NSG 212 UNIT 5 EXAM MEDICAL-SURGICAL NURSING
COMPLETE EXAM QUESTIONS WITH 100% VERIFIED ANSWERS
Question 1
A client has a platelet count of 18,000. What intervention does the
nurse include in the plan of care?
A) Institute reverse isolation (neutropenic precautions)
B) Obtain temperature axillary
C) Change IM injections to sub-Q
D) Monitor closely for altered mental status
Correct Answer: D) Monitor closely for altered mental status
Explanation: A platelet count of 18,000 indicates severe
thrombocytopenia. Altered mental status could indicate intracranial
bleeding, which is a life-threatening emergency. Axillary temperatures
are still safe. IM injections should be avoided entirely, not just changed
to sub-Q.
Question 2
The nurse is caring for a client with acute myelocytic leukemia who is in
week 3 of induction chemotherapy. Which is the priority diagnosis?
A) Activity intolerance
B) Ineffective coping
C) Risk for infection
D) Altered skin integrity-oral
,Correct Answer: C) Risk for infection
Explanation: During induction chemotherapy, the bone marrow is
suppressed, leading to neutropenia. The client is at high risk for life-
threatening infection. This is the priority over activity intolerance,
coping, and oral mucositis.
Question 3
A client with polycythemia vera is admitted with chest pain and SOB.
Based on provided orders, the nurse should prepare to perform which
task first?
A) Administer Allopurinol
B) Assess lung sounds
C) Schedule for phlebotomy with apheresis
D) Administer hydroxyurea
Correct Answer: C) Schedule for phlebotomy with apheresis
Explanation: Polycythemia vera causes increased blood viscosity,
leading to thrombosis. Chest pain and SOB may indicate pulmonary
embolism or myocardial infarction. Phlebotomy rapidly reduces blood
viscosity and is the priority.
Question 4
Which task would the RN on an oncology unit delegate to the LPN?
A) Reinforce teaching to a client about non-pharm pain relief
B) Admission assessment of a client admitted with a sickle cell crisis
C) Pre-procedure teaching to a client about to have a bone marrow
biopsy
D) Administration of 1 unit of PRBCs
,Correct Answer: A) Reinforce teaching to a client about non-pharm
pain relief
Explanation: The LPN can reinforce teaching that has already been
initiated by the RN. Admission assessment, pre-procedure teaching, and
blood transfusion administration (in most facilities) require RN scope of
practice.
Question 5
The nurse is caring for a client immediately after a bone marrow biopsy.
What is the nurse's priority intervention?
A) Instruct the client to keep site dry for 24 hours
B) Apply pressure to the site
C) Assess the client's temperature
D) Apply a Vaseline gauze dressing
Correct Answer: B) Apply pressure to the site
Explanation: After bone marrow biopsy, the priority is hemostasis.
Applying pressure prevents bleeding. The client may have
coagulopathies from their underlying condition, making bleeding risk
significant.
Question 6
The nurse determines that a client is experiencing a left shift with which
lab trend?
A) Increased bands
B) Increased reticulocytes
C) Increased eosinophils
D) Increased basophils
Correct Answer: A) Increased bands
, Explanation: A left shift refers to an increased number of immature
neutrophils (bands) in the blood, indicating the bone marrow is
responding to infection by releasing immature cells before they are fully
mature.
Question 7
A community health nurse is teaching health promotion to a group of
new retirees. Which fact indicates a warning sign of cancer?
A) Changes in hair color and texture
B) Occasional constipation
C) A sore or lesion that does not heal
D) A decrease in thirst sensation
Correct Answer: C) A sore or lesion that does not heal
Explanation: A non-healing sore or lesion is a classic warning sign of
cancer (CAUTION mnemonic). Changes in hair color, occasional
constipation, and decreased thirst are not specific cancer warning signs.
Question 8
A client is diagnosed with high grade lung cancer. How does the nurse
describe this to the client?
A) The cancer has a high chance for cure
B) The cancer tumor size is small
C) The cancer tumor size is large
D) This cancer is resistant to treatment
Correct Answer: D) This cancer is resistant to treatment
Explanation: High grade cancers are poorly differentiated, aggressive,
and more resistant to treatment. They grow and spread rapidly. Grade
refers to differentiation, not size.
COMPLETE EXAM QUESTIONS WITH 100% VERIFIED ANSWERS
Question 1
A client has a platelet count of 18,000. What intervention does the
nurse include in the plan of care?
A) Institute reverse isolation (neutropenic precautions)
B) Obtain temperature axillary
C) Change IM injections to sub-Q
D) Monitor closely for altered mental status
Correct Answer: D) Monitor closely for altered mental status
Explanation: A platelet count of 18,000 indicates severe
thrombocytopenia. Altered mental status could indicate intracranial
bleeding, which is a life-threatening emergency. Axillary temperatures
are still safe. IM injections should be avoided entirely, not just changed
to sub-Q.
Question 2
The nurse is caring for a client with acute myelocytic leukemia who is in
week 3 of induction chemotherapy. Which is the priority diagnosis?
A) Activity intolerance
B) Ineffective coping
C) Risk for infection
D) Altered skin integrity-oral
,Correct Answer: C) Risk for infection
Explanation: During induction chemotherapy, the bone marrow is
suppressed, leading to neutropenia. The client is at high risk for life-
threatening infection. This is the priority over activity intolerance,
coping, and oral mucositis.
Question 3
A client with polycythemia vera is admitted with chest pain and SOB.
Based on provided orders, the nurse should prepare to perform which
task first?
A) Administer Allopurinol
B) Assess lung sounds
C) Schedule for phlebotomy with apheresis
D) Administer hydroxyurea
Correct Answer: C) Schedule for phlebotomy with apheresis
Explanation: Polycythemia vera causes increased blood viscosity,
leading to thrombosis. Chest pain and SOB may indicate pulmonary
embolism or myocardial infarction. Phlebotomy rapidly reduces blood
viscosity and is the priority.
Question 4
Which task would the RN on an oncology unit delegate to the LPN?
A) Reinforce teaching to a client about non-pharm pain relief
B) Admission assessment of a client admitted with a sickle cell crisis
C) Pre-procedure teaching to a client about to have a bone marrow
biopsy
D) Administration of 1 unit of PRBCs
,Correct Answer: A) Reinforce teaching to a client about non-pharm
pain relief
Explanation: The LPN can reinforce teaching that has already been
initiated by the RN. Admission assessment, pre-procedure teaching, and
blood transfusion administration (in most facilities) require RN scope of
practice.
Question 5
The nurse is caring for a client immediately after a bone marrow biopsy.
What is the nurse's priority intervention?
A) Instruct the client to keep site dry for 24 hours
B) Apply pressure to the site
C) Assess the client's temperature
D) Apply a Vaseline gauze dressing
Correct Answer: B) Apply pressure to the site
Explanation: After bone marrow biopsy, the priority is hemostasis.
Applying pressure prevents bleeding. The client may have
coagulopathies from their underlying condition, making bleeding risk
significant.
Question 6
The nurse determines that a client is experiencing a left shift with which
lab trend?
A) Increased bands
B) Increased reticulocytes
C) Increased eosinophils
D) Increased basophils
Correct Answer: A) Increased bands
, Explanation: A left shift refers to an increased number of immature
neutrophils (bands) in the blood, indicating the bone marrow is
responding to infection by releasing immature cells before they are fully
mature.
Question 7
A community health nurse is teaching health promotion to a group of
new retirees. Which fact indicates a warning sign of cancer?
A) Changes in hair color and texture
B) Occasional constipation
C) A sore or lesion that does not heal
D) A decrease in thirst sensation
Correct Answer: C) A sore or lesion that does not heal
Explanation: A non-healing sore or lesion is a classic warning sign of
cancer (CAUTION mnemonic). Changes in hair color, occasional
constipation, and decreased thirst are not specific cancer warning signs.
Question 8
A client is diagnosed with high grade lung cancer. How does the nurse
describe this to the client?
A) The cancer has a high chance for cure
B) The cancer tumor size is small
C) The cancer tumor size is large
D) This cancer is resistant to treatment
Correct Answer: D) This cancer is resistant to treatment
Explanation: High grade cancers are poorly differentiated, aggressive,
and more resistant to treatment. They grow and spread rapidly. Grade
refers to differentiation, not size.
