NURSING MISC VSIM SABINA VASQUEZ TEST
PAPER 2026 STUDY GUIDE REVIEW
◉ The nurse is reviewing laboratory results for a patient with sickle
cell anemia presenting with splenic sequestration. Which of the
following results would the nurse expect to be elevated? (Select all
that apply.) Answer: Platelet count
Bilirubin
Reticulocyte count
Erythrocyte sedimentation rate
Rationale:Expected laboratory findings for a patient with splenic
sequestration include decreased hemoglobin, greatly elevated
reticulocyte count, increased erythrocyte sedimentation rate,
abnormal liver function tests with elevated bilirubin, and increased
platelet count.
◉ The nurse is preparing to administer a blood transfusion to a 5-
year-old patient with acute splenic sequestration. Which of the
following steps should be included during the preparation and
administration process? (Select all that apply.) Answer: Follow
institution protocol for blood transfusion administration and
management
Use a two-person verification process to verify the patient and blood
component
, Rationale:The nurse should follow institution protocol when
administering blood and/or blood components. Blood and blood
components should be verified by two nurses using a two-person
verification process to identify the patient, check the blood type, and
confirm the label on the blood component per institution protocol.
The blood transfusion should be initiated within 30 minutes of
receiving the blood component from the blood bank. Blood should
be infused slowly for the first 15 minutes and the nurse should
remain at the bedside to monitor the patient closely. If the patient
tolerates the transfusion, the infusion rate will be increased per
institution protocol. If a transfusion reaction occurs, the blood
transfusion should be stopped and the patient should be monitored
closely following institution protocol to manage a transfusion
reaction.
◉ The nurse has an order to administer normal saline 20 mL/kg
bolus intravenously over 30 minutes. The patient weighs 35 lb. How
many milliliters should the nurse prepare to administer? Round the
weight in kilograms to nearest the whole number. Answer: 320 mL
Rationale:Fluid boluses are calculated using the 20 mL/kg formula.
Convert pounds to kilograms: 35 ÷ 2.2 = 15.90 kg. Round 15.90 to
nearest whole number: 15.90 = 16 kg. Multiply 20 mL/kg by 16 kg:
20 × 16 = 320 mL.
◉ A patient with sickle cell anemia who was admitted in vaso-
occlusive crisis for leg pain reports stomach pain and is guarding her
left side. Which of the following assessments should the nurse
PAPER 2026 STUDY GUIDE REVIEW
◉ The nurse is reviewing laboratory results for a patient with sickle
cell anemia presenting with splenic sequestration. Which of the
following results would the nurse expect to be elevated? (Select all
that apply.) Answer: Platelet count
Bilirubin
Reticulocyte count
Erythrocyte sedimentation rate
Rationale:Expected laboratory findings for a patient with splenic
sequestration include decreased hemoglobin, greatly elevated
reticulocyte count, increased erythrocyte sedimentation rate,
abnormal liver function tests with elevated bilirubin, and increased
platelet count.
◉ The nurse is preparing to administer a blood transfusion to a 5-
year-old patient with acute splenic sequestration. Which of the
following steps should be included during the preparation and
administration process? (Select all that apply.) Answer: Follow
institution protocol for blood transfusion administration and
management
Use a two-person verification process to verify the patient and blood
component
, Rationale:The nurse should follow institution protocol when
administering blood and/or blood components. Blood and blood
components should be verified by two nurses using a two-person
verification process to identify the patient, check the blood type, and
confirm the label on the blood component per institution protocol.
The blood transfusion should be initiated within 30 minutes of
receiving the blood component from the blood bank. Blood should
be infused slowly for the first 15 minutes and the nurse should
remain at the bedside to monitor the patient closely. If the patient
tolerates the transfusion, the infusion rate will be increased per
institution protocol. If a transfusion reaction occurs, the blood
transfusion should be stopped and the patient should be monitored
closely following institution protocol to manage a transfusion
reaction.
◉ The nurse has an order to administer normal saline 20 mL/kg
bolus intravenously over 30 minutes. The patient weighs 35 lb. How
many milliliters should the nurse prepare to administer? Round the
weight in kilograms to nearest the whole number. Answer: 320 mL
Rationale:Fluid boluses are calculated using the 20 mL/kg formula.
Convert pounds to kilograms: 35 ÷ 2.2 = 15.90 kg. Round 15.90 to
nearest whole number: 15.90 = 16 kg. Multiply 20 mL/kg by 16 kg:
20 × 16 = 320 mL.
◉ A patient with sickle cell anemia who was admitted in vaso-
occlusive crisis for leg pain reports stomach pain and is guarding her
left side. Which of the following assessments should the nurse
