Download 2025-2026 NUR 242 MEDICAL SURGICAL EXAMS: EXAM 1, EXAM 2, EXAM 3 AND FINAL EXAM|Qs&As and more Exams Nursing in PDF only on Docsity!
2025 - 2026 NUR 242 MEDICAL SURGICAL EXAMS:
EXAM 1, EXAM 2, EXAM 3 AND FINAL EXAM|ACTUAL
QUESTIONS AND ANSWERS|ALREADY GRADED A+
EXAM 1
A client had part of the ileum surgically removed. The nurse monitors the client closely for anemia based on which rationale? Cobalamin is absorbed in the ileum. The parents of a child with sickle cell anemia (SSA) tell the nurse, "We have never had any symptoms of SSA and do not understand why our child has this problem." Which information will the nurse include when teaching the parents? If both parents are carriers of SSA, there is a 25% chance that offspring will have SSA. When a client develops iron-deficiency anemia, which of the client's laboratory test results would the nurse expect to be decreased? Ferritin level An adolescent child with sickle cell anemia is admitted to the pediatric unit during a vaso-occlusive crisis. Which pathophysiology is correct? Blockage of small blood vessels as a result of clumping of RBCs Which is the most appropriate nursing intervention for an adolescent child with sickle cell anemia? Teaching the family how to limit sickling episodes The nurse is helping an adolescent with iron-deficiency anemia make breakfast meal choices. Which food would the nurse suggest? Bowl of raisin bran
The parent of a child with sickle cell anemia tells the nurse that the family is going camping by a lake in the mountains this summer. The parent inquires what activities are appropriate. Which activity would the nurse suggest? Motorboat rides around the lake The nurse concludes that the teaching about sickle cell anemia has been understood when an adolescent with the disorder makes which statement? "I'll start to have symptoms when I drink less fluid." Which cause of anemia would the nurse recognize as the most common cause of anemia in 1-year-olds? Iron deficiency Which assessment finding would the nurse expect when assessing an 11-month-old infant with iron-deficiency anemia whose hemoglobin is 8 g/dL (80 mmol/L)? Pallor Which education would the nurse provide the parents of a 3-year-old child with sickle cell anemia about splenomegaly during a pain crisis? Triggered by a vasoocclusive crisis Which symptoms would the nurse expect in a 3-year-old child with mild iron- deficiency anemia and fatigue? Increased pulse rate Which iron-rich foods would the nurse recommend for a toddler diagnosed with iron deficiency anemia? Select all that apply. One, some, or all responses may be correct. Chicken, broccoli, lean steak What would the nurse include in the plan of care to minimize the potential for a sickling episode in a child with sickle cell anemia? Promoting adequate oxygenation
A child with sickle cell anemia is admitted to the pediatric unit in a vasoocclusive crisis. Which interventions would be implemented after the pain is under control? Select all that apply. One, some, or all responses may be correct. Rehydration, Oxygen (O 2) therapy A client who has renal failure asks the nurse why anemia keeps recurring. Which reason would the nurse explain to the client? Decrease in erythropoietin Which is the priority nursing intervention to prevent thrombus formation in a child with sickle cell anemia? Encouraging fluids Which common concern of most parents of children with sickle cell anemia would the nurse address at a family education conference? Sharing feelings regarding the transmission of the disorder The nurse is teaching the parents of a child with sickle cell anemia about ways to prevent sickling. Which would the nurse explain as the primary cause of sickling? Hypoxia Which laboratory result in a client who has just been admitted with anemia of unknown etiology requires the most rapid action by the nurse? White blood cell count 950 mm 3 (950 × 10 9/L The nurse assesses a client for the development of pernicious anemia after reviewing the client's history. Which condition did the nurse most likely find in the history? Partial gastrectomy Which instruction would the nurse give to the pregnant client with anemia? Drink orange juice with an iron supplement
Which nursing interventions are most important in the care of an infant with iron- deficiency anemia? Select all that apply. One, some, or all responses may be correct. Conserving the infant's energy, Protecting the infant from infection, Teaching the parents about nutrition The nurse is teaching the parents of a child who is prescribed iron supplements for iron-deficiency anemia. Which food would the nurse encourage to provide to enhance absorption of iron? Orange juice Which foods would the nurse suggest for inclusion in a toddler's diet who has been diagnosed with iron-deficiency anemia? Gingerbread molasses cookies Which assessments beyond the standard would be made at every prenatal visit when the client has sickle cell anemia? Select all that apply. One, some, or all responses may be correct. Evidence of urinary tract infection, Presence of hyperemesis gravidarum Which iron-rich foods would the nurse encourage the client with mild anemia in early pregnancy to eat? Select all that apply. One, some, or all responses may be correct. liver, meats, whole grain or enriched breads, dark green leafy vegetables, legumes, and dried fruits How would the nurse explain physiological anemia to a pregnant client? Plasma volume increases
The nurse provides teaching regarding vitamin B 12 injections to a client with pernicious anemia. Which statement by the client indicates that teaching was understood? I must take this medication for the rest of my life A child with sickle cell anemia is experiencing a painful episode (vaso-occlusive crisis). The nurse assesses the child, obtains the child's vital signs, and reviews the child's laboratory test results. Which is the priority nursing action? O2 is 92% Administering an analgesic A client with sickle cell anemia is experiencing a painful episode (vaso-occlusive crisis) and has a patient-controlled analgesia (PCA) pump. The current pain rating is 5 on a scale of 1 to 10 at the right elbow. The nurse observes that the pump is "locked out" for another 10 minutes. Which action would the nurse implement? Placing the prescribed as-needed warm, wet compress on the elbow A child with sickle cell anemia is admitted to the unit in vasoocclusive crisis (VOC). After the child has been given the prescribed analgesic, which intervention is the priority to minimize the effects of the crisis? Intravenous fluids Which discharge education would the nurse provide the parents of a 3-year-old child with thalassemia (Cooley anemia)? Minimize the risk of infection While counseling the parents of an adolescent with anemia related to an inadequate diet, the nurse explains that several different nutrients, including
protein, iron, and vitamin B 12, are involved. Which other nutrient would the nurse include in the teaching? Folic acid A client is evaluated at a clinic, and the health care provider suspects that the client has anemia and a peptic ulcer. To determine if the client has a peptic ulcer, the nurse expects that which diagnostic test will be performed? Gastric culture A client who is underweight has autoimmune hemolytic anemia that has been unresponsive to corticosteroids. A splenectomy is scheduled. For which complication would the nurse assess the client in the immediate postoperative period? Hemorrhage A client with Crohn disease is admitted to the hospital with a history of chronic, bloody diarrhea, weight loss, and signs of general malnutrition. The client has anemia, a low serum albumin level, and signs of negative nitrogen balance. The nurse concludes that the client's health status is related to which major deficiency? Protein During a period of heavy play activity, a first-grader with a known history of anemia complains of feeling "woozy." Which would be the school nurse's initial response? Sitting the child on a chair until the dizziness subsides Which statement would the nurse include when discharging a school-aged child who underwent a splenectomy for beta-thalassemia (Cooley anemia)? A high fever should be reported to the child's health care provider
The nurse is teaching a pregnant client with sickle cell anemia about the importance of taking supplemental folic acid. Which response by the nurse explains how folic acid would help? "It will promote production of hemoglobin A 37-year-old woman with a history of fibroids and menorrhagia that have not been responsive to hormonal treatments is admitted with severe menorrhagia with resulting anemia. She also has depression and pelvic pain. She is crying and states, "I don't know what to do—my primary health care provider is recommending a hysterectomy, but I haven't had children yet!" Which response would the nurse provide? This must feel so difficult for you. Children are really important to you? A pregnant client with iron-deficiency anemia is prescribed iron supplements daily. To help the client increase iron absorption, the nurse would suggest the client eat foods high in which substance? Vitamin C A pregnant client and her husband tell the nurse they have a 1-year-old daughter with sickle cell anemia, but that they themselves do not have the disease. Which response would correctly answer the clients' question, "Will this baby also have sickle cell anemia?" The chance that another child will have sickle cell anemia is 25%. Which foods will the nurse recommend to a client with iron deficiency anemia? Select all that apply. One, some, or all responses may be correct. Spinach, Beef liver Assessment findings of a client include fatigue, hair loss, weight gain, and diagnostic tests indicating anemia. The nurse anticipates a prescription for which therapy? Levothyroxine
Which laboratory value will the nurse review to determine whether treatment for a client with a megaloblastic anemia has been successful? Folate level When a client who has sickle cell anemia has been admitted with acute chest syndrome, which prescribed treatment would the nurse question? Daily iron supplement The student nurse demonstrates correct understanding of anemia related to chronic disease with which statement Red blood cells (RBCs) are normal in size and color; however, the number of cells produced is decreased." When performing a focused assessment on a client with a possible diagnosis of iron deficiency anemia, which locations would the nurse examine? Select all that apply. One, some, or all responses may be correct. Nail beds, Conjunctivae, Palms of hands When caring for a client with iron-deficiency anemia, which abnormal laboratory value will the nurse expect? Increased total iron-binding capacity (TIBC) After the nurse has finished teaching a client about sickle cell anemia, which statement indicates that the client has a correct understanding of the condition? "I have abnormal hemoglobin." Which type of cytokine is used to treat anemia secondary to chronic kidney disease?
Administer two more doses of PCV A primary health care provider examines an 11-month-old infant and suspects anemia. Which questions would the primary health care provider most likely ask the mother? Select all that apply. One, some, or all responses may be correct. Do you use whole cow's milk? Do you use 2% cow's milk? Do you use alternative milk products? Which child would the nurse consider at risk for beta thalassemia (Cooley anemia)? Two-year-old child of Greek descent with a large abdomen A child is admitted to the pediatric unit with a diagnosis of thalassemia major (Cooley anemia). The parents are told that there is no cure, but that the anemia can be treated with frequent blood transfusions. How do blood transfusions treat children with the diagnosis of thalassemia major? Correct the anemia, but they may cause other problems Which foods will the nurse include when suggesting dietary sources of iron to a client with anemia? Select all that apply. One, some, or all responses may be correct. Boiled spinach, Dried prunes Which dietary choices by a client with iron deficiency anemia indicate that the nurse's dietary teaching has been effective? Select all that apply. One, some, or all responses may be correct. Scrambled eggs, Baked potato, Spinach salad, Dried apricots Which medication is most beneficial to the client with sickle cell anemia on a blood transfusion regimen who has cardiac dysrhythmias due to iron overdose toxicity? Deferoxamine
Which postpartum client is at the highest risk for disseminated intravascular coagulation (DIC)? Gravida I who has had an intrauterine fetal death Which assessment finding indicates that disseminated intravascular coagulation (DIC) is occurring in a postpartum client who has experienced an abruptio placentae? Bleeding at the venipuncture site When a client is admitted to the emergency department with disseminated intravascular coagulation caused by sepsis, which prescribed action will the nurse take first? Draw blood for culture and sensitivity Which finding would the nurse expect when assessing the nasal passages of a client with thrombocytopenia? Blood clots A client who was admitted with a diagnosis of acute lymphoblastic leukemia is receiving chemotherapy. Which assessment findings would alert the nurse to the possible development of thrombocytopenia? Select all that apply. One, some, or all responses may be correct. Melena, Hematuria, Ecchymosis A client receiving chemotherapy develops bone marrow suppression. The nurse will monitor for which thrombocytopenic effect? Select all that apply. One, some, or all responses may be correct. Melena, purpura, hematuria
A postpartum client receiving a continuous heparin infusion for a deep vein thrombosis has an activated partial thromboplastin time (aPTT) of 98 seconds. Which action would the nurse take in response to this situation? Interrupt the infusion and notify the primary health care provider of the APTT result. To prevent excessive bruising when administering subcutaneous heparin, which technique will the nurse employ? Avoid massaging the injection site after the injection A client who has atrial fibrillation with rapid ventricular response is started on a continuous heparin infusion. Which clinical finding enables the nurse to conclude that the heparin therapy is effective? An activated partial thromboplastin time (aPTT) is twice the usual value A client develops thrombophlebitis in the right calf. Bed rest is prescribed, and an intravenous (IV) infusion of heparin is initiated. Which drug action will the nurse include when describing the purpose of this medication to the client? It prevents extension of the clot A client is admitted to the hospital with a diagnosis of deep vein thrombosis, and intravenous (IV) heparin sodium is prescribed. If the client experiences excessive bleeding, which medication will the nurse be prepared to administer? Protamine sulfate A client with a continuous intravenous (IV) heparin drip is prescribed IV vancomycin every 12 hours. Which action will the nurse take when it is time to administer the vancomycin? Start a second IV line for the vancomycin and continue the heparin as prescribed
Warfarin is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both medications are needed at the same time. Which rationale would the nurse include to address the client's concern? Heparin provides anticoagulant effects until warfarin reaches therapeutic levels. The nurse manager is teaching the licensed practical nurse (LPN) the evidence- based practice regarding use of normal saline and low-dose heparin flush solutions for capped angiocatheters. Which statements by the LPN indicate they understood the teaching? Select all that apply. One, some, or all responses may be correct. The use of heparin flushes disappeared in the late 1990s.", The use of high doses of heparin solutions is not recommended in adults. The nurse is administering 5000 units of heparin to a prenatal client on prolonged bed rest. The label indicates there are 20,000 units of heparin in each milliliter of solution. How much solution would the nurse give the client?___ mL 0.25 ml A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects would the nurse anticipate with this medication? Select all that apply. One, some, or all responses may be correct. Osteoporosis, Compression fractures of the spine Which adverse effect of heparin would the nurse assess a client for during pregnancy? Osteoporosis A client needs a continuous intravenous infusion of heparin at a rate of 1000 units per hour. There are 25,000 units of heparin in 500 mL of 5% dextrose solution. The
The nurse provides discharge medication education to a client who has a prescription for warfarin. Which client statement indicates to the nurse that teaching was effective? I will avoid taking aspirin and nonsteroidal anti-inflammatory drugs [NSAIDs]. The international normalized ratio (INR) results of a client receiving warfarin have been variable. Which factor can help the nurse identify the cause of the INR fluctuations Adherence to the prescribed medication regimen Warfarin is prescribed for the client who takes phenytoin for a seizure disorder. Which medication interaction complicates seizure therapy? Warfarin inhibits the metabolism of phenytoin. A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin. Which adverse effect will the nurse identify as a reason for the client to seek medical consultation? Select all that apply. One, some, or all responses may be correct. Hematuria, hemoptysis, Vomiting coffee-ground emesis A client is taking warfarin. If an antidote is needed, which agent will be used? Vitamin K The nurse teaches a client about warfarin and concludes the teaching is effective when the client agrees to avoid which drink? Cranberry juice The nurse teaches the client about appropriate foods to consume when taking warfarin. The nurse evaluates that the client needs further teaching when the client makes which statement?
Dark green leafy vegetables are high in vitamin K, so I should eat them more often. The laboratory report establishes that the client has a warfarin overdose. Which antidote would the nurse anticipate administering? Vitamin K When teaching a client with atrial fibrillation about a new prescription for warfarin, the nurse will include information about which vitamin? Vitamin K When the international normalized ratio (INR) for a client receiving warfarin for venous thrombosis is 4.6, which action will the nurse take? Notify the health care provider of the laboratory results When a staff nurse is instructed by the charge nurse to give the scheduled warfarin dose to a client whose current international normalized ratio (INR) is 6, which action would the staff nurse take first? Remind the charge nurse of the INR result After the nurse provides teaching about diet to a client who has a new prescription for warfarin, which food selected by the client indicates that further teaching may be needed? Spinach salad When a client has a prescription for warfarin, which foods would the nurse teach the client to limit? Select all that apply. One, some, or all responses may be correct. Spinach, Broccoli
