NURS 400 MIDTERM QUESTIONS AND CORRECT ANSWERS
A client with acute lymphoblastic leukemia (ALL) has a right subclavian central venous catheter in place.
At which time(s) should the nurse change the dressing? Select all that apply. CORRECT ANSWERS✓✓a.
every 7 days for a transparent semipermeable dressings
b. when the dressing is becoming loose
c. when the dressing is soiled
d. when the site is reddened
A client with aplastic anemia is instructed to eat foods rich in iron. The nurse should instruct the client to
include which food in the diet to increase iron intake? CORRECT ANSWERS✓✓dark green leafy
vegetables
A client with rheumatoid arthritis tells the nurse, "I know it's important to exercise my joints so I won't
lose mobility, but my joints are so stiff and painful that exercising is difficult." Which response by the
nurse would be most appropriate? CORRECT ANSWERS✓✓"Take a warm tub bath or shower before
exercising. This may help with your discomfort"
A client with rheumatoid arthritis has been on aspirin therapy for an extended time. Which assessment
is the most important for the nurse to obtain? CORRECT ANSWERS✓✓Hearing
-Usually resolves 2 weeks after discontinued
A client with the beta-thalassemia trait plans to marry a person of Italian ancestry who also has the trait.
Which client statement indicates understanding of the teaching provided by the nurse? CORRECT
ANSWERS✓✓"We'll need more genetic counselling in the future"
25% having a child with thalassemia if both parents have it and a potentially life-threatening disease
A nurse is teaching a client who has a severe allergy to bee stings how to manage a reaction. What
medication does the nurse encourage the client to take first after being stung by a bee? CORRECT
ANSWERS✓✓Epinephrine
,The nurse is assessing a client with an ankle wound and foot pain. Which white blood cell (WBC)
differential would be elevated if the client has osteomyelitis? CORRECT ANSWERS✓✓Neutrophils
Osteomyelitis is a bone inflammation caused by pyogenic bone infection. Osteomyelitis would increase
neutrophil count.
A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which
nursing intervention should the nurse include? CORRECT ANSWERS✓✓Place a pressure reducing
mattress on the clients bed as at risk for impaired skin integrity related to bleeding or ischemia. Perform
skin care every 2 hours.
What information should a nurse plan to teach a client newly diagnosed with an infection who has
acquired-immune deficiency syndrome (AIDS)? CORRECT ANSWERS✓✓"You are more susceptible to
infection due to damage to your immune system"
A client is newly diagnosed with pernicious anemia. The nurse is teaching the client to increase vitamin
B12 intake. Which is the most effective way for this client to increase vitamin B12 intake? CORRECT
ANSWERS✓✓taking vitamin B12 injections or nasal spray replacement
On the fourth day after surgery, a client's incision is red and inflamed. There is moderate drainage from
the incision. The client has a temperature of 102°F (38.9°C). The total white blood cell (WBC) count is
10,000/mm3 (10 × 109/L). What should the nurse do first? CORRECT ANSWERS✓✓Notify the health care
provider (HCP)
A client is receiving a transfusion of packed red blood cells. What should the nurse do to safely
administer the blood? CORRECT ANSWERS✓✓Stay with the client during the first 15 minutes to detect
signs or symptoms of a reaction
A client with acquired immunodeficiency syndrome is admitted with Pneumocystis jiroveci pneumonia.
The client begins to cry and says, "My friends and relatives have stopped visiting and calling." What is
the nurse's best response? CORRECT ANSWERS✓✓"That sounds very difficult. How are you coping with
this"
,A nurse preparing to discharge a child with leukemia observes a family member who has a cold sharing a
meal with the child. How should the nurse approach the situation? CORRECT ANSWERS✓✓Offer a face
mask to the person with the cold and use this as an opportunity for further teaching
A client is about to undergo bone marrow aspiration of the sternum. What should the nurse tell the
client? CORRECT ANSWERS✓✓You will feel a pulling type of discomfort for a few seconds
The client will feel a suction or pulling type of sensation or discomfort that lasts a few seconds, local
anesthetic is used and a small dressing is applied
A client being treated for leukemia has an absolute neutrophil count of 400 cells/mm3. What
precautions would the nurse include in the plan of care? CORRECT ANSWERS✓✓Place sign on client's
door reminding all persons to wash hands prior to entering
Neutrophils fall below 1000 or less than 500 reflects a severe risk of infection. Positive pressure isolation
room.
The nurse is assessing a client with chronic hepatitis B who is receiving lamivudine. What information
about the client is most important to communicate to the health care provider? CORRECT
ANSWERS✓✓a 6.6lb weight gain over 2 days
the fuild weight gain is of concern since the drug should be used with caution in patients with impaired
renal function. Renal insufficiency *
A client with anemia has been prescribed 2 units of packed red blood cells (PRBCs). What should the
nurse do to reduce the possibility of a transfusion error? CORRECT ANSWERS✓✓Remain near the client
during the first 15 minutes of infusion to monitor for transfusion reaction
A client undergoing antineoplastic therapy is prescribed subcutaneous epoetin. What indicates to the
nurse that the drug has been effective? CORRECT ANSWERS✓✓Hemoglobin levels rise.
Epoetin stimulates erythropoiesis and the production of red blood cells.
, The nurse is caring for a client being discharged following kidney transplantation. The client is ordered
Mofetil to prevent organ rejection. Which nursing instruction is essential regarding medication use?
CORRECT ANSWERS✓✓Contact the health care provider at first signs of an infection
Mofetil is an organ rejection medication that diminishes the body's ability to identify and eliminate
pathogens (immunosuppressant).
A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are
characteristic of iron deficiency anemia? CORRECT ANSWERS✓✓dyspnea, tachycardia, pallor
As well as fatigue, listlessness, irritability and headache
The nurse is teaching a client with rheumatoid arthritis about measures to conserve energy in activities
of daily living involving the small joints. Which activity, if observed by the nurse, indicates the need for
additional teaching? CORRECT ANSWERS✓✓carrying a laundry basket with clenched fingers and fists
conserve energy
A client is scheduled to receive intravenous immunoglobulin (Ig). Which action(s) should the nurse take?
Select all that apply. CORRECT ANSWERS✓✓a. Ensure the client is receiving IV fluids.
b. Assess for chest pain.
c. Monitor for respiratory distress.
d. Place epinephrine at the bedside.
The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). Which precaution
should the nurse take? CORRECT ANSWERS✓✓standard
The nurse is making a room assignment for a client whose laboratory test result indicate pancytopenia.
Which client should the nurse put into the same room with the client with pancytopenia? CORRECT
ANSWERS✓✓a client with digoxin toxicity
A client with acute lymphoblastic leukemia (ALL) has a right subclavian central venous catheter in place.
At which time(s) should the nurse change the dressing? Select all that apply. CORRECT ANSWERS✓✓a.
every 7 days for a transparent semipermeable dressings
b. when the dressing is becoming loose
c. when the dressing is soiled
d. when the site is reddened
A client with aplastic anemia is instructed to eat foods rich in iron. The nurse should instruct the client to
include which food in the diet to increase iron intake? CORRECT ANSWERS✓✓dark green leafy
vegetables
A client with rheumatoid arthritis tells the nurse, "I know it's important to exercise my joints so I won't
lose mobility, but my joints are so stiff and painful that exercising is difficult." Which response by the
nurse would be most appropriate? CORRECT ANSWERS✓✓"Take a warm tub bath or shower before
exercising. This may help with your discomfort"
A client with rheumatoid arthritis has been on aspirin therapy for an extended time. Which assessment
is the most important for the nurse to obtain? CORRECT ANSWERS✓✓Hearing
-Usually resolves 2 weeks after discontinued
A client with the beta-thalassemia trait plans to marry a person of Italian ancestry who also has the trait.
Which client statement indicates understanding of the teaching provided by the nurse? CORRECT
ANSWERS✓✓"We'll need more genetic counselling in the future"
25% having a child with thalassemia if both parents have it and a potentially life-threatening disease
A nurse is teaching a client who has a severe allergy to bee stings how to manage a reaction. What
medication does the nurse encourage the client to take first after being stung by a bee? CORRECT
ANSWERS✓✓Epinephrine
,The nurse is assessing a client with an ankle wound and foot pain. Which white blood cell (WBC)
differential would be elevated if the client has osteomyelitis? CORRECT ANSWERS✓✓Neutrophils
Osteomyelitis is a bone inflammation caused by pyogenic bone infection. Osteomyelitis would increase
neutrophil count.
A nurse is developing a care plan for a client with disseminated intravascular coagulation (DIC). Which
nursing intervention should the nurse include? CORRECT ANSWERS✓✓Place a pressure reducing
mattress on the clients bed as at risk for impaired skin integrity related to bleeding or ischemia. Perform
skin care every 2 hours.
What information should a nurse plan to teach a client newly diagnosed with an infection who has
acquired-immune deficiency syndrome (AIDS)? CORRECT ANSWERS✓✓"You are more susceptible to
infection due to damage to your immune system"
A client is newly diagnosed with pernicious anemia. The nurse is teaching the client to increase vitamin
B12 intake. Which is the most effective way for this client to increase vitamin B12 intake? CORRECT
ANSWERS✓✓taking vitamin B12 injections or nasal spray replacement
On the fourth day after surgery, a client's incision is red and inflamed. There is moderate drainage from
the incision. The client has a temperature of 102°F (38.9°C). The total white blood cell (WBC) count is
10,000/mm3 (10 × 109/L). What should the nurse do first? CORRECT ANSWERS✓✓Notify the health care
provider (HCP)
A client is receiving a transfusion of packed red blood cells. What should the nurse do to safely
administer the blood? CORRECT ANSWERS✓✓Stay with the client during the first 15 minutes to detect
signs or symptoms of a reaction
A client with acquired immunodeficiency syndrome is admitted with Pneumocystis jiroveci pneumonia.
The client begins to cry and says, "My friends and relatives have stopped visiting and calling." What is
the nurse's best response? CORRECT ANSWERS✓✓"That sounds very difficult. How are you coping with
this"
,A nurse preparing to discharge a child with leukemia observes a family member who has a cold sharing a
meal with the child. How should the nurse approach the situation? CORRECT ANSWERS✓✓Offer a face
mask to the person with the cold and use this as an opportunity for further teaching
A client is about to undergo bone marrow aspiration of the sternum. What should the nurse tell the
client? CORRECT ANSWERS✓✓You will feel a pulling type of discomfort for a few seconds
The client will feel a suction or pulling type of sensation or discomfort that lasts a few seconds, local
anesthetic is used and a small dressing is applied
A client being treated for leukemia has an absolute neutrophil count of 400 cells/mm3. What
precautions would the nurse include in the plan of care? CORRECT ANSWERS✓✓Place sign on client's
door reminding all persons to wash hands prior to entering
Neutrophils fall below 1000 or less than 500 reflects a severe risk of infection. Positive pressure isolation
room.
The nurse is assessing a client with chronic hepatitis B who is receiving lamivudine. What information
about the client is most important to communicate to the health care provider? CORRECT
ANSWERS✓✓a 6.6lb weight gain over 2 days
the fuild weight gain is of concern since the drug should be used with caution in patients with impaired
renal function. Renal insufficiency *
A client with anemia has been prescribed 2 units of packed red blood cells (PRBCs). What should the
nurse do to reduce the possibility of a transfusion error? CORRECT ANSWERS✓✓Remain near the client
during the first 15 minutes of infusion to monitor for transfusion reaction
A client undergoing antineoplastic therapy is prescribed subcutaneous epoetin. What indicates to the
nurse that the drug has been effective? CORRECT ANSWERS✓✓Hemoglobin levels rise.
Epoetin stimulates erythropoiesis and the production of red blood cells.
, The nurse is caring for a client being discharged following kidney transplantation. The client is ordered
Mofetil to prevent organ rejection. Which nursing instruction is essential regarding medication use?
CORRECT ANSWERS✓✓Contact the health care provider at first signs of an infection
Mofetil is an organ rejection medication that diminishes the body's ability to identify and eliminate
pathogens (immunosuppressant).
A client with anemia has been admitted to the medical-surgical unit. Which assessment findings are
characteristic of iron deficiency anemia? CORRECT ANSWERS✓✓dyspnea, tachycardia, pallor
As well as fatigue, listlessness, irritability and headache
The nurse is teaching a client with rheumatoid arthritis about measures to conserve energy in activities
of daily living involving the small joints. Which activity, if observed by the nurse, indicates the need for
additional teaching? CORRECT ANSWERS✓✓carrying a laundry basket with clenched fingers and fists
conserve energy
A client is scheduled to receive intravenous immunoglobulin (Ig). Which action(s) should the nurse take?
Select all that apply. CORRECT ANSWERS✓✓a. Ensure the client is receiving IV fluids.
b. Assess for chest pain.
c. Monitor for respiratory distress.
d. Place epinephrine at the bedside.
The nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). Which precaution
should the nurse take? CORRECT ANSWERS✓✓standard
The nurse is making a room assignment for a client whose laboratory test result indicate pancytopenia.
Which client should the nurse put into the same room with the client with pancytopenia? CORRECT
ANSWERS✓✓a client with digoxin toxicity
