NURS 5315 FINAL EXAM 2026 SPRING UTA
VERIFIED EXAM SOLVED QUESTIONS
A 64-year-old male patient presents to your office with a complaint of intermittent fevers,
weight loss, and profuse night sweats. On examination he has an enlarged mass on the right
side of his neck. Which of the following pathological processes best explains the clinical
manifestations?
Malignant transformation of lymphocytes to Reed Sternberg cells
Malignant transformation of B-cells which infiltrate the bone marrow, bone and other soft
tissues
Uncontrolled proliferation of malignant leukocytes which blocks the growth of healthy blood
cells
Antigen antibody complexes bind to the Fc receptors on platelets which leads to their
destruction in the spleen.
The clinical scenario is consistent with Hodgkin's Lymphoma. Option A is the only answer which
describes the pathological process of the Hodgkin's Lymphoma. Option B describes the
pathological process for multiple myeloma. Option C is the pathological basis of leukemias.
Option D describes the pathological process for immune thrombocytopenic purpura (ITP).
Which of the following intravenous fluids would be best to order to help reverse the sickling
process associated with sickle cell anemia during an acute vaso-occlusive crisis?
0.45% normal saline
0.9% normal saline
3% normal saline
D5 normal saline (D5NS)
The best fluid to order in a patient with sickle cell disease who is experiencing an acute vaso-
occlusive crisis is a hypotonic solution. Hypotonic solutions will cause fluid to move into the
intracellular space i.e. the red blood cell. This will cause the red blood cells to swell and thereby
reverse the sickling. Option B is an isotonic fluid which will remain mainly in the intravascular
space. Options C and D are both hypertonic solutions which will draw fluid out of the cells into
the intravascular space.
,An adult patient with sickle cell anemia is at the greatest risk for which type of infection?
Pneumoccoccal
Staphylococcal
Fungal
Viral
An adult patient with sickle cell anemia has a functional asplenia. This leaves them at an
increased risk for acquiring pneumococcal infections.
Vaso-occlusive crises are best treated with which type of IV fluid?
Hypotonic
Isotonic
Hypertonic
Isometric
Hypotonic IV solutions are the best treatment for sickle cell crises. The administrative of a
hypotonic IV solution to a person experiencing a sickle cell crisis will help to reverse the crisis by
causing fluid to shift into the intracellular space. This will help the RBCs return to their normal
biconcave shape.
Which abnormality is normally seen in a newborn?
Polycythemia
Leukopenia
Monocytopenia
Anemia
A newborn will normally have polycythemia . RBC counts decrease for the first 6-8 weeks after
birth. Leukocytosis and monocytosis are normally seen in the newborn as well.
Which patient will most likely have issues with bleeding secondary to a platelet dysfunction?
A 72y/o patient with acute myelogenous leukemia .
A 3y/o male child with hemophilia A.
A patient with Hageman deficiency.
A patient with a protein C deficiency.
Acute leukemia causes a thrombocytopenia, thus patients with acute leukemia are likely to
experience bleeds secondary to platelet deficiencies. Hemophilia A causes a coagulopathy.
Hagemen factor is a coagulation protein that has a role in the coagulation cascade but a
deficiency does not cause a coagulopathy. A protein C deficiency causes a hypercoagulable
state.
, A male patient presents to the emergency department with a complaint of acute, left elbow
progressive pain and swelling. An x-ray completed of the elbow was concerning for
hemarthrosis. Which of the following lab values would be the most important for the nurse
practitioner to order?
Platelet count
White blood count
Prothrombin time
Hemoglobin
A coagulopathy is a dysfunction in either the intrinsic or extrinsic clotting cascade which
prevents hemostasis. The clotting cascade is independent of the platelet plug formation and
individuals with a coagulopathy may have normal platelet production and function. The clinical
picture is consistent with a coagulopathy and not a platelet disorder. Individuals with a
coagulopathy tend to bleed into the joints and persons with thrombocytopenia or platelet
dysfunction tend to experience mucosal bleeds. While a platelet count is reasonable the
question ask which lab would be the most important to order. In this instance the prothrombin
time is the most important to order. The prothrombin time will identify a disorder in the
clotting cascade and the clinical scenario is consistent with a coagulopathy. A white blood cell
count may be helpful to rule out an infected joint but given the clinical scenario it is not the
most important lab to order. Again a hemoglobin will be helpful to determine the extent of the
bleeding but what is most important at this point is to determine the etiology. The prothrombin
time will help isolate the etiology which will help the nurse practitioner determine the
appropriate treatment.
A 70-year-old female client presents to your office with a three week history of numbness
and tingling in her bilateral, lower extremities. The sensation has progressively gotten worse
and she complains of fatigue. The CBC shows a hemoglobin of 8mg/dl and a hematocrit of
24%. Which of the following findings would the nurse practitioner likely observe when
examining the patient?
Koilonychia
Positive stool guaiac
Jaundice
Smooth, beefy, red tongue
The clinical scenario is consistent with a pernicious anemia which is secondary to a B12
deficiency. The only clinical manifestation listed in the choices that is consistent with a B12
deficiency is option D. Koilonychia is a spooning of the nail beds and is seen in iron deficiency
anemia. A positive stool for guaiac may be present in an iron deficiency anemia and could be a
sign of colon cancer. Jaundice would be present in a hemolytic anemia such as sickle cell
anemia.
VERIFIED EXAM SOLVED QUESTIONS
A 64-year-old male patient presents to your office with a complaint of intermittent fevers,
weight loss, and profuse night sweats. On examination he has an enlarged mass on the right
side of his neck. Which of the following pathological processes best explains the clinical
manifestations?
Malignant transformation of lymphocytes to Reed Sternberg cells
Malignant transformation of B-cells which infiltrate the bone marrow, bone and other soft
tissues
Uncontrolled proliferation of malignant leukocytes which blocks the growth of healthy blood
cells
Antigen antibody complexes bind to the Fc receptors on platelets which leads to their
destruction in the spleen.
The clinical scenario is consistent with Hodgkin's Lymphoma. Option A is the only answer which
describes the pathological process of the Hodgkin's Lymphoma. Option B describes the
pathological process for multiple myeloma. Option C is the pathological basis of leukemias.
Option D describes the pathological process for immune thrombocytopenic purpura (ITP).
Which of the following intravenous fluids would be best to order to help reverse the sickling
process associated with sickle cell anemia during an acute vaso-occlusive crisis?
0.45% normal saline
0.9% normal saline
3% normal saline
D5 normal saline (D5NS)
The best fluid to order in a patient with sickle cell disease who is experiencing an acute vaso-
occlusive crisis is a hypotonic solution. Hypotonic solutions will cause fluid to move into the
intracellular space i.e. the red blood cell. This will cause the red blood cells to swell and thereby
reverse the sickling. Option B is an isotonic fluid which will remain mainly in the intravascular
space. Options C and D are both hypertonic solutions which will draw fluid out of the cells into
the intravascular space.
,An adult patient with sickle cell anemia is at the greatest risk for which type of infection?
Pneumoccoccal
Staphylococcal
Fungal
Viral
An adult patient with sickle cell anemia has a functional asplenia. This leaves them at an
increased risk for acquiring pneumococcal infections.
Vaso-occlusive crises are best treated with which type of IV fluid?
Hypotonic
Isotonic
Hypertonic
Isometric
Hypotonic IV solutions are the best treatment for sickle cell crises. The administrative of a
hypotonic IV solution to a person experiencing a sickle cell crisis will help to reverse the crisis by
causing fluid to shift into the intracellular space. This will help the RBCs return to their normal
biconcave shape.
Which abnormality is normally seen in a newborn?
Polycythemia
Leukopenia
Monocytopenia
Anemia
A newborn will normally have polycythemia . RBC counts decrease for the first 6-8 weeks after
birth. Leukocytosis and monocytosis are normally seen in the newborn as well.
Which patient will most likely have issues with bleeding secondary to a platelet dysfunction?
A 72y/o patient with acute myelogenous leukemia .
A 3y/o male child with hemophilia A.
A patient with Hageman deficiency.
A patient with a protein C deficiency.
Acute leukemia causes a thrombocytopenia, thus patients with acute leukemia are likely to
experience bleeds secondary to platelet deficiencies. Hemophilia A causes a coagulopathy.
Hagemen factor is a coagulation protein that has a role in the coagulation cascade but a
deficiency does not cause a coagulopathy. A protein C deficiency causes a hypercoagulable
state.
, A male patient presents to the emergency department with a complaint of acute, left elbow
progressive pain and swelling. An x-ray completed of the elbow was concerning for
hemarthrosis. Which of the following lab values would be the most important for the nurse
practitioner to order?
Platelet count
White blood count
Prothrombin time
Hemoglobin
A coagulopathy is a dysfunction in either the intrinsic or extrinsic clotting cascade which
prevents hemostasis. The clotting cascade is independent of the platelet plug formation and
individuals with a coagulopathy may have normal platelet production and function. The clinical
picture is consistent with a coagulopathy and not a platelet disorder. Individuals with a
coagulopathy tend to bleed into the joints and persons with thrombocytopenia or platelet
dysfunction tend to experience mucosal bleeds. While a platelet count is reasonable the
question ask which lab would be the most important to order. In this instance the prothrombin
time is the most important to order. The prothrombin time will identify a disorder in the
clotting cascade and the clinical scenario is consistent with a coagulopathy. A white blood cell
count may be helpful to rule out an infected joint but given the clinical scenario it is not the
most important lab to order. Again a hemoglobin will be helpful to determine the extent of the
bleeding but what is most important at this point is to determine the etiology. The prothrombin
time will help isolate the etiology which will help the nurse practitioner determine the
appropriate treatment.
A 70-year-old female client presents to your office with a three week history of numbness
and tingling in her bilateral, lower extremities. The sensation has progressively gotten worse
and she complains of fatigue. The CBC shows a hemoglobin of 8mg/dl and a hematocrit of
24%. Which of the following findings would the nurse practitioner likely observe when
examining the patient?
Koilonychia
Positive stool guaiac
Jaundice
Smooth, beefy, red tongue
The clinical scenario is consistent with a pernicious anemia which is secondary to a B12
deficiency. The only clinical manifestation listed in the choices that is consistent with a B12
deficiency is option D. Koilonychia is a spooning of the nail beds and is seen in iron deficiency
anemia. A positive stool for guaiac may be present in an iron deficiency anemia and could be a
sign of colon cancer. Jaundice would be present in a hemolytic anemia such as sickle cell
anemia.
