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N255C Adult Health II Exam 1 Practice Questions and Answers
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N255C Adult Health II Exam 1Practice Questions and Answers
The healthcare provider is reviewing a patient's laboratory results and notes
the hemoglobin is 9 g/dL (90g/L) and the hematocrit is 28% (0.28). Which of
the following orders will the healthcare provider expect to implement first.
A) Administer cyanocobalamin (B12) IM.
B) Type and crossmatch for a blood transfusion.
C) Draw blood for RBC indices (e.g., MCV, MCH, MCHC).
D) Administer PO ferrous sulfate (iron). - -C) Draw blood for RBC indices
(e.g., MCV, MCH, MCHC).
Rationale: The Hgb and Hct are below normal limits.
A) You do not know if this pt has pernicious anemia in order to treat it with
B12
B) Blood transfusions are indicated when Hgb is < 7 and the pt is
symptomatic
D) You do not know if this pt has iron deficiency anemia to treat it with
ferrous sulfate.
Vocab:
- Hgb are blood cells that transport O2 and make RBCs red (Normal values =
Female 11.7-16.0 g/dL;
Male 13.2-17.3 g/dL)
- Hct is the proportion of Hbg in blood (Normal values = Female 35-47%;
Male 39-50%)
- Mean corpuscular volume (MCV) is the RCB volume.
- Mean corpuscular Hgb (MCH) is the RBC weight.
- Mean corpuscular Hgb saturation (MCHC) is the RCB color (↑ Hgb = more
color)
-The healthcare provider is planning are for four patients. Which patient is
MOST in need of interventions aimed at preventing anemia? The patient...
A) who is vegetarian
B) with a Jackson-Pratt drain
C) with renal failure on hemodialysis
D) who has been NPO for 3 days - -C) with renal failure on hemodialysis
Rationale: All of these are risk factors. However, chronic disease (renal
failure included) is one risk factor for anemia. Combining that with dialysis
which puts RBCs at risk of hemolysis, C is the correct answer.
, -The healthcare provider is seeing four patients at the neighborhood clinic.
Which of these patients should the healthcare provider identify to be most at
risk for iron-deficiency anemia?
A) The patient who has a diagnosis of chronic renal failure.
B) The woman of childbearing age reporting a craving for ice.
C) The obese patient with a history of gastric bypass surgery.
D) The patient who follows a strict vegan diet - -B) The woman of
childbearing age reporting a craving for ice.
Rationale: Etiologies of iron deficiency anemia include chronic blood loss (GI
bleed, menstruation),
inadequate intake or absorption, drugs (may interfere with normal fx like
chemo), and increased energy demand.
A) Renal disease risks tendency for bleeding
C) Gastric bypass surgery risks acquired hemolytic anemia.
D) Vegans are at risk of Vit B12 anemia
-The healthcare provider is teaching an adolescent patient how to include
iron-rich foods in the diet. Which of these, if selected by the patient, would
indicate correct understanding of the teaching?
A) Dark green vegetables
B) Oranges
C) Yogurt
D) Bananas - -A) Dark green vegetables
Rationale: A is the only food listed indicated for any kind of anemia. But, it is
specific to iron deficiency anemia
-A patient receiving a blood transfusion complains of a headache. Which
action should the health professional take first?
A) Stop the infusion
B) Continue the infusion rate as ordered
C) Call for help
D) Administer pain medication - -A) Stop the infusion
Rationale: If any new sx arise after beginning a transfusion, immediately stop
the transfusion.
-On the second postoperative day, the healthcare provider notes the
patient's hemoglobin has remained steady but the hematocrit has decreased
from 48% (0.48) to 46% (0.46). Which intervention is most appropriate for
the healthcare provider to implement?
A) Check the surgical site for increased bleeding
B) Administer oxygen at 2 L/min
C) Increase the IV flow rate
D) Continue to monitor the patient - -D) Continue to monitor the patient
,Rationale: This Hct level is within normal limits (Female 35-47%; Male 39-
50%).
A) If the pt was bleeding, Hgb would fall as well
B) O2 isn't indicated for decreases in Hct
C) You need a physicians order to manipulate IV flow rate
-The healthcare provider is teaching parents of a child who has a diagnosis
of iron-deficiency anemia how to increase their child's absorption of dietary
iron. Which of these supplements should the healthcare provider
recommend?
A) Vitamin D
B) Folic Acid
C) Vitamin C
D) Vitamin B12 - -C) Vitamin C
Rationale: Iron deficiency anemia may be causes by inadequate absorption
of iron. Vitamin C aids iron absorption.
-A 55-year-old male has a myocardial infarction requiring admission to the
hospital. He is being treated with an anticoagulant. The healthcare provider
would be most concerned about which of the following:
A) Purpura
B) Trouble sleeping
C) An elevated creatinine
D) Nausea - -A) Purpura
Rationale: Anticoagulant therapy puts a pt at risk of bleeding, and therefore
a reduction in platelets. Purpura are large purple bruises that can occur with
thrombocytopenia (low platelet count).
-Which of these would be most important to include in discharge teaching
for a patient with a platelet count of 40,000 mcL?
A) You may resume shaving with a straight edge razor
B) You should take a multivitamin daily
C) Be sure to take your aspirin with meals daily
D) Use a soft toothbrush and floss gently - -D) Use a soft toothbrush and
floss gently
Rationale: Normal limits for platelet count is 150,000-400,000 mcL. With
thrombocytopenia, nursing care includes preventing injury that can cause
bleeding and avoiding aspirin and garlic.
-A patient is receiving ferrous sulfate to treat iron-deficiency anemia. When
reviewing the laboratory report, the healthcare provider notes the patient's
, reticulocyte count has increased. How should the healthcare provider
interpret these findings?
A) The ferrous sulfate dosage should be increased
B) The ferrous sulfate dosage should be discontinued
C) The patient is not responding to treatment
D) The patient is beginning to recover from the anemia - -D) The patient is
beginning to recover from the anemia
Rationale: Reticulocytes are immature RBCs. An increase in number indicates
blood loss or anemia recovery.
-Newborns are protected for the first 6 months of life from some bacterial
infections due to maternal transmission of which type of antibodies?
A) IgM
B) IgD
C) IgE
D) IgG - -B) IgD
Rationale: IgD is a class of immunoglobulin that are a differentiation of B
cells. They primary activate B cells to begin an immune response but also
have a role in protection against pathogenic bacteria and viruses
A) IgM are primary antibodies released at every antigen exposure
C) IgE are antibodies that cause allergic reactions
D) IgG can cross the placenta, but are secondary antibodies that react to
other human cell antigens and can form immune complexes.
Vocab:
- Immunoglobulins = antibodies
- B cell = lymphocyte that makes antibodies against specific antigens
- Antibody-mediated (humoral) immunity response = B cells create
antibodies and memory T cells to the specific antigen to create sustained
immunity to the antigen
-Which statement by the client supports the diagnosis of myasthenia gravis
(MG)?
A) "I get chest pain and faint after I walk in the hall."
B) "I gained 3 pounds this week, and I am spitting up pink frothy sputum."
C) "My eyelids droop, and I see double everything."
D) "I have weakness and fatigue in my feet and legs." - -C) "My eyelids
droop, and I see double everything."
Rationale: MG is an organ-specific autoimmune disorder characterized by
muscle weakness that ↑ during activity & improves after rest. Early sx of MG
are ptosis (droopy eyelids) and diplopia (blurry or double vision)
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