EXCELSIOR COLLEGE – NUR 211 LIFESPAN1 –
FINAL EXAM STUDY AND PRACTICE
MATERIAL GRADED A+ (COMPREHENSIVE
NURSING REVIEW 2026) LATEST!!
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory
work. Which finding should the nurse report to the provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 - answer-A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit
level of 30% is an expected finding, as is a slightly elevated white blood cell count. A
sodium of 147, although slightly high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications,
often shortly after receiving a dose. The nurses on the unit believe the client is drug
seeking. When the client requests pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication - answer-A. Give the client
pain medication it it is time for another dose.
Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours
of IV opioid analgesics. Even if the client is addicted and drug seeking, he or she is still
in extreme pain. If the client can receive another doe of medication, the nurse should
provide it, The other options are judgmental and do not address the client's pain. Giving
placebos is unethical.
,A client in sickle cell crisis is dehydrated and in the emergency department. The nurse
plans to start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution - answer-A. 0.45% normal saline
Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a
hypotonic solution such as 0.45% normal saline. ).9% normal saline and lactated
ringers solution are isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis. What intervention by
the nurse takes priority?
A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line - answer-A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would come first. The
main problem in a sickle cell crisis is tissue and organ hypoxia, so providing oxygen
helps halt the process.
A client has a sickle cell crisis with extreme lower extremity pain. What comfort
measure does the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. - answer-C. Keep the lower
extremities warm
,During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow
and ischemia, leading to pain. Due to decreased blood flow, the clients legs will be cool
or cold. The UAP can attempt to keep the clients legs warm. Ice and elevation will
further decrease perfusion. Elastic bandage wraps are not indicated and may constrict
perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her child also has the
disease. What response by the nurse is best?
A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days. - answer-B. I can
see you are upset. I can stay here with you awhile if you like.
The best response is for the nurse to offer self, a therapeutic communication technique
that uses presence. Attempting to assign blame to both parents will not help the client
feel better. There is genetic testing available, so it is inaccurate to state there is no way
to know who will have the disease. Stating that good treatments exist belittles the
client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to
the clinic reporting an increase in fatigue. What laboratory result should the nurse
report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 - answer-D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this extreme elevation
could indicate leukemia, a complication of taking hydoxyurea. The nurse should report
this finding immediately. Alternatively, it could indicate infection, a serious problem for
clients with SCD. Hematocrit and hemoglobin levels are normally low in people with
SCD. The potassium level, while slightly low, is not worrisome as the WBCs.
, A nurse working with clients with sickle cell disease teaches about self-management to
prevent exacerbations and sickle cell crisis. What factors should clients be taught to
avoid? (Select all that apply)
A. Dehydration
B. Exercise
C. Extreme stress
D. High altitudes
E. Pregnancy - answer-A,C,D,E
Several factors cause RBCs to sickle in SCD, including dehydration, extreme stress, high
altitudes, and pregnancy. Strenuous exercise can also cause sickling, but not unless it
is very vigorous.
The nurse is teaching a client who has sickle cell disease and was admitted for
splenomegaly and abdominal pain. Which instruction does the nurse include in the
clients discharge teaching?
A. Avoid drinking large amounts of fluids
B. Eat six small meals daily instead of large meals
C. Engage in aerobic 3 days a week
D. Receive a yearly influenza vaccination - answer-D. Receive a yearly influenza
vaccination
Abdominal pain and a palpable spleen could indicate blood trapped in the spleen. Over
time, the spleen may become nonfunctional, which the client at risk for infection. An
annual influenza vaccination helps prevent infection. A client with sickle cell disease
should not become dehydrated or engage in strenuous physical activity because this
could precipitate a crisis. Eating smaller meals has no impact on sickle cell disease of
infection.
The nurse is caring for a client during a sickle cell crisis. Which intervention does the
nurse implement for the client?
FINAL EXAM STUDY AND PRACTICE
MATERIAL GRADED A+ (COMPREHENSIVE
NURSING REVIEW 2026) LATEST!!
A nurse caring for a client with sickle cell disease (SCD) reviews the client's laboratory
work. Which finding should the nurse report to the provider?
A. Creatinine: 2.9
B. Hematocrit: 30%
C. Sodium: 147
D. WBC: 12,000 - answer-A. Creatinine: 2.9
An elevated creatinine indicates kidney damage, which occurs in SCD. A hematocrit
level of 30% is an expected finding, as is a slightly elevated white blood cell count. A
sodium of 147, although slightly high, is not concerning
A client hospitalized with sickle cell crisis frequently asks for opioid pain medications,
often shortly after receiving a dose. The nurses on the unit believe the client is drug
seeking. When the client requests pain medication, what action by the nurse is best?
A. Give the client pain medication if it is time for another dose.
B. Instruct the client not to request pain medication too early.
C. Request the provider to leave a prescription for a placebo
D. Tell the client it is too early to have more pain medication - answer-A. Give the client
pain medication it it is time for another dose.
Clients with sickle cell crisis often have severe pain that is managed with up to 48 hours
of IV opioid analgesics. Even if the client is addicted and drug seeking, he or she is still
in extreme pain. If the client can receive another doe of medication, the nurse should
provide it, The other options are judgmental and do not address the client's pain. Giving
placebos is unethical.
,A client in sickle cell crisis is dehydrated and in the emergency department. The nurse
plans to start an IV. Which fluid choice is best?
A. 0.45% normal saline
B. 0.9% normal saline
C. Dextrose 50% (D50)
D. Lactated Ringers solution - answer-A. 0.45% normal saline
Because clients in sickle cell crisis are often dehydrated, the fluid of choice is a
hypotonic solution such as 0.45% normal saline. ).9% normal saline and lactated
ringers solution are isotonic. D50 is hypertonic and not used for hydration.
A client presents to the emergency department in sickle cell crisis. What intervention by
the nurse takes priority?
A. Administer oxygen
B. Apply an oximetry probe
C. Give pain medication
D. Start an IV line - answer-A. Administer oxygen
All actions are appropriate, but remembering the ABCs, oxygen would come first. The
main problem in a sickle cell crisis is tissue and organ hypoxia, so providing oxygen
helps halt the process.
A client has a sickle cell crisis with extreme lower extremity pain. What comfort
measure does the nurse delegate to the UAP?
A. Apply ice packs to the client's legs
B. Elevate the clients legs on pillows
C. Keep the lower extremities warms.
D. Place elastic bandage wraps on the client's legs. - answer-C. Keep the lower
extremities warm
,During a sickle cell crisis, the tissue distal to the occlusion has decreased blood flow
and ischemia, leading to pain. Due to decreased blood flow, the clients legs will be cool
or cold. The UAP can attempt to keep the clients legs warm. Ice and elevation will
further decrease perfusion. Elastic bandage wraps are not indicated and may constrict
perfusion in the legs
A client admitted for sickle cell crisis is distraught after learning her child also has the
disease. What response by the nurse is best?
A. Both you and the father are equally responsible for passing it on.
B. I can see you are upset. I can stay here with you awhile if you like
C. It's not your fault; there is no way to know who will have this disease
D. There are many good treatments for sickle cell disease these days. - answer-B. I can
see you are upset. I can stay here with you awhile if you like.
The best response is for the nurse to offer self, a therapeutic communication technique
that uses presence. Attempting to assign blame to both parents will not help the client
feel better. There is genetic testing available, so it is inaccurate to state there is no way
to know who will have the disease. Stating that good treatments exist belittles the
client's feelings.
A client with sickle cell disease (SCD) takes hydroxyurea (Droxia). The client presents to
the clinic reporting an increase in fatigue. What laboratory result should the nurse
report immediately?
A. Hematocrit: 25%
B. Hemoglobin: 9.2
C. Potassium: 3.2
D. WBC: 38,000 - answer-D. WBC: 38,000
Although individuals with SCD often have elevated WBC counts, this extreme elevation
could indicate leukemia, a complication of taking hydoxyurea. The nurse should report
this finding immediately. Alternatively, it could indicate infection, a serious problem for
clients with SCD. Hematocrit and hemoglobin levels are normally low in people with
SCD. The potassium level, while slightly low, is not worrisome as the WBCs.
, A nurse working with clients with sickle cell disease teaches about self-management to
prevent exacerbations and sickle cell crisis. What factors should clients be taught to
avoid? (Select all that apply)
A. Dehydration
B. Exercise
C. Extreme stress
D. High altitudes
E. Pregnancy - answer-A,C,D,E
Several factors cause RBCs to sickle in SCD, including dehydration, extreme stress, high
altitudes, and pregnancy. Strenuous exercise can also cause sickling, but not unless it
is very vigorous.
The nurse is teaching a client who has sickle cell disease and was admitted for
splenomegaly and abdominal pain. Which instruction does the nurse include in the
clients discharge teaching?
A. Avoid drinking large amounts of fluids
B. Eat six small meals daily instead of large meals
C. Engage in aerobic 3 days a week
D. Receive a yearly influenza vaccination - answer-D. Receive a yearly influenza
vaccination
Abdominal pain and a palpable spleen could indicate blood trapped in the spleen. Over
time, the spleen may become nonfunctional, which the client at risk for infection. An
annual influenza vaccination helps prevent infection. A client with sickle cell disease
should not become dehydrated or engage in strenuous physical activity because this
could precipitate a crisis. Eating smaller meals has no impact on sickle cell disease of
infection.
The nurse is caring for a client during a sickle cell crisis. Which intervention does the
nurse implement for the client?
