NRSG 3420 Adults II FINAL EXAM STUDY
GUIDE 2026/2027 ACCURATE QUESTIONS
WITH CORRECT DETAILED SOLUTIONS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. medical management of sickle cell anemia - ANSWER ✔ hematopoietic
stem cell transplant (HSCT) - may cure SCD but is not readily available due
to lack of compatible donors or due to severe organ damage that may be
already present in patient
pharmacologic therapy:
- hydroxyurea (increases levels of fetal hemoglobin decreasing
formation of sickled cells)
- folic acid supplements (maintain the amount needed for increased
erythropoiesis to counteract the effects of hemolysis)
- infections are common and can lead to crisis: immunization
- transfusion therapy (caution with repeat blood transfusions - pt can
develop antibodies to donor blood, hemolytic transfusion reactions
may mimic the s/sx of sickle cell crisis
- supportive therapy (pain management, aspirin, NSAIDS, PCA,
hydration, oxygen therapy)
2. cancer & thrombocytopenia - ANSWER ✔ many chemotherapy agents
cause some degree of myelosuppression (depression of bone marrow
function), resulting in:
- leukopenia
- neutropenia
- anemia
- thrombocytopenia
- increased r/o infection and bleeding
,is predictable:
- pts usually reach point at which blood counts are lowest 7 to 14 days
after chemo
- during 2 weeks, nurses anticipate associated toxicities, especially a
fever associated with neutrophil count less than 1500 cells/mm3
- frequent monitoring of CBC is essential
- pts are educated on strategies to protect against infection, injury, and
blood loss
- erythropoetin (EPO) stimulated RBC production, decreasing the
symptoms of treatment-induced chronic anemia and reducing the need
for blood transfusions
- interleukin 11 (IL-11) (oprelvekin) stimulates the production of
megakaryocytes (precursors to platelets) and can be used to prevent
and treat severe thrombocytopenia but has had limited use because of
toxicities
3. thrombocytopenia - ANSWER ✔ abnormally low platelet levels
<20,000 - petechiae, gingival bleeding, excessive menstrual bleeding, excessive
bleeding after surgery/dental extractions
<5,000 - fatal CNS, or GI hemorrhage
4. patient education for pelvic inflammatory disease - ANSWER ✔
inflammatory condition of the pelvic cavity that may begin with cervicitis
and involve the uterus, fallopian tubes, pelvic peritoneum, or pelvic vascular
system; caused by bacteria, virus, fungus, or parasite (most common - chlam
and gonorrhea)
- explain how pelvic infections occur, how they can be controlled and
avoided, and associated s/sx
- ectopic pregnancy
- proper perineal care
- proper nutrition, exercise, weight control, safe sex practices
- recognize s/sx that require call to provider (pelvic pain or abnormal
discharge, unusual vaginal discharge/odor, pain, abnormal bleeding,
delayed menses, faintness, dizziness, and shoulder pain)
, - maintain follow up appointments
5. medical management of pelvic inflammatory disease - ANSWER ✔ -
broad-spectrum antibiotics (combination fo ceftriaxone, doxycycline, and
metronidazole)
- may require hospitalizations if surgical emergencies, pregnancy, no
clinical response to outpatient oral antimicrobial therapy, inability to
tolerate outpatient oral regimen, severe illness (N/V, high fever), tubo-
ovarian abscess
treatment of sexual partners is necessary to prevent reinfection
6. timing of breast self-examination - ANSWER ✔ best performed after
menses (day 5 to day 7, counting the first day or menses as day 1)
5-7 days after menses begin for women who are premenopausal and once
monthly for women who are postmenopausal or not menstruating
7. ovarian cancer - ANSWER ✔ leading cause of gynecologic cancer deaths
in US; fifth deadliest cancer for women; arise from egg-producing cells
(stromal cell tumors, epithelial tumors)
tumors are difficult to detect because they are usually deep in pelvis; "silent
killer" - 70% are not diagnosed until stage III or IV, incidences increase with
age until 70
most significant r/f is family history (mutations in BRCA1 and BRCA2); also
older age, early menarche, late menopause, obesity
lifetime risk has been shown to decrease with use of long-term suppression of
ovulation through oral contraceptives
8. manifestations of ovarian cancer - ANSWER ✔ nonspecific
increased abdominal girth
pelvic pressure
bloating
back pain
constipation
, abdominal pain
urinary urgency
indigestion
flatulence
increase waist size
leg pain
pelvic pain
palpable ovaries in women who are postmenopausal is concerning
9. The nurse is teaching a local community group about the importance of
disease prevention. Why is the nurse justified in emphasizing disease
prevention as a component of health promotion?
A. Prevention is emphasized as the link between personal
behavior and health.
B. The external environment affects the outcome of most disease
processes.
C. International organizations emphasize prevention as the main
criterion of health care.
D. Most individuals die of preventable causes. - ANSWER ✔
Correct response:
A. Prevention is emphasized as the link between personal behavior and health.
Explanation:
Most deaths are not classified as being preventable. HMO priorities do not
underlie this emphasis. The external environment affects many disease
processes, but the course of illness is primarily determined by factors intrinsic
to the client.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-
Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 4:
Health Education and Health Promotion, Health Promotion, p. 53.
GUIDE 2026/2027 ACCURATE QUESTIONS
WITH CORRECT DETAILED SOLUTIONS ||
100% GUARANTEED PASS
<NEWEST VERSION>
1. medical management of sickle cell anemia - ANSWER ✔ hematopoietic
stem cell transplant (HSCT) - may cure SCD but is not readily available due
to lack of compatible donors or due to severe organ damage that may be
already present in patient
pharmacologic therapy:
- hydroxyurea (increases levels of fetal hemoglobin decreasing
formation of sickled cells)
- folic acid supplements (maintain the amount needed for increased
erythropoiesis to counteract the effects of hemolysis)
- infections are common and can lead to crisis: immunization
- transfusion therapy (caution with repeat blood transfusions - pt can
develop antibodies to donor blood, hemolytic transfusion reactions
may mimic the s/sx of sickle cell crisis
- supportive therapy (pain management, aspirin, NSAIDS, PCA,
hydration, oxygen therapy)
2. cancer & thrombocytopenia - ANSWER ✔ many chemotherapy agents
cause some degree of myelosuppression (depression of bone marrow
function), resulting in:
- leukopenia
- neutropenia
- anemia
- thrombocytopenia
- increased r/o infection and bleeding
,is predictable:
- pts usually reach point at which blood counts are lowest 7 to 14 days
after chemo
- during 2 weeks, nurses anticipate associated toxicities, especially a
fever associated with neutrophil count less than 1500 cells/mm3
- frequent monitoring of CBC is essential
- pts are educated on strategies to protect against infection, injury, and
blood loss
- erythropoetin (EPO) stimulated RBC production, decreasing the
symptoms of treatment-induced chronic anemia and reducing the need
for blood transfusions
- interleukin 11 (IL-11) (oprelvekin) stimulates the production of
megakaryocytes (precursors to platelets) and can be used to prevent
and treat severe thrombocytopenia but has had limited use because of
toxicities
3. thrombocytopenia - ANSWER ✔ abnormally low platelet levels
<20,000 - petechiae, gingival bleeding, excessive menstrual bleeding, excessive
bleeding after surgery/dental extractions
<5,000 - fatal CNS, or GI hemorrhage
4. patient education for pelvic inflammatory disease - ANSWER ✔
inflammatory condition of the pelvic cavity that may begin with cervicitis
and involve the uterus, fallopian tubes, pelvic peritoneum, or pelvic vascular
system; caused by bacteria, virus, fungus, or parasite (most common - chlam
and gonorrhea)
- explain how pelvic infections occur, how they can be controlled and
avoided, and associated s/sx
- ectopic pregnancy
- proper perineal care
- proper nutrition, exercise, weight control, safe sex practices
- recognize s/sx that require call to provider (pelvic pain or abnormal
discharge, unusual vaginal discharge/odor, pain, abnormal bleeding,
delayed menses, faintness, dizziness, and shoulder pain)
, - maintain follow up appointments
5. medical management of pelvic inflammatory disease - ANSWER ✔ -
broad-spectrum antibiotics (combination fo ceftriaxone, doxycycline, and
metronidazole)
- may require hospitalizations if surgical emergencies, pregnancy, no
clinical response to outpatient oral antimicrobial therapy, inability to
tolerate outpatient oral regimen, severe illness (N/V, high fever), tubo-
ovarian abscess
treatment of sexual partners is necessary to prevent reinfection
6. timing of breast self-examination - ANSWER ✔ best performed after
menses (day 5 to day 7, counting the first day or menses as day 1)
5-7 days after menses begin for women who are premenopausal and once
monthly for women who are postmenopausal or not menstruating
7. ovarian cancer - ANSWER ✔ leading cause of gynecologic cancer deaths
in US; fifth deadliest cancer for women; arise from egg-producing cells
(stromal cell tumors, epithelial tumors)
tumors are difficult to detect because they are usually deep in pelvis; "silent
killer" - 70% are not diagnosed until stage III or IV, incidences increase with
age until 70
most significant r/f is family history (mutations in BRCA1 and BRCA2); also
older age, early menarche, late menopause, obesity
lifetime risk has been shown to decrease with use of long-term suppression of
ovulation through oral contraceptives
8. manifestations of ovarian cancer - ANSWER ✔ nonspecific
increased abdominal girth
pelvic pressure
bloating
back pain
constipation
, abdominal pain
urinary urgency
indigestion
flatulence
increase waist size
leg pain
pelvic pain
palpable ovaries in women who are postmenopausal is concerning
9. The nurse is teaching a local community group about the importance of
disease prevention. Why is the nurse justified in emphasizing disease
prevention as a component of health promotion?
A. Prevention is emphasized as the link between personal
behavior and health.
B. The external environment affects the outcome of most disease
processes.
C. International organizations emphasize prevention as the main
criterion of health care.
D. Most individuals die of preventable causes. - ANSWER ✔
Correct response:
A. Prevention is emphasized as the link between personal behavior and health.
Explanation:
Most deaths are not classified as being preventable. HMO priorities do not
underlie this emphasis. The external environment affects many disease
processes, but the course of illness is primarily determined by factors intrinsic
to the client.
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-
Surgical Nursing, 14th ed., Philadelphia, Wolters Kluwer, 2018, Chapter 4:
Health Education and Health Promotion, Health Promotion, p. 53.
