NUR 211 EXAM TEST PREPARATION
QUESTIONS WITH 100% CORRECT
SOLUTIONS
What are some potential complications of a sickle cell crisis? - Answer-Thrombosis and
infarction, cardiovascular collapse, cerebral occlusion, Acute chest syndrome (common
cause for hospitalization for SCD patients) , pulmonary infiltrate.
What are some diagnostic tests for sickle cell diesease? - Answer-Initial testing in the
U.S. is done on newborns. Obtain a heelstick and test for presence of HbS.
Reticulocyte count: reticulocytes are immature red blood cells. Reticulocyte count would
be elevated in sickle cell crisis.
What is the expected treatment for someone with sickle cell disease? - Answer-
Hydroxurea - management for sickle cell disease. It increases fetal hemoglobin and
decreases sickling of red blood cells. Adverse effect: bone marrow suppression and
WBC, RBC, and Platelet inhibition.
Morphine PCA pump - instruct patient not to let family push button. Monitor for
respiratory depression and sedation.
Non-pharmacological: Do NOT use hot & cold therapy. Cold causes vasoconstriction
and increases the risk for sickling of cells. Heat can cause inflammation and increase
burn injury risk. Can use light massage.
What education about SCD should be provided to the patient and family ? - Answer-
Provide information about treatment.
For parents/caregivers: look for signs of dehydration such as dry mucous membranes,
weight loss, & sunken fontanelles (in infants). Give specific instructions about how many
ounces of liquid the child needs to drink each day. It is okay to use flavored popsicles
and drinks to increase fluid intake in children.
Provide patient/caregiver with careful instructions on infusion therapy and to monitor for
signs of iron overload.
Medical ID bracelet
Current Vaccinations
Provide ongoing support, refer to support groups.
Encourage activity with appropriate periods of rest.
Ways to decrease caregiver role strain for someone caring for an individual with SCD. -
Answer-Determine the ability of the caregiver to administer medications and fluids to
provide adequate nutrition.
,Assess caregiver's knowledge of signs of infection and sickle cell crisis and when to
seek medical care.
Refer parents for genetic counseling, especially if they plan on having more children.
Provide referrals to support groups
Provide resources, including information about respite care for parents and information
as needed for siblings.
What is a drug that is used to treat Lupus (and rheumatoid arthritis), and is a category X
pregnancy risk? - Answer-Methotrexate
What is hydroxychloroquine (Plaquenil) used to treat? What is an adverse effect of
hydroxychloroquine (Plaquenil)? - Answer-It is used to treat Lupus (and rheumatoid
arthritis). Benefits should outweigh the risks.
Adverse effect: Retinopathy, patient should have vision monitored every 6 months.
What are some adverse effects of cyclophosphamide and what is it used to treat? -
Answer-Adverse effects: cytotoxic (toxic to living cells), immunosuppressive agent -
more susceptible to infection, cardio toxic
It is used to treat lupus
What patient teaching should be provided to an individual being treated for lupus? -
Answer-Disease and treatment
Medications
Signs of exacerbations and renal involvement
Importance of using mild soap and shampoo
Wearing warm socks and gloves for Raynaud's phenomenon
Sesitivity to light
Rheumatoid Arthritis (RA) - Answer-A chronic autoimmune disease causing
inflammation of connective tissue.
Risk factors of RA - Answer-Family history
Smokers
Obesity
Physical, emotional trauma
Exposure to pollution, insecticides, occupational exposures
What are some clinical manifestations of RA? - Answer-Slow, insidious onset
Joint deformities
Boutonniere deformity of the thumb
Swan-neck deformity of fingers
Inflammation of eyes, lungs, heart, kidneys, GI tract
Sjogren's syndrome: Dry mouth and eyes "hallmark" signs
What diagnostic testing is done to confirm Rheumatoid arthritis? - Answer-Look at
history, Physical Exam, Lab findings
, RA factor
ESR and CRP
Anti-CCP (more specific)
X-rays/CT
Examination of synovial fluid
What is the expected pharmacologic treatment of rheumatoid arthritis? - Answer-
Disease modifying anti-rheumatic drugs (DMARDS)
Methotrexate
NSAIDS (pain only)
Hydroxychloroquine (plaquenil)
Short term steroids - often used as a "bridge" while a drug is taking effect or during
severe disease flare up. ***Monitor for infections, never stop taking medication abruptly,
monitor glucose level, monitor I/Os.****
What are some nursing diagnoses for Rheumatoid arthritis? - Answer-Chronic pain
Fatigue
Ineffective role performance
Disturbed body image
Impaired physical mobility
Anxiety
Activity intolerance
Self-care deficit
What is the main goal of treatment for RA? - Answer-To reduce pain and inflammation,
preserve function, and to prevent deformity.
Non-pharmacological treatment of RA includes: - Answer-Rest and exercise
Splinting inflamed joints reduces unwanted motion, provides joint rest.
Physical therapy
Balanced diet containing fish
Drinking plenty of fluids
Risk factors for hypersensitivity reactions: - Answer-Anyone is at risk.
Repeated exposure
Family history
Types of hypersensitivity reactions: - Answer-Type 1 (IgE-mediated) hypersensitivity:
localized or systemic reactions
Type 2: Tissue specific reactions
Type 3: Immune complex-mediated reactions
Type 4: delayed reactions
What is an example of a Type 1 hypersensitivity reaction? - Answer-Poison plants
Latex
Animal dander
QUESTIONS WITH 100% CORRECT
SOLUTIONS
What are some potential complications of a sickle cell crisis? - Answer-Thrombosis and
infarction, cardiovascular collapse, cerebral occlusion, Acute chest syndrome (common
cause for hospitalization for SCD patients) , pulmonary infiltrate.
What are some diagnostic tests for sickle cell diesease? - Answer-Initial testing in the
U.S. is done on newborns. Obtain a heelstick and test for presence of HbS.
Reticulocyte count: reticulocytes are immature red blood cells. Reticulocyte count would
be elevated in sickle cell crisis.
What is the expected treatment for someone with sickle cell disease? - Answer-
Hydroxurea - management for sickle cell disease. It increases fetal hemoglobin and
decreases sickling of red blood cells. Adverse effect: bone marrow suppression and
WBC, RBC, and Platelet inhibition.
Morphine PCA pump - instruct patient not to let family push button. Monitor for
respiratory depression and sedation.
Non-pharmacological: Do NOT use hot & cold therapy. Cold causes vasoconstriction
and increases the risk for sickling of cells. Heat can cause inflammation and increase
burn injury risk. Can use light massage.
What education about SCD should be provided to the patient and family ? - Answer-
Provide information about treatment.
For parents/caregivers: look for signs of dehydration such as dry mucous membranes,
weight loss, & sunken fontanelles (in infants). Give specific instructions about how many
ounces of liquid the child needs to drink each day. It is okay to use flavored popsicles
and drinks to increase fluid intake in children.
Provide patient/caregiver with careful instructions on infusion therapy and to monitor for
signs of iron overload.
Medical ID bracelet
Current Vaccinations
Provide ongoing support, refer to support groups.
Encourage activity with appropriate periods of rest.
Ways to decrease caregiver role strain for someone caring for an individual with SCD. -
Answer-Determine the ability of the caregiver to administer medications and fluids to
provide adequate nutrition.
,Assess caregiver's knowledge of signs of infection and sickle cell crisis and when to
seek medical care.
Refer parents for genetic counseling, especially if they plan on having more children.
Provide referrals to support groups
Provide resources, including information about respite care for parents and information
as needed for siblings.
What is a drug that is used to treat Lupus (and rheumatoid arthritis), and is a category X
pregnancy risk? - Answer-Methotrexate
What is hydroxychloroquine (Plaquenil) used to treat? What is an adverse effect of
hydroxychloroquine (Plaquenil)? - Answer-It is used to treat Lupus (and rheumatoid
arthritis). Benefits should outweigh the risks.
Adverse effect: Retinopathy, patient should have vision monitored every 6 months.
What are some adverse effects of cyclophosphamide and what is it used to treat? -
Answer-Adverse effects: cytotoxic (toxic to living cells), immunosuppressive agent -
more susceptible to infection, cardio toxic
It is used to treat lupus
What patient teaching should be provided to an individual being treated for lupus? -
Answer-Disease and treatment
Medications
Signs of exacerbations and renal involvement
Importance of using mild soap and shampoo
Wearing warm socks and gloves for Raynaud's phenomenon
Sesitivity to light
Rheumatoid Arthritis (RA) - Answer-A chronic autoimmune disease causing
inflammation of connective tissue.
Risk factors of RA - Answer-Family history
Smokers
Obesity
Physical, emotional trauma
Exposure to pollution, insecticides, occupational exposures
What are some clinical manifestations of RA? - Answer-Slow, insidious onset
Joint deformities
Boutonniere deformity of the thumb
Swan-neck deformity of fingers
Inflammation of eyes, lungs, heart, kidneys, GI tract
Sjogren's syndrome: Dry mouth and eyes "hallmark" signs
What diagnostic testing is done to confirm Rheumatoid arthritis? - Answer-Look at
history, Physical Exam, Lab findings
, RA factor
ESR and CRP
Anti-CCP (more specific)
X-rays/CT
Examination of synovial fluid
What is the expected pharmacologic treatment of rheumatoid arthritis? - Answer-
Disease modifying anti-rheumatic drugs (DMARDS)
Methotrexate
NSAIDS (pain only)
Hydroxychloroquine (plaquenil)
Short term steroids - often used as a "bridge" while a drug is taking effect or during
severe disease flare up. ***Monitor for infections, never stop taking medication abruptly,
monitor glucose level, monitor I/Os.****
What are some nursing diagnoses for Rheumatoid arthritis? - Answer-Chronic pain
Fatigue
Ineffective role performance
Disturbed body image
Impaired physical mobility
Anxiety
Activity intolerance
Self-care deficit
What is the main goal of treatment for RA? - Answer-To reduce pain and inflammation,
preserve function, and to prevent deformity.
Non-pharmacological treatment of RA includes: - Answer-Rest and exercise
Splinting inflamed joints reduces unwanted motion, provides joint rest.
Physical therapy
Balanced diet containing fish
Drinking plenty of fluids
Risk factors for hypersensitivity reactions: - Answer-Anyone is at risk.
Repeated exposure
Family history
Types of hypersensitivity reactions: - Answer-Type 1 (IgE-mediated) hypersensitivity:
localized or systemic reactions
Type 2: Tissue specific reactions
Type 3: Immune complex-mediated reactions
Type 4: delayed reactions
What is an example of a Type 1 hypersensitivity reaction? - Answer-Poison plants
Latex
Animal dander
