1. A client has been diagnosed with polycythemia vera. The nurse
should assess the client for which of the following symptoms?
A. Jaundice
B. Weight loss
C. Enlarged spleen
D. Hypotension
Answer: C. Enlarged spleen
Rationale: Polycythemia vera is characterized by an increase in red
blood cell production, leading to an enlarged spleen (splenomegaly) as
it works harder to filter the excess cells.
2. A nurse is caring for a client who is receiving chemotherapy and has
developed neutropenia. Which of the following interventions is a
priority?
A. Place the client on a low-sodium diet.
B. Monitor the client for signs of infection.
C. Encourage the client to perform deep-breathing exercises.
D. Increase the client’s fluid intake.
Answer: B. Monitor the client for signs of infection.
,Rationale: Neutropenia increases the risk of infection. The priority
intervention is to monitor for signs of infection, such as fever, redness,
or drainage.
3. A nurse is reviewing the laboratory results of a client with a history
of chronic kidney disease. Which of the following laboratory results
would the nurse expect to find?
A. Decreased creatinine levels
B. Decreased hemoglobin levels
C. Elevated platelet count
D. Elevated white blood cell count
Answer: B. Decreased hemoglobin levels
Rationale: Chronic kidney disease can lead to decreased erythropoietin
production, which in turn results in low hemoglobin levels (anemia).
4. A nurse is assessing a client who has a low hemoglobin level. Which
finding would the nurse expect to observe?
A. Bradycardia
B. Cyanosis
C. Tachypnea
D. Hypotension
Answer: C. Tachypnea
, Rationale: Low hemoglobin levels reduce oxygen-carrying capacity,
leading to compensatory tachypnea (rapid breathing) as the body
attempts to maintain adequate oxygen levels.
5. A nurse is assessing a client’s laboratory results. The client’s white
blood cell count is 18,000/mm³. The nurse understands that this result
suggests which of the following conditions?
A. Anemia
B. Infection
C. Leukopenia
D. Hemophilia
Answer: B. Infection
Rationale: A white blood cell count of 18,000/mm³ is elevated and
suggests the presence of an infection or inflammatory process.
6. A nurse is caring for a client with hemophilia. Which of the
following actions is most important?
A. Administering vitamin K as prescribed.
B. Encouraging the client to increase fluid intake.
C. Monitoring the client for signs of bleeding.
D. Restricting activity to prevent injury.
Answer: C. Monitoring the client for signs of bleeding.
should assess the client for which of the following symptoms?
A. Jaundice
B. Weight loss
C. Enlarged spleen
D. Hypotension
Answer: C. Enlarged spleen
Rationale: Polycythemia vera is characterized by an increase in red
blood cell production, leading to an enlarged spleen (splenomegaly) as
it works harder to filter the excess cells.
2. A nurse is caring for a client who is receiving chemotherapy and has
developed neutropenia. Which of the following interventions is a
priority?
A. Place the client on a low-sodium diet.
B. Monitor the client for signs of infection.
C. Encourage the client to perform deep-breathing exercises.
D. Increase the client’s fluid intake.
Answer: B. Monitor the client for signs of infection.
,Rationale: Neutropenia increases the risk of infection. The priority
intervention is to monitor for signs of infection, such as fever, redness,
or drainage.
3. A nurse is reviewing the laboratory results of a client with a history
of chronic kidney disease. Which of the following laboratory results
would the nurse expect to find?
A. Decreased creatinine levels
B. Decreased hemoglobin levels
C. Elevated platelet count
D. Elevated white blood cell count
Answer: B. Decreased hemoglobin levels
Rationale: Chronic kidney disease can lead to decreased erythropoietin
production, which in turn results in low hemoglobin levels (anemia).
4. A nurse is assessing a client who has a low hemoglobin level. Which
finding would the nurse expect to observe?
A. Bradycardia
B. Cyanosis
C. Tachypnea
D. Hypotension
Answer: C. Tachypnea
, Rationale: Low hemoglobin levels reduce oxygen-carrying capacity,
leading to compensatory tachypnea (rapid breathing) as the body
attempts to maintain adequate oxygen levels.
5. A nurse is assessing a client’s laboratory results. The client’s white
blood cell count is 18,000/mm³. The nurse understands that this result
suggests which of the following conditions?
A. Anemia
B. Infection
C. Leukopenia
D. Hemophilia
Answer: B. Infection
Rationale: A white blood cell count of 18,000/mm³ is elevated and
suggests the presence of an infection or inflammatory process.
6. A nurse is caring for a client with hemophilia. Which of the
following actions is most important?
A. Administering vitamin K as prescribed.
B. Encouraging the client to increase fluid intake.
C. Monitoring the client for signs of bleeding.
D. Restricting activity to prevent injury.
Answer: C. Monitoring the client for signs of bleeding.
