NU 185 EXAM 4 -MED SURG NURSING II |ACTUAL
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
The nurse is caring for a patient who is being discharged after an emergency splenectomy
following a motor vehicle crash. Which instructions should the nurse include in the
discharge teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill.
CORRECT ANSWER
ANS: D
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The
risks for lymphedema, bleeding, and anemia are not increased after a person has a
splenectomy.
Question 2
The nurse assesses a patient who has numerous petechiae on both arms. Which question
should the nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?"
CORRECT ANSWER
ANS: C
1
, Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.
Antiseizure drugs may cause anemia but not clotting disorders or bleeding. Oral
contraceptives increase a person's clotting risk. Antihypertensives do not usually cause
problems with decreased clotting.
Question 3
A nurse reviews the laboratory data for an older patient. The nurse would be most
concerned about which finding?
a. Hematocrit of 35%
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/μL
d. White blood cell (WBC) count of 2800/μL
CORRECT ANSWER
ANS: D
Because the total WBC count is not usually affected by aging, the low WBC count in this
patient would indicate that the patient's immune function may be compromised and the
underlying cause of the problem needs to be investigated. The platelet count is normal.
The slight decrease in hemoglobin and hematocrit are not unusual for an older patient.
Question 4
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac
crest. Which action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound.
CORRECT ANSWER
ANS: B
2
, To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60
minutes. After a bone marrow biopsy, the wound is small and will not be packed with
gauze. A pressure dressing is used to cover the aspiration site. There is no indication to
elevate the patient's head.
Question 5
The nurse assesses a patient with pernicious anemia. Which assessment finding would the
nurse expect?
a. Yellow-tinged sclerae
c. Numbness of the extremities
b. Shiny, smooth tongue
d. Gum bleeding and tenderness
CORRECT ANSWER
ANS: C
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious
anemia. Loss of the papillae of the tongue occurs with chronic iron deficiency. Yellow-
tinged sclera is associated with hemolytic anemia and the resulting jaundice. Gum
bleeding and tenderness occur with thrombocytopenia or neutropenia.
Question 6
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit
of 54%. Which question should the nurse ask to determine possible causes of this finding?
a. "Have you had a recent weight loss?"
b. "Do you have any history of lung disease?"
c. "Have you noticed any dark or bloody stools?"
d. "What is your dietary intake of meats and protein?"
CORRECT ANSWER
ANS: B
3
, The hemoglobin and hematocrit results indicate polycythemia, which can be associated
with chronic obstructive pulmonary disease. The other questions would be appropriate
for patients who are anemic.
Question 7
The nurse is reviewing laboratory results and notes a patient's activated partial
thromboplastin time (aPTT) level of 28 seconds. The nurse should notify the health care
provider in anticipation of adjusting which medication?
a. Aspirin
c. Warfarin
b. Heparin
d. Erythropoietin
CORRECT ANSWER
ANS: B
aPTT assesses intrinsic coagulation by measuring factors I, II, V, VIII, IX, X, XI, XII. aPTT is
increased (prolonged) in heparin administration. aPTT is used to monitor whether
heparin is at a therapeutic level (needs to be greater than the normal range of 25 to 35
sec). Prothrombin time (PT) and international normalized ratio (INR) are most commonly
used to test for therapeutic levels of warfarin (Coumadin). Aspirin affects platelet
function. Erythropoietin is used to stimulate red blood cell production.
Question 8
The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse
should ensure that which laboratory test has been ordered?
a. Platelet count
c. Hemoglobin level
b. Neutrophil count
d. White blood cell count
CORRECT ANSWER
4
QUESTIONS AND VERIFIED ANSWERS|BRAND NEW
2026-2027 UPDATE|GRADED A+
Question 1
The nurse is caring for a patient who is being discharged after an emergency splenectomy
following a motor vehicle crash. Which instructions should the nurse include in the
discharge teaching?
a. Check often for swollen lymph nodes.
b. Watch for excess bleeding or bruising.
c. Take iron supplements to prevent anemia.
d. Wash hands and avoid persons who are ill.
CORRECT ANSWER
ANS: D
Splenectomy increases the risk for infection, especially with gram-positive bacteria. The
risks for lymphedema, bleeding, and anemia are not increased after a person has a
splenectomy.
Question 2
The nurse assesses a patient who has numerous petechiae on both arms. Which question
should the nurse ask the patient?
a. "Are you taking any oral contraceptives?"
b. "Have you been prescribed antiseizure drugs?"
c. "Do you take medication containing salicylates?"
d. "How long have you taken antihypertensive drugs?"
CORRECT ANSWER
ANS: C
1
, Salicylates interfere with platelet function and can lead to petechiae and ecchymoses.
Antiseizure drugs may cause anemia but not clotting disorders or bleeding. Oral
contraceptives increase a person's clotting risk. Antihypertensives do not usually cause
problems with decreased clotting.
Question 3
A nurse reviews the laboratory data for an older patient. The nurse would be most
concerned about which finding?
a. Hematocrit of 35%
b. Hemoglobin of 11.8 g/dL
c. Platelet count of 400,000/μL
d. White blood cell (WBC) count of 2800/μL
CORRECT ANSWER
ANS: D
Because the total WBC count is not usually affected by aging, the low WBC count in this
patient would indicate that the patient's immune function may be compromised and the
underlying cause of the problem needs to be investigated. The platelet count is normal.
The slight decrease in hemoglobin and hematocrit are not unusual for an older patient.
Question 4
A patient with pancytopenia has a bone marrow aspiration from the left posterior iliac
crest. Which action would be important for the nurse to take after the procedure?
a. Elevate the head of the bed to 45 degrees.
b. Have the patient lie on the left side for 1 hour.
c. Apply a sterile 2-inch gauze dressing to the site.
d. Use a half-inch sterile gauze to pack the wound.
CORRECT ANSWER
ANS: B
2
, To decrease the risk for bleeding, the patient should lie on the left side for 30 to 60
minutes. After a bone marrow biopsy, the wound is small and will not be packed with
gauze. A pressure dressing is used to cover the aspiration site. There is no indication to
elevate the patient's head.
Question 5
The nurse assesses a patient with pernicious anemia. Which assessment finding would the
nurse expect?
a. Yellow-tinged sclerae
c. Numbness of the extremities
b. Shiny, smooth tongue
d. Gum bleeding and tenderness
CORRECT ANSWER
ANS: C
Extremity numbness is associated with cobalamin (vitamin B12) deficiency or pernicious
anemia. Loss of the papillae of the tongue occurs with chronic iron deficiency. Yellow-
tinged sclera is associated with hemolytic anemia and the resulting jaundice. Gum
bleeding and tenderness occur with thrombocytopenia or neutropenia.
Question 6
A patient's complete blood count (CBC) shows a hemoglobin of 19 g/dL and a hematocrit
of 54%. Which question should the nurse ask to determine possible causes of this finding?
a. "Have you had a recent weight loss?"
b. "Do you have any history of lung disease?"
c. "Have you noticed any dark or bloody stools?"
d. "What is your dietary intake of meats and protein?"
CORRECT ANSWER
ANS: B
3
, The hemoglobin and hematocrit results indicate polycythemia, which can be associated
with chronic obstructive pulmonary disease. The other questions would be appropriate
for patients who are anemic.
Question 7
The nurse is reviewing laboratory results and notes a patient's activated partial
thromboplastin time (aPTT) level of 28 seconds. The nurse should notify the health care
provider in anticipation of adjusting which medication?
a. Aspirin
c. Warfarin
b. Heparin
d. Erythropoietin
CORRECT ANSWER
ANS: B
aPTT assesses intrinsic coagulation by measuring factors I, II, V, VIII, IX, X, XI, XII. aPTT is
increased (prolonged) in heparin administration. aPTT is used to monitor whether
heparin is at a therapeutic level (needs to be greater than the normal range of 25 to 35
sec). Prothrombin time (PT) and international normalized ratio (INR) are most commonly
used to test for therapeutic levels of warfarin (Coumadin). Aspirin affects platelet
function. Erythropoietin is used to stimulate red blood cell production.
Question 8
The nurse notes pallor of the skin and nail beds in a newly admitted patient. The nurse
should ensure that which laboratory test has been ordered?
a. Platelet count
c. Hemoglobin level
b. Neutrophil count
d. White blood cell count
CORRECT ANSWER
4
