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NURS 223 EXAM 4 ACTUAL EXAM 2025 REVIEW WITH QUESTIONS AND CORRECT ANSWERS RATED A+
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NURS 223 EXAM 4 ACTUAL EXAM 2025 REVIEW WITH QUESTIONS AND CORRECT ANSWERS RATED A+
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NURS 223 EXAM 4 ACTUAL EXAM 2025REVIEW WITH QUESTIONS AND CORRECT
ANSWERS RATED A+
A client tells the nurse that the doctor told her she has too many
red blood cells accompanied by elevated white cells and platelet
counts. The nurse recognizes this as:
a) Aplastic anemia
b) Hemolytic anemia
c) Pernicious anemia
d) Polycythemia vera Correct Answer d) Polycythemia vera
Polycythemia vera is a neoplastic disease of the pluripotent cells
of the bone marrow characterized by an absolute increase in total
red blood cell (RBC) mass accompanied by elevated white cell
and platelet counts. In pernicious anemia, the RBCs are not high
in number but are larger in size. In aplastic and hemolytic anemia,
there is a small number of RBCs
A female patient comes to the clinic with symptoms of fatigue and
heavy menses over the last 6 months. Laboratory tests reveal a
microcytic hemochromic anemia. Based on these results, the
nurse anticipates teaching the patient about which type of
anemia?
a) Aplastic anemia
b) Iron deficiency anemia
c) Anemia related to kidney disease
d) Sickle cell anemia Correct Answer b) Iron deficiency anemia
The red blood cell indices identified that it was a microcytic
hemochromic anemia, specifically iron deficiency.
,A client was involved in an auto accident and suffered massive
internal injuries that resulted in a large blood loss. Select the type
of anemia the client is at greatest risk to develop.
a) Blood loss
b) Iron deficiency
c) Aplastic
d) Hemolytic Correct Answer a) Blood loss
The clinical manifestations and red cell changes associated with
blood loss anemia depend on the rate of hemorrhage and
whether the bleeding loss is internal or external. The effects of
acute blood loss are mainly due to loss of intravascular volume,
which can lead to cardiovascular collapse and shock. Hemolytic
anemia is characterized by the premature destruction of red cells.
The usual reason for iron deficiency in adults in the Western world
is chronic blood loss. Aplastic anemia describes a disorder of
pluripotential bone marrow stem cells.
The nurse is educating a pregnant client about the importance of
folic acid. Select the food that has the highest levels of folic acid.
a) Apples
b) Carrots
c) Kale
d) Eggs Correct Answer c) Kale
Folic acid is readily absorbed from the intestine. It is found in
vegetables (particularly the green leafy types), fruits, cereals, and
meats. Much of the vitamin, however, is lost in cooking. The most
common causes of folic acid deficiency are malnutrition or dietary
lack, especially in the elderly or in association with alcoholism.
All cells of the body age and are replaced in a natural order.
When RBCs age, they are destroyed in the spleen. During this
process, the iron from their hemoglobin is released into the
circulation and returned where?
, a) To the muscles to be stored for strength.
b) To the lungs to bind with oxygen.
c) To the bone marrow for incorporation into new RBCs.
d) To the liver to bind with oxygen. Correct Answer c) To the
bone marrow for incorporation into new RBCs.
When RBCs age and are destroyed in the spleen, the iron from
their hemoglobin is released into the circulation and returned to
the bone marrow for incorporation into new RBCs or to the liver
and other tissues for storage. Iron is not bound to RBCs in the
liver. Iron does not bind with oxygen in the lung without first being
incorporated into an RBC. Iron is stored in tissues of the body, but
not for strength, only for its oxygen-binding capacity.
The Rh-negative mother, who has become sensitized during a
previous birth, gives birth to a Rh-positive infant. Which method
will the practitioner chose to prevent kernicterus in the infant?
a) Administration of erythropoietin
b) Exchange transfusions
c) Injection of Rh immune globulin
d) Transfusion of fresh frozen plasma Correct Answer b)
Exchange transfusions
After an Rh-negative mother has been sensitized, the Rh
antibodies from her blood are transferred to subsequent infants
through placental circulation. These antibodies react with the red
cell antigens of the Rh-positive infant causing agglutination and
hemolysis. There is a danger of kernicterus developing in the
infant, resulting in severe brain damange or death. Exchange
transfusions are administered after birth by removing and
replacing the infant's blood volume with type O Rh-negative
blood. The injection of Rh immune globulin is given to the Rh-
negative mother post delivery to prevent sensitization.
Erythropoietin and plasma administration do not prevent
kernicterus.
, An elderly patient is brought to the emergency department with
garbled speech, unilateral facial drooping, and weakness. One
hour after admission, the patient dies. An autopsy reveals the
presence of polycythemia. Which of the following was the most
likely cause of the patient's death?
a) Cerebral thrombosis
b) Infection and sepsis
c) Acute leukemia
d) Anaphylactic reaction Correct Answer a) Cerebral thrombosis
Unregulated overproduction of the red cell mass is termed
polycythemia, which causes a thickening of the blood and an
increased risk of blood clots.
An infant from parents of Mediterranean decent has been
diagnosed with a severe form of β-thalassemia anemia. The
nurse caring for this infant knows that the infant will likely receive
which of the following medical treatments?
a) Warfarin, a blood thinner to decrease clot formation
b) Iron sulfate supplements
c) Stem cell transplant
d) Transfusion therapy Correct Answer d) Transfusion therapy
Persons who are homozygous for the trait (thalassemia major)
have severe, transfusion-dependent anemia that is evident at 6 to
9 months of age when the hemoglobin switches from HbF to HbA.
If transfusion therapy is not started early in life, severe growth
retardation occurs in children with the disorder. Iron and blood
thinners will not be therapeutic for this client. Stem cell
transplantation is a potential cure for low-risk clients, particularly
in younger persons with no complications of the disease or its
treatment, and has excellent results.
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