NUR 231 Final Exam – Adult Nursing II
(2026) Actual Questions & Verified
Answers | Illinois State University (A+
Guarantee)
A client receiving induction chemotherapy for acute leukemia has an absolute
neutrophil count (ANC) of 400/mm³. Which nursing intervention is the priority?
A. Encourage fresh fruits and vegetables
B. Place the client on protective infection-prevention measures
C. Encourage visitors to stay for several hours
D. Administer an intramuscular injection
Answer: B. Place the client on protective infection-prevention measures
Rationale: An ANC below 500/mm³ represents severe neutropenia and
significantly increases the risk for infection. Appropriate infection-prevention
measures are therefore a priority.
A client receiving chemotherapy develops painful oral ulcerations and erythema.
Which intervention should the nurse recommend?
A. Use an alcohol-based mouthwash
B. Brush vigorously after every meal
C. Perform gentle oral care with a soft toothbrush
D. Eat spicy foods to stimulate salivation
Answer: C. Perform gentle oral care with a soft toothbrush
Rationale: Chemotherapy can cause stomatitis and mucosal injury. Gentle oral
hygiene helps reduce infection and trauma while avoiding further irritation.
,A client with leukemia has a platelet count of 18,000/mm³. Which intervention is
most appropriate?
A. Use a soft toothbrush and institute bleeding precautions
B. Encourage vigorous exercise
C. Administer aspirin for headache
D. Obtain rectal temperatures every 4 hours
Answer: A. Use a soft toothbrush and institute bleeding precautions
Rationale: Severe thrombocytopenia places the client at high risk for bleeding.
Measures that minimize trauma and avoid medications that impair platelet
function are appropriate.
A client undergoing chemotherapy is at risk for tumor lysis syndrome. Which
laboratory finding requires immediate attention?
A. Decreased uric acid
B. Increased potassium
C. Decreased phosphate
D. Increased calcium
Answer: B. Increased potassium
Rationale: Tumor lysis syndrome can cause hyperkalemia, hyperphosphatemia,
hyperuricemia, and hypocalcemia. Hyperkalemia is particularly dangerous
because it can produce life-threatening cardiac dysrhythmias.
Which assessment finding is most concerning in a client receiving chemotherapy?
A. Mild fatigue
B. Temporary taste changes
C. Temperature of 38.3°C (100.9°F)
D. Decreased appetite
,Answer: C. Temperature of 38.3°C (100.9°F)
Rationale: Fever in a significantly immunocompromised client may indicate a
serious infection. Prompt assessment and intervention are required.
A client receiving chemotherapy reports persistent nausea. Which nursing
intervention is appropriate?
A. Encourage large meals three times daily
B. Encourage small, frequent meals
C. Restrict all oral fluids
D. Recommend high-fat foods
Answer: B. Encourage small, frequent meals
Rationale: Small, frequent meals are often better tolerated during chemotherapy.
Avoiding large meals and strong odors may also reduce nausea.
A client with multiple myeloma reports new severe back pain. Which complication
should the nurse suspect?
A. Pathologic fracture
B. Appendicitis
C. Hypoglycemia
D. Pneumothorax
Answer: A. Pathologic fracture
Rationale: Multiple myeloma causes destructive bone lesions and increases the
risk for pathologic fractures, particularly involving the spine and other weight-
bearing bones.
A client with advanced cancer is receiving hospice care. Which statement best
describes the primary goal of hospice?
, A. Cure the underlying disease
B. Prolong life through aggressive treatment
C. Promote comfort and quality of life
D. Prevent family involvement
Answer: C. Promote comfort and quality of life
Rationale: Hospice focuses on comfort, symptom management, dignity, and quality
of life for clients approaching the end of life.
A client with a peptic ulcer suddenly develops severe abdominal pain and a rigid
abdomen. Which complication should the nurse suspect?
A. Dumping syndrome
B. Perforation
C. Constipation
D. Gastric outlet obstruction
Answer: B. Perforation
Rationale: Sudden severe abdominal pain with a rigid or board-like abdomen is
concerning for perforation and peritonitis, which require urgent intervention.
Which finding is most consistent with dumping syndrome following gastric bypass
surgery?
A. Bradycardia and constipation
B. Abdominal cramping, diaphoresis, and tachycardia after eating
C. Severe hypertension before meals
D. Increased appetite immediately after meals
Answer: B. Abdominal cramping, diaphoresis, and tachycardia after eating
Rationale: Rapid movement of hyperosmolar food into the small intestine can
produce abdominal cramping, vasomotor symptoms, tachycardia, weakness, and
diaphoresis.
(2026) Actual Questions & Verified
Answers | Illinois State University (A+
Guarantee)
A client receiving induction chemotherapy for acute leukemia has an absolute
neutrophil count (ANC) of 400/mm³. Which nursing intervention is the priority?
A. Encourage fresh fruits and vegetables
B. Place the client on protective infection-prevention measures
C. Encourage visitors to stay for several hours
D. Administer an intramuscular injection
Answer: B. Place the client on protective infection-prevention measures
Rationale: An ANC below 500/mm³ represents severe neutropenia and
significantly increases the risk for infection. Appropriate infection-prevention
measures are therefore a priority.
A client receiving chemotherapy develops painful oral ulcerations and erythema.
Which intervention should the nurse recommend?
A. Use an alcohol-based mouthwash
B. Brush vigorously after every meal
C. Perform gentle oral care with a soft toothbrush
D. Eat spicy foods to stimulate salivation
Answer: C. Perform gentle oral care with a soft toothbrush
Rationale: Chemotherapy can cause stomatitis and mucosal injury. Gentle oral
hygiene helps reduce infection and trauma while avoiding further irritation.
,A client with leukemia has a platelet count of 18,000/mm³. Which intervention is
most appropriate?
A. Use a soft toothbrush and institute bleeding precautions
B. Encourage vigorous exercise
C. Administer aspirin for headache
D. Obtain rectal temperatures every 4 hours
Answer: A. Use a soft toothbrush and institute bleeding precautions
Rationale: Severe thrombocytopenia places the client at high risk for bleeding.
Measures that minimize trauma and avoid medications that impair platelet
function are appropriate.
A client undergoing chemotherapy is at risk for tumor lysis syndrome. Which
laboratory finding requires immediate attention?
A. Decreased uric acid
B. Increased potassium
C. Decreased phosphate
D. Increased calcium
Answer: B. Increased potassium
Rationale: Tumor lysis syndrome can cause hyperkalemia, hyperphosphatemia,
hyperuricemia, and hypocalcemia. Hyperkalemia is particularly dangerous
because it can produce life-threatening cardiac dysrhythmias.
Which assessment finding is most concerning in a client receiving chemotherapy?
A. Mild fatigue
B. Temporary taste changes
C. Temperature of 38.3°C (100.9°F)
D. Decreased appetite
,Answer: C. Temperature of 38.3°C (100.9°F)
Rationale: Fever in a significantly immunocompromised client may indicate a
serious infection. Prompt assessment and intervention are required.
A client receiving chemotherapy reports persistent nausea. Which nursing
intervention is appropriate?
A. Encourage large meals three times daily
B. Encourage small, frequent meals
C. Restrict all oral fluids
D. Recommend high-fat foods
Answer: B. Encourage small, frequent meals
Rationale: Small, frequent meals are often better tolerated during chemotherapy.
Avoiding large meals and strong odors may also reduce nausea.
A client with multiple myeloma reports new severe back pain. Which complication
should the nurse suspect?
A. Pathologic fracture
B. Appendicitis
C. Hypoglycemia
D. Pneumothorax
Answer: A. Pathologic fracture
Rationale: Multiple myeloma causes destructive bone lesions and increases the
risk for pathologic fractures, particularly involving the spine and other weight-
bearing bones.
A client with advanced cancer is receiving hospice care. Which statement best
describes the primary goal of hospice?
, A. Cure the underlying disease
B. Prolong life through aggressive treatment
C. Promote comfort and quality of life
D. Prevent family involvement
Answer: C. Promote comfort and quality of life
Rationale: Hospice focuses on comfort, symptom management, dignity, and quality
of life for clients approaching the end of life.
A client with a peptic ulcer suddenly develops severe abdominal pain and a rigid
abdomen. Which complication should the nurse suspect?
A. Dumping syndrome
B. Perforation
C. Constipation
D. Gastric outlet obstruction
Answer: B. Perforation
Rationale: Sudden severe abdominal pain with a rigid or board-like abdomen is
concerning for perforation and peritonitis, which require urgent intervention.
Which finding is most consistent with dumping syndrome following gastric bypass
surgery?
A. Bradycardia and constipation
B. Abdominal cramping, diaphoresis, and tachycardia after eating
C. Severe hypertension before meals
D. Increased appetite immediately after meals
Answer: B. Abdominal cramping, diaphoresis, and tachycardia after eating
Rationale: Rapid movement of hyperosmolar food into the small intestine can
produce abdominal cramping, vasomotor symptoms, tachycardia, weakness, and
diaphoresis.
