NUR 205 | NUR 205 Med Surg Exam 3 Version 3 |
Questions with Correct Answers and Expert
Explanation for Each Question | Saint Paul’s School
of Nursing
1. A patient with iron deficiency anemia is being discharged. Which food choice by the
patient indicates an understanding of the dietary instructions?
A. Whole grain bread and tea
B. Milk and cheese
C. Oranges and fortified cereal
D. Apple juice and white rice
Correct Answer: C
Expert Explanation: Iron deficiency anemia requires the intake of heme and non-
heme iron sources to replenish stores. Oranges provide Vitamin C, which
significantly enhances the absorption of iron from fortified cereals. The nurse must
teach the patient to avoid drinking tea with meals as it can inhibit iron absorption.
Dairy products like milk should be consumed separately from iron-rich foods for
optimal results. Effective dietary management is a cornerstone of long-term
recovery for these patients.
,2. A nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which
action should the nurse take first?
A. Verify the blood type with another registered nurse
B. Start an IV line with 5% Dextrose
C. Hang the blood using a single-lead infusion set
D. Warm the blood in a microwave to prevent chills
Correct Answer: A
Expert Explanation: Safety protocols for blood transfusions require two licensed
professionals to verify the patient and the blood product at the bedside. This step is
critical to prevent life-threatening ABO incompatibility reactions. The nurse must
ensure that only 0.9% normal saline is used to prime the tubing to avoid hemolysis.
Blood should never be warmed in a microwave because it can damage the cells and
cause a reaction. Checking the patient’s identifiers against the blood bag and the
medical record is the highest priority.
3. A patient with sickle cell anemia is admitted in a vaso-occlusive crisis. Which
intervention should the nurse prioritize?
A. Administering intravenous fluids at 200 mL/hr
B. Applying cold compresses to painful joints
C. Encouraging the patient to walk in the hallway
,D. Restricting oral fluid intake to prevent edema
Correct Answer: A
Expert Explanation: Hydration is the primary intervention for a vaso-occlusive
crisis to reduce blood viscosity. Increased fluid intake helps sickled cells flow
through the narrow capillaries more easily. Cold compresses should be avoided
because they cause vasoconstriction and worsen the sickling process. Bed rest is
typically indicated during the acute phase to reduce oxygen demand on the body.
This management strategy aims to alleviate pain and prevent further tissue
ischemia and infarction.
4. The nurse is caring for a patient with a platelet count of 15,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage the use of a firm toothbrush
B. Apply pressure to injection sites for 10 minutes
C. Check the rectal temperature every 4 hours
D. Administer aspirin for mild headaches
Correct Answer: B
Expert Explanation: A platelet count below 20,000/mm³ puts the patient at high
risk for spontaneous and prolonged bleeding. The nurse must apply extended
pressure to any puncture sites to ensure adequate clot formation. Soft-bristled
, toothbrushes should be used to prevent gingival trauma and subsequent
hemorrhage. Rectal temperatures and aspirin are strictly contraindicated because
they increase the risk of internal bleeding. Monitoring for signs of intracranial or
gastrointestinal bleeding is a vital component of safety for these patients.
5. A patient with pernicious anemia asks why they must receive Vitamin B12 injections
instead of oral tablets. What is the nurse’s best response?
A. Your stomach lacks the intrinsic factor needed to absorb Vitamin B12.
B. The injections work faster to increase your energy levels.
C. Oral tablets are too expensive for long-term treatment.
D. Your liver is unable to store Vitamin B12 from food sources.
Correct Answer: A
Expert Explanation: Pernicious anemia is caused by an autoimmune destruction of
gastric parietal cells. These cells produce intrinsic factor, which is essential for the
absorption of Vitamin B12 in the terminal ileum. Without intrinsic factor, oral
supplements are not effectively absorbed into the bloodstream. Therefore, patients
require lifelong intramuscular or deep subcutaneous injections to bypass the
gastrointestinal tract. Educating the patient on the physiological basis of this
requirement improves compliance with therapy.
Questions with Correct Answers and Expert
Explanation for Each Question | Saint Paul’s School
of Nursing
1. A patient with iron deficiency anemia is being discharged. Which food choice by the
patient indicates an understanding of the dietary instructions?
A. Whole grain bread and tea
B. Milk and cheese
C. Oranges and fortified cereal
D. Apple juice and white rice
Correct Answer: C
Expert Explanation: Iron deficiency anemia requires the intake of heme and non-
heme iron sources to replenish stores. Oranges provide Vitamin C, which
significantly enhances the absorption of iron from fortified cereals. The nurse must
teach the patient to avoid drinking tea with meals as it can inhibit iron absorption.
Dairy products like milk should be consumed separately from iron-rich foods for
optimal results. Effective dietary management is a cornerstone of long-term
recovery for these patients.
,2. A nurse is preparing to administer a unit of packed red blood cells (PRBCs). Which
action should the nurse take first?
A. Verify the blood type with another registered nurse
B. Start an IV line with 5% Dextrose
C. Hang the blood using a single-lead infusion set
D. Warm the blood in a microwave to prevent chills
Correct Answer: A
Expert Explanation: Safety protocols for blood transfusions require two licensed
professionals to verify the patient and the blood product at the bedside. This step is
critical to prevent life-threatening ABO incompatibility reactions. The nurse must
ensure that only 0.9% normal saline is used to prime the tubing to avoid hemolysis.
Blood should never be warmed in a microwave because it can damage the cells and
cause a reaction. Checking the patient’s identifiers against the blood bag and the
medical record is the highest priority.
3. A patient with sickle cell anemia is admitted in a vaso-occlusive crisis. Which
intervention should the nurse prioritize?
A. Administering intravenous fluids at 200 mL/hr
B. Applying cold compresses to painful joints
C. Encouraging the patient to walk in the hallway
,D. Restricting oral fluid intake to prevent edema
Correct Answer: A
Expert Explanation: Hydration is the primary intervention for a vaso-occlusive
crisis to reduce blood viscosity. Increased fluid intake helps sickled cells flow
through the narrow capillaries more easily. Cold compresses should be avoided
because they cause vasoconstriction and worsen the sickling process. Bed rest is
typically indicated during the acute phase to reduce oxygen demand on the body.
This management strategy aims to alleviate pain and prevent further tissue
ischemia and infarction.
4. The nurse is caring for a patient with a platelet count of 15,000/mm³. Which nursing
intervention is most appropriate?
A. Encourage the use of a firm toothbrush
B. Apply pressure to injection sites for 10 minutes
C. Check the rectal temperature every 4 hours
D. Administer aspirin for mild headaches
Correct Answer: B
Expert Explanation: A platelet count below 20,000/mm³ puts the patient at high
risk for spontaneous and prolonged bleeding. The nurse must apply extended
pressure to any puncture sites to ensure adequate clot formation. Soft-bristled
, toothbrushes should be used to prevent gingival trauma and subsequent
hemorrhage. Rectal temperatures and aspirin are strictly contraindicated because
they increase the risk of internal bleeding. Monitoring for signs of intracranial or
gastrointestinal bleeding is a vital component of safety for these patients.
5. A patient with pernicious anemia asks why they must receive Vitamin B12 injections
instead of oral tablets. What is the nurse’s best response?
A. Your stomach lacks the intrinsic factor needed to absorb Vitamin B12.
B. The injections work faster to increase your energy levels.
C. Oral tablets are too expensive for long-term treatment.
D. Your liver is unable to store Vitamin B12 from food sources.
Correct Answer: A
Expert Explanation: Pernicious anemia is caused by an autoimmune destruction of
gastric parietal cells. These cells produce intrinsic factor, which is essential for the
absorption of Vitamin B12 in the terminal ileum. Without intrinsic factor, oral
supplements are not effectively absorbed into the bloodstream. Therefore, patients
require lifelong intramuscular or deep subcutaneous injections to bypass the
gastrointestinal tract. Educating the patient on the physiological basis of this
requirement improves compliance with therapy.
