NUR 529 EXAM 2 - COMPREHENSIVE EXAM QUESTIONS COMPLETE
WITH 100% VERIFIED ANSWERS
Question 1
A patient's laboratory results show a platelet count of 85,000 cells/µL.
The nurse should anticipate which clinical manifestation?
A) Joint bleeding and deep muscle hematomas
B) Petechiae and gum bleeding
C) Large vessel thrombosis
D) Pulmonary embolism
E) Ischemic stroke
Correct Answer: B) Petechiae and gum bleeding
Rationale: A platelet count of 85,000 cells/µL indicates
thrombocytopenia. Clinical manifestations of thrombocytopenia
primarily involve bleeding from small vessels in the skin and mucous
membranes, including petechiae, purpura, and gingival bleeding. Deep
tissue bleeding and hemarthrosis are more characteristic of coagulation
factor deficiencies.
Question 2
Which vitamin is essential for the synthesis of clotting factors II, VII, IX,
and X in the liver?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
,D) Vitamin D
E) Vitamin K
Correct Answer: E) Vitamin K
Rationale: Vitamin K is required for the hepatic synthesis of clotting
factors II (prothrombin), VII, IX, and X. Vitamin K deficiency or
antagonism (as with warfarin therapy) leads to impaired coagulation
and increased bleeding risk.
Question 3
A patient with hemolytic anemia has laboratory findings showing
elevated indirect bilirubin and decreased haptoglobin. What is the
pathophysiological explanation for these findings?
A) Liver failure prevents bilirubin conjugation
B) RBC destruction releases hemoglobin, which binds haptoglobin, and
heme is converted to unconjugated bilirubin
C) Bone marrow overproduction overwhelms the spleen
D) Iron overload damages hepatocytes
E) Vitamin K deficiency impairs bilirubin metabolism
Correct Answer: B) RBC destruction releases hemoglobin, which binds
haptoglobin, and heme is converted to unconjugated bilirubin
Rationale: In hemolytic anemia, red blood cell destruction releases
hemoglobin into the plasma. Haptoglobin binds free hemoglobin,
leading to decreased serum haptoglobin levels. The heme portion is
converted to unconjugated (indirect) bilirubin, causing elevated indirect
bilirubin levels.
,Question 4
Which of the following medications would the nurse question if
prescribed for a patient with known Glucose-6-Phosphate
Dehydrogenase (G6PD) deficiency?
A) Acetaminophen
B) Furosemide
C) Sulfamethoxazole-trimethoprim
D) Lisinopril
E) Metformin
Correct Answer: C) Sulfamethoxazole-trimethoprim
Rationale: G6PD deficiency causes susceptibility to oxidative stress-
induced hemolysis. Sulfonamides (including sulfamethoxazole-
trimethoprim) are known triggers that can precipitate hemolytic crisis in
these patients. Other triggers include certain antibiotics, antimalarials,
and fava beans.
Question 5
The nurse is educating a patient newly diagnosed with pernicious
anemia. Which statement indicates the patient understands the
underlying pathophysiology?
A) "My body doesn't absorb iron properly from my diet."
B) "My body doesn't produce enough intrinsic factor to absorb vitamin
B12."
C) "My bone marrow is failing to produce red blood cells."
, D) "My red blood cells are being destroyed by antibodies."
E) "My body has a genetic defect in hemoglobin production."
Correct Answer: B) "My body doesn't produce enough intrinsic factor
to absorb vitamin B12."
Rationale: Pernicious anemia is caused by autoimmune destruction of
gastric parietal cells, leading to intrinsic factor deficiency. Intrinsic factor
is essential for the absorption of vitamin B12 in the terminal ileum.
Without intrinsic factor, B12 cannot be absorbed regardless of dietary
intake.
Question 6
A patient with chronic kidney disease is receiving erythropoietin
therapy. The nurse understands that the primary reason for this
treatment is to:
A) Prevent bleeding complications
B) Stimulate white blood cell production
C) Increase platelet production
D) Correct anemia by stimulating RBC production
E) Enhance immune function
Correct Answer: D) Correct anemia by stimulating RBC production
Rationale: Erythropoietin (EPO) is produced by the kidneys and
stimulates erythrocyte production in the bone marrow. In chronic
kidney disease, EPO production is diminished, leading to anemia.
Exogenous EPO therapy replaces this deficiency to stimulate RBC
production and correct the anemia.
WITH 100% VERIFIED ANSWERS
Question 1
A patient's laboratory results show a platelet count of 85,000 cells/µL.
The nurse should anticipate which clinical manifestation?
A) Joint bleeding and deep muscle hematomas
B) Petechiae and gum bleeding
C) Large vessel thrombosis
D) Pulmonary embolism
E) Ischemic stroke
Correct Answer: B) Petechiae and gum bleeding
Rationale: A platelet count of 85,000 cells/µL indicates
thrombocytopenia. Clinical manifestations of thrombocytopenia
primarily involve bleeding from small vessels in the skin and mucous
membranes, including petechiae, purpura, and gingival bleeding. Deep
tissue bleeding and hemarthrosis are more characteristic of coagulation
factor deficiencies.
Question 2
Which vitamin is essential for the synthesis of clotting factors II, VII, IX,
and X in the liver?
A) Vitamin A
B) Vitamin B12
C) Vitamin C
,D) Vitamin D
E) Vitamin K
Correct Answer: E) Vitamin K
Rationale: Vitamin K is required for the hepatic synthesis of clotting
factors II (prothrombin), VII, IX, and X. Vitamin K deficiency or
antagonism (as with warfarin therapy) leads to impaired coagulation
and increased bleeding risk.
Question 3
A patient with hemolytic anemia has laboratory findings showing
elevated indirect bilirubin and decreased haptoglobin. What is the
pathophysiological explanation for these findings?
A) Liver failure prevents bilirubin conjugation
B) RBC destruction releases hemoglobin, which binds haptoglobin, and
heme is converted to unconjugated bilirubin
C) Bone marrow overproduction overwhelms the spleen
D) Iron overload damages hepatocytes
E) Vitamin K deficiency impairs bilirubin metabolism
Correct Answer: B) RBC destruction releases hemoglobin, which binds
haptoglobin, and heme is converted to unconjugated bilirubin
Rationale: In hemolytic anemia, red blood cell destruction releases
hemoglobin into the plasma. Haptoglobin binds free hemoglobin,
leading to decreased serum haptoglobin levels. The heme portion is
converted to unconjugated (indirect) bilirubin, causing elevated indirect
bilirubin levels.
,Question 4
Which of the following medications would the nurse question if
prescribed for a patient with known Glucose-6-Phosphate
Dehydrogenase (G6PD) deficiency?
A) Acetaminophen
B) Furosemide
C) Sulfamethoxazole-trimethoprim
D) Lisinopril
E) Metformin
Correct Answer: C) Sulfamethoxazole-trimethoprim
Rationale: G6PD deficiency causes susceptibility to oxidative stress-
induced hemolysis. Sulfonamides (including sulfamethoxazole-
trimethoprim) are known triggers that can precipitate hemolytic crisis in
these patients. Other triggers include certain antibiotics, antimalarials,
and fava beans.
Question 5
The nurse is educating a patient newly diagnosed with pernicious
anemia. Which statement indicates the patient understands the
underlying pathophysiology?
A) "My body doesn't absorb iron properly from my diet."
B) "My body doesn't produce enough intrinsic factor to absorb vitamin
B12."
C) "My bone marrow is failing to produce red blood cells."
, D) "My red blood cells are being destroyed by antibodies."
E) "My body has a genetic defect in hemoglobin production."
Correct Answer: B) "My body doesn't produce enough intrinsic factor
to absorb vitamin B12."
Rationale: Pernicious anemia is caused by autoimmune destruction of
gastric parietal cells, leading to intrinsic factor deficiency. Intrinsic factor
is essential for the absorption of vitamin B12 in the terminal ileum.
Without intrinsic factor, B12 cannot be absorbed regardless of dietary
intake.
Question 6
A patient with chronic kidney disease is receiving erythropoietin
therapy. The nurse understands that the primary reason for this
treatment is to:
A) Prevent bleeding complications
B) Stimulate white blood cell production
C) Increase platelet production
D) Correct anemia by stimulating RBC production
E) Enhance immune function
Correct Answer: D) Correct anemia by stimulating RBC production
Rationale: Erythropoietin (EPO) is produced by the kidneys and
stimulates erythrocyte production in the bone marrow. In chronic
kidney disease, EPO production is diminished, leading to anemia.
Exogenous EPO therapy replaces this deficiency to stimulate RBC
production and correct the anemia.
