACTICE QUESTIONS &
ANSWERS | HEMATOLOGY STUDY GUIDE &
EXAM PREPARATION PDF
Which clinical finding would the nurse expect to identify when caring for a client with a left leg
venous thrombosis? select all that apply.
a. pain in the left calf
b. intermittent claudication
c. redness in the affected area
d. swelling of the lower left leg
e. ecchymotic areas at the left ankle
f. localized warmth in the lower left leg
A, C, D, F
pain is related to the edema associated with the inflammatory response. Redness is related to vasodilation
and the inflammatory response. Edema distal to the venous thrombosis occurs because of increased
venous pressure. Warmth in the affected part of the leg occurs due to the inflammatory response.
Intermittent claudication (pain when walking, resulting from tissue ischemia) may occur with peripheral
arterial disease. Ecchymosis is a sign of bleeding and would not be seen with venous thrombosis.
A nurse is caring for a client admitted with cardiovascular disease. During the assessment of the
client's lower extremities, the nurse notes that the client has thin, shiny skin, decreased hair growth,
and thickened toenails. The nurse understands that this may indicate:
a. Venous insufficiency
b. Arterial Insufficiency
c. Phlebitis
d. Lymphedema
b. Arterial Insufficiency
clients experiencing arterial insufficiency present with extremities that become pale when elevated and
dusky red when lowered. Lower extremities may also be cool to touch, pulses may be absent or mild, and
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skin may be shiny and thin with decreased hair growth and thickened nails. Clients with venous
insufficiency often have normal-colored extremities, normal temperature, normal pulses, marked edema,
and brown pigmentation around the ankles. Phlebitis is an inflammation of a vein that occurs most often
after trauma to the vessel wall, infection, and immobilization. Lymphedema is swelling in one or more
extremities that is a direct result of impaired flow of the lymphatic system.
a client is admitted to the hospital with a long history of uncontrolled hypertension. which
laboratory result will be important for the nurse to review?
a. blood glucose level
b. white blood cell count
c. blood urea nitrogen
d. lactic dehydrogenase
c. blood urea nitrogen
hypertension leads to changes in renal blood flow and eventually to decreased renal function, which is
tested with blood urea nitrogen levels. all of the other results would also be reviewed by the nurse, but
they are no associated with complications of hypertension. Changes in blood glucose level are not
associated with hypertension, although if the client also has diabetes then there will be more risk for
kidney disease. White blood cell count is not affected by hypertension, but it would be assessed for any
possible infectious or inflammatory process. Lactic dehydrogenase is an enzyme associated with multiple
other diagnoses, but it is not affected by hypertension.
which clinical finding would the nurse expect for a client with hypertensive emergency?
a. increased urine output
b. severe pounding headache
c. heart rate 110 beats/min
d. weak & thready radial pulses
b. severe pounding headache
hypertensive emergency often causes hypertensive encephalopathy because of increased cerebral capillary
permeability, leading to severe headache, nausea, vomiting, and confusion or coma. Increased urine
output would not be expected because acute kidney injury can occur with hypertensive emergency.
Tachycardia is not typically seen with hypertensive emergency; high blood pressure can lead to
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bradycardia because of increased pressure on the carotid sinus and bodies. Radial pulses would be
bounding with hypertensive emergency.
The nurse is teaching pursed-lip breathing to a client with COPD. The client asks about the benefit
of the exercises. Which explanation would the nurse give?
a. prevents complications that are associated with COPD
b. relieves shortness of breath by increasing the breath rate
c. increases the amount of air that the client can inhale with each breath
d. keeps the airway open longer to decrease the work that goes into breathing
d. keeps the airway open longer to decrease the work that goes into breathing
pursed-lip breathing keeps the airway open longer to decrease the work that goes into breathing. clients
with COPD are taught to breathe out through pursed lips to help keep the air passages open until
exhalation is complete. pursed-lip breathing does not prevent COPD complications. pursed-lip breathing
may relieve shortness of breath by decreasing the breath rate. pursed-lip breathing does not increase the
amount of air taken in during inspiration.
which finding by the nurse will be of most concern when a client has venous insufficiency?
a. bilateral brown lower leg discoloration
b. calf pain when the feet are dorsiflexed
c. severe edema from ankles to calves
d. thickened and dry skin on lower legs
b. calf pain when the feet are dorsiflexed
calf pain when the feet are dorsiflexed, which is referred to as Homans sign, is a symptoms of possible
venous thrombosis and would require further diagnostic testing and treatment. bilateral brown lower leg
discoloration is a common symptoms of chronic edema caused by venous insufficiency and would be
expected in this client. severe edema is a common and expected symptom of venous insufficiency and
may require actions such as leg elevation, but is not as concerning as a positive Homans sign. thick and
dry skin is common in chronic venous insufficiency and the nurse will plan to use a lubricating ointment,
but it is not as big a concern as a possible venous thrombosis.
The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus
(combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that
teaching about medication administration has been successful?
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a. The patient shakes the device before use.
b. The patient rapidly inhales the medication.
c. The patient attaches a spacer to the Diskus.
d. The patient performs huff coughing after inhalation.
b. The patient rapidly inhales the medication.
The patient should inhale the medication rapidly. Otherwise the dry particles will stick to the tongue and
oral mucosa and not get inhaled into the lungs. Advair Diskus is a dry powder inhaler; shaking is not
recommended. Spacers are not used with dry powder inhalers. Huff coughing is a technique to move
mucus into larger airways to expectorate. The patient should not huff cough or exhale forcefully after
taking Advair in order to keep the medication in the lungs.
The nurse teaches a patient how to administer formoterol (Perforomist) through a nebulizer. Which
action by the patient indicates good understanding of the teaching?
a. The patient attaches a spacer before using the inhaler.
b. The patient coughs vigorously after using the inhaler.
c. The patient removes the facial mask when misting stops.
d. The patient activates the inhaler at the onset of expiration.
c. The patient removes the facial mask when misting stops.
A nebulizer is used to administer aerosolized medication. A mist is seen when the medication is
aerosolized, and when all of the medication has been used, the misting stops. The other options refer to
inhaler use. Coughing vigorously after inhaling and activating the inhaler at the onset of expiration are
both incorrect techniques when using an inhaler.
Which information will the nurse include in the asthma teaching plan for a patient being
discharged?
a. Use the inhaled corticosteroid when shortness of breath occurs.
b. Inhale slowly and deeply when using the dry powder inhaler (DPI).
c. Hold your breath for 5 seconds after using the bronchodilator inhaler.
d. Tremors are an expected side effect of rapidly acting bronchodilators.
d. Tremors are an expected side effect of rapidly acting bronchodilators.
Tremors are a common side effect of short-acting b2-adrenergic (SABA) medications and not a reason to
MCA 2 HEMATOLOGY EXAM | LATEST UPDATE |
COMPREHENSIVE PRACTICE QUESTIONS &
ANSWERS | HEMATOLOGY STUDY GUIDE &
EXAM PREPARATION PDF
Which clinical finding would the nurse expect to identify when caring for a client with a left leg
venous thrombosis? select all that apply.
a. pain in the left calf
b. intermittent claudication
c. redness in the affected area
d. swelling of the lower left leg
e. ecchymotic areas at the left ankle
f. localized warmth in the lower left leg
A, C, D, F
pain is related to the edema associated with the inflammatory response. Redness is related to vasodilation
and the inflammatory response. Edema distal to the venous thrombosis occurs because of increased
venous pressure. Warmth in the affected part of the leg occurs due to the inflammatory response.
Intermittent claudication (pain when walking, resulting from tissue ischemia) may occur with peripheral
arterial disease. Ecchymosis is a sign of bleeding and would not be seen with venous thrombosis.
A nurse is caring for a client admitted with cardiovascular disease. During the assessment of the
client's lower extremities, the nurse notes that the client has thin, shiny skin, decreased hair growth,
and thickened toenails. The nurse understands that this may indicate:
a. Venous insufficiency
b. Arterial Insufficiency
c. Phlebitis
d. Lymphedema
b. Arterial Insufficiency
clients experiencing arterial insufficiency present with extremities that become pale when elevated and
dusky red when lowered. Lower extremities may also be cool to touch, pulses may be absent or mild, and
,2|Page
skin may be shiny and thin with decreased hair growth and thickened nails. Clients with venous
insufficiency often have normal-colored extremities, normal temperature, normal pulses, marked edema,
and brown pigmentation around the ankles. Phlebitis is an inflammation of a vein that occurs most often
after trauma to the vessel wall, infection, and immobilization. Lymphedema is swelling in one or more
extremities that is a direct result of impaired flow of the lymphatic system.
a client is admitted to the hospital with a long history of uncontrolled hypertension. which
laboratory result will be important for the nurse to review?
a. blood glucose level
b. white blood cell count
c. blood urea nitrogen
d. lactic dehydrogenase
c. blood urea nitrogen
hypertension leads to changes in renal blood flow and eventually to decreased renal function, which is
tested with blood urea nitrogen levels. all of the other results would also be reviewed by the nurse, but
they are no associated with complications of hypertension. Changes in blood glucose level are not
associated with hypertension, although if the client also has diabetes then there will be more risk for
kidney disease. White blood cell count is not affected by hypertension, but it would be assessed for any
possible infectious or inflammatory process. Lactic dehydrogenase is an enzyme associated with multiple
other diagnoses, but it is not affected by hypertension.
which clinical finding would the nurse expect for a client with hypertensive emergency?
a. increased urine output
b. severe pounding headache
c. heart rate 110 beats/min
d. weak & thready radial pulses
b. severe pounding headache
hypertensive emergency often causes hypertensive encephalopathy because of increased cerebral capillary
permeability, leading to severe headache, nausea, vomiting, and confusion or coma. Increased urine
output would not be expected because acute kidney injury can occur with hypertensive emergency.
Tachycardia is not typically seen with hypertensive emergency; high blood pressure can lead to
,3|Page
bradycardia because of increased pressure on the carotid sinus and bodies. Radial pulses would be
bounding with hypertensive emergency.
The nurse is teaching pursed-lip breathing to a client with COPD. The client asks about the benefit
of the exercises. Which explanation would the nurse give?
a. prevents complications that are associated with COPD
b. relieves shortness of breath by increasing the breath rate
c. increases the amount of air that the client can inhale with each breath
d. keeps the airway open longer to decrease the work that goes into breathing
d. keeps the airway open longer to decrease the work that goes into breathing
pursed-lip breathing keeps the airway open longer to decrease the work that goes into breathing. clients
with COPD are taught to breathe out through pursed lips to help keep the air passages open until
exhalation is complete. pursed-lip breathing does not prevent COPD complications. pursed-lip breathing
may relieve shortness of breath by decreasing the breath rate. pursed-lip breathing does not increase the
amount of air taken in during inspiration.
which finding by the nurse will be of most concern when a client has venous insufficiency?
a. bilateral brown lower leg discoloration
b. calf pain when the feet are dorsiflexed
c. severe edema from ankles to calves
d. thickened and dry skin on lower legs
b. calf pain when the feet are dorsiflexed
calf pain when the feet are dorsiflexed, which is referred to as Homans sign, is a symptoms of possible
venous thrombosis and would require further diagnostic testing and treatment. bilateral brown lower leg
discoloration is a common symptoms of chronic edema caused by venous insufficiency and would be
expected in this client. severe edema is a common and expected symptom of venous insufficiency and
may require actions such as leg elevation, but is not as concerning as a positive Homans sign. thick and
dry skin is common in chronic venous insufficiency and the nurse will plan to use a lubricating ointment,
but it is not as big a concern as a possible venous thrombosis.
The nurse teaches a patient with chronic bronchitis about a new prescription for Advair Diskus
(combined fluticasone and salmeterol). Which action by the patient would indicate to the nurse that
teaching about medication administration has been successful?
, 4|Page
a. The patient shakes the device before use.
b. The patient rapidly inhales the medication.
c. The patient attaches a spacer to the Diskus.
d. The patient performs huff coughing after inhalation.
b. The patient rapidly inhales the medication.
The patient should inhale the medication rapidly. Otherwise the dry particles will stick to the tongue and
oral mucosa and not get inhaled into the lungs. Advair Diskus is a dry powder inhaler; shaking is not
recommended. Spacers are not used with dry powder inhalers. Huff coughing is a technique to move
mucus into larger airways to expectorate. The patient should not huff cough or exhale forcefully after
taking Advair in order to keep the medication in the lungs.
The nurse teaches a patient how to administer formoterol (Perforomist) through a nebulizer. Which
action by the patient indicates good understanding of the teaching?
a. The patient attaches a spacer before using the inhaler.
b. The patient coughs vigorously after using the inhaler.
c. The patient removes the facial mask when misting stops.
d. The patient activates the inhaler at the onset of expiration.
c. The patient removes the facial mask when misting stops.
A nebulizer is used to administer aerosolized medication. A mist is seen when the medication is
aerosolized, and when all of the medication has been used, the misting stops. The other options refer to
inhaler use. Coughing vigorously after inhaling and activating the inhaler at the onset of expiration are
both incorrect techniques when using an inhaler.
Which information will the nurse include in the asthma teaching plan for a patient being
discharged?
a. Use the inhaled corticosteroid when shortness of breath occurs.
b. Inhale slowly and deeply when using the dry powder inhaler (DPI).
c. Hold your breath for 5 seconds after using the bronchodilator inhaler.
d. Tremors are an expected side effect of rapidly acting bronchodilators.
d. Tremors are an expected side effect of rapidly acting bronchodilators.
Tremors are a common side effect of short-acting b2-adrenergic (SABA) medications and not a reason to
