NRSG 2350 Practice Exam Questions with Actual
Complete Questions and Correct Answers with Detailed
Rationales Already Graded + | 2026 Updated
Integrated Pathophysiology and Pharmacology
Ace your Nursing Exam 2 with this ultimate master question bank featuring 350 high -yield,
NCLEX-style multiple-choice questions! Designed exactly around the core blueprints for
Integrated Pathophysiology and Pharmacology, this guide delivers deep-dive coverage on
Hematology (anemias, sickle cell, clotting), Oncology (TLS, emergencies), Neurology (seizures,
strokes, Parkinson's), and Cardiovascular concepts. Every question includes the correct answer
in bold and a highly detailed clinical rationale to guarantee you master the "why" behind every
concept. Perfect for quick review, active recall, and building testing stamina. Download today
and pass with confidence!
,Question 1
Which of the following interventions is a priority teaching point for a patient prescribed oral
ferrous sulfate?
A) Take the medication with an antacid to decrease gastric upset.
B) Take the medication with orange juice to enhance absorption.
C) Expect stools to become light and clay-colored while taking this drug.
D) Crush the tablet if it is too large to swallow.
Rationale: Vitamin C provides an acidic environment that significantly increases
iron absorption.
Question 2
A patient with iron deficiency anemia is likely to exhibit which of the following laboratory
results?
A) Increased mean corpuscular volume (MCV)
B) Decreased mean corpuscular hemoglobin concentration (MCHC)
C) Elevated serum iron levels
D) Increased total iron-binding capacity (TIBC) with decreased transferrin saturation
Rationale: Iron deficiency results in smaller, paler red blood cells, causing a
decreased MCHC.
Question 3
Which of the following is the primary therapeutic goal of epoetin alfa administration?
A) To stimulate white blood cell production in neutropenic patients
B) To destroy cancer cells in leukemia
C) To elevate hematocrit and hemoglobin levels in patients with chronic kidney disease
D) To decrease platelet aggregation and prevent stroke
Rationale: Epoetin alfa mimics erythropoietin to stimulate RBC production,
thereby treating anemia.
Question 4
Before administering epoetin alfa, the nurse must assess which of the following essential
baseline parameters?
A) Coagulation studies (PT/INR)
B) White blood cell (WBC) count with differential
C) Liver function tests (ALT/AST)
D) Blood pressure and hemoglobin levels
Rationale: Epoetin alfa can cause or exacerbate hypertension and is
contraindicated if hemoglobin is too high.
,Question 5
A patient receiving filgrastim should be closely monitored for which of the following expected
therapeutic outcomes?
A) Decrease in bleeding episodes
B) Increase in neutrophil count
C) Decrease in fatigue and shortness of breath
D) Increase in red blood cell count
Rationale: Filgrastim is a granulocyte colony-stimulating factor that stimulates
the bone marrow to produce neutrophils.
Question 6
Which factor is a common trigger for a sickle cell crisis?
A) Hyperventilation
B) Dehydration
C) Mild to moderate exercise
D) High environmental oxygen levels
Rationale: Dehydration increases blood viscosity, which promotes the sickling of
red blood cells.
Question 7
A patient with sickle cell anemia is prescribed hydroxyurea. The nurse explains that the primary
purpose of this medication is to:
A) Provide pain relief during a vaso-occlusive crisis.
B) Decrease the frequency of sickle cell crises
C) Cure the underlying genetic mutation causing the disease
D) Stimulate the production of normal platelets
Rationale: Hydroxyurea increases the production of fetal hemoglobin (HbF),
which prevents the sickling of RBCs.
Question 8
During a painful vaso-occlusive sickle cell crisis, what is the nurse's primary intervention?
A) Administration of prophylactic antibiotics
B) Fluid restriction to prevent circulatory overload
C) Application of cold compresses to painful joints
D) Administration of opioid analgesics on a scheduled basis
Rationale: Severe pain is the hallmark of a crisis and requires aggressive,
scheduled pain management.
, Question 10
Vitamin B12 deficiency anemia is commonly caused by a lack of:
A) Intrinsic factor
B) Folic acid in the diet
C) Erythropoietin produced by the liver
D) Ascorbic acid
Rationale: Pernicious anemia results from a lack of intrinsic factor, which is
necessary for Vitamin B12 absorption.
Question 11
A patient with Vitamin B12 deficiency may present with which unique clinical manifestation not
typically seen in iron deficiency anemia?
A) Severe fatigue and pallor
B) Koilonychia (spoon-shaped nails)
C) Neurological symptoms such as paresthesias and difficulty walking
D) Glossitis (smooth, beefy-red tongue)
Rationale: Vitamin B12 is essential for nerve myelin maintenance, so its
deficiency causes neurological deficits.
Question 12
Which of the following interventions is the standard treatment for pernicious anemia?
A) Oral folic acid supplementation
B) Daily oral Vitamin B12 tablets
C) Parenteral (IM or SubQ) Vitamin B12 injections
D) Epoetin alfa subcutaneous injections
Rationale: Injections bypass the need for intrinsic factor in the stomach, ensuring
proper absorption.
Question 13
A nurse reviews a complete blood count (CBC) and notes a high mean corpuscular volume
(MCV). This finding is indicative of:
A) Microcytic anemia
B) Normocytic anemia
C) Macrocytic anemia
D) Hypochromic anemia
Rationale: MCV measures the size of RBCs; a high MCV indicates larger than
normal (macrocytic) RBCs.
Complete Questions and Correct Answers with Detailed
Rationales Already Graded + | 2026 Updated
Integrated Pathophysiology and Pharmacology
Ace your Nursing Exam 2 with this ultimate master question bank featuring 350 high -yield,
NCLEX-style multiple-choice questions! Designed exactly around the core blueprints for
Integrated Pathophysiology and Pharmacology, this guide delivers deep-dive coverage on
Hematology (anemias, sickle cell, clotting), Oncology (TLS, emergencies), Neurology (seizures,
strokes, Parkinson's), and Cardiovascular concepts. Every question includes the correct answer
in bold and a highly detailed clinical rationale to guarantee you master the "why" behind every
concept. Perfect for quick review, active recall, and building testing stamina. Download today
and pass with confidence!
,Question 1
Which of the following interventions is a priority teaching point for a patient prescribed oral
ferrous sulfate?
A) Take the medication with an antacid to decrease gastric upset.
B) Take the medication with orange juice to enhance absorption.
C) Expect stools to become light and clay-colored while taking this drug.
D) Crush the tablet if it is too large to swallow.
Rationale: Vitamin C provides an acidic environment that significantly increases
iron absorption.
Question 2
A patient with iron deficiency anemia is likely to exhibit which of the following laboratory
results?
A) Increased mean corpuscular volume (MCV)
B) Decreased mean corpuscular hemoglobin concentration (MCHC)
C) Elevated serum iron levels
D) Increased total iron-binding capacity (TIBC) with decreased transferrin saturation
Rationale: Iron deficiency results in smaller, paler red blood cells, causing a
decreased MCHC.
Question 3
Which of the following is the primary therapeutic goal of epoetin alfa administration?
A) To stimulate white blood cell production in neutropenic patients
B) To destroy cancer cells in leukemia
C) To elevate hematocrit and hemoglobin levels in patients with chronic kidney disease
D) To decrease platelet aggregation and prevent stroke
Rationale: Epoetin alfa mimics erythropoietin to stimulate RBC production,
thereby treating anemia.
Question 4
Before administering epoetin alfa, the nurse must assess which of the following essential
baseline parameters?
A) Coagulation studies (PT/INR)
B) White blood cell (WBC) count with differential
C) Liver function tests (ALT/AST)
D) Blood pressure and hemoglobin levels
Rationale: Epoetin alfa can cause or exacerbate hypertension and is
contraindicated if hemoglobin is too high.
,Question 5
A patient receiving filgrastim should be closely monitored for which of the following expected
therapeutic outcomes?
A) Decrease in bleeding episodes
B) Increase in neutrophil count
C) Decrease in fatigue and shortness of breath
D) Increase in red blood cell count
Rationale: Filgrastim is a granulocyte colony-stimulating factor that stimulates
the bone marrow to produce neutrophils.
Question 6
Which factor is a common trigger for a sickle cell crisis?
A) Hyperventilation
B) Dehydration
C) Mild to moderate exercise
D) High environmental oxygen levels
Rationale: Dehydration increases blood viscosity, which promotes the sickling of
red blood cells.
Question 7
A patient with sickle cell anemia is prescribed hydroxyurea. The nurse explains that the primary
purpose of this medication is to:
A) Provide pain relief during a vaso-occlusive crisis.
B) Decrease the frequency of sickle cell crises
C) Cure the underlying genetic mutation causing the disease
D) Stimulate the production of normal platelets
Rationale: Hydroxyurea increases the production of fetal hemoglobin (HbF),
which prevents the sickling of RBCs.
Question 8
During a painful vaso-occlusive sickle cell crisis, what is the nurse's primary intervention?
A) Administration of prophylactic antibiotics
B) Fluid restriction to prevent circulatory overload
C) Application of cold compresses to painful joints
D) Administration of opioid analgesics on a scheduled basis
Rationale: Severe pain is the hallmark of a crisis and requires aggressive,
scheduled pain management.
, Question 10
Vitamin B12 deficiency anemia is commonly caused by a lack of:
A) Intrinsic factor
B) Folic acid in the diet
C) Erythropoietin produced by the liver
D) Ascorbic acid
Rationale: Pernicious anemia results from a lack of intrinsic factor, which is
necessary for Vitamin B12 absorption.
Question 11
A patient with Vitamin B12 deficiency may present with which unique clinical manifestation not
typically seen in iron deficiency anemia?
A) Severe fatigue and pallor
B) Koilonychia (spoon-shaped nails)
C) Neurological symptoms such as paresthesias and difficulty walking
D) Glossitis (smooth, beefy-red tongue)
Rationale: Vitamin B12 is essential for nerve myelin maintenance, so its
deficiency causes neurological deficits.
Question 12
Which of the following interventions is the standard treatment for pernicious anemia?
A) Oral folic acid supplementation
B) Daily oral Vitamin B12 tablets
C) Parenteral (IM or SubQ) Vitamin B12 injections
D) Epoetin alfa subcutaneous injections
Rationale: Injections bypass the need for intrinsic factor in the stomach, ensuring
proper absorption.
Question 13
A nurse reviews a complete blood count (CBC) and notes a high mean corpuscular volume
(MCV). This finding is indicative of:
A) Microcytic anemia
B) Normocytic anemia
C) Macrocytic anemia
D) Hypochromic anemia
Rationale: MCV measures the size of RBCs; a high MCV indicates larger than
normal (macrocytic) RBCs.
