Med Surg Exam #3 2025 | Comprehensive Nursing Study Guide with
NCLEX Questions, Rationales, Key Concepts | Verified for RN, LPN
& BSN TESTBANK
A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse take after this
occurs? (select all that apply)
A) administer diphenhydramine
B) begin iron chelation therapy
C) collect a urine sample to detect hemoglobin
D) document the reaction according to policy
CDE
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior
iliac crest. What position will the nurse place the patient in?
A) lateral position with one leg flexed
B) lithotomy position
C) supine with head of the bed elevated 30 degrees
D) jackknife position
A
A patient with CKD has chronic anemia. What pharmacologic alternative to blood transfusion may be used for
the patient?
A) GM-CSF
B) erythropoietin
C) eltrombopag
D) thrombopoietin
B
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse recognize is the most
likely clinical disorder the patient is being treated for?
A) essential thrombocythemia
B) extreme leukocytosis
C) sickle cell disease
D) renal transplantation
A
The nurse is assessing a patient who comes to the clinic reporting feeling constantly tired and very weak. The
patient also has a very sore tongue, and upon observing the patient's oral cavity, the nurse notices the tongue is
beefy red. What type of anemia does the nurse know these symptoms indicate?
A) iron deficiency anemia
B) megaloblastic anemia
,C) sickle cell disease
D) aplastic anemia
B
The nurse observes a coworker eating ice frequently. The nurse encourages the coworker to have an
examination and diagnostic workup with the healthcare provider. What type of anemia is the nurse concerned
the coworker may have?
A) iron deficiency anemia
B) megaloblastic anemia
C) sickle cell disease
D) aplastic anemia
A
The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood
transfusions administered. Why would the nurse need to include a nutritional assessment for this patient?
A) it is part of the required assessment information
B) it is important for the nurse to determine what type of foods the patient will eat
C) it may indicate deficiencies in essential nutrients
D) it will determine what type of anemia the patient has
C
The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this
patient is at risk for?
A) iron deficiency anemia
B) megaloblastic anemia
C) sickle cell disease
D) aplastic anemia
B
A patient describes numbness in the arms and hands with a tingling sensation and frequent stumbling when
walking. What vitamin deficiency does the nurse determine may contribute to some of these symptoms?
A) thiamine
B) folate
C) B12
D) iron
C
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to
enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the
absorption?
A) eating calf's liver with a glass of orange juice
B) eating leafy green vegetables with a glass of water
C) eating apple slices with carrots
D) eating a steak with mushrooms
,A
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse
understand to be significant in this stage of anemia?
A) potassium level of 5.2 mEq/L
B) magnesium level of 2.5 mg/dL
C) calcium level of 9.4 mg/dL
D) creatinine level of 6 mg/100 mL
D
A patient with ESRD is taking recombinant erythtopoietin for the treatment of anemia. What laboratory study
does the nurse determine will have to be assessed at least monthly related to this medication?
A) potassium level
B) creatinine level
C) hemoglobin level
D) folate levels
C
A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the
cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this
patient at risk for?
A) aplastic anemia
B) iron deficiency anemia
C) sickle cell disease
D) pernicious anemia
D
The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will
receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive dose
of B12. What test is the patient being prepared for?
A) bone marrow aspiration
B) Schilling test
C) bone marrow biopsy
D) MRI study
B
Which patient does the nurse recognize as being most likely to be affected by sickle cell disease?
A) 14 year old African American boy
B) 26 year old Eastern European Jewish woman
C) 18 year old Chinese woman
D) 28 year old Israeli man
A
A patient with sickle cell disease is brought to the ED by a parent. The patient has a fever of 101.6F, HR of 116,
and RR of 32. The nurse ausculates bilateral wheezes in both lung fields. What does the nurse suspect this
, patient is experiencing?
A) pneumocystis pneumonia
B) acute chest syndrome
C) an exacerbation of asthma
D) pulmonary edema
D
A patient with sickle cell disease is to begin treatment for the disease with hydroxyurea. What does the nurse
inform the patient will be the benefits of treatment with this medication? (select all that apply)
A) fewer painful episodes of sickle cell crisis
B) lower incidence of acute chest syndrome
C) decreased need for blood transfusion
D) decreased need for other analgesic medication
E) ability to reverse the damage done from sickling cells
ABC
A patient with sickle cell disease comes to the ED reporting sever pain in the back, right hip, and right arm.
What intervention is important for the nurse to provide?
A) administer aspirin
B) administer ibuprofen
C) start an IV line with dextrose 5% in 0.24 NS
D) begin oxygen at 2 L/M
C
A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The
patient has developed lymphopenia with a lymphocyte count of less than 1500 mm3. That should the nurse
monitor the client for?
A) onset of a bacterial infection
B) bleeding
C) abdominal pain
D) diarrhea
A
A patient with AML is having aggressive chemo to attempt to achieve remission. The patient is aware that
hospitalization will be necessary for several weeks. What type of therapy that the patient will receive will the
nurse educate the patient about?
A) induction therapy
B) supportive therapy
C) antimicrobial therapy
D) standard therapy
A
A patient with AML is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. With
which complication does the nurse know that the donor's lymphocytes recognize the patient's body as foreign
and set up reactions to attack the foreign host?
NCLEX Questions, Rationales, Key Concepts | Verified for RN, LPN
& BSN TESTBANK
A patient develops a hemolytic reaction to a blood transfusion. What actions should the nurse take after this
occurs? (select all that apply)
A) administer diphenhydramine
B) begin iron chelation therapy
C) collect a urine sample to detect hemoglobin
D) document the reaction according to policy
CDE
The nurse is preparing a patient for a bone marrow aspiration and biopsy from the site of the posterior superior
iliac crest. What position will the nurse place the patient in?
A) lateral position with one leg flexed
B) lithotomy position
C) supine with head of the bed elevated 30 degrees
D) jackknife position
A
A patient with CKD has chronic anemia. What pharmacologic alternative to blood transfusion may be used for
the patient?
A) GM-CSF
B) erythropoietin
C) eltrombopag
D) thrombopoietin
B
A patient is undergoing platelet pheresis at the outpatient clinic. What does the nurse recognize is the most
likely clinical disorder the patient is being treated for?
A) essential thrombocythemia
B) extreme leukocytosis
C) sickle cell disease
D) renal transplantation
A
The nurse is assessing a patient who comes to the clinic reporting feeling constantly tired and very weak. The
patient also has a very sore tongue, and upon observing the patient's oral cavity, the nurse notices the tongue is
beefy red. What type of anemia does the nurse know these symptoms indicate?
A) iron deficiency anemia
B) megaloblastic anemia
,C) sickle cell disease
D) aplastic anemia
B
The nurse observes a coworker eating ice frequently. The nurse encourages the coworker to have an
examination and diagnostic workup with the healthcare provider. What type of anemia is the nurse concerned
the coworker may have?
A) iron deficiency anemia
B) megaloblastic anemia
C) sickle cell disease
D) aplastic anemia
A
The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood
transfusions administered. Why would the nurse need to include a nutritional assessment for this patient?
A) it is part of the required assessment information
B) it is important for the nurse to determine what type of foods the patient will eat
C) it may indicate deficiencies in essential nutrients
D) it will determine what type of anemia the patient has
C
The nurse is assessing a patient who is a strict vegetarian. What type of anemia is the nurse aware that this
patient is at risk for?
A) iron deficiency anemia
B) megaloblastic anemia
C) sickle cell disease
D) aplastic anemia
B
A patient describes numbness in the arms and hands with a tingling sensation and frequent stumbling when
walking. What vitamin deficiency does the nurse determine may contribute to some of these symptoms?
A) thiamine
B) folate
C) B12
D) iron
C
The nurse is educating a patient with iron deficiency anemia about food sources high in iron and how to
enhance the absorption of iron when eating these foods. What can the nurse inform the client would enhance the
absorption?
A) eating calf's liver with a glass of orange juice
B) eating leafy green vegetables with a glass of water
C) eating apple slices with carrots
D) eating a steak with mushrooms
,A
A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse
understand to be significant in this stage of anemia?
A) potassium level of 5.2 mEq/L
B) magnesium level of 2.5 mg/dL
C) calcium level of 9.4 mg/dL
D) creatinine level of 6 mg/100 mL
D
A patient with ESRD is taking recombinant erythtopoietin for the treatment of anemia. What laboratory study
does the nurse determine will have to be assessed at least monthly related to this medication?
A) potassium level
B) creatinine level
C) hemoglobin level
D) folate levels
C
A patient had gastric bypass surgery 3 years ago and now, experiencing fatigue, visits the clinic to determine the
cause. The patient takes pantoprazole for the treatment of frequent heartburn. What type of anemia is this
patient at risk for?
A) aplastic anemia
B) iron deficiency anemia
C) sickle cell disease
D) pernicious anemia
D
The nurse is preparing the patient for a test to determine the cause of vitamin B12 deficiency. The patient will
receive a small oral dose of radioactive vitamin B12 followed by a large parenteral dose of nonradioactive dose
of B12. What test is the patient being prepared for?
A) bone marrow aspiration
B) Schilling test
C) bone marrow biopsy
D) MRI study
B
Which patient does the nurse recognize as being most likely to be affected by sickle cell disease?
A) 14 year old African American boy
B) 26 year old Eastern European Jewish woman
C) 18 year old Chinese woman
D) 28 year old Israeli man
A
A patient with sickle cell disease is brought to the ED by a parent. The patient has a fever of 101.6F, HR of 116,
and RR of 32. The nurse ausculates bilateral wheezes in both lung fields. What does the nurse suspect this
, patient is experiencing?
A) pneumocystis pneumonia
B) acute chest syndrome
C) an exacerbation of asthma
D) pulmonary edema
D
A patient with sickle cell disease is to begin treatment for the disease with hydroxyurea. What does the nurse
inform the patient will be the benefits of treatment with this medication? (select all that apply)
A) fewer painful episodes of sickle cell crisis
B) lower incidence of acute chest syndrome
C) decreased need for blood transfusion
D) decreased need for other analgesic medication
E) ability to reverse the damage done from sickling cells
ABC
A patient with sickle cell disease comes to the ED reporting sever pain in the back, right hip, and right arm.
What intervention is important for the nurse to provide?
A) administer aspirin
B) administer ibuprofen
C) start an IV line with dextrose 5% in 0.24 NS
D) begin oxygen at 2 L/M
C
A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The
patient has developed lymphopenia with a lymphocyte count of less than 1500 mm3. That should the nurse
monitor the client for?
A) onset of a bacterial infection
B) bleeding
C) abdominal pain
D) diarrhea
A
A patient with AML is having aggressive chemo to attempt to achieve remission. The patient is aware that
hospitalization will be necessary for several weeks. What type of therapy that the patient will receive will the
nurse educate the patient about?
A) induction therapy
B) supportive therapy
C) antimicrobial therapy
D) standard therapy
A
A patient with AML is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. With
which complication does the nurse know that the donor's lymphocytes recognize the patient's body as foreign
and set up reactions to attack the foreign host?
