NURS 2630 - MEDSURG II:
FINAL EXAM REVIEW, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Medical-Surgical Nursing II or Nursing Care
for Clients with Acute and Chronic Health
Challenges. The final exam is a comprehensive
assessment of advanced nursing concepts for
adult patients.
1. Know the different types of anemia, their signs and
symptoms, treatments, and lab values.
a. Patho: decrease in RBC, O2 delivery or hemoglobin
b. Diagnosis:
i. Mild anemia: Hgb 10-11 g/dL
ii. Moderate: Hgb 7-10 g/dL
iii. Severe: Hgb < 7 g/dL
iv. Transfusion trigger: Hgb < 7 g/dL
v. Caused by:
1. Iron deficiency
2. B vitamin deficiency
3. Sickle cell disease
4. Thalassemia
5. Medications
vi. Lead to:
1. Decreased cardiac output and oxygenation
c. Anemias that develop more rapidly will have more severe symptoms
i. A gradual decrease in hemoglobin of 50% may not produce symptoms
ii. A rapid decrease of 30% will produce symptoms
d. Active people are more likely to have symptoms
i. Increased O2 demand
e. Cardiopulmonary disease will produce more symptoms
i. Baseline decrease in O2 delivery
f. Types of Anemia:
i. Hypoproliferative: defect in production of RBCs
1. Abnormal RBCs are produced, then destroyed
, ii. Hemolytic: excess destruction of RBCs
1. even if RBCs appear normal, patient will have
increased byproducts of RBC breakdown
2. increased levels of immature RBCs
iii. Can also be caused by blood loss
g. Signs & Symptoms/Assessment Data:
i. Neuro – fatigue, weakness, dizziness, syncope
ii. Cardiovascular – tachycardia, hypotension, orthostasis, weak pulses,
palpitations
iii. Pulmonary – SOB on exertion, decreased SpO2
, iv. GI – changes in appetit, nutritional intake, jaundice, splenomegaly
v. GU – decreased UOP
vi. Integ. – pallor, cool extremities
vii. Lab data – decreased RBC, Hgb, Hct, changes in size and colors
of cells
h. Nursing Interventions:
i. Neuro – fall precautions, lower HOB, frequent neuro checks
ii. Cardiovascular – monitor pulses, intervention to prevent orthostatis,
frequent vital sign monitoring (Q4hr), cardiac monitoring
iii. Pulmonary – O2 PRN & during activity, SpO2 monitoring,
alternate activity and rest
iv. GI – food diary, small, frequent, high protein/high calorie foods
v. GU – strict I&O, monitor renal labs
vi. Integ. – maintain normothermia; bair hugger, fluid warmer
vii. Lab data – frequent lab monitoring, medical intervention
i. Medical Interventions:
i. Neuro & Cardio – fluid boluses, blood transfusions: PRBCs, plasma,
erythropoietin injection
ii. Pulmonary – supplemental O2
iii. GI – dietary supplements ~ depending on cause of anemia
iv. GU – foley cath., fluid bolus
v. Lab data – frequent lab monitoring, pre & post-transfusion H&H,
RBC, differential to detect “blasts”
j. Complications:
i. Hypovolemic/Hemorrhagic shock
ii. Hypothermia
iii. Falls
iv. Heart Failure
k. Anemic Disorders: ~alterations in RBC function~
i. Iron deficient anemia
ii. Thalassemia
iii. Megaloblastic
iv. Pernicious
v. Chronic Disease
vi. Renal Failure
vii. Sickle Cell
viii. G6P4
ix. Immune Hemolytic
x. Myelofibrosis
xi. Myelodysplastic
FINAL EXAM REVIEW, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
Medical-Surgical Nursing II or Nursing Care
for Clients with Acute and Chronic Health
Challenges. The final exam is a comprehensive
assessment of advanced nursing concepts for
adult patients.
1. Know the different types of anemia, their signs and
symptoms, treatments, and lab values.
a. Patho: decrease in RBC, O2 delivery or hemoglobin
b. Diagnosis:
i. Mild anemia: Hgb 10-11 g/dL
ii. Moderate: Hgb 7-10 g/dL
iii. Severe: Hgb < 7 g/dL
iv. Transfusion trigger: Hgb < 7 g/dL
v. Caused by:
1. Iron deficiency
2. B vitamin deficiency
3. Sickle cell disease
4. Thalassemia
5. Medications
vi. Lead to:
1. Decreased cardiac output and oxygenation
c. Anemias that develop more rapidly will have more severe symptoms
i. A gradual decrease in hemoglobin of 50% may not produce symptoms
ii. A rapid decrease of 30% will produce symptoms
d. Active people are more likely to have symptoms
i. Increased O2 demand
e. Cardiopulmonary disease will produce more symptoms
i. Baseline decrease in O2 delivery
f. Types of Anemia:
i. Hypoproliferative: defect in production of RBCs
1. Abnormal RBCs are produced, then destroyed
, ii. Hemolytic: excess destruction of RBCs
1. even if RBCs appear normal, patient will have
increased byproducts of RBC breakdown
2. increased levels of immature RBCs
iii. Can also be caused by blood loss
g. Signs & Symptoms/Assessment Data:
i. Neuro – fatigue, weakness, dizziness, syncope
ii. Cardiovascular – tachycardia, hypotension, orthostasis, weak pulses,
palpitations
iii. Pulmonary – SOB on exertion, decreased SpO2
, iv. GI – changes in appetit, nutritional intake, jaundice, splenomegaly
v. GU – decreased UOP
vi. Integ. – pallor, cool extremities
vii. Lab data – decreased RBC, Hgb, Hct, changes in size and colors
of cells
h. Nursing Interventions:
i. Neuro – fall precautions, lower HOB, frequent neuro checks
ii. Cardiovascular – monitor pulses, intervention to prevent orthostatis,
frequent vital sign monitoring (Q4hr), cardiac monitoring
iii. Pulmonary – O2 PRN & during activity, SpO2 monitoring,
alternate activity and rest
iv. GI – food diary, small, frequent, high protein/high calorie foods
v. GU – strict I&O, monitor renal labs
vi. Integ. – maintain normothermia; bair hugger, fluid warmer
vii. Lab data – frequent lab monitoring, medical intervention
i. Medical Interventions:
i. Neuro & Cardio – fluid boluses, blood transfusions: PRBCs, plasma,
erythropoietin injection
ii. Pulmonary – supplemental O2
iii. GI – dietary supplements ~ depending on cause of anemia
iv. GU – foley cath., fluid bolus
v. Lab data – frequent lab monitoring, pre & post-transfusion H&H,
RBC, differential to detect “blasts”
j. Complications:
i. Hypovolemic/Hemorrhagic shock
ii. Hypothermia
iii. Falls
iv. Heart Failure
k. Anemic Disorders: ~alterations in RBC function~
i. Iron deficient anemia
ii. Thalassemia
iii. Megaloblastic
iv. Pernicious
v. Chronic Disease
vi. Renal Failure
vii. Sickle Cell
viii. G6P4
ix. Immune Hemolytic
x. Myelofibrosis
xi. Myelodysplastic
