CARINO, SHIRLENEDEL 

HEMA/ONCO/INTEG

1. . A client who suffered a burn injury has received fluid resuscitation and is now diuresing,   indicating the end of
the emergency phase. Which prescription is the highest priority at this  time? 
A. pos 

B. Assist the client in activities of daily living as tolerated  

C. Contact the client’s religious advisor for spiritual support  

D. Educate the client's family about dressings and medications 

2. The nurse assesses a client with the burn on the arm and finds that the arm is red, moist and   covered in shiny,
fluid filled wrinkles. Which burn stage does the nurse document? 

         A.First degree  
B.Second degree  
C.Third degree 
D.Fourth degree 
3. The nurse cares for a client admitted with severe burns who is now on fluid resuscitation therapy. Which
assessment findings would best indicate that fluid resuscitation has been  successful? 
A.Heart rate 89/min, blood pressure 99/52 mm Hg  
B.Potassium decrease from 5.7 mEq/L to 5.0 mEq/L  
C.Urine output 31 mL/hr, respirations 20/min  
D.Weight gain of 2.2 lbs (1 kg) in last 8 hours and palpable pulses  
4. The nurse is caring for a client who sustained superficialpartial-thickness burns on the anterior   lower legs and
anterior thorax. Which finding does the nurse expect to note during the   resuscitation/emergent phase of the burn
injury? 
1. Decreased heart rate 
2. Increased urinary output 
3. Increased blood pressure 
4. Elevated hematocrit levels 
5. When caring for a client with severe burns, the nurse can expect to administer pain medication  via which route? 
A.Intramuscular  
B.Intravenous  
C.Oral  
D.Subcutaneous 
6. Silver sulfadiazine is prescribed for a client with a 
burn injury. Which laboratory finding requires 
the need for follow-up by the nurse? 
1. Glucose level of 99 mg/dL (5.65 mmol/L) 
2. Magnesium level of 1.5 mEq/L (0.75 mmol/L) 
3. Platelet level of 300,000 mm3 (300Â109/L) 
4. White blood cell count of 3000 mm3  
7. The nurse is preparing to care for a burn client 
scheduled for an escharotomy procedure being
performed for a third-degree circumferential arm 
burn. The nurse understands that which finding 
is the anticipated therapeutic outcome of the 
escharotomy? 
A. Return of distal pulses 
B. Brisk bleeding from the site 
C. Decreasing edema formation 
D. Formation of granulation tissues 
8. Silver sulfadiazine is prescribed for a client with a 
burn injury. Which laboratory finding requires 
CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

the need for follow-up by the nurse? 

1. Glucose level of 99 mg/dL (5.65 mmol/L) 
2. Magnesium level of 1.5 mEq/L (0.75 mmol/L) 
3. Platelet level of 300,000 mm3 (300Â109/L) 
4. White blood cell count of 3000 mm3  
9. Silver sulfadiazine is prescribed for a client with a partial-thickness burn and the nurse provides teaching about the
medication. Which statement made by the client indicates a need for further teaching about the treatments? 
1. “The medication is an antibacterial.” 
2. “The medication will help heal the burn.” 
3. “The medication is likely to cause stinging every time it is applied.” 
4. “The medication should be applied directly to the wound.” 
10. Skin closure with heterograft will be performed on a client with a burn injury, and the client   asks the nurse about the
meaning of a heterograft. The nurse tells the client that a heterograft is  skin from:  
1 A cadaver  
2 Another species  
3 The burned client  
4 A synthetic source 
11. A nurse is teaching home management to a client newly diagnosed with severe psoriasis.   Whichclient
statement indicates that further teaching is needed? 
A. "Exposure to sunlight will worsen my psoriasis."  
B. "I should avoid drinking alcohol."  
C. "I should use moisturizing creams frequently." 
D. "Stress can worsen psoriasis." 
12. A preschooler has just been diagnosed with impetigo. The child’s mother tells the nurse, “But   my children take
baths every day.” The nurse should make which therapeutic response to the  mother?  
1 “You are concerned about how your child got impetigo?”  
2 “There is no need to worry. We will not tell your day care provider why your child is absent.”   3 “Not only do
you have to do a better job of keeping your children clean, you must also wash  your hands more frequently.”  
4 “You should have seen the doctor before the wound became infected, and then you would not  have had to
worry about the child having 
13. The nurse is taking the family history of a 2-year-old child with atopic dermatitis (eczema).   Which statement by
the mother is most important in formulating a plan of care for this child? A."Our first child was born with a cleft
lip." 
B."We are very careful not to get sunburns in our family." 
C."My first child sometimes got a diaper rash." 
D."My husband and our daughter are both lactose-intolerant." 
14. . You're providing education to a group of parents about impetigo. Which statement is CORRECT  about this disease?* 
A. "It tends to affect the preadolescent and adolescent population." 
B. "Cases of impetigo most likely to occur during the summer when the weather is warm." C. "Most
cases of impetigo are not contagious." 
D. "Impetigo is caused by a mite parasite." 
15. A 4 year old is admitted to your unit with a severe case of impetigo. It is important the nurse  follows which
precaution while providing care to this patient:* 
A. Droplet precautions 
B. Standard precautions only 
C. Contact precautions 
D. Airborne precaution 
16. A parent brings her child into the clinic due to skin lesions that fail to heal. The lesions are red,   reported to be itchy,
and exhibit exudate. You suspect the child may have impetigo. What is a  hallmark finding with this condition?* 
A. Round patches with light pink centers 
B. Short grey lines on the skin 
C. Silver colored scales over the lesions 
D. Yellow crusts over the lesions 
CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

17. Which client is the nurse’s priority when providing instruction on self-breast examination? 
A. . Linda, 35 years-old, who breastfed all her three children 
B.  Carol, 37 years-old, who never had a child and whose aunt died of breast cancer
 C. Dolor, 42 years-old, with history of fibrocystic disease 
D. Ethel, 25 years-old with a large breast 
18. A woman is undergoing chemotherapy treatment for uterine cancer. She asks the nurse how  chemotherapeutic
drug work. The most accurate explanation would include which statement? 
A.. They affect all rapid dividing cells. 
B. Molecular structure of DNA segment is altered. 
C. Chemotherapy only kills cancer cells. 
D. The cancer cells are sensitive to drug toxins. 
19. Safety precautions used in caring for the client with an internal radiation implant include all of   the following
except: 
A. Limit visits to 30 minutes daily 
B. See that visitors maintain a 3-feet distance from the radiation source 
C. Prohibit visits by children and pregnant women 
D. Assign the client to a private room 
20. After 2 weeks of chemotherapy treatments, a patient’s white blood cell count is 2,000/mm3.   The nurse knows
that this finding is most likely due to: 
A. infection C. bone marrow depression 
B. weight loss D. polycythemia 
21. The nurse is caring for a client with radium implant for the treatment of cervical cancer. When   caring for the client
with a radioactive implant, the nurse should: 
A. Provide emotional support by spending additional time with the client. 
B. Stand at the floor of the bed when talking to the client. 
C. Avoid handling items used by the client. 
D. Wear a dosimeter bandage to monitor the amount of time spent in the clients room.
 22. The patient had an external radiation of his chest, Which of the following is an incorrect  statement of the
patient? 
A. “ I will avoid washing and applying lotion to the areas subjected with radiation.”
 B. ‘ I will tell my pregnant daughter not to visit me during the entire period of my  treatment.” 
C. “ I will avoid exposure of my chest to the sunshine.” 
D. “I will have adequate rest after each treatment.” 
23. Radiation therapy is use to treat colon cancer before surgery for which of the following reasons? 
A. Reducing the size of tumor.  
B. Curing the cancer 
C. Eliminating the malignant cells. 
D. Helping heal the bowel before surgery 
24. Which of the following is the correct action by the nurse, if the patient’s intracavity implant was  dislodge? 
A. Wear gloves before picking up the implant. 
B. Call some personnel to pick up the implant. 
C.. Call for help. 
D. Use long forceps to pick up the implant and put it in the lead container. 
25. The patient has been diagnosed to have cancer of the cervix. She has cobalt implant in place.  Which of the
following statement is most incorrect? 
A. “ I will turn by back towards the door when I’m in bed. 
B.. “ I will have a urinary catheter in place. 
C.. I am allowed to walk and go to the bathroom.” 
D. “ I need to remain in bed during the treatment. 
26. During external radiation therapy, the nurse should teach the client that: 
A. She can apply lotion or powder on the radiated area. 
B. Pregnant client is allowed to visit after the procedure. 
C. Give antiemetics prior to treatment. 
CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

D. Lock the door to confined the radiation after therapy. 

27. In patient who undergone chemotherapy the nurse understand the treatment when he instruct  the patient with
alopecia to wear the wig: 
A. After alopecia to know the extent of hair loss. 
B. Before alopecia has occur. 
C. Wig should be replace on area having hair loss. 
D. Hair loss would not occurs since hair grows automatically.
28. The nurse knows that the common site of bone marrow aspiration in pediatric patient should  be: 
A. Clavicle B. Iliac crest C. Tibia D. Palanges 
29. Which of the following statements made by the client who is being administered Adriamycin  would indicate
further instruction? 
A. “ My hair is going to fall out.”  
B. “ I can expect some constipation.” 
C. . ” My urine will turn red.”  
D. “ I may develop irregular heartbeat.” 
30. The male patient has platelet count of 100,000/cu mm. Which of the following should be   avoided in patient
teaching? 
1. Use soft-bristled toothbrush. 
2. Include green leafy vegetable in the diet. 
3. Use electric razor. 
4. Avoid plants in the room. 
31. The nurse suspects that the vesicant IV chemotherapy being administered to the client has  extravasated. Based
on this assessment, which of the following is the priority intervention? 
A. Continue administration until extravasation is confirmed by the physician
 B. Stop the infusion and notify the physician 
C. Remove the IV needle immediately and reinsert the needle in another area 
D. Slow down the infusion anD continue to observe the area 
32. The nurse is providing discharge teaching for the client with leukemia. The client should be told  to avoid: 
A. Using oil- or cream-based soaps C. The intake of salt 
B. Flossing between the teeth D. Using an electric razor 
33. Which of the following dietary choices should be avoided by the client with a recent bone  marrow
transplant? 
A. Applesauce C. Apple pie 
B. Apple juice D. Raw apple 
34. Chemotherapy is one of the treatment modalities given to patients with malignancies of the   hematopoietic
system and as systemic therapy of solid tumors. As a nurse caring for a group of  patients receiving chemotherapy,
you have crucial responsibilities to address chemotherapy  related problems. Gerry who is receiving intravenous
chemotherapy ask you why you are  wearing mask, gloves and gown when giving the drugs to him. What is your
BEST response? 
A. “The clothing protects me from accidentally absorbing these drugs through the skin and  mucous membrane” 
B. “I am preventing the spread of infection from you to me or to any  other clients 
C. “Our hospital policy requires that any nurse giving these drugs  should wear a gown” 
D. “These protective barriers will prevent you from getting an  infection coming from me” 

35. You are caring for Gerry who is receiving a chemotherapy agent intravenously through a  peripheral line.
What will be your FIRST action when he complains of burning at the site? 
A. Discontinue C. Check for a blood return
B. Decrease the rate of infusion D. Apply a cold compress 
36. Janice is experiencing chemotherapy induced anemia. What is your PRIORITY nursing diagnosis  for her? 
         A. . Imbalanced nutrition, less than body requirements related to anorexia 
B. Risk for injury related to poor blood clotting 
C. Disturbed body image related to changes in skin color and texture 
D. Fatigue related to decreased cellular oxygenation 
CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

37. Perry’s chemotherapy has been postponed because of a low white blood count. When she   expressed
concern regarding its postponements, what will be your BEST response?
 A “You know, it is too dangerous to give you the chemotherapy now” 
 B. “Why don’t you look at things positively and wait for the best time” 
C. “Your counts will be probably high enough next week and the  chemotherapy will work just as well then” 
D. “I will call your physician and request a prescription to calm your  nerves” 
38. Nessy, a staff nurse on probation is assigned in the pediatric oncology unit As Nessy was about   to administer an antiemetic
drug to one of her patients, the mother stopped her. She tells Nessy  nausea and vomiting are proof that chemotherapy is
working. Which of the following will Nessy  do? 
A.. Listen and proceed with the administration of the drug 
B. Explain to the mother the effects of the drugs and proceed with  the administration 
C. Ask mother where the information was obtained 
D. Do not administer the drug and refer to the physician immediately 
39. One of the patients of Nessy is for chemotherapy at 8am. Which of the following is MOST  appropriate for
Nessy to do ensure nausea and vomiting are prevented? 
A. Administer anti emetic an hour before therapy 
B. Provide oral care with lukewarm water 
C. Give the food in small frequent interval 
D. Maintain an intravenous hydration therapy 
40. Nessy always includes in her instructions to mothers not to give vitamins when on   chemotherapy. Which of the
following chemotherapeutic agents effects will be interfered by  vitamins with folic acid? 
A. Vincristine C. Prednisone 
B. Mercapturine D. Methotrexate 
41. The community health nurse provides an educational session regarding the risk factors for  cervical cancer to women
in the local community. The nurse determines that further teaching is  needed if a woman attending the session
identifies which of the following as a risk factor for  this type of cancer? 
A. Smoking tobacco C. early first intercourse 
B. Single sex partner D. HPV infection 

32. A client with cancer of the cervix has a radium implant in place. What position is most appropriate to the
client? 

A.Any position of comfort C. Semi-Fowler’s 

B.Flat D. Sitting
33. The oncology nurse specialist provides an educational session to nursing staff regarding the characteristics of 
Hodgkin’s disease. The nurse determines that further education is needed if a nursing staff member states
that  which of the following is characteristic of the disease? 

A.Presence of Reed-Sternberg cell 

B. Involvement of lymph nodes, spleen, and liver 
C.Occurs most often in the older client. 
D. Prognosis depends on the stage of the disease 

34. The nurse is reviewing the laboratory results of a client receiving chemotherapy. The platelet count is
10,000  cells/mm. Based on this laboratory value, the priority nursing assessment is which of the following? 

A.Assess level of consciousness 

B.Assess temperature 
C.Assess bowel sounds 
D.Assess skin turgor 

35. The nurse is caring for a client following a modified radical mastectomy. Which assessment finding would 
indicate that the client is experiencing a complication related to this surgery? 
A. Sanguineous drainage in the Jackson-Pratt drain 
B. Pain at the incisional site 
 CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

C. Complaints of decreased sensation near the operative site 

D. Arm edema on the operative side 

36. A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. 
Which of the following recommendations is appropriate? 

A.Apply sunscreen only after going in the water. 

B.Avoid peak exposure hours from 9am to 1pm 
C.Wear loosely woven clothing for added ventilation 
D.Apply sunscreen with a sun protection factor (SPF) of 15 or more before sun exposure 

37. The nurse is caring for a client who is receiving radiation therapy. Which activity by the client indicates further 
instruction on the side effects of radiation therapy? 

A.Using an electric razor. 

B.Eating a high protein diet. 
C.Taking his children to play at Timezone at the mall. 
D.Calling the doctor for the temperature of 38.3 C. 

38. The nurse is caring for a client with radium implant for the treatment of cervical cancer. When caring for the client 
with a radioactive implant, the nurse should: 
A.Provide emotional support by spending additional time with the client. 
B.Stand at the floor of the bed when talking to the client. 
C.Avoid handling items used by the client. 
D.Wear a dosimeter bandage to monitor the amount of time spent in the clients room. 
39. A woman is undergoing chemotherapy treatment for uterine cancer. She asks the nurse how chemotherapeutic 
drug work. The most accurate explanation would include which statement? 
A.They affect all rapid dividing cells. 
B.Molecular structure of DNA segment is altered. 
C.Chemotherapy only kills cancer cells. 
D.The cancer cells are sensitive to drug toxins. 
40. Radiation therapy is use to treat colon cancer before surgery for which of the following reasons?
A. Reducing the size of tumor.  
B. Curing the cancer 
C. Eliminating the malignant cells.
D. Helping heal the bowel before surgery 
41. Which of the following is the correct action by the nurse, if the patient’s intracavity implant was dislodge?
A.Wear gloves before picking up the implant. 
B.Call some personnel to pick up the implant. 
C.Call for help. 
D.Use long forceps to pick up the implant and put it in the lead container. 
42. The patient has been diagnosed to have cancer of the cervix. She has cobalt implant in place. Which of the 
following statement is incorrect? 
A.“ I will turn by back towards the door when I’m in bed. 
B.“ I will have a urinary catheter in place. 
C.“I am allowed to walk and go to the bathroom.” 
D.“ I need to remain in bed during the treatment. 
43. In patient who undergone chemotherapy the nurse understand the treatment when he instruct the patient with 
alopecia to wear the wig: 
A.After alopecia to know the extent of hair loss. 
B. Before alopecia has occur. 
C.Wig should be replace on area having hair loss. 
D. Hair loss would not occurs since hair grows automatically. 
44. The nurse knows that the common site of bone marrow aspiration in pediatric patient should be:
A.Clavicle B. Iliac crest C. Tibia D. Palanges 
45. Which of the following statements made by the client who is receiving Adriamycin would indicate that the 
teaching about adverse effect of his medication was effective? 
A. “My hair is going to fall out.”  
 CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

B. “I can expect some constipation.”  

C.” My urine will turn red.” 
D. “I may develop irregular heartbeat.” 
46. A patient underwent modified radical mastectomy. The nurse recognizes that the findings seen in patient with 
breast cancer are: 
A.Symmetry of the breast, movable mass. 
B.Retraction of the nipple, orange peel appearance on affected breast. 
C.Presence of fibroadenomaon the upper outer quadrant of left breast 
D.Presence of encapsulated movable mass on upper outer quadrant of right breast. 
47. Mr. GT 36 years old post mastectomy was given health teachings on post op mastectomy exercises. The goal of 
these teaching is to: 
A. Provide mobility 
B. Prevent contracture deformity 
C. Prevent lymphedema  
D. Prevent scar formation on post op site 
48. Nurse Hus Des is approached by Georgina, one of the attendees. The client tells her that they havr a family  
history of breast cancer. The client asks her for methods to prevent her from having the disease, Nurse Hus
Des  expects that the client be prescribed with: 
A. Tamoxifen (Novaldex) C. Doxorubicin  
B. Estrogen (Premarin ) D. Cytoxan 

Situation: Specific surgical interventions may be done when the lung cancer is detected early. You have
"important  peri-operative" responsibilities in caring for patients with lung cancer. 
49. Leonel underwent lobectomy. Which of the following is the purpose of Leonel's closed chest drainage post 
lobectomy? 
A.Prevention of mediastinal shift 
B.Expansion of the remaining lung 
C.Promotion of wound healing 
D.Facilitation of coughing 
50. Following lobectomy you can best help Leonel to reduce pain during deep breathing and coughing
exercises by: A.Splinting his chest with both hands during the exercise 
B.Administering the prescribed analgesic immediately prior to exercises 
C.Providing rest for six hours before exercises 
D.Placing him on his operative side during exercises 

51. On which of the following position should you place Joshua?

A.Any position is acceptable 
B.On his back or on the side of surgery 
C.On his abdomen or on the side opposite of the surgery 
D.Prone position  

52. The nurse devises a teaching plan for the patient with aplastic anemia. Which of the following is the most 
important concept to teach for health maintenance? 
A. Eat animal protein and dark leafy vegetables each day 
B. Avoid exposure to others with acute infection 
C. Practice yoga and meditation to decrease stress and anxiety 
D. Get 8 hours of sleep at night and take naps during the day 

53. When a client is diagnosed with aplastic anemia, the nurse monitors for changes in which of the following 
physiological functions? 
A. Bleeding tendencies C. Peripheral sensation 
B. Intake and output D. Bowel function 

54. Which of the following diagnostic findings are most likely for a client with aplastic anemia?
A. Decreased production of T-helper cells 
B. Decreased levels of white blood cells, red blood cells, and platelets 
C. Increased levels of WBCs, RBCs, and platelets 
 CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

D. Reed-Sternberg cells and lymph node enlargement 

55. Gigi, 17 yrs old is admitted with the diagnosis of Leukemia. Assessment of client with leukemia
is:    
        A. Easy fatigability, Irritable 
  B. Malaise, nausea, increase exercise tolerance 
C. Malaise, Fatigue, increased in weight, decrease exercise tolerance. 
D. Malaise, Fatigue, weight Loss, decrease exercise tolerance. 

56. Edward, 9yrs old was diagnosed with Acute Lymphocytic Leukemia, What is the route of administration of Bone 
Marrow Transplant for a child suffering from Leukemia? 
A. Posterior Tibia C. IV 
B. Oral D. Suppository 

57. Which of the following conditions is not a complication of Hodgkin’s disease? 

A. weight loss C. Infection 
B. Myocardial Infarction D. Nausea 

58. The community nurse is conducting a health promotion program at a local school and is discussing the risk 
factors associated with cancer. Which of the following, if identified by the client as a risk factor, indicates a
need  for further instructions? 
A. Viral factors  C. Low-fat and high-fiber diets 
B. Stress D. Exposure to radiation 

59. Dehydration occurs during the first 48 hours of burns. Which of the following is the primary cause of
dehydration?       A.Increased fluid loss by evaporation from the areas of burns. 
B.Actual fluid destruction by the burning process. 
C.Shifting of plasma into the interstitial compartment. 
D.Fluid loss through blister formation. 
60. During the emergent phase of burns, which of the following assessment is NOT expected?
A. Hypovolemia, increased hematocrit.  
B. Diuresis, decreased hematocrit.  
C. Hyperkalemia, hyponatremia 
D. Oliguria, fall of BP 
61. A client has just arrived at the emergency department after sustaining a major burn injury. Which of the
following  metabolic alterations is expected during the first 8 hours post-burn? 
A.Hyponatremia and hypokalemia 
B. Hyponatremia and hyperkalemia 
C.Hypernatremia and hypokalemia
D.Hypernatremia and hyperkalemia 
62. The client has experienced an electrical injury, with the entrance site on the left hand and the exit site on the
left  foot. What are the priority assessment data to obtain from this client on admission? 
A. Airway patency 
B. Heart rate and rhythm 
C.Orientation to time, place, and person 
D.Current range of motion in all extremities 
63. A client arrived at a burn clinic sustaining a serious burn injury. The burn area is white and leathery with
no  blisters. What is the best classification? 
A.First degree burn 
B.Superficial partial thickness burn injury 
C.Deep partial thickness burn injury. 
D.Third degree burn injury 
64. A client weighing 76 kg is admitted at 6am with TBSA of 40%. Using the Parkland formula , the
client’s  intravenous fluid replacement should be: 
A.6,080 ml B. 9,120 ml C. 12,160 ml D. 15, 180 ml  
65. The burned client is ordered to receive intravenous cimetidine, an H2 histamine blocking agent, during the 
emergent phase. When the client's family asks why this drug is being given, what is the nurse’s best response?
 A. “To increase the urine output and prevent kidney damage.” 
B. “To stimulate intestinal movement and prevent abdominal bloating.” 
C. “To decrease hydrochloric acid production in the stomach and prevent ulcers.” 
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D. “To inhibit loss of fluid from the circulatory system and prevent hypovolemic shock.” 

66. A child suspected of having sickle cell disease is seen in a clinic,   and laboratory studies are performed. A
nurse checks the lab results,  knowing that which of the following would be increased in this  disease?
A. Platelet count 
B. Hematocrit level 
C. Reticulocyte count 
D. Hemoglobin level 
67. Laboratory studies are performed for a child suspected of having iron deficiency anemia.   The nurse reviews the laboratory
results, knowing that which of the following results would  indicate this type of anemia? 
       A. An elevated hemoglobin level 
B. A decreased reticulocyte count 
C. An elevated RBC count 
D. Red blood cells that are microcytic and hypochromic
68. Which of the following would the nurse identify as the  priority nursing diagnosis during a toddler’s vaso-occlusive sickle
cell  crisis? 
A. Ineffective coping related to the presence of a life-threatening  disease 
B. Decreased cardiac output related to abnormal hemoglobin  formation 
C. Pain related to tissue anoxia 
D. Excess fluid volume related to infection 
69.After 2 weeks of chemotherapy treatments, a patient’s white blood cell count is 2,000/mm3. The  nurse knows that this
finding is most likely due to: 
A. infection C. bone marrow depression 
B. weight loss D. polycythemia 

70. A clinic nurse instructs the mother of a child with sickle cell  disease about the precipitating factors related to pain crisis.
Which of  the following, if identified by the mother as a precipitating factor,  indicates the need for further instructions?      
A. Infection B. Trauma C. Fluid overload D. Stress 

71. The primary purpose of the Schilling test is to measure the client’s ability to:
      A. Store vitamin B12 B. Digest vitamin B12 C. Absorb vitamin B12 D. Produce vitamin B12 

71.B. The nurse devises a teaching plan for the patient with aplastic anemia. Which of the  following is the most important
concept to teach for health maintenance?
A. Eat animal protein and dark leafy vegetables each day B. Avoid exposure to others with acute infection 
C. Practice yoga and meditation to decrease stress and anxiety D. Get 8 hours of sleep at night and take naps during the
day 

72. doctor suspects pernicious anemia in a patient presenting with a beefy red tongue. The   patient reports feeling extremely
fatigued and numbness and tingling in the hands. The doctor  orders a peripheral blood smear. From your nursing knowledge,
how will the red blood cells  appear in the peripheral blood smear if pernicious anemia is present?* 
 A. Round-shaped and hypochromic   B. Oval-shaped and hyperchromic  
C. Large and oval-shaped D. Small and hyperchromic
       
73. A patient with pernicious anemia is ordered to receive supplementary Vitamin B12. What  is the best route to administer this
medication for patients with this disorder?      
A. Intravenous  B. Orally C. Through a central line D. Intramuscular      

74. A patient with severe pernicious anemia is being discharged home and requires  routine injections of Vitamin B12.
Which statement by the patient demonstrates they  understood your instructions about their treatment regime?* 
 A. "I will require one injection every 6 months until my Vitamin B12 levels are  therapeutic and then I'm done." 

 B. "Initially B12 monthly injections for maintenance, which will be a lifelong regime." 

C. "I will only need vitamin B12 injections for a month and then I can take a low dose  of oral vitamin B12." 

D. "When I start to feel weak and short of breath I need to call the doctor so I can  schedule an appointment for a Vitamin
B12 injection." 
CARINO, SHIRLENEDEL  HEMA/ONCO/INTEG

75. "In formulating a nursing diagnosis of risk for infection for a client with chronic lymphoid  leukemia (CLL),
nursing measures should include except? 
"A. Maintaining a clean technique for all invasive procedures. 
B. Placing the client in protective isolation.
C. Limiting visitors who have colds and infections. 
D. Ensuring meticulous handwashing by all persons coming in contact with the client."