NUR 240 FINAL EXAM QUESTIONS AND
CORRECT ANSWERS
Bone Marrow Aspiration/Biopsy - What is this procedure? - CORRECT ANSWERS Removal
of bone marrow for examination.
Bone Marrow Aspiration/Biopsy - What is the difference between the two? - CORRECT
ANSWERS In an aspiration, cells and fluids are suctioned from the bone marrow. In a
biopsy, solid tissue and cells are obtained by coring out an area of bone marrow with a large-
bore needle.
Bone Marrow Aspiration/Biopsy - What are indications for the procedure? - CORRECT
ANSWERS Done to evaluate hematologic status when other lab results show abnormal
findings that might indicate problems with blood cell production or maturation.
Bone Marrow Aspiration/Biopsy - Know the common patient sites. - CORRECT
ANSWERS Posterior superior iliac crest - preferred site because no vital organs or vessels
are near. Patient will be prone or side-lying. Spinous process of the 3rd or 4th lumbar vertebrae
- preferred if multiple punctures are needed. Patient will sit on the edge of the bed leaning over
the bedside stand. Sternum - Seldom used; has the greatest risk. Patient will be supine. Will not
be done anywhere radiation has been used because it may have altered or destroyed the
marrow in that area.
Bone Marrow Aspiration/Biopsy - What are the nursing actions pre-procedure? - CORRECT
ANSWERS Explain the procedure to the patient, and that sometimes a crunching sound
can be heard or scraping sensation felt as the needle punctures the bone. Explain that a brief
sensation of painful pulling will be experienced as the marrow is being aspirated by mild suction
in the syringe. If a biopsy is performed, the patient may feel more pressure and discomfort as
the needle is rotated into the bone.
, Bone Marrow Aspiration/Biopsy - What are the nursing actions post procedure? - CORRECT
ANSWERS Priority is prevention of excessive bleeding. Cover the site with a dressing after
bleeding is controlled, and closely observe it for 24 hours for signs of bleeding and infection. A
mild analgesic (aspirin-free) may be given for discomfort, and ice packs can be placed over the
site to limit bruising. Instruct the patient to inspect the site every 2 hours for the first 24 hours
and to note the presence of active bleeding or bruising. Advise him or her to avoid contact
sports or any activity that might result in trauma to the site for 48 hours
Bone Marrow Aspiration/Biopsy - What are the potential complications? - CORRECT
ANSWERS Excessive bleeding, infection. If sternum is used, puncture of the heart or major
blood vessels, or puncture of a lung.
Bone Marrow Aspiration/Biopsy - What is included in appropriate documentation? - CORRECT
ANSWERS Time, date, location, patient's tolerance of procedure, amount and color of
aspirate, lab tests ordered, time specimen was sent, patient's vitals and pain level, type of
dressing applied.
Abdominal Paracentesis - What is the procedure? - CORRECT ANSWERS Removal of fluid
(ascites) from the peritoneal cavity.
Abdominal Paracentesis - Why is it done? - CORRECT ANSWERS Removal of excess fluid
helps reduce breathing problems (hepatopulmonary syndrome - dyspnea caused by increased
intra-abdominal pressure). Reduces the risk of SBP - spontaneous bacterial peritonitis -
spontaneous bacterial growth in ascites.
Abdominal Paracentesis - What are the nursing responsibilities during the procedure? -
CORRECT ANSWERS Explain the procedure, and answer patient questions. Obtain vital
signs, including weight. Ask the patient to void before the procedure to prevent injury to the
bladder. Position the patient in bed with the head of the bed elevated. Monitor vital signs,
watching for signs of hypovolemic shock. Measure the drainage. Label and send the fluid for
laboratory analysis; After the physician removes the catheter, apply a dressing to the site; assess
for leakage. Maintain bedrest per protocol. Weigh the patient after the paracentesis.
CORRECT ANSWERS
Bone Marrow Aspiration/Biopsy - What is this procedure? - CORRECT ANSWERS Removal
of bone marrow for examination.
Bone Marrow Aspiration/Biopsy - What is the difference between the two? - CORRECT
ANSWERS In an aspiration, cells and fluids are suctioned from the bone marrow. In a
biopsy, solid tissue and cells are obtained by coring out an area of bone marrow with a large-
bore needle.
Bone Marrow Aspiration/Biopsy - What are indications for the procedure? - CORRECT
ANSWERS Done to evaluate hematologic status when other lab results show abnormal
findings that might indicate problems with blood cell production or maturation.
Bone Marrow Aspiration/Biopsy - Know the common patient sites. - CORRECT
ANSWERS Posterior superior iliac crest - preferred site because no vital organs or vessels
are near. Patient will be prone or side-lying. Spinous process of the 3rd or 4th lumbar vertebrae
- preferred if multiple punctures are needed. Patient will sit on the edge of the bed leaning over
the bedside stand. Sternum - Seldom used; has the greatest risk. Patient will be supine. Will not
be done anywhere radiation has been used because it may have altered or destroyed the
marrow in that area.
Bone Marrow Aspiration/Biopsy - What are the nursing actions pre-procedure? - CORRECT
ANSWERS Explain the procedure to the patient, and that sometimes a crunching sound
can be heard or scraping sensation felt as the needle punctures the bone. Explain that a brief
sensation of painful pulling will be experienced as the marrow is being aspirated by mild suction
in the syringe. If a biopsy is performed, the patient may feel more pressure and discomfort as
the needle is rotated into the bone.
, Bone Marrow Aspiration/Biopsy - What are the nursing actions post procedure? - CORRECT
ANSWERS Priority is prevention of excessive bleeding. Cover the site with a dressing after
bleeding is controlled, and closely observe it for 24 hours for signs of bleeding and infection. A
mild analgesic (aspirin-free) may be given for discomfort, and ice packs can be placed over the
site to limit bruising. Instruct the patient to inspect the site every 2 hours for the first 24 hours
and to note the presence of active bleeding or bruising. Advise him or her to avoid contact
sports or any activity that might result in trauma to the site for 48 hours
Bone Marrow Aspiration/Biopsy - What are the potential complications? - CORRECT
ANSWERS Excessive bleeding, infection. If sternum is used, puncture of the heart or major
blood vessels, or puncture of a lung.
Bone Marrow Aspiration/Biopsy - What is included in appropriate documentation? - CORRECT
ANSWERS Time, date, location, patient's tolerance of procedure, amount and color of
aspirate, lab tests ordered, time specimen was sent, patient's vitals and pain level, type of
dressing applied.
Abdominal Paracentesis - What is the procedure? - CORRECT ANSWERS Removal of fluid
(ascites) from the peritoneal cavity.
Abdominal Paracentesis - Why is it done? - CORRECT ANSWERS Removal of excess fluid
helps reduce breathing problems (hepatopulmonary syndrome - dyspnea caused by increased
intra-abdominal pressure). Reduces the risk of SBP - spontaneous bacterial peritonitis -
spontaneous bacterial growth in ascites.
Abdominal Paracentesis - What are the nursing responsibilities during the procedure? -
CORRECT ANSWERS Explain the procedure, and answer patient questions. Obtain vital
signs, including weight. Ask the patient to void before the procedure to prevent injury to the
bladder. Position the patient in bed with the head of the bed elevated. Monitor vital signs,
watching for signs of hypovolemic shock. Measure the drainage. Label and send the fluid for
laboratory analysis; After the physician removes the catheter, apply a dressing to the site; assess
for leakage. Maintain bedrest per protocol. Weigh the patient after the paracentesis.
