NUR 2502 MDC 3 Final Exam Review |
Questions and Correct Answers plus Rationale |
2026-2027 Update
1. A nurse is identifying the client’s point of maximum impulse (PMI). Where
should the nurse best palpate the PMI?
A) Midline between the xiphoid process and the left nipple
B) Two to three centimeters to the left of the sternum
C) Left midclavicular line of the chest at the fifth intercostal space
D) Left midclavicular line of the chest at the level of the nipple
Correct Answer: C) Left midclavicular line of the chest at the fifth intercostal
space
Rationale: The PMI is normally located at the left midclavicular line in the fifth
intercostal space, where the apical impulse is best felt.
2. Which of the following describes a grade II heart murmur?
A) Loud murmur with moderate intensity
B) Extremely loud heart murmur with a palpable thrill
C) Very loud murmur with a palpable thrill
D) Faint heart murmur that is barely recognizable
Correct Answer: D) Faint heart murmur that is barely recognizable
Rationale: A grade II murmur is soft but audible. Strictly, a barely recognizable
murmur is grade I; however, among the options, D is the only low-intensity
description. Grades IV–VI are louder and often have thrills.
3. A client with leukemia is exhibiting early signs of malnutrition. Which
intervention should the nurse implement?
A) Assign responsibility for nutrition to friends and family
B) Provide the client with several small, soft-textured meals each day
,C) Arrange for total parenteral nutrition (TPN)
D) Facilitate placement of a PEG tube
Correct Answer: B) Provide the client with several small, soft-textured meals
each day
Rationale: Small, frequent, soft meals are best tolerated early on. TPN or PEG
tubes are more invasive and used if oral intake remains inadequate.
4. A nurse is caring for a client with Hodgkin Lymphoma. Why is it important for
the client to stop smoking, drinking, and stay out of the sun?
A) These behaviors reduce the effectiveness of chemotherapy
B) Avoiding these factors reduces the development of Reed–Sternberg cells
C) Engaging in these activities increases the risk of hemorrhage
D) It is important to reduce other factors that increase the risk of secondary
cancers
Correct Answer: D) It is important to reduce other factors that increase the risk
of secondary cancers
Rationale: Survivors of Hodgkin lymphoma are at increased risk for secondary
cancers. Avoiding tobacco, alcohol, and excessive sun exposure reduces additional
carcinogenic risk.
5. Which topic should the nurse emphasize for a client with Chronic Myeloid
Leukemia (CML) being treated at home?
A) The importance of adhering to the prescribed drug regimen
B) The need to avoid shellfish and raw foods
C) The importance of daily physical activity
D) The need to ensure vaccinations are up to date
Correct Answer: A) The importance of adhering to the prescribed drug regimen
Rationale: CML is often managed with oral tyrosine kinase inhibitors. Strict
adherence is critical to suppress the disease and prevent progression.
,6. A client with Acute Lymphocytic Leukemia (ALL) is distraught. How should the
nurse prepare to meet their psychosocial needs?
A) Identify the client’s plan of medical care
B) Reassure them that treatment will be challenging but successful
C) Assess the client's specific needs for education and support
D) Assess the client's previous experience with the health care system
Correct Answer: C) Assess the client's specific needs for education and support
Rationale: The nurse should first assess the client’s individual psychosocial,
educational, and support needs before planning interventions.
7. The presence of which assessment finding is considered diagnostic for
Hodgkin lymphoma?
A) Reed–Sternberg cells
B) Pancytopenia
C) Bence-Jones proteins
D) Elevated BNP
Correct Answer: A) Reed–Sternberg cells
Rationale: Reed–Sternberg cells are the hallmark diagnostic finding in Hodgkin
lymphoma. Bence-Jones proteins are associated with multiple myeloma.
8. The nurse is caring for four clients with leukemia. Which client should be seen
first?
A) A client who is crying and feeling lonely
B) A client who had two bloody diarrhea stools this morning
C) A client with an unchanged lesion to the lower right lateral malleolus
D) A client who has been premedicated for nausea prior to chemotherapy
Correct Answer: B) A client who had two bloody diarrhea stools this morning
Rationale: Bloody diarrhea suggests possible bleeding, infection, or mucosal
injury. This is the most urgent physiologic concern.
, 9. A 19-year-old male is recently diagnosed with leukemia. Which nursing
intervention is appropriate?
A) Fluid restriction
B) Therapeutic phlebotomy
C) Strict hand hygiene to prevent infection
D) Low residual diet
Correct Answer: C) Strict hand hygiene to prevent infection
Rationale: Leukemia and its treatment cause immunosuppression. Infection
prevention, including strict hand hygiene, is a priority.
10. A client undergoing CAR T-cell therapy has fatigue, petechiae, and bleeding.
Which side effect is associated with these manifestations?
A) Neutropenia
B) Hemolytic anemia
C) Polycythemia vera
D) Pancytopenia
Correct Answer: D) Pancytopenia
Rationale: Pancytopenia is a decrease in all blood cell lines. It can cause fatigue
from anemia, petechiae/bleeding from thrombocytopenia, and infection from
leukopenia.
11. The family of a neutropenic client reports the client is confused. What is the
nurse's priority action?
A) Delegate taking a set of vital signs
B) Assess the client for a urinary tract infection
C) Look at today’s laboratory results
D) Ask the client about pain
Correct Answer: A) Delegate taking a set of vital signs
Rationale: Acute confusion in a neutropenic client may indicate sepsis. Vital signs
are needed urgently. The nurse can delegate vital signs to assistive personnel
while proceeding to assess the client.
Questions and Correct Answers plus Rationale |
2026-2027 Update
1. A nurse is identifying the client’s point of maximum impulse (PMI). Where
should the nurse best palpate the PMI?
A) Midline between the xiphoid process and the left nipple
B) Two to three centimeters to the left of the sternum
C) Left midclavicular line of the chest at the fifth intercostal space
D) Left midclavicular line of the chest at the level of the nipple
Correct Answer: C) Left midclavicular line of the chest at the fifth intercostal
space
Rationale: The PMI is normally located at the left midclavicular line in the fifth
intercostal space, where the apical impulse is best felt.
2. Which of the following describes a grade II heart murmur?
A) Loud murmur with moderate intensity
B) Extremely loud heart murmur with a palpable thrill
C) Very loud murmur with a palpable thrill
D) Faint heart murmur that is barely recognizable
Correct Answer: D) Faint heart murmur that is barely recognizable
Rationale: A grade II murmur is soft but audible. Strictly, a barely recognizable
murmur is grade I; however, among the options, D is the only low-intensity
description. Grades IV–VI are louder and often have thrills.
3. A client with leukemia is exhibiting early signs of malnutrition. Which
intervention should the nurse implement?
A) Assign responsibility for nutrition to friends and family
B) Provide the client with several small, soft-textured meals each day
,C) Arrange for total parenteral nutrition (TPN)
D) Facilitate placement of a PEG tube
Correct Answer: B) Provide the client with several small, soft-textured meals
each day
Rationale: Small, frequent, soft meals are best tolerated early on. TPN or PEG
tubes are more invasive and used if oral intake remains inadequate.
4. A nurse is caring for a client with Hodgkin Lymphoma. Why is it important for
the client to stop smoking, drinking, and stay out of the sun?
A) These behaviors reduce the effectiveness of chemotherapy
B) Avoiding these factors reduces the development of Reed–Sternberg cells
C) Engaging in these activities increases the risk of hemorrhage
D) It is important to reduce other factors that increase the risk of secondary
cancers
Correct Answer: D) It is important to reduce other factors that increase the risk
of secondary cancers
Rationale: Survivors of Hodgkin lymphoma are at increased risk for secondary
cancers. Avoiding tobacco, alcohol, and excessive sun exposure reduces additional
carcinogenic risk.
5. Which topic should the nurse emphasize for a client with Chronic Myeloid
Leukemia (CML) being treated at home?
A) The importance of adhering to the prescribed drug regimen
B) The need to avoid shellfish and raw foods
C) The importance of daily physical activity
D) The need to ensure vaccinations are up to date
Correct Answer: A) The importance of adhering to the prescribed drug regimen
Rationale: CML is often managed with oral tyrosine kinase inhibitors. Strict
adherence is critical to suppress the disease and prevent progression.
,6. A client with Acute Lymphocytic Leukemia (ALL) is distraught. How should the
nurse prepare to meet their psychosocial needs?
A) Identify the client’s plan of medical care
B) Reassure them that treatment will be challenging but successful
C) Assess the client's specific needs for education and support
D) Assess the client's previous experience with the health care system
Correct Answer: C) Assess the client's specific needs for education and support
Rationale: The nurse should first assess the client’s individual psychosocial,
educational, and support needs before planning interventions.
7. The presence of which assessment finding is considered diagnostic for
Hodgkin lymphoma?
A) Reed–Sternberg cells
B) Pancytopenia
C) Bence-Jones proteins
D) Elevated BNP
Correct Answer: A) Reed–Sternberg cells
Rationale: Reed–Sternberg cells are the hallmark diagnostic finding in Hodgkin
lymphoma. Bence-Jones proteins are associated with multiple myeloma.
8. The nurse is caring for four clients with leukemia. Which client should be seen
first?
A) A client who is crying and feeling lonely
B) A client who had two bloody diarrhea stools this morning
C) A client with an unchanged lesion to the lower right lateral malleolus
D) A client who has been premedicated for nausea prior to chemotherapy
Correct Answer: B) A client who had two bloody diarrhea stools this morning
Rationale: Bloody diarrhea suggests possible bleeding, infection, or mucosal
injury. This is the most urgent physiologic concern.
, 9. A 19-year-old male is recently diagnosed with leukemia. Which nursing
intervention is appropriate?
A) Fluid restriction
B) Therapeutic phlebotomy
C) Strict hand hygiene to prevent infection
D) Low residual diet
Correct Answer: C) Strict hand hygiene to prevent infection
Rationale: Leukemia and its treatment cause immunosuppression. Infection
prevention, including strict hand hygiene, is a priority.
10. A client undergoing CAR T-cell therapy has fatigue, petechiae, and bleeding.
Which side effect is associated with these manifestations?
A) Neutropenia
B) Hemolytic anemia
C) Polycythemia vera
D) Pancytopenia
Correct Answer: D) Pancytopenia
Rationale: Pancytopenia is a decrease in all blood cell lines. It can cause fatigue
from anemia, petechiae/bleeding from thrombocytopenia, and infection from
leukopenia.
11. The family of a neutropenic client reports the client is confused. What is the
nurse's priority action?
A) Delegate taking a set of vital signs
B) Assess the client for a urinary tract infection
C) Look at today’s laboratory results
D) Ask the client about pain
Correct Answer: A) Delegate taking a set of vital signs
Rationale: Acute confusion in a neutropenic client may indicate sepsis. Vital signs
are needed urgently. The nurse can delegate vital signs to assistive personnel
while proceeding to assess the client.
