1. A 43-year-old African American male is admitted with sickle cell
anemia. The nurse plans to assess circulation in the lower extrem-
ities every two hours. Which of the following outcome criteria
would the nurse use?
❍ A. Body temperature of 99°F or less
❍ B. Toes moved in active range of motion
❍ C. Sensation reported when soles of feet are touched
❍ D. Capillary refill of < 3 seconds
2. A 30-year-old male from Haiti is brought to the emergency depart-
ment in sickle cell crisis. What is the best position for this client?
❍ A. Side-lying with knees flexed
❍ B. Knee-chest
❍ C. High Fowler’s with knees flexed
❍ D. Semi-Fowler’s with legs extended on the bed
3. A 25-year-old male is admitted in sickle cell crisis. Which of the
following interventions would be of highest priority for this client?
❍ A. Taking hourly blood pressures with mechanical cuff
❍ B. Encouraging fluid intake of at least 200mL per hour
❍ C. Position in high Fowler’s with knee gatch raised
❍ D. Administering Tylenol as ordered
4. Which of the following foods would the nurse encourage the client
in sickle cell crisis to eat?
❍ A. Steak
❍ B. Cottage cheese
❍ C. Popsicle
❍ D. Lima beans
5. A newly admitted client has sickle cell crisis. He is complaining of
pain in his feet and hands. The nurse’s assessment findings
include a pulse oximetry of 92. Assuming that all the following
interventions are ordered, which should be done first?
❍ A. Adjust the room temperature
❍ B. Give a bolus of IV fluids
❍ C. Start O2
❍ D. Administer meperidine (Demerol) 75mg IV push
6. The nurse is instructing a client with iron-deficiency anemia.
Which of the following meal plans would the nurse expect the
client to select?
❍ A. Roast beef, gelatin salad, green beans, and peach pie
❍ B. Chicken salad sandwich, coleslaw, French fries, ice
cream
, ❍ C. Egg salad on wheat bread, carrot sticks, lettuce salad,
raisin pie
❍ D. Pork chop, creamed potatoes, corn, and coconut cake
7. Clients with sickle cell anemia are taught to avoid activities that
cause hypoxia and hypoxemia. Which of the following activities
would the nurse recommend?
❍ A. A family vacation in the Rocky Mountains
❍ B. Chaperoning the local boys club on a snow-skiing trip
❍ C. Traveling by airplane for business trips
❍ D. A bus trip to the Museum of Natural History
8. The nurse is conducting an admission assessment of a client with
vitamin B12 deficiency. Which finding reinforces the diagnosis of
B12 deficiency?
❍ A. Enlarged spleen
❍ B. Elevated blood pressure
❍ C. Bradycardia
❍ D. Beefy tongue
9. The body part that would most likely display jaundice in the dark-
skinned individual is the:
❍ A. Conjunctiva of the eye
❍ B. Soles of the feet
❍ C. Roof of the mouth
❍ D. Shins
10. The nurse is conducting a physical assessment on a client with
anemia. Which of the following clinical manifestations would be
most indicative of the anemia?
❍ A. BP 146/88
❍ B. Respirations 28 shallow
❍ C. Weight gain of 10 pounds in six months
❍ D. Pink complexion
11. The nurse is teaching the client with polycythemia vera about pre-
vention of complications of the disease. Which of the following
statements by the client indicates a need for further teaching?
❍ A. “I will drink 500mL of fluid or less each day.”
❍ B. “I will wear support hose.”
❍ C. “I will check my blood pressure regularly.”
❍ D. “I will report ankle edema.”
12. A 33-year-old male is being evaluated for possible acute leukemia.
Which of the following findings is most likely related to the diag-
nosis of leukemia?
❍ A. The client collects stamps as a hobby.
❍ B. The client recently lost his job as a postal worker.
❍ C. The client had radiation for treatment of Hodgkin’s dis-
ease as a teenager.
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