MDC 3 – FINAL EXAM REVIEW – SPLIT BY CATEGORIES & QUESTIONS
Know the placement where to put stethoscope for cardiac landmarks
• During a shift assessment, the nurse is identifying the client’s point of maximum impulse
(PMI). Where should the nurse best palpate the PMI?
o Left midclavicular line of the chest at the level of the nipple
o Left midclavicular line of the chest at the fifth intercostal space
o Midline between the xiphoid process and the left nipple
o Two to three centimeters to the left of the sternum
• Chronic Aortic Regurgitation –
o Diastolic blowing murmur at the left sternal boarder with bounding pulses, high pitched
diastolic murmur, and low blood pressure.
• Which best describes a grade II heart murmur?
o a. faint heart murmur that is barely recognizable
o b. loud murmur with moderate intensity
o c. very loud murmur with a palpable thrill
o d. extremely loud heart murmur with a palpable thrill
Nutrition intervention for leukemia
• A nurse is caring for a client who is being treated for leukemia in the hospital. The client
was able to maintain nutritional status for the first few weeks following the diagnosis but
is now exhibiting early signs and symptoms of malnutrition. In collaboration with the
dietitian, the nurse should implement what intervention?
o Arrange for total parenteral nutrition (TPN)
o Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube
o Provide the client with several small, soft textured meals each day
o Assign responsibility for the client’s nutrition to the client’s friends and family
• A client with Hodgkin Lymphoma is receiving information from the oncology nurse. The
client asks the nurse why it is necessary to stop drinking and smoking and stay out of the
sun. Which response by the nurse would be best? CHAT SAYS A ON ONE LINK BUT D ON
THE OTHER…… (I THINK IT’S A)
o “Avoiding these factors can reduce the risk of Reed-Sternberg cells developing.”
o “These behaviors can reduce the effectiveness of your chemotherapy.”
o “Engaging in these activities increases your risk of hemorrhage.”
o “It’s important to reduce other factors that increase the risk of secondary
cancers.”
• A 60-year-old client with chronic myeloid leukemia (CML) we'll be treated in the home
setting, and the nurse is preparing appropriate health education period which topic should
the nurse emphasize?
, o The importance of adhering to the prescribed drug regimen
o The need to ensure that vaccinations are up to date
o The importance of daily physical activity
o The need to avoid shellfish and raw foods
• After receiving a diagnosis of acute lymphocytic leukemia, client is visibly distraught,
stating, “I have no idea where to go from here.” How should the nurse prepare to meet the
clients’ psychosocial needs?
o Assessed the clients’ previous experience with the health care system
o Reassure the client that treatment will be challenging but successful
o Assess the client specific needs for education and support
o Identify the clients’ plan of medical care
• An adult client’s abnormal complete blood count (CBC) and physical assessment have
prompted the health care provider to order a diagnostic workup for Hodgkin lymphoma.
The presence of what assessment finding is considered diagnostic of the disease?
o Presence of Reed–Sternberg cells
• A nurse is caring for four clients with leukemia. After handing off a report which client
should the nurse see first?
o a. Client who had two bloody diarrhea stools this morning
o b. Client who has been premedicated for nausea prior to chemotherapy
o c. A client who is crying and feeling lonely
o d. Client with an unchanged lesion to the lower right lateral malleolus
• The nurse is caring for a 19-year-old male recently diagnosed with leukemia. Which of the
following nursing interventions is appropriate for the care of this client?
o a. Strict hand hygiene to prevent infection
o b. Fluid restriction
o c. Low residual diet
o d. Therapeutic phlebotomy
• A client is undergoing chimeric antigen receptor (CAR) T-cell therapy treatment for Non-
Hodgkin’s lymphoma. The nurse assessment finding indicates the client has fatigue,
petechiae, and bleeding. Which acute side effect of this therapy is associated with these
clinical manifestations?
o a. Pancytopenia
o b. Hemolytic anemia
o c. Neutropenia
o d. Polycythemia vera
• The family of a neutropenic client reports that the client is confused and is not acting right.
What action by the nurse is the priority?
o a. asks the client about pain.
o b. assesses the client for a urinary tract infection ✅
o c. delegate taking a set of vital signs.
o d. look at today’s laboratory results.
,• A nurse is caring for a client recently diagnosed with leukemia. Which of the following
signs and symptoms are consistent with this diagnosis? (SATA)
o Bleeding gums
o Bone pain
o Weight gain
o Increase urination
o Bruising
• Which of the following is a possible treatment plan for a client diagnosed with leukemia?
o Therapeutic phlebotomy
o Stem cell transplant
o Splenectomy
o Dialysis
• The nurse is caring for a 55-year-old male who presented to this primary physician’s office
for his yearly check-up. Upon the physical assessment, the provider noted enlarged lymph
nodes in the groin and neck region. The provider Questioned Joe regarding the possible
causes of the finding. Which of the following diagnoses are consistent with this finding?
o Leukemia
o Lymphoma
o Sickle cell anemia
o Polycythemia vera
• The family of a neutropenic client reports that the client is confused and “is not acting
right.” What action by the nurse is the priority?
o Ask the client about pain
o Look at today’s laboratory results
o Delegate taking a set of vitals
o Assess the client for urinary tract infection
DIC
(No direct Q/A in your list uses the term “DIC.” Keeping this placeholder for quick linking to future
items if you add one.)
• Disseminated intravascular coagulation (DIC) – Treatment –
o Treat underlying cause
Review polycythemia vera
• Polycythemia Vera – Treatment –
o Phlebotomy
o Aspirin
, o Maintain hydration
o Avoid tight clothes
o Ambulation to prevent clots
• The nurse’s brief review of a client’s electronic health record indicates that the client
regularly undergoes therapeutic phlebotomy. Which of the following rationales for this
therapy is most plausible?
o The client’s bone marrow does not produce enough red blood cells
o The client has chronically low relative plasma volume
o The client has polycythemia vera and can dangerously produce excess red blood
cells
o The client has iron deficiency anemia
• A nurse is caring for a client diagnosed with polycythemia vera. Which of the following
should the nurse include in the client and family education?
o Encourages fluid restriction to 1 liter per day
o Exercise moderately for 40 minutes 4 times a week
o Brush and floss teeth twice a day
o Take anticoagulants as prescribed
• A nurse in a hematology clinic is working with four clients with polycythemia vera. Which
client should the nurse see first?
o Client with a blood pressure of 180/98mm Hg
o Client who reports new onset dyspnea
o Client who reports calf tenderness and swelling
o Client with a swollen and painful left great toe
• A nurse is caring for a client diagnosed with polycythemia vera. Which of the following
should the nurse include in the client and family education?
o Resume normal activity
o Wear support hose while awake
o Decrease fluid intake to no more than 1 liter per day
o Diet high in vitamin K intake
• A client with polycythemia vera is being discharged. Which statement indicates the need
for further teaching?
o “I will maintain adequate hydration.”
o “I will avoid tight clothing.”
o “I should limit activity to prevent clots.”
o “I will notify my provider if I have calf pain.”
Know the difference between cardioversion and shocking your patient
Know the placement where to put stethoscope for cardiac landmarks
• During a shift assessment, the nurse is identifying the client’s point of maximum impulse
(PMI). Where should the nurse best palpate the PMI?
o Left midclavicular line of the chest at the level of the nipple
o Left midclavicular line of the chest at the fifth intercostal space
o Midline between the xiphoid process and the left nipple
o Two to three centimeters to the left of the sternum
• Chronic Aortic Regurgitation –
o Diastolic blowing murmur at the left sternal boarder with bounding pulses, high pitched
diastolic murmur, and low blood pressure.
• Which best describes a grade II heart murmur?
o a. faint heart murmur that is barely recognizable
o b. loud murmur with moderate intensity
o c. very loud murmur with a palpable thrill
o d. extremely loud heart murmur with a palpable thrill
Nutrition intervention for leukemia
• A nurse is caring for a client who is being treated for leukemia in the hospital. The client
was able to maintain nutritional status for the first few weeks following the diagnosis but
is now exhibiting early signs and symptoms of malnutrition. In collaboration with the
dietitian, the nurse should implement what intervention?
o Arrange for total parenteral nutrition (TPN)
o Facilitate placement of a percutaneous endoscopic gastrostomy (PEG) tube
o Provide the client with several small, soft textured meals each day
o Assign responsibility for the client’s nutrition to the client’s friends and family
• A client with Hodgkin Lymphoma is receiving information from the oncology nurse. The
client asks the nurse why it is necessary to stop drinking and smoking and stay out of the
sun. Which response by the nurse would be best? CHAT SAYS A ON ONE LINK BUT D ON
THE OTHER…… (I THINK IT’S A)
o “Avoiding these factors can reduce the risk of Reed-Sternberg cells developing.”
o “These behaviors can reduce the effectiveness of your chemotherapy.”
o “Engaging in these activities increases your risk of hemorrhage.”
o “It’s important to reduce other factors that increase the risk of secondary
cancers.”
• A 60-year-old client with chronic myeloid leukemia (CML) we'll be treated in the home
setting, and the nurse is preparing appropriate health education period which topic should
the nurse emphasize?
, o The importance of adhering to the prescribed drug regimen
o The need to ensure that vaccinations are up to date
o The importance of daily physical activity
o The need to avoid shellfish and raw foods
• After receiving a diagnosis of acute lymphocytic leukemia, client is visibly distraught,
stating, “I have no idea where to go from here.” How should the nurse prepare to meet the
clients’ psychosocial needs?
o Assessed the clients’ previous experience with the health care system
o Reassure the client that treatment will be challenging but successful
o Assess the client specific needs for education and support
o Identify the clients’ plan of medical care
• An adult client’s abnormal complete blood count (CBC) and physical assessment have
prompted the health care provider to order a diagnostic workup for Hodgkin lymphoma.
The presence of what assessment finding is considered diagnostic of the disease?
o Presence of Reed–Sternberg cells
• A nurse is caring for four clients with leukemia. After handing off a report which client
should the nurse see first?
o a. Client who had two bloody diarrhea stools this morning
o b. Client who has been premedicated for nausea prior to chemotherapy
o c. A client who is crying and feeling lonely
o d. Client with an unchanged lesion to the lower right lateral malleolus
• The nurse is caring for a 19-year-old male recently diagnosed with leukemia. Which of the
following nursing interventions is appropriate for the care of this client?
o a. Strict hand hygiene to prevent infection
o b. Fluid restriction
o c. Low residual diet
o d. Therapeutic phlebotomy
• A client is undergoing chimeric antigen receptor (CAR) T-cell therapy treatment for Non-
Hodgkin’s lymphoma. The nurse assessment finding indicates the client has fatigue,
petechiae, and bleeding. Which acute side effect of this therapy is associated with these
clinical manifestations?
o a. Pancytopenia
o b. Hemolytic anemia
o c. Neutropenia
o d. Polycythemia vera
• The family of a neutropenic client reports that the client is confused and is not acting right.
What action by the nurse is the priority?
o a. asks the client about pain.
o b. assesses the client for a urinary tract infection ✅
o c. delegate taking a set of vital signs.
o d. look at today’s laboratory results.
,• A nurse is caring for a client recently diagnosed with leukemia. Which of the following
signs and symptoms are consistent with this diagnosis? (SATA)
o Bleeding gums
o Bone pain
o Weight gain
o Increase urination
o Bruising
• Which of the following is a possible treatment plan for a client diagnosed with leukemia?
o Therapeutic phlebotomy
o Stem cell transplant
o Splenectomy
o Dialysis
• The nurse is caring for a 55-year-old male who presented to this primary physician’s office
for his yearly check-up. Upon the physical assessment, the provider noted enlarged lymph
nodes in the groin and neck region. The provider Questioned Joe regarding the possible
causes of the finding. Which of the following diagnoses are consistent with this finding?
o Leukemia
o Lymphoma
o Sickle cell anemia
o Polycythemia vera
• The family of a neutropenic client reports that the client is confused and “is not acting
right.” What action by the nurse is the priority?
o Ask the client about pain
o Look at today’s laboratory results
o Delegate taking a set of vitals
o Assess the client for urinary tract infection
DIC
(No direct Q/A in your list uses the term “DIC.” Keeping this placeholder for quick linking to future
items if you add one.)
• Disseminated intravascular coagulation (DIC) – Treatment –
o Treat underlying cause
Review polycythemia vera
• Polycythemia Vera – Treatment –
o Phlebotomy
o Aspirin
, o Maintain hydration
o Avoid tight clothes
o Ambulation to prevent clots
• The nurse’s brief review of a client’s electronic health record indicates that the client
regularly undergoes therapeutic phlebotomy. Which of the following rationales for this
therapy is most plausible?
o The client’s bone marrow does not produce enough red blood cells
o The client has chronically low relative plasma volume
o The client has polycythemia vera and can dangerously produce excess red blood
cells
o The client has iron deficiency anemia
• A nurse is caring for a client diagnosed with polycythemia vera. Which of the following
should the nurse include in the client and family education?
o Encourages fluid restriction to 1 liter per day
o Exercise moderately for 40 minutes 4 times a week
o Brush and floss teeth twice a day
o Take anticoagulants as prescribed
• A nurse in a hematology clinic is working with four clients with polycythemia vera. Which
client should the nurse see first?
o Client with a blood pressure of 180/98mm Hg
o Client who reports new onset dyspnea
o Client who reports calf tenderness and swelling
o Client with a swollen and painful left great toe
• A nurse is caring for a client diagnosed with polycythemia vera. Which of the following
should the nurse include in the client and family education?
o Resume normal activity
o Wear support hose while awake
o Decrease fluid intake to no more than 1 liter per day
o Diet high in vitamin K intake
• A client with polycythemia vera is being discharged. Which statement indicates the need
for further teaching?
o “I will maintain adequate hydration.”
o “I will avoid tight clothing.”
o “I should limit activity to prevent clots.”
o “I will notify my provider if I have calf pain.”
Know the difference between cardioversion and shocking your patient
