NURS740 Final Exam Guide With
Complete Solution
Sandra is 70 years old and has just been diagnosed with leukemia. She is
complaining of bone and joint pain. Which type of leukemia is most likely the
culprit?
A. Acute lymphoblastic leukemia (ALL)
B. Acute myelogenous leukemia (AML)
C. Chronic myelogenous leukemia (CML)
D. Chronic lymphocytic leukemia (CLL) - ANSWER D. Chronic lymphocytic
leukemia (CLL)
CLL most common in adult > 60
ALL most common in kids
CML most common in middle age
AML most prominent at age 40.
Which type of bone marrow transplant is obtained from an identical twin?
A. Xenograft
B. Autologous
,C. Allogeneic
D. Syngeneic - ANSWER D. Syngeneic
The bone marrow is "harvested" from a donor. It may be an autologous
(aspirated from the pelvic bones of the patient during a remission), an
allogeneic transplant (from a compatible donor such as a parent or sibling
with a similar tissue type), or a syngeneic transplant (from an identical twin).
transplant (from a compatible donor such as a parent or sibling with a similar
tissue type), or a syngeneic transplant (from an identical twin).
During treatment for anaphylaxis, which site is used for the initial injection of
epinephrine?
A. Antecubital vein
B. Abdomen
C. Upper lateral thigh
D. Deltoid - ANSWER C. Upper lateral thigh
• Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg
(0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position
with the head below heart level, if possible.
• Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical
presentation. If hypotensive, position the patient supine with feet elevated.
,• Step 3: Support bronchodilation if patient is without laryngospasm by
administering albuterol 3 mL (2.5 mg) inhalation via nebulizer.
• Step 4: If patient is in laryngospasm or pulmonary arrest, perform
emergency endotracheal intubation and provide respiratory support.
• Step 5: Start IV fluids using normal saline or Ringer's lactate solution to
maintain systolic blood pressure greater than 90 mm Hg. The rate of flow
should be determined by the blood pressure reading but typically may be
bolused.
• Step 6: If the patient is conscious and without laryngospasm, administer
diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms.
H2-blockers may also be added (particularly if GI symptoms are present) but
have not been shown to be as effective as H1-blockers.
• Step 7: Transfer the patient to an acute-care emergency center for
continued support and observation. Add corticosteroids (IV or PO) to prevent
late-phase anaphylactic reactions, which may be as severe as early-phase
reactions.
After the initial treatment for anaphylaxis, which medication should be added
to prevent late-phase anaphylactic reactions?
A. Albuterol
B. Diphenhydramine
C. H2 blocker
D. Corticosteroid - ANSWER D. Corticosteroid
, • Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg
(0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position
with the head below heart level, if possible.
• Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical
presentation. If hypotensive, position the patient supine with feet elevated.
• Step 3: Support bronchodilation if patient is without laryngospasm by
administering albuterol 3 mL (2.5 mg) inhalation via nebulizer.
• Step 4: If patient is in laryngospasm or pulmonary arrest, perform
emergency endotracheal intubation and provide respiratory support.
• Step 5: Start IV fluids using normal saline or Ringer's lactate solution to
maintain systolic blood pressure greater than 90 mm Hg. The rate of flow
should be determined by the blood pressure reading but typically may be
bolused.
• Step 6: If the patient is conscious and without laryngospasm, administer
diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms.
H2-blockers may also be added (particularly if GI symptoms are present) but
have not been shown to be as effective as H1-blockers.
• Step 7: Transfer the patient to an acute-care emergency center for
continued support and observation. Add corticosteroids (IV or PO) to prevent
late-phase anaphylactic reactions, which may be as severe as early-phase
reactions.
When analyzing synovial fluid, if it has 10,000 white blood cells/mcL with
Complete Solution
Sandra is 70 years old and has just been diagnosed with leukemia. She is
complaining of bone and joint pain. Which type of leukemia is most likely the
culprit?
A. Acute lymphoblastic leukemia (ALL)
B. Acute myelogenous leukemia (AML)
C. Chronic myelogenous leukemia (CML)
D. Chronic lymphocytic leukemia (CLL) - ANSWER D. Chronic lymphocytic
leukemia (CLL)
CLL most common in adult > 60
ALL most common in kids
CML most common in middle age
AML most prominent at age 40.
Which type of bone marrow transplant is obtained from an identical twin?
A. Xenograft
B. Autologous
,C. Allogeneic
D. Syngeneic - ANSWER D. Syngeneic
The bone marrow is "harvested" from a donor. It may be an autologous
(aspirated from the pelvic bones of the patient during a remission), an
allogeneic transplant (from a compatible donor such as a parent or sibling
with a similar tissue type), or a syngeneic transplant (from an identical twin).
transplant (from a compatible donor such as a parent or sibling with a similar
tissue type), or a syngeneic transplant (from an identical twin).
During treatment for anaphylaxis, which site is used for the initial injection of
epinephrine?
A. Antecubital vein
B. Abdomen
C. Upper lateral thigh
D. Deltoid - ANSWER C. Upper lateral thigh
• Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg
(0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position
with the head below heart level, if possible.
• Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical
presentation. If hypotensive, position the patient supine with feet elevated.
,• Step 3: Support bronchodilation if patient is without laryngospasm by
administering albuterol 3 mL (2.5 mg) inhalation via nebulizer.
• Step 4: If patient is in laryngospasm or pulmonary arrest, perform
emergency endotracheal intubation and provide respiratory support.
• Step 5: Start IV fluids using normal saline or Ringer's lactate solution to
maintain systolic blood pressure greater than 90 mm Hg. The rate of flow
should be determined by the blood pressure reading but typically may be
bolused.
• Step 6: If the patient is conscious and without laryngospasm, administer
diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms.
H2-blockers may also be added (particularly if GI symptoms are present) but
have not been shown to be as effective as H1-blockers.
• Step 7: Transfer the patient to an acute-care emergency center for
continued support and observation. Add corticosteroids (IV or PO) to prevent
late-phase anaphylactic reactions, which may be as severe as early-phase
reactions.
After the initial treatment for anaphylaxis, which medication should be added
to prevent late-phase anaphylactic reactions?
A. Albuterol
B. Diphenhydramine
C. H2 blocker
D. Corticosteroid - ANSWER D. Corticosteroid
, • Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg
(0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position
with the head below heart level, if possible.
• Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical
presentation. If hypotensive, position the patient supine with feet elevated.
• Step 3: Support bronchodilation if patient is without laryngospasm by
administering albuterol 3 mL (2.5 mg) inhalation via nebulizer.
• Step 4: If patient is in laryngospasm or pulmonary arrest, perform
emergency endotracheal intubation and provide respiratory support.
• Step 5: Start IV fluids using normal saline or Ringer's lactate solution to
maintain systolic blood pressure greater than 90 mm Hg. The rate of flow
should be determined by the blood pressure reading but typically may be
bolused.
• Step 6: If the patient is conscious and without laryngospasm, administer
diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms.
H2-blockers may also be added (particularly if GI symptoms are present) but
have not been shown to be as effective as H1-blockers.
• Step 7: Transfer the patient to an acute-care emergency center for
continued support and observation. Add corticosteroids (IV or PO) to prevent
late-phase anaphylactic reactions, which may be as severe as early-phase
reactions.
When analyzing synovial fluid, if it has 10,000 white blood cells/mcL with
