Final Exam NURS740 Practice Questions and Answers

Final Exam NURS740 Practice Questions and Answers Sandra is 70 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit? A. Acute lymphoblastic leukemia (ALL) B. Acute myelogenous leukemia (AML) C. Chronic myelogenous leukemia (CML) D. Chronic lymphocytic leukemia (CLL) - Ans:-D. Chronic lymphocytic leukemia (CLL) CLL most common in adult 60 ALL most common in kids CML most common in middle age AML most prominent at age 40. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/112 Which type of bone marrow transplant is obtained from an identical twin? A. Xenograft B. Autologous C. Allogeneic D. Syngeneic - Ans:-D. Syngeneic The bone marrow is "harvested" from a donor. It may be an autologous (aspirated from the pelvic bones of the patient during a remission), an allogeneic transplant (from a compatible donor such as a parent or sibling with a similar tissue type), or a syngeneic transplant (from an identical twin). transplant (from a compatible donor such as a parent or sibling with a similar tissue type), or a syngeneic transplant (from an identical twin). During treatment for anaphylaxis, which site is used for the initial injection of epinephrine? A. Antecubital vein B. Abdomen C. Upper lateral thigh D. Deltoid - Ans:-C. Upper lateral thigh ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/112 • Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg (0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position with the head below heart level, if possible. • Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical presentation. If hypotensive, position the patient supine with feet elevated. • Step 3: Support bronchodilation if patient is without laryngospasm by administering albuterol 3 mL (2.5 mg) inhalation via nebulizer. • Step 4: If patient is in laryngospasm or pulmonary arrest, perform emergency endotracheal intubation and provide respiratory support. • Step 5: Start IV fluids using normal saline or Ringer's lactate solution to maintain systolic blood pressure greater than 90 mm Hg. The rate of flow should be determined by the blood pressure reading but typically may be bolused. • Step 6: If the patient is conscious and without laryngospasm, administer diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms. H2-blockers may also be added (particularly if GI symptoms are present) but have not been shown to be as effective as H1-blockers. • Step 7: Transfer the patient to an acute-care emergency center for continued support and observation. Add corticosteroids (IV or PO) to prevent late-phase anaphylactic reactions, which may be as severe as early-phase reactions. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/112 After the initial treatment for anaphylaxis, which medication should be added to prevent late-phase anaphylactic reactions? A. Albuterol B. Diphenhydramine C. H2 blocker D. Corticosteroid - Ans:-D. Corticosteroid • Step 1: Administer aqueous epinephrine 1:1,000 dilution 0.3-0.5 mg (0.3-0.5 mL) intramuscularly into the upper lateral thigh, in a supine position with the head below heart level, if possible. • Step 2: Repeat epinephrine every 5-15 minutes as required by the clinical presentation. If hypotensive, position the patient supine with feet elevated. • Step 3: Support bronchodilation if patient is without laryngospasm by administering albuterol 3 mL (2.5 mg) inhalation via nebulizer. • Step 4: If patient is in laryngospasm or pulmonary arrest, perform emergency endotracheal intubation and provide respiratory support. ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/112 • Step 5: Start IV fluids using normal saline or Ringer's lactate solution to maintain systolic blood pressure greater than 90 mm Hg. The rate of flow should be determined by the blood pressure reading but typically may be bolused. • Step 6: If the patient is conscious and without laryngospasm, administer diphenhydramine (Benadryl) 25-50 mg to relieve cutaneous symptoms. H2-blockers may also be added (particularly if GI symptoms are present) but have not been shown to be as effective as H1-blockers. • Step 7: Transfer the patient to an acute-care emergency center for continued support and observation. Add corticosteroids (IV or PO) to prevent late-phase anaphylactic reactions, which may be as severe as early-phase reactions. When analyzing synovial fluid, if it has 10,000 white blood cells/mcL with 80% polymorphonuclear neutrophils (PMNs), it may be indicative of which of the following conditions? A. None, this is a normal result B. Scleroderma C. Rheumatoid arthritis D. Sickle cell disease - Ans:-C. Rheumatoid arthritis ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 6/112 Within the synovial fluid, an inflammatory response also ensues but with a notably different distribution of immune cells. Polymorphonuclear neutrophils are the most prominent cellular infiltrate, numbering upwards of one billion in severely inflamed joints. Which of the following disease-modifying antirheumatic drugs is a folic acid antagonist? A. Methotrexate (Rheumatrex) B. Etanercept (Enbrel) C. Rituximab (Rituxan) D. Anakinra (Kineret) - Ans:-A. Methotrexate (Rheumatrex)