Pass NUR 231 Final Exam – Adult Nursing
II (2026) Actual Questions & Verified
Answers Illinois State University (A+
Guarantee)
1.
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³. Which finding requires immediate
action?
A. Fatigue
B. Temperature of 38.3°C (100.9°F)
C. Decreased appetite
D. Hair loss
Answer: B
Rationale: Fever in a severely neutropenic client may indicate a life-threatening infection and requires immediate
evaluation.
2.
Which intervention is appropriate for a client with severe thrombocytopenia?
A. Use a hard-bristled toothbrush
B. Administer aspirin for pain
C. Use an electric razor
D. Encourage contact sports
Answer: C
Rationale: An electric razor reduces the risk of cuts and bleeding.
3.
Which laboratory pattern is characteristic of tumor lysis syndrome?
A. Hypokalemia and hypercalcemia
B. Hyperkalemia, hyperphosphatemia, and hyperuricemia
C. Hypernatremia and hypouricemia
D. Hypophosphatemia and hypercalcemia
Answer: B
,Rationale: Rapid tumor-cell destruction releases intracellular potassium, phosphate, and nucleic acids, producing
hyperkalemia, hyperphosphatemia, and hyperuricemia with secondary hypocalcemia.
4.
Which intervention helps prevent tumor lysis syndrome?
A. Fluid restriction
B. Adequate hydration as prescribed
C. Potassium supplementation
D. Calcium supplementation for every client
Answer: B
Rationale: Hydration supports renal clearance of uric acid and electrolytes released during tumor-cell breakdown.
5.
A client with multiple myeloma is at increased risk for:
A. Hypercalcemia
B. Hypoglycemia
C. Severe hypernatremia
D. Polycythemia
Answer: A
Rationale: Bone destruction associated with multiple myeloma can release calcium into the bloodstream.
6.
Which finding in a client with multiple myeloma requires urgent evaluation?
A. Mild fatigue
B. New severe back pain with leg weakness
C. Decreased appetite
D. Mild thirst
Answer: B
Rationale: Severe back pain with neurological changes may indicate spinal cord compression.
7.
A client receiving chemotherapy develops painful oral ulcers. Which intervention is appropriate?
A. Alcohol-based mouthwash
B. Soft toothbrush and gentle oral care
C. Vigorous brushing
D. Lemon-glycerin swabs routinely
Answer: B
,Rationale: Gentle oral hygiene minimizes trauma while reducing infection risk.
8.
Which instruction is most appropriate for a client with neutropenia?
A. Avoid people who are ill
B. Eat raw eggs
C. Receive live vaccines routinely
D. Keep fresh flowers in the room
Answer: A
Rationale: Avoiding infectious exposures is important when immune defenses are significantly reduced.
9.
A client receiving chemotherapy has a platelet count of 18,000/mm³. Which finding is most concerning?
A. Fatigue
B. Petechiae
C. Black, tarry stool
D. Mild nausea
Answer: C
Rationale: Melena may indicate significant gastrointestinal bleeding.
10.
Colony-stimulating factors are used primarily to:
A. Increase neutrophil production
B. Lower blood glucose
C. Increase calcium levels
D. Reduce tumor pain
Answer: A
Rationale: Colony-stimulating factors promote production of specific blood-cell lines, including neutrophils.
11.
A client undergoing induction therapy for acute leukemia is particularly vulnerable to:
A. Infection and bleeding
B. Hypertension only
C. Hyperglycemia only
D. Constipation only
Answer: A
, Rationale: Intensive chemotherapy can cause profound myelosuppression, resulting in neutropenia and
thrombocytopenia.
12.
After a bone marrow biopsy, which finding should the nurse report?
A. Mild tenderness
B. Small bruise
C. Persistent bleeding
D. Temporary soreness
Answer: C
Rationale: Persistent bleeding can indicate hemorrhage, especially in a thrombocytopenic client.
13.
A client with chronic myeloid leukemia asks about tyrosine kinase inhibitors. The nurse explains that they:
A. Target abnormal cellular signaling
B. Replace red blood cells
C. Prevent all infections
D. Increase platelet destruction
Answer: A
Rationale: CML is commonly associated with BCR-ABL signaling, which can be targeted by tyrosine kinase
inhibitors.
14.
Which intervention is appropriate for chemotherapy-related fatigue?
A. Complete bed rest
B. Schedule activities around rest periods
C. Avoid all physical activity
D. Encourage strenuous exercise
Answer: B
Rationale: Balancing activity and rest helps conserve energy without promoting complications of prolonged
inactivity.
15.
A client with cancer reports severe fatigue and dizziness when standing. What is the priority?
A. Encourage rapid ambulation
B. Assess perfusion and fall risk
C. Restrict fluids
D. Encourage strenuous exercise
II (2026) Actual Questions & Verified
Answers Illinois State University (A+
Guarantee)
1.
A client receiving chemotherapy has an absolute neutrophil count of 400/mm³. Which finding requires immediate
action?
A. Fatigue
B. Temperature of 38.3°C (100.9°F)
C. Decreased appetite
D. Hair loss
Answer: B
Rationale: Fever in a severely neutropenic client may indicate a life-threatening infection and requires immediate
evaluation.
2.
Which intervention is appropriate for a client with severe thrombocytopenia?
A. Use a hard-bristled toothbrush
B. Administer aspirin for pain
C. Use an electric razor
D. Encourage contact sports
Answer: C
Rationale: An electric razor reduces the risk of cuts and bleeding.
3.
Which laboratory pattern is characteristic of tumor lysis syndrome?
A. Hypokalemia and hypercalcemia
B. Hyperkalemia, hyperphosphatemia, and hyperuricemia
C. Hypernatremia and hypouricemia
D. Hypophosphatemia and hypercalcemia
Answer: B
,Rationale: Rapid tumor-cell destruction releases intracellular potassium, phosphate, and nucleic acids, producing
hyperkalemia, hyperphosphatemia, and hyperuricemia with secondary hypocalcemia.
4.
Which intervention helps prevent tumor lysis syndrome?
A. Fluid restriction
B. Adequate hydration as prescribed
C. Potassium supplementation
D. Calcium supplementation for every client
Answer: B
Rationale: Hydration supports renal clearance of uric acid and electrolytes released during tumor-cell breakdown.
5.
A client with multiple myeloma is at increased risk for:
A. Hypercalcemia
B. Hypoglycemia
C. Severe hypernatremia
D. Polycythemia
Answer: A
Rationale: Bone destruction associated with multiple myeloma can release calcium into the bloodstream.
6.
Which finding in a client with multiple myeloma requires urgent evaluation?
A. Mild fatigue
B. New severe back pain with leg weakness
C. Decreased appetite
D. Mild thirst
Answer: B
Rationale: Severe back pain with neurological changes may indicate spinal cord compression.
7.
A client receiving chemotherapy develops painful oral ulcers. Which intervention is appropriate?
A. Alcohol-based mouthwash
B. Soft toothbrush and gentle oral care
C. Vigorous brushing
D. Lemon-glycerin swabs routinely
Answer: B
,Rationale: Gentle oral hygiene minimizes trauma while reducing infection risk.
8.
Which instruction is most appropriate for a client with neutropenia?
A. Avoid people who are ill
B. Eat raw eggs
C. Receive live vaccines routinely
D. Keep fresh flowers in the room
Answer: A
Rationale: Avoiding infectious exposures is important when immune defenses are significantly reduced.
9.
A client receiving chemotherapy has a platelet count of 18,000/mm³. Which finding is most concerning?
A. Fatigue
B. Petechiae
C. Black, tarry stool
D. Mild nausea
Answer: C
Rationale: Melena may indicate significant gastrointestinal bleeding.
10.
Colony-stimulating factors are used primarily to:
A. Increase neutrophil production
B. Lower blood glucose
C. Increase calcium levels
D. Reduce tumor pain
Answer: A
Rationale: Colony-stimulating factors promote production of specific blood-cell lines, including neutrophils.
11.
A client undergoing induction therapy for acute leukemia is particularly vulnerable to:
A. Infection and bleeding
B. Hypertension only
C. Hyperglycemia only
D. Constipation only
Answer: A
, Rationale: Intensive chemotherapy can cause profound myelosuppression, resulting in neutropenia and
thrombocytopenia.
12.
After a bone marrow biopsy, which finding should the nurse report?
A. Mild tenderness
B. Small bruise
C. Persistent bleeding
D. Temporary soreness
Answer: C
Rationale: Persistent bleeding can indicate hemorrhage, especially in a thrombocytopenic client.
13.
A client with chronic myeloid leukemia asks about tyrosine kinase inhibitors. The nurse explains that they:
A. Target abnormal cellular signaling
B. Replace red blood cells
C. Prevent all infections
D. Increase platelet destruction
Answer: A
Rationale: CML is commonly associated with BCR-ABL signaling, which can be targeted by tyrosine kinase
inhibitors.
14.
Which intervention is appropriate for chemotherapy-related fatigue?
A. Complete bed rest
B. Schedule activities around rest periods
C. Avoid all physical activity
D. Encourage strenuous exercise
Answer: B
Rationale: Balancing activity and rest helps conserve energy without promoting complications of prolonged
inactivity.
15.
A client with cancer reports severe fatigue and dizziness when standing. What is the priority?
A. Encourage rapid ambulation
B. Assess perfusion and fall risk
C. Restrict fluids
D. Encourage strenuous exercise
