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UNIT 19: HEMATOLOGIC, ONCOLOGIC & INFECTIOUS DISEASE 186. A 34-year-old woman presents with fatigue and pallor. Her labs reveal hemoglobin 9.2 g/dL, MCV 72 fL, and low ferritin. What is the most likely diagnosis? A. Anemia of chronic disease B. Vitamin B12 deficiency C. Iron deficiency anemia D. Thalassemia Correct Answer: C. Iron deficiency anemia Rationale: Microcytic anemia (low MCV) and low ferritin point to iron deficiency, the most common cause of anemia, especially in menstruating ...

1. During an advanced physical exam, the nurse practitioner documents “AP > ML” in the thoracic region. What is the clinical significance of this finding? A. It is a normal thoracic configuration B. It suggests a barrel chest, commonly seen in COPD C. It indicates scoliosis D. It reflects costovertebral tenderness Correct Answer: B Rationale: An anterior-posterior diameter greater than the mediolateral diameter ("AP > ML") suggests a barrel-shaped chest, which is a hallmark of ch...

1. A nurse is preparing a patient for surgery. Which action best ensures patient safety during the perioperative period? A) Confirming the procedure with the patient’s family B) Ensuring the patient has signed the surgical consent C) Asking the surgeon to explain the risks again D) Administering preoperative medication before consent Answer: B Rationale: The nurse must verify that informed consent is obtained and documented before administering sedatives or transferring to surgery. ____...

1. A nurse is caring for a patient with expressive aphasia. What is the most appropriate nursing intervention? A) Speak loudly and slowly B) Use visual aids and gestures C) Encourage the patient to speak more D) Provide written materials only Answer: B Rationale: Expressive aphasia impairs verbal expression. Gestures and visual aids support communication. ________________________________________ 2. A patient is newly diagnosed with presbycusis. What nursing action is most effective? A) ...

1. A nurse is assessing a client with a pressure injury on the sacrum that presents with full-thickness skin loss and visible subcutaneous tissue. Which pressure injury stage is this? A) Stage 1 B) Stage 2 C) Stage 3 D) Stage 4 Answer: C Rationale: Stage 3 pressure injuries involve full-thickness tissue loss with possible exposure of subcutaneous fat but not bone, tendon, or muscle. ________________________________________ 2. Which of the following best describes a stage 1 pressure injur...

1. A nurse is assessing a patient with prolonged constipation. Which finding is most concerning and requires immediate action? A. Abdominal distension B. Hypoactive bowel sounds C. Hematochezia (bright red rectal bleeding) D. Hard, dry stool Correct Answer: C Rationale: Bright red rectal bleeding could indicate hemorrhoids, anal fissures, or colorectal pathology and requires prompt evaluation. ________________________________________ 2. A nurse is preparing a patient for a colonoscopy. W...

1. A nurse is educating a patient about normal urinary output. Which statement by the patient indicates understanding? A. “I should urinate about 100 mL per day.” B. “Normal urine output is at least 30 mL per hour.” C. “As long as I void once a day, it’s okay.” D. “Urine output depends only on how much I eat.” Correct Answer: B Rationale: Normal urinary output is approximately 30 mL/hour or 720 mL/day. Less than this may indicate impaired kidney function. _______________...

1. A nurse is educating a patient with hypertension about dietary changes. Which of the following should the nurse recommend? A. Increase sodium intake B. Follow a high-protein diet C. Adopt the DASH diet D. Eliminate all carbohydrates Correct Answer: C Rationale: The Dietary Approaches to Stop Hypertension (DASH) diet is rich in fruits, vegetables, and low-fat dairy and is effective in lowering blood pressure. ________________________________________ 2. A patient with a stage 3 pressure...

1. A patient reports severe, stabbing pain following abdominal surgery. How should the nurse classify this type of pain? A. Chronic B. Neuropathic C. Nociceptive D. Referred Correct Answer: C Rationale: Post-surgical pain is typically acute and nociceptive, resulting from tissue injury and inflammation. ________________________________________ 2. Which principle is most important when assessing a patient’s pain? A. Vital signs are the most reliable indicator of pain. B. The nurse’s...

1. A nurse is caring for a hospitalized patient who reports difficulty sleeping. Which intervention best promotes sleep? A. Administering a sedative-hypnotic at bedtime B. Offering a warm caffeinated beverage before sleep C. Reducing noise and dimming the lights in the room D. Encouraging exercise immediately before bedtime Correct Answer: C Rationale: A quiet, dark environment promotes melatonin release and supports restful sleep. Sedatives may disrupt sleep architecture. _______________...