1
NURS 480 Medical-Surgical FINAL EXAM
NURS 480 Medical-Surgical FINALE EXAM
3 WEST COAST UNIVERSITY PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
ACE
1. A nurse is reviewing the hematologic test results for a patient in whom the hematocrit
(Hct) is reported at a reading of 30%. Based on this result, the nurse should interpret that the
patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an inflammatory response.
D. is experiencing an acute hemolytic crisis.
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NURS 480 Medical-Surgical FINAL EXAM
B. has fewer red blood cells than normal.The Hct is the measure of the volume of red blood
cells in whole blood expressed as a percentage. This test is useful in the diagnosis of anemia,
polycythemia, and abnormal hydration states. Patients who are susceptible to bleeding
disorders likely will have a low platelet count. The inflammatory response may best be
evaluated by examination of results that include the white blood cell count with differential
analysis. Acute hemolytic crisis develops in patients receiving blood components in which
incompatibility occurs or in patients with bleeding disorders or conditions that promote
cellular damage, such as damage associated with shock.
2. Which of the following is a factor significant in the development of anemia in men?
A. Condom use
B. Large hemorrhoids
C. A diet high in cholesterol
D. Smoking one pack of cigarettes daily
B. Large hemorrhoids Gastrointestinal (GI) tract bleeding is a common etiologic factor in
men and may result from peptic ulcers, hiatal hernia, gastritis, cancer, hemorrhoids,
diverticula, ulcerative colitis, or salicylate poisoning.
3. Following a patient's bone marrow aspiration, which of the following nursing
interventions should a nurse anticipate?
A. Application of firm pressure to the site B. Positioning the patient in a prone position
C. Positioning the patient in a supine position
D. Application of a warm, moist compress to the site
A. Application of firm pressure to the site After a bone marrow aspiration procedure, a nurse
should apply pressure to the aspiration site until bleeding stops. Application of a warm,
moist compress will not alter the potential for bleeding. Positioning the patient to assume a
supine or prone position also will not address the need to control bleeding from the
aspiration site.
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NURS 480 Medical-Surgical FINAL EXAM
4. The nurse is teaching a patient who is to undergo bone marrow aspiration. Which of the
following statements made by the nurse would indicate correct instruction regarding the
site for the aspiration procedure?
A. "The health care provider will perform the aspiration by needle to the femur."
B. "The health care provider will perform the aspiration by needle to the scapula." C. "The
health care provider will perform the aspiration by needle to the antecubital fossa."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest." Bone marrow samples are commonly taken from the posterior iliac crest or, as an
alternative, the sternum may be aspirated. These sites provide relative ease in accessing the
bone marrow via the biopsy needle. The antecubital fossa, femur, and scapula do not allow
access to bone marrow while also providing reduced risk of harm to the patient.
5. Absorption of vitamin B12 may be decreased in older adults because of decreased
A. intestinal motility.
B. production of bile by the liver.
C. production of intrinsic factor by the stomach.
D. synthesis of cobalamin (vitamin B12) by intestinal bacteria.
C. production of intrinsic factor by the stomach. Older persons are at risk for deficiency of
cobalamin (pernicious anemia) because of a naturally occurring reduction of the intrinsic
factor by the stomach mucosa. Absorption of cobalamin relies on intrinsic factor. Both must
be present for absorption. Megaloblastic anemia is related to folate dysfunction. Intestinal
motility (peristalsis) is the motion that moves food down the GI tract. The rhythmic
contractions of muscles cause wave-like motions. Lack of peristalsis is called "paralytic
ileus." Bile is produced in the liver, is stored and concentrated in the gallbladder, and is
released into the duodenum when fat is eaten. Bile emulsifies fats and prepares them for
enzyme digestion in order for the nutrient to be absorbed into lymph and eventually into
blood vessels to the liver. Vitamin K (the blood-clotting vitamin) is synthesized by intestinal
bacteria.
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NURS 480 Medical-Surgical FINAL EXAM
6. What type of anemia is associated with folate deficiency?
A. Microcytic
B. Pernicious
C. Megaloblastic
D. Iron deficiency
C. Megaloblastic Megaloblastic anemia is nutritional anemia; large immature red blood cells
with a decreased oxygen-carrying capacity can occur as a result of impaired DNA synthesis.
Folic acid is used in the synthesis of DNA and helps convert B12 to coenzyme form. Folic acid
is needed for growth and development of red blood cells. Microcytic anemia is anemia with
abnormally small erythrocytes (red blood cells) in Hb. This anemia is associated with vitamin
B6 (pyridoxine) deficiency. Pernicious anemia is caused by a deficiency of vitamin B12. Iron-
deficiency anemia results from loss of blood or deficient intake of iron foods or disease
states in which the body does not absorb or utilize iron as it should.
7. During care of a patient with multiple myeloma, an important nursing intervention is
A. limiting activity to prevent pathologic fractures.
B. assessing for changes in size and characteristics of lymph nodes.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load.
D. administering narcotic analgesics continuously to control bone pain.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load. Adequate hydration must
be maintained to minimize problems from hypercalcemia. The goal of a urinary output of 1.5
to 2 L/day requires an intake of 3 to 4 L/day.
8. While obtaining the admission assessment data, which of the following characteristics
would a nurse expect a patient with anemia to report?
A. Palpitations
B. Blurred vision
C. Increased appetite
D. Feeling of warm flushing sensation
A. Palpitations Patients experiencing moderate anemia (hemoglobin [Hb] 6 to 10 g/dL) may
experience dyspnea (shortness of breath), palpitations, diaphoresis (profound perspiration)
NURS 480 Medical-Surgical FINAL EXAM
NURS 480 Medical-Surgical FINALE EXAM
3 WEST COAST UNIVERSITY PREDICTOR
VERIFIED QUESTIONS AND CORRECT
DETAILED ANSWERS WITH DETAILED
RATIONALES GRADED A+ GUARANTEED PASS
ACE
1. A nurse is reviewing the hematologic test results for a patient in whom the hematocrit
(Hct) is reported at a reading of 30%. Based on this result, the nurse should interpret that the
patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an inflammatory response.
D. is experiencing an acute hemolytic crisis.
, 2
NURS 480 Medical-Surgical FINAL EXAM
B. has fewer red blood cells than normal.The Hct is the measure of the volume of red blood
cells in whole blood expressed as a percentage. This test is useful in the diagnosis of anemia,
polycythemia, and abnormal hydration states. Patients who are susceptible to bleeding
disorders likely will have a low platelet count. The inflammatory response may best be
evaluated by examination of results that include the white blood cell count with differential
analysis. Acute hemolytic crisis develops in patients receiving blood components in which
incompatibility occurs or in patients with bleeding disorders or conditions that promote
cellular damage, such as damage associated with shock.
2. Which of the following is a factor significant in the development of anemia in men?
A. Condom use
B. Large hemorrhoids
C. A diet high in cholesterol
D. Smoking one pack of cigarettes daily
B. Large hemorrhoids Gastrointestinal (GI) tract bleeding is a common etiologic factor in
men and may result from peptic ulcers, hiatal hernia, gastritis, cancer, hemorrhoids,
diverticula, ulcerative colitis, or salicylate poisoning.
3. Following a patient's bone marrow aspiration, which of the following nursing
interventions should a nurse anticipate?
A. Application of firm pressure to the site B. Positioning the patient in a prone position
C. Positioning the patient in a supine position
D. Application of a warm, moist compress to the site
A. Application of firm pressure to the site After a bone marrow aspiration procedure, a nurse
should apply pressure to the aspiration site until bleeding stops. Application of a warm,
moist compress will not alter the potential for bleeding. Positioning the patient to assume a
supine or prone position also will not address the need to control bleeding from the
aspiration site.
, 3
NURS 480 Medical-Surgical FINAL EXAM
4. The nurse is teaching a patient who is to undergo bone marrow aspiration. Which of the
following statements made by the nurse would indicate correct instruction regarding the
site for the aspiration procedure?
A. "The health care provider will perform the aspiration by needle to the femur."
B. "The health care provider will perform the aspiration by needle to the scapula." C. "The
health care provider will perform the aspiration by needle to the antecubital fossa."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest." Bone marrow samples are commonly taken from the posterior iliac crest or, as an
alternative, the sternum may be aspirated. These sites provide relative ease in accessing the
bone marrow via the biopsy needle. The antecubital fossa, femur, and scapula do not allow
access to bone marrow while also providing reduced risk of harm to the patient.
5. Absorption of vitamin B12 may be decreased in older adults because of decreased
A. intestinal motility.
B. production of bile by the liver.
C. production of intrinsic factor by the stomach.
D. synthesis of cobalamin (vitamin B12) by intestinal bacteria.
C. production of intrinsic factor by the stomach. Older persons are at risk for deficiency of
cobalamin (pernicious anemia) because of a naturally occurring reduction of the intrinsic
factor by the stomach mucosa. Absorption of cobalamin relies on intrinsic factor. Both must
be present for absorption. Megaloblastic anemia is related to folate dysfunction. Intestinal
motility (peristalsis) is the motion that moves food down the GI tract. The rhythmic
contractions of muscles cause wave-like motions. Lack of peristalsis is called "paralytic
ileus." Bile is produced in the liver, is stored and concentrated in the gallbladder, and is
released into the duodenum when fat is eaten. Bile emulsifies fats and prepares them for
enzyme digestion in order for the nutrient to be absorbed into lymph and eventually into
blood vessels to the liver. Vitamin K (the blood-clotting vitamin) is synthesized by intestinal
bacteria.
, 4
NURS 480 Medical-Surgical FINAL EXAM
6. What type of anemia is associated with folate deficiency?
A. Microcytic
B. Pernicious
C. Megaloblastic
D. Iron deficiency
C. Megaloblastic Megaloblastic anemia is nutritional anemia; large immature red blood cells
with a decreased oxygen-carrying capacity can occur as a result of impaired DNA synthesis.
Folic acid is used in the synthesis of DNA and helps convert B12 to coenzyme form. Folic acid
is needed for growth and development of red blood cells. Microcytic anemia is anemia with
abnormally small erythrocytes (red blood cells) in Hb. This anemia is associated with vitamin
B6 (pyridoxine) deficiency. Pernicious anemia is caused by a deficiency of vitamin B12. Iron-
deficiency anemia results from loss of blood or deficient intake of iron foods or disease
states in which the body does not absorb or utilize iron as it should.
7. During care of a patient with multiple myeloma, an important nursing intervention is
A. limiting activity to prevent pathologic fractures.
B. assessing for changes in size and characteristics of lymph nodes.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load.
D. administering narcotic analgesics continuously to control bone pain.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load. Adequate hydration must
be maintained to minimize problems from hypercalcemia. The goal of a urinary output of 1.5
to 2 L/day requires an intake of 3 to 4 L/day.
8. While obtaining the admission assessment data, which of the following characteristics
would a nurse expect a patient with anemia to report?
A. Palpitations
B. Blurred vision
C. Increased appetite
D. Feeling of warm flushing sensation
A. Palpitations Patients experiencing moderate anemia (hemoglobin [Hb] 6 to 10 g/dL) may
experience dyspnea (shortness of breath), palpitations, diaphoresis (profound perspiration)
