1
Test bank for medical surgical
nursing 6th edition by
stromberg Chapter 1- 49
1. A nurse is reviewing the hematologic test results for a patient in whom the hematocrit
(Hct) is reported at a reading of 30%. Based on this result, the nurse should interpret that the
patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an inflammatory response.
D. is experiencing an acute hemolytic crisis.
- ANS :B. has fewer red blood cells than normal.The Hct is the measure of the volume of red
blood cells in whole blood expressed as a percentage. This test is useful in the diagnosis of
anemia, polycythemia, and abnormal hydration states. Patients who are susceptible to
bleeding disorders likely will have a low platelet count. The inflammatory response may best
be evaluated by examination of results that include the white blood cell count with
differential analysis. Acute hemolytic crisis develops in patients receiving blood components
in which incompatibility occurs or in patients with bleeding disorders or conditions that
promote cellular damage, such as damage associated with shock.
2. Which of the following is a factor significant in the development of anemia in men?
A. Condom use
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B. Large hemorrhoids
C. A diet high in cholesterol
D. Smoking one pack of cigarettes daily - ANS :B. Large hemorrhoids Gastrointestinal (GI)
tract bleeding is a common etiologic factor in men and may result from peptic ulcers, hiatal
hernia, gastritis, cancer, hemorrhoids, diverticula, ulcerative colitis, or salicylate poisoning.
3. Following a patient's bone marrow aspiration, which of the following nursing
interventions should a nurse anticipate?
A. Application of firm pressure to the site B. Positioning the patient in a prone position
C. Positioning the patient in a supine position
D. Application of a warm, moist compress to the site - ANS :A. Application of firm pressure to
the site After a bone marrow aspiration procedure, a nurse should apply pressure to the
aspiration site until bleeding stops. Application of a warm, moist compress will not alter the
potential for bleeding. Positioning the patient to assume a supine or prone position also will
not address the need to control bleeding from the aspiration site.
4. The nurse is teaching a patient who is to undergo bone marrow aspiration. Which of the
following statements made by the nurse would indicate correct instruction regarding the
site for the aspiration procedure?
A. "The health care provider will perform the aspiration by needle to the femur."
B. "The health care provider will perform the aspiration by needle to the scapula." C. "The
health care provider will perform the aspiration by needle to the antecubital fossa."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest." - ANS :D. "The health care provider will perform the aspiration by needle to the
posterior iliac crest." Bone marrow samples are commonly taken from the posterior iliac
crest or, as an alternative, the sternum may be aspirated. These sites provide relative ease in
accessing the bone marrow via the biopsy needle. The antecubital fossa, femur, and scapula
do not allow access to bone marrow while also providing reduced risk of harm to the
patient.
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5. Absorption of vitamin B12 may be decreased in older adults because of decreased
A. intestinal motility.
B. production of bile by the liver.
C. production of intrinsic factor by the stomach.
D. synthesis of cobalamin (vitamin B12) by intestinal bacteria. - ANS :C. production of intrinsic
factor by the stomach. Older persons are at risk for deficiency of cobalamin (pernicious
anemia) because of a naturally occurring reduction of the intrinsic factor by the stomach
mucosa. Absorption of cobalamin relies on intrinsic factor. Both must be present for
absorption. Megaloblastic anemia is related to folate dysfunction. Intestinal motility
(peristalsis) is the motion that moves food down the GI tract. The rhythmic contractions of
muscles cause wave-like motions. Lack of peristalsis is called "paralytic ileus." Bile is
produced in the liver, is stored and concentrated in the gallbladder, and is released into the
duodenum when fat is eaten. Bile emulsifies fats and prepares them for enzyme digestion in
order for the nutrient to be absorbed into lymph and eventually into blood vessels to the
liver. Vitamin K (the blood-clotting vitamin) is synthesized by intestinal bacteria.
6. What type of anemia is associated with folate deficiency?
A. Microcytic
B. Pernicious
C. Megaloblastic
D. Iron deficiency - ANS :C. Megaloblastic Megaloblastic anemia is nutritional anemia; large
immature red blood cells with a decreased oxygen-carrying capacity can occur as a result of
impaired DNA synthesis. Folic acid is used in the synthesis of DNA and helps convert B12 to
coenzyme form. Folic acid is needed for growth and development of red blood cells.
Microcytic anemia is anemia with abnormally small erythrocytes (red blood cells) in Hb. This
anemia is associated with vitamin B6 (pyridoxine) deficiency. Pernicious anemia is caused by
a deficiency of vitamin B12. Iron-deficiency anemia results from loss of blood or deficient
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intake of iron foods or disease states in which the body does not absorb or utilize iron as it
should.
7. During care of a patient with multiple myeloma, an important nursing intervention is
A. limiting activity to prevent pathologic fractures.
B. assessing for changes in size and characteristics of lymph nodes.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load.
D. administering narcotic analgesics continuously to control bone pain. - ANS :C. maintaining
a fluid intake of 3 to 4 L/day to dilute calcium load. Adequate hydration must be maintained
to minimize problems from hypercalcemia. The goal of a urinary output of 1.5 to 2 L/day
requires an intake of 3 to 4 L/day.
8. While obtaining the admission assessment data, which of the following characteristics
would a nurse expect a patient with anemia to report?
A. Palpitations
B. Blurred vision
C. Increased appetite
D. Feeling of warm flushing sensation - ANS :A. Palpitations Patients experiencing moderate
anemia (hemoglobin [Hb] 6 to 10 g/dL) may experience dyspnea (shortness of breath),
palpitations, diaphoresis (profound perspiration) with exertion, and chronic fatigue. Blurred
vision is associated in patients experiencing profound anemia states. Anorexia is common in
patients with severe anemia, as well. Patients with anemia often appear pale and complain
of feeling cold because of compensatory vasoconstriction of the subcutaneous capillaries.
9. If a health care provider is planning to transfuse a patient with a unit of packed red blood
cells, which of the following solutions should the health care provider hang with the
transfusion?
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Test bank for medical surgical
nursing 6th edition by
stromberg Chapter 1- 49
1. A nurse is reviewing the hematologic test results for a patient in whom the hematocrit
(Hct) is reported at a reading of 30%. Based on this result, the nurse should interpret that the
patient
A. is susceptible to bleeding disorders.
B. has fewer red blood cells than normal. C. is experiencing an inflammatory response.
D. is experiencing an acute hemolytic crisis.
- ANS :B. has fewer red blood cells than normal.The Hct is the measure of the volume of red
blood cells in whole blood expressed as a percentage. This test is useful in the diagnosis of
anemia, polycythemia, and abnormal hydration states. Patients who are susceptible to
bleeding disorders likely will have a low platelet count. The inflammatory response may best
be evaluated by examination of results that include the white blood cell count with
differential analysis. Acute hemolytic crisis develops in patients receiving blood components
in which incompatibility occurs or in patients with bleeding disorders or conditions that
promote cellular damage, such as damage associated with shock.
2. Which of the following is a factor significant in the development of anemia in men?
A. Condom use
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, 2
B. Large hemorrhoids
C. A diet high in cholesterol
D. Smoking one pack of cigarettes daily - ANS :B. Large hemorrhoids Gastrointestinal (GI)
tract bleeding is a common etiologic factor in men and may result from peptic ulcers, hiatal
hernia, gastritis, cancer, hemorrhoids, diverticula, ulcerative colitis, or salicylate poisoning.
3. Following a patient's bone marrow aspiration, which of the following nursing
interventions should a nurse anticipate?
A. Application of firm pressure to the site B. Positioning the patient in a prone position
C. Positioning the patient in a supine position
D. Application of a warm, moist compress to the site - ANS :A. Application of firm pressure to
the site After a bone marrow aspiration procedure, a nurse should apply pressure to the
aspiration site until bleeding stops. Application of a warm, moist compress will not alter the
potential for bleeding. Positioning the patient to assume a supine or prone position also will
not address the need to control bleeding from the aspiration site.
4. The nurse is teaching a patient who is to undergo bone marrow aspiration. Which of the
following statements made by the nurse would indicate correct instruction regarding the
site for the aspiration procedure?
A. "The health care provider will perform the aspiration by needle to the femur."
B. "The health care provider will perform the aspiration by needle to the scapula." C. "The
health care provider will perform the aspiration by needle to the antecubital fossa."
D. "The health care provider will perform the aspiration by needle to the posterior iliac
crest." - ANS :D. "The health care provider will perform the aspiration by needle to the
posterior iliac crest." Bone marrow samples are commonly taken from the posterior iliac
crest or, as an alternative, the sternum may be aspirated. These sites provide relative ease in
accessing the bone marrow via the biopsy needle. The antecubital fossa, femur, and scapula
do not allow access to bone marrow while also providing reduced risk of harm to the
patient.
P a g e 2 | 294
, 3
5. Absorption of vitamin B12 may be decreased in older adults because of decreased
A. intestinal motility.
B. production of bile by the liver.
C. production of intrinsic factor by the stomach.
D. synthesis of cobalamin (vitamin B12) by intestinal bacteria. - ANS :C. production of intrinsic
factor by the stomach. Older persons are at risk for deficiency of cobalamin (pernicious
anemia) because of a naturally occurring reduction of the intrinsic factor by the stomach
mucosa. Absorption of cobalamin relies on intrinsic factor. Both must be present for
absorption. Megaloblastic anemia is related to folate dysfunction. Intestinal motility
(peristalsis) is the motion that moves food down the GI tract. The rhythmic contractions of
muscles cause wave-like motions. Lack of peristalsis is called "paralytic ileus." Bile is
produced in the liver, is stored and concentrated in the gallbladder, and is released into the
duodenum when fat is eaten. Bile emulsifies fats and prepares them for enzyme digestion in
order for the nutrient to be absorbed into lymph and eventually into blood vessels to the
liver. Vitamin K (the blood-clotting vitamin) is synthesized by intestinal bacteria.
6. What type of anemia is associated with folate deficiency?
A. Microcytic
B. Pernicious
C. Megaloblastic
D. Iron deficiency - ANS :C. Megaloblastic Megaloblastic anemia is nutritional anemia; large
immature red blood cells with a decreased oxygen-carrying capacity can occur as a result of
impaired DNA synthesis. Folic acid is used in the synthesis of DNA and helps convert B12 to
coenzyme form. Folic acid is needed for growth and development of red blood cells.
Microcytic anemia is anemia with abnormally small erythrocytes (red blood cells) in Hb. This
anemia is associated with vitamin B6 (pyridoxine) deficiency. Pernicious anemia is caused by
a deficiency of vitamin B12. Iron-deficiency anemia results from loss of blood or deficient
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, 4
intake of iron foods or disease states in which the body does not absorb or utilize iron as it
should.
7. During care of a patient with multiple myeloma, an important nursing intervention is
A. limiting activity to prevent pathologic fractures.
B. assessing for changes in size and characteristics of lymph nodes.
C. maintaining a fluid intake of 3 to 4 L/day to dilute calcium load.
D. administering narcotic analgesics continuously to control bone pain. - ANS :C. maintaining
a fluid intake of 3 to 4 L/day to dilute calcium load. Adequate hydration must be maintained
to minimize problems from hypercalcemia. The goal of a urinary output of 1.5 to 2 L/day
requires an intake of 3 to 4 L/day.
8. While obtaining the admission assessment data, which of the following characteristics
would a nurse expect a patient with anemia to report?
A. Palpitations
B. Blurred vision
C. Increased appetite
D. Feeling of warm flushing sensation - ANS :A. Palpitations Patients experiencing moderate
anemia (hemoglobin [Hb] 6 to 10 g/dL) may experience dyspnea (shortness of breath),
palpitations, diaphoresis (profound perspiration) with exertion, and chronic fatigue. Blurred
vision is associated in patients experiencing profound anemia states. Anorexia is common in
patients with severe anemia, as well. Patients with anemia often appear pale and complain
of feeling cold because of compensatory vasoconstriction of the subcutaneous capillaries.
9. If a health care provider is planning to transfuse a patient with a unit of packed red blood
cells, which of the following solutions should the health care provider hang with the
transfusion?
P a g e 4 | 294
