NRSG 4580 Exam 4 Practice Questions With Complete
Solutions
A client comes into the emergency department reporting an
enlarged tongue. The tongue appears smooth and beefy red in
color. The nurse also observes a 5-cm incision on the upper left
quadrant of the abdomen. When questioned, the client states, "I
had a partial gastrostomy 2 years ago." Based on this
information, the nurse attributes these symptoms to which
problem?
A) Vitamin B12 deficiency
B) Folic acid deficiency
C) Iron deficiency anemia
D) Sickle cell anemia Correct Answer A) Vitamin B12
deficiency
Vitamin B12 combines with intrinsic factor produced in the
stomach. The vitamin B12-intrinsic factor complex is absorbed
in the distal ileum. Clients who have had a partial or total
gastrectomy may have limited amounts of intrinsic factor, and
therefore the absorption of vitamin B12 may be diminished. The
effects of either decreased absorption or decreased intake of
vitamin B12 are not apparent for 2-4 years. This results in
megaloblastic anemia. Some symptoms are a smooth, beefy red,
enlarged tongue and cranial nerve deficiencies.
A client has a known allergy to peanuts, meaning that the
client's immune system has identified peanuts as a foreign
invader and has produced specific cells to attack if the client
,should come in contact with peanuts again. The formation of
these specific cells is known as:
A) Memory response
B) Inflammatory response
C) Humoral response
D) Cell-mediated response Correct Answer C) Humoral
response
The B-cell lymphocytes mature in the bone marrow and migrate
to the spleen and other lymphoid tissues such as the lymph
nodes. When stimulated by T cells, the B cells become either
plasma or memory cells. Plasma cells produce antibodies.
Formation of antibodies is called a humoral response.
A client has been diagnosed with a lymphoid stem cell defect.
This client has the potential for a problem involving which of
the following?
A) Platelets
B) Plasma cells
C) Neutrophils
D) Red blood cells Correct Answer B) Plasma cells
A defect in a myeloid stem cell can cause problems with
erythrocyte, leukocyte, and platelet production. In contrast, a
defect in the lymphoid stem cell can cause problems with T or B
lymphocytes, plasma cells (a more differentiated form of B
lymphocyte), or natural killer (NK) cells.
, A client has been diagnosed with multiple myeloma. Which of
the following laboratory values should the nurse expect to find
in a client with multiple myeloma?
A) Polycythemia vera
B) Increased urinary protein
C) Decreased serum protein
D) Decreased calcium level Correct Answer B) Increased
urinary protein
A characteristic finding in multiple myeloma is protein in the
urine. (RENAL INSUFFICENCY) Other laboratory findings
include increased serum protein, hypercalcemia, anemia, and
hyperuricemia. Polycythemia vera is not found in multiple
myeloma.
A client has been living with seasonal allergies for many years,
but does not take antihistamines, stating, "When I was young I
used to take antihistamines, but they always put me to sleep."
How should the nurse best respond?
A) "Have you considered taking them at bedtime instead of in
the morning?"
B) "Most people find that they develop a tolerance to sedation
after a few months."
C) "Newer antihistamines are combined with a stimulant that
offsets drowsiness."
D) "The newer antihistamines are different than in years past,
and cause less sedation." Correct Answer D) "The newer
antihistamines are different than in years past, and cause less
sedation."
Solutions
A client comes into the emergency department reporting an
enlarged tongue. The tongue appears smooth and beefy red in
color. The nurse also observes a 5-cm incision on the upper left
quadrant of the abdomen. When questioned, the client states, "I
had a partial gastrostomy 2 years ago." Based on this
information, the nurse attributes these symptoms to which
problem?
A) Vitamin B12 deficiency
B) Folic acid deficiency
C) Iron deficiency anemia
D) Sickle cell anemia Correct Answer A) Vitamin B12
deficiency
Vitamin B12 combines with intrinsic factor produced in the
stomach. The vitamin B12-intrinsic factor complex is absorbed
in the distal ileum. Clients who have had a partial or total
gastrectomy may have limited amounts of intrinsic factor, and
therefore the absorption of vitamin B12 may be diminished. The
effects of either decreased absorption or decreased intake of
vitamin B12 are not apparent for 2-4 years. This results in
megaloblastic anemia. Some symptoms are a smooth, beefy red,
enlarged tongue and cranial nerve deficiencies.
A client has a known allergy to peanuts, meaning that the
client's immune system has identified peanuts as a foreign
invader and has produced specific cells to attack if the client
,should come in contact with peanuts again. The formation of
these specific cells is known as:
A) Memory response
B) Inflammatory response
C) Humoral response
D) Cell-mediated response Correct Answer C) Humoral
response
The B-cell lymphocytes mature in the bone marrow and migrate
to the spleen and other lymphoid tissues such as the lymph
nodes. When stimulated by T cells, the B cells become either
plasma or memory cells. Plasma cells produce antibodies.
Formation of antibodies is called a humoral response.
A client has been diagnosed with a lymphoid stem cell defect.
This client has the potential for a problem involving which of
the following?
A) Platelets
B) Plasma cells
C) Neutrophils
D) Red blood cells Correct Answer B) Plasma cells
A defect in a myeloid stem cell can cause problems with
erythrocyte, leukocyte, and platelet production. In contrast, a
defect in the lymphoid stem cell can cause problems with T or B
lymphocytes, plasma cells (a more differentiated form of B
lymphocyte), or natural killer (NK) cells.
, A client has been diagnosed with multiple myeloma. Which of
the following laboratory values should the nurse expect to find
in a client with multiple myeloma?
A) Polycythemia vera
B) Increased urinary protein
C) Decreased serum protein
D) Decreased calcium level Correct Answer B) Increased
urinary protein
A characteristic finding in multiple myeloma is protein in the
urine. (RENAL INSUFFICENCY) Other laboratory findings
include increased serum protein, hypercalcemia, anemia, and
hyperuricemia. Polycythemia vera is not found in multiple
myeloma.
A client has been living with seasonal allergies for many years,
but does not take antihistamines, stating, "When I was young I
used to take antihistamines, but they always put me to sleep."
How should the nurse best respond?
A) "Have you considered taking them at bedtime instead of in
the morning?"
B) "Most people find that they develop a tolerance to sedation
after a few months."
C) "Newer antihistamines are combined with a stimulant that
offsets drowsiness."
D) "The newer antihistamines are different than in years past,
and cause less sedation." Correct Answer D) "The newer
antihistamines are different than in years past, and cause less
sedation."
