ADA’S Exam Review Practice Questions
and Answers
A week after kidney transplantation, a client develops a temperature of 101 F (38.3 C), the blood
pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising
and urine output is decreased. The x ray indicates that the transplanted kidney is enlarged. Based on
these assessment findings, the nurse anticipates which treatment?
A. antibiotic therapy
B. peritoneal dialysis
C. removal of the transplanted kidney
D. increased immunosuppression therapy - Answer-D. increased immunosuppression therapy
This sx presentation should lead you to think the patient's going thru rejection, the tx for which would
be taking more immunosuppressants. Patients who get organ transplants have to be on anti-rejection
meds for the rest of their life w that organ.
Removal of the transplanted organ is only done in extreme cases. Peritoneal dialysis isn't indicated here
bc it wouldn't help fix the problem. Antibiotic therapy would be good if the case pertained to infection,
but since it's bc of rejection, that's not right.
,A nurse is caring for a patient with newly diagnosed leukemia who is receiving chemotherapy for the
first time. Twenty-four hours after the first dose of chemotherapy, the patient experiences decreased
urine output, an abnormal heart rate, and lethargy. Which of the following laboratory results would help
support the nurse's suspicion for tumor lysis syndrome?
A. Serum calcium 13.0 mg/dL, potassium 3.5 mEq/L, magnesium 2.0 mg/dL
B. Potassium 2.0 mEq/L, phosphorous 3.0 mg/dL, calcium 6.0 mg/dL
C. Uric acid 4.0 mg/dL, creatinine 3.0 mg/dL
D. Uric acid 10.0 mg/dL, potassium 5.5 mEq/L, phosphorous 5.0 mg/dL - Answer-D. Uric acid 10.0
mg/dL, potassium 5.5 mEq/L, phosphorous 5.0 mg/dL
This answer provides labs that appropriately indicate tumor lysis syndrome. These would be as follows:
- uric acid > 8.0 mg/dL - the uric acid given here is 10, which meets this criteria
- potassium > 6.0 mEq/L - the level given here isn't above 6 but it's borderline high of the normal range
so it's close enough to consider TLS here
- phosphorous > 4.5 mg/dL - the level given here is 5, which meets this criteria
- calcium < 7.0 mg/dL - calcium wasn't given in this answer but you need to know this number since
calcium was included in some of the other options
A patient is receiving external beam radiation therapy for head and neck cancer. The patient reports
moderate pain to the tongue and buccal mucosa that is interfering with his ability to eat, sleep, and
speak. Which of the following interventions would you recommend for this patient? Select all that apply.
A. Take pain medication 30 minutes before meals.
B. Avoid acidic, spicy, and sharp foods such as chips.
C. Keep dentures out when not eating to promote healing.
D. Rinse the oral mucosa regularly with an alcohol-based solution. - Answer-A. Take pain medication 30
minutes before meals.
B. Avoid acidic, spicy, and sharp foods such as chips.
C. Keep dentures out when not eating to promote healing.
, Lots of pain meds have an onset of action that's about 30 min, so if you take it 30 min before eating, it'll
help address pain experienced that has been interfering with eating. Each of the types of foods listed in
the second option irritate the tongue and oral mucosa more, which is the opposite of what you want for
a patient already experiencing pain that must be pretty constant if it's interfering with their ability to not
only eat but speak and sleep. Keeping dentures out is another way of preventing the mouth from getting
more irritated and being in more pain.
Never rinse the mouth with alcohol-based solutions because it'll dry out the mucosa and irritate them
more. Use saltwater or other non-alcohol mouthwashes instead if you wish to clean the mouth.
In assessing the neutropenic patient's understanding of discharge education, which patient statement
indicates that the nurse needs to provide further education?
A. "I should stay away from crowds and people who are sick."
B. "I should wash my hands carefully after using the bathroom and before eating meals."
C. "If I have a fever or chills, I should take acetaminophen immediately and recheck my temperature an
hour later."
D. "My WBC count should recover about 14 days after my treatment is completed." - Answer-C. "If I
have a fever or chills, I should take acetaminophen immediately and recheck my temperature an hour
later."
Having abnormally low WBCs, as revealed by the question saying that the patient is neutropenic, tells
you that their body does not present s/s of infection normally - they have atypical presentations. Fevers
aren't generated in this demographic of patients until there's a major issue in the body, so this needs to
be treated like an emergency and the patient should instead go straight to the ER after finding out they
have a high temperature. If they have low WBCs and are presenting w normal s/s of infection then
there's a major problem.
Each of the other statements reflect a proper understanding of what happens after discharge.
The nurse is explaining the potential signs and symptoms of a transfusion reaction to a patient who is
receiving a blood transfusion for the first time. How will the nurse ensure safe blood product
administration? Select all that apply.
and Answers
A week after kidney transplantation, a client develops a temperature of 101 F (38.3 C), the blood
pressure is elevated, and there is tenderness over the transplanted kidney. The serum creatinine is rising
and urine output is decreased. The x ray indicates that the transplanted kidney is enlarged. Based on
these assessment findings, the nurse anticipates which treatment?
A. antibiotic therapy
B. peritoneal dialysis
C. removal of the transplanted kidney
D. increased immunosuppression therapy - Answer-D. increased immunosuppression therapy
This sx presentation should lead you to think the patient's going thru rejection, the tx for which would
be taking more immunosuppressants. Patients who get organ transplants have to be on anti-rejection
meds for the rest of their life w that organ.
Removal of the transplanted organ is only done in extreme cases. Peritoneal dialysis isn't indicated here
bc it wouldn't help fix the problem. Antibiotic therapy would be good if the case pertained to infection,
but since it's bc of rejection, that's not right.
,A nurse is caring for a patient with newly diagnosed leukemia who is receiving chemotherapy for the
first time. Twenty-four hours after the first dose of chemotherapy, the patient experiences decreased
urine output, an abnormal heart rate, and lethargy. Which of the following laboratory results would help
support the nurse's suspicion for tumor lysis syndrome?
A. Serum calcium 13.0 mg/dL, potassium 3.5 mEq/L, magnesium 2.0 mg/dL
B. Potassium 2.0 mEq/L, phosphorous 3.0 mg/dL, calcium 6.0 mg/dL
C. Uric acid 4.0 mg/dL, creatinine 3.0 mg/dL
D. Uric acid 10.0 mg/dL, potassium 5.5 mEq/L, phosphorous 5.0 mg/dL - Answer-D. Uric acid 10.0
mg/dL, potassium 5.5 mEq/L, phosphorous 5.0 mg/dL
This answer provides labs that appropriately indicate tumor lysis syndrome. These would be as follows:
- uric acid > 8.0 mg/dL - the uric acid given here is 10, which meets this criteria
- potassium > 6.0 mEq/L - the level given here isn't above 6 but it's borderline high of the normal range
so it's close enough to consider TLS here
- phosphorous > 4.5 mg/dL - the level given here is 5, which meets this criteria
- calcium < 7.0 mg/dL - calcium wasn't given in this answer but you need to know this number since
calcium was included in some of the other options
A patient is receiving external beam radiation therapy for head and neck cancer. The patient reports
moderate pain to the tongue and buccal mucosa that is interfering with his ability to eat, sleep, and
speak. Which of the following interventions would you recommend for this patient? Select all that apply.
A. Take pain medication 30 minutes before meals.
B. Avoid acidic, spicy, and sharp foods such as chips.
C. Keep dentures out when not eating to promote healing.
D. Rinse the oral mucosa regularly with an alcohol-based solution. - Answer-A. Take pain medication 30
minutes before meals.
B. Avoid acidic, spicy, and sharp foods such as chips.
C. Keep dentures out when not eating to promote healing.
, Lots of pain meds have an onset of action that's about 30 min, so if you take it 30 min before eating, it'll
help address pain experienced that has been interfering with eating. Each of the types of foods listed in
the second option irritate the tongue and oral mucosa more, which is the opposite of what you want for
a patient already experiencing pain that must be pretty constant if it's interfering with their ability to not
only eat but speak and sleep. Keeping dentures out is another way of preventing the mouth from getting
more irritated and being in more pain.
Never rinse the mouth with alcohol-based solutions because it'll dry out the mucosa and irritate them
more. Use saltwater or other non-alcohol mouthwashes instead if you wish to clean the mouth.
In assessing the neutropenic patient's understanding of discharge education, which patient statement
indicates that the nurse needs to provide further education?
A. "I should stay away from crowds and people who are sick."
B. "I should wash my hands carefully after using the bathroom and before eating meals."
C. "If I have a fever or chills, I should take acetaminophen immediately and recheck my temperature an
hour later."
D. "My WBC count should recover about 14 days after my treatment is completed." - Answer-C. "If I
have a fever or chills, I should take acetaminophen immediately and recheck my temperature an hour
later."
Having abnormally low WBCs, as revealed by the question saying that the patient is neutropenic, tells
you that their body does not present s/s of infection normally - they have atypical presentations. Fevers
aren't generated in this demographic of patients until there's a major issue in the body, so this needs to
be treated like an emergency and the patient should instead go straight to the ER after finding out they
have a high temperature. If they have low WBCs and are presenting w normal s/s of infection then
there's a major problem.
Each of the other statements reflect a proper understanding of what happens after discharge.
The nurse is explaining the potential signs and symptoms of a transfusion reaction to a patient who is
receiving a blood transfusion for the first time. How will the nurse ensure safe blood product
administration? Select all that apply.
