cancer
hematology
neurology
respiratory
musculoskeletal
100

A client with cancer is being evaluated for possible metastasis. What is one of the most common metastasis sites for cancer cells?
Colon
Reproductive tract
Liver
White blood cells (WBCs)

Liver

100

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia?
"I have an increase in my appetite."
"I have difficulty breathing when walking 30 feet."
"I feel hot all of the time."
"I have a difficult time falling asleep at night."

"I have difficulty breathing when walking 30 feet."

100

How often should neurologic assessments and vital signs be taken initially for the patient receiving tissue plasminogen activator (tPA)?
Every 30 minutes
Every 15 minutes
Every hour
Every 45 minutes

Every 15 minutes

100

DAILY DOUBLE

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
Metabolic acidosis

for bonus points what causes respitaroy alkalosis

Respiratory acidosis

Alkalosis caused by hyperventilation 

100

The nurse suspects "compartment syndrome" for a casted extremity. What characteristic symptoms would the nurse assess that would confirm these suspicions? (Select all that apply.)
Decreased sensory function
Excruciating pain
Loss of motion
Capillary refill less than 3 seconds
2+ peripheral pulses in the affected distal pulse

Decreased sensory function
Excruciating pain
Loss of motion

200

The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of
graft-versus-host disease.
metastasis.
acute leukopenia.
Nadir.

graft-versus-host disease.

200

A client was admitted to the hospital with the following laboratory values: hemoglobin 5 g/dL, leukocyte count 2000/mm3, and a platelet count of 48,000/mm3; abnormally shaped erythrocytes and hypersegmented neutrophils were seen. The platelets appear abnormally large. A bone marrow biopsy was competed and revealed hyperplasia. Based on this information, the nurse determines that client most likely has which diagnosis?
Sickle cell anemia
Folic acid deficiency
Hemolytic anemia
Thalassemia

Folic acid deficiency

200

A client is hospitalized when presenting to the emergency department with right-sided weakness. Within 6 hours of being admitted, the neurologic deficits had resolved and the client was back to his presymptomatic state. The nurse caring for the client knows that the probable cause of the neurologic deficit was what?
Left-sided stroke
Right-sided stroke
Cerebral aneurysm
Transient ischemic attack

Transient ischemic attack

200

A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can't produce an effective cough, the nurse should monitor closely for:
pleural effusion.
pulmonary edema.
atelectasis.
oxygen toxicity.

atelectasis

200

The nurse is caring for a client with a right below-the-knee amputation. There is a large amount of bright red blood on the client's residual limb dressing. Which intervention should the nurse implements first?
Notify the client's surgeon immediately.
Assess the client's blood pressure and pulse.
Reinforce the dressing with additional dressing.
Check the client's last hemoglobin and hematocrit levels.

Assess the client's blood pressure and pulse.

300

When evaluating a patient's symptoms that are consistent with a diagnosis of leukemia, the nurse is aware that all leukemias have which common feature?
Reduced plasma volume in response to a reduced production of cellular elements
Compensatory polycythemia stimulated by thrombocytopenia
Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements
Increased blood viscosity, resulting from an overproduction of white cells

Unregulated accumulation of white cells in the bone marrow, which replace normal marrow elements

300

A client with severe anemia reports symptoms of tachycardia, palpitations, exertional dyspnea, cool extremities, and dizziness with ambulation. Laboratory test results reveal low hemoglobin and hematocrit levels. Based on the assessment data, which nursing diagnoses is most appropriate for this client?
Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit
Risk for falls related to complaints of dizziness
Fatigue related to decreased hemoglobin and hematocrit
Imbalanced nutrition, less than body requirements, related to inadequate intake of essential nutrients

Ineffective tissue perfusion related to inadequate hemoglobin and hematocrit

300

Which of the following is the initial diagnostic in suspected stroke
Noncontrast computed tomography (CT)
CT with contrast
Magnetic resonance imaging (MRI)
Cerebral angiography

Noncontrast computed tomography (CT)

300

The nurse is caring for a client with a right-sided chest tube that is accidentally pulled out of the pleural space. Which action should the nurse implement first?
Notify the health care provider to have chest tube reinserted stat.
Instruct the client to take slow shallow breaths until the tube is reinserted.
Take no action and assess the clients respiratory status every 15 minutes.
Tape a petroleum jelly occlusive dressing on 3 sides to the insertion site.

Tape a petroleum jelly occlusive dressing on 3 sides to the insertion site.

300

The nurse is preparing the preoperative client, for a total hip replacement. Which intervention should the nurse implement postoperatively?
Keep an abduction pillow in place between the legs at all times.
Cough and deep breathe at least every 4 to 5 hours.
Turn to both sides every 2 hours to prevent pressure ulcers.
Sit in a high-seated chair for a flexion of less than 90 degrees.

Sit in a high-seated chair for a flexion of less than 90 degrees.

400

Chemotherapeutic agents have which effect associated with the renal system?
Hypokalemia
Hypercalcemia
Increased uric acid excretion
Hypophosphatemia

Increased uric acid excretion

400

Which of the following is accurate regarding the use of corticosteroids for immune hemolytic anemia?
Select all that apply.
Corticosteroids are not effective in the treatment of immune hemolytic anemia.
If the hemoglobin returns to normal, the corticosteroid dose can be lowered.
They produce lasting effects. The treatment consists of low doses of corticosteroids.
They decrease the macrophages ability to clear the antibody-coated RBCs.

If the hemoglobin returns to normal, the corticosteroid dose can be lowered.
They decrease the macrophages ability to clear the antibody-coated RBCs.

400

A client admitted to the emergency department is being evaluated for the possibility of a stroke. Which assessment finding would lead the nurse to suspect that the client is experiencing a hemorrhagic stroke?
left-sided weakness
severe exploding headache
difficulty finding appropriate words
slurred speech

severe exploding headache

400

A client with chronic lung disease is prescribed chest percussion. For which reason will the nurse question this treatment for the client?
Age 75 years
Left hip replaced 5 years ago
Receiving intravenous fluid therapy
Diagnosed with bacterial pneumonia

Age 75 years

400

A nurse is performing a shift assessment on an elderly client who is recovering after surgery for a hip fracture. The client reports chest pain, has an increased heart rate, and increased respiratory rate. The nurse further notes that the client is febrile and hypoxic, coughing, and producing large amounts of thick, white sputum. The nurse recognizes that this is a medical emergency and calls for assistance, recognizing that this client is likely demonstrating symptoms of what complication?
Avascular necrosis of bone
Compartment syndrome
Fat embolism syndrome
Complex regional pain syndrome

Fat embolism syndrome

500

The nurse is preparing to assess a client whose chart documents that the client experienced extravasation when receiving the vesicant vincristine during the previous shift. The documentation also notes that an antidote was administered immediately. The nurse prepares to assess for which conditions? Select all that apply.
Tissue necrosis
Active bleeding
Sloughing tissue
Effectiveness of the antidote

Tissue necrosis
Sloughing tissue
Effectiveness of the antidote

500

The nurse is caring for a client diagnosed with sickle cell disease. Which should the nurse include in the client's plan of care? Select all that apply.
Teach the client to limit fluids.
Discuss the interventions to maintain hydration.
Measure the client's calf for swelling.
Have the client take narcotic pain medication every four hours.
Monitor for fever.
Monitor oxygen saturation frequently.
Assess neurological status frequently.

Discuss the interventions to maintain hydration.
Monitor for fever.
Monitor oxygen saturation frequently.
Assess neurological status frequently

500

The nurse is checking in the client diagnosed with ALS 2 years ago for a routine check-up at the outpatient clinic. The patient is now wheelchair bound and having trouble with speech. Which topics will be included in the clients visit with the healthcare provider? Select all that apply.
Aspiration precautions
Rehabilitation programs
Wound care prevention
Advance directives
Bowel and bladder training
Dietary changes

Aspiration precautions
Wound care prevention
Advance directives
Dietary changes

500

A client with chronic obstructive pulmonary disease (COPD) is admitted to the medical-surgical unit. To help this client maintain a patent airway and achieve maximal gas exchange, the nurse should:
instruct the client to drink at least 2 L of fluid daily.
maintain the client on bed rest.
administer anxiolytics, as ordered, to control anxiety.
administer pain medication as ordered.

instruct the client to drink at least 2 L of fluid daily.

500

A nurse is admitting a client to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the client may have a peroneal nerve injury?
Numbness and burning of the foot
Pallor to the dorsal surface of the foot
Visible cyanosis in the toes
Inadequate capillary refill to the toes

Numbness and burning of the foot