NURSEZONE

4
th
Floor Florentine Bldg. Bonifacio St., Davao City
Tel No. 300 !"0# and 303 0""3
SUBJECT: MEDICAL SURGICAL NURSING
BLOOD AND IMMUNITY
EXAM CODE: CGFNS / NCLEX REVIEW JUNE
PREPARED BY: MR. ALLAN ALDRICH J. OCAMPO, RMT, RN
!. $ client %ith &''er ga(trointe(tinal )leeding develo'( a *ild ane*ia. The n&r(e (ho&ld e+'ect the client to )e treated
%ith,
$. De+tran B. E'ogen C. -ron (alt( D. .ita*in B!#
#. The e*ergency de'art*ent n&r(e i( ad*itting a client follo%ing an a&to*o)ile accident. The client ha( lo(t a
con(idera)le a*o&nt of )lood, and early (tage hy'ovole*ic (hoc/ i( (&('ected. $n a((e((*ent finding the n&r(e %o&ld
e+'ect thi( client to e+hi)it i(,
$. $ di(tention of the nec/ vein(
B. $n a'ical heart rate of !4# )'*
C. $n o&t'&t of 00 *l &rine 'er ho&r
D. $ )lood 're((&re of !00120 ** 3g
3. The 'hy(ician order( 3 &nit( of %hole )lood for a client in hy'ovole*ic (hoc/ after a ga(trointe(tinal he*orrhage. 4hen
ad*ini(tering )lood, the n&r(e fir(t verifie( the ty'e and cro((5*atch and then,
A. 4ar*( the )lood to )ody te*'erat&re to 'revent chill(
B. U(e( an inf&(ion '&*' to increa(e the acc&racy of the inf&(ion
C. Dra%( )lood (a*'le( fro* the client )efore and after each &nit i( tran(f&(ed
D. R&n( the )lood at a (lo%er rate d&ring the fir(t 0 to !0 *in&te( of the tran(f&(ion
4. D&ring a )lood tran(f&(ion a client develo'( chill( and headache. The n&r(e6( )e(t action i( to,
A. 7ightly cover the client
B. Notify the 'hy(ician (tat
C. Sto' the tran(f&(ion i**ediately
D. Slo% the )lood flo% to /ee' vein o'en
0. $n e+a*'le of 'ri*ary health care )y the n&r(e %o&ld )e,
$. 8revention of di(a)ilitie(
B. Correction of dietary deficiencie(
C. E(ta)li(hing goal( for reha)ilitation
D. $((i(ting in i**&ni9ation 'rogra*(
:. -n general, the higher the red )lood cell co&nt,
$. The higher the )lood '3
B. The lo%er the he*atocrit
C. The greater the )lood vi(co(ity
D. The le(( it contri)&te( to i**&nity
". The n&r(e &nder(tand( that the only *olec&le( that cannot 'a(( thro&gh the ca'illary endotheli&* are,
$. Blood ga(e(
B. 8la(*a 'rotein(
C. ;l&co(e and ion(
D. $*ino acid( and %ater
<. 4hen caring for a client %ith an i*'aired i**&ne (y(te*, the n&r(e recogni9e( that the )lood 'rotein involved i(,
$. $l)&*in B. ;lo)&lin C. Thro*)in D. 3e*oglo)in
2. $nti)odie( are 'rod&ced )y,
$. Eo(ino'hil( B. 8la(*a cell( C. Erythrocyte( D. 7y*'hocyte(
!0. -nfection %ith ;ro&' $ )eta5he*olytic (tre'tococci i( a((ociated %ith,
$. Rhe&*atic fever
B. 3e'atiti( Ty'e $
C. S'inal *eningiti(
D. Rhe&*atoid arthriti(
!!. $ client i( concerned a)o&t contracting *alaria %hile vi(iting relative( in So&thea(t $(ia. The n&r(e e+'lain( that the
)e(t %ay to 'revent *alaria i( to avoid,
$. =o(>&ito )ite(
B. Untreated %ater
C. Undercoo/ed food
D. ?ver5'o'&lated area(
!#. The n&r(e i( revie%ing the 'hy(ical e+a*ination and la)oratory te(t( of a client %ith *alaria. The n&r(e &nder(tand(
that an i*'ortant finding in *alaria i(,
$. 7e&/ocyto(i(
B. Erythrocyto(i(
C. S'leno*egaly
D. Elevated (edi*entation rate
!3. 4hen caring for a client %ith *alaria, the n&r(e (ho&ld /no% that,
$. Sei9&re 'reca&tion( *&(t )e follo%ed
B. 8eritoneal dialy(i( i( &(&ally indicated
C. -(olation i( nece((ary to 'revent cro((5infection
D. N&trition (ho&ld )e 'rovided )et%een
'aro+y(*(
!4. 4hen teaching a client a)o&t dr&g thera'y again(t 8la(*odi&* falci'ar&*, the n&r(e (ho&ld incl&de the fact that,
$. The infection( are controlled
B. -**&nity %ill 'revent reinfe(tation
C. The infection( can generally )e eli*inated
D. Tran(*i((ion )y the $no'hele( *o(>&ito can occ&r
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NURSEZONE
4
th
Floor Florentine Bldg. Bonifacio St., Davao City
Tel No. 300 !"0# and 303 0""3
!0. Blac/%ater fever occ&r( in (o*e client( %ith *alaria@ therefore, the n&r(e (ho&ld o)(erve client %ith chronic *alaria
for,
$. Diarrhea
B. Dar/ red &rine
C. 7o%5grade fever
D. Coffee gro&nd e*e(i(
!:. 4hen caring for a client %ho i( 3-. 'o(itive 'ri*ary re('on(i)ility of the n&r(e i( to e+'lain ho% the client can 'revent,
$. $-DS
B. Social i(olation
C. ?ther infection(
D. Aa'o(i6( (arco*a
!". 4hen a tra&*a victi* e+'re((e( fear that $-DS *ay develo' a( a re(&lt of a )lood tran(f&(ion the n&r(e (ho&ld
e+'lain that,
$. Blood i( treated %ith radiation to /ill the v
B. Screening for the 3-. anti)odie( ha( *ini*i9ed thi( ri(/
C. The a)ility to directly identify 3-. ha( eli*inated thi( concern
D. Con(ideration (ho&ld )e given to done o%n )lood for tran(f&(ion
!<. $ *other %ith the diagno(i( of $-DS (tate( (he ha( )een caring for her little )a)y eventho&gh (he ha( not )een
feeling %ell. The n&r(e (ho&ld a(/ her,
$. -f (he i( )rea(tfeeding the )a)y
B. -f (he ha( h&gged or /i((ed the )a)y
C. 4hen the )a)y la(t received anti)iotic(
D. 3o% long (he ha( )een caring for the )a)y
!2. 4hen 'roviding di(charge teaching to the fa*ily of a client %ith $-DS, the n&r(e (ho&ld teach the fa*ily,
A. BCo& need to )oil the di(he( for 30 *in&te( after &(e.B
B. B7et the client eat fro* 'a'er 'late( and di(card the*.B
C. B4a(h the di(he( in hot (oa'y %ater a( yo& &(&ally do.B
D. B7et the di(he( (oa/ in hot %ater overnight )efore %a(hing.B
#0. D&ring an $-DS ed&cation cla((, a client (tate B.a(eline %or/( great %hen - &(e condo*(.B The n&r(e recogni9e( that
thi( (tate*ent indicate(,
$. $n &nder(tanding of (afer (e+
B. The a)ility to a((&*e (elf5re('on(i)ility
C. -gnorance concerning the tran(*i((ion of 3-.
D. $ lac/ of infor*ation concerning correct condo* &(e
#!. $ client ha( a )one *arro% a('iration 'erfor*ed. -**ediately after the 'roced&re, the n&r(e (ho&ld,
$. 8o(ition the client on the affected (ide
B. Begin fre>&ent *onitoring of vital (ign(
C. Clean(e the (ite %ith an anti(e'tic (ol&tion
D. Briefly a''ly 're((&re over the a('iration (ite.
##. 4ith 3odg/in6( di(ea(e the ly*'h node( &(&ally affected fir(t are the,
$. $+illary B. -ng&inal C. Cervical D. =edia(tinal
#3. The highe(t incidence of 3odg/in6( di(ea(e i( in,
$. Children
B. Co&ng ad&lt(
C. Elderly 'er(on(
D. =iddle5aged 'er(on(
#4. $ client i( to have %hole5)ody radiation for 3odg/in6( di(ea(e. The n&r(e6( teaching 'lan (ho&ld center aro&nd the
li/ely occ&rrence of increa(ed,
$. Blood vi(co(ity
B. S&(ce'ti)ility to infection
C. Red )lood cell 'rod&ction
D. Tendency for 'athologic fract&re(
#0. Frag*ent( of cell( in the )lood(trea* that )rea/ do%n on e+'o(&re to inD&red ti((&e and )egin the chain reaction
leading to a )lood clot are /no%n a(,
$. 8latelet( B. 7e&/ocyte( C. Erythrocyte( D. Red )lood cell(
#:. The n&r(e &nder(tand( that thro*)o'la(tin, %hich initiate( the clotting 'roce(( i( fo&nd in,
$. Bile B. 8la(*a C. 8latelet( D. Erythrocyte(
#". 4hen a((e((ing a %o&nd that e+hi)it( (ign( of )lood coag&lation and healing, the n&r(e &nder(tand( that the (ol&)le
(&)(tance that )eco*e( an in(ol&)le gel i(,
$. Fi)rin B. Thro*)in C. Fi)rinogen D. 8rothro*)in
#<. The n&r(e &nder(tand( that )lood clotting re>&ire( the 're(ence of the cataly(t,
$. FE B. C-E
C. CaFF
D. FeFFF
#2. .ita*in A i( e((ential for nor*al )lood clotting )eca&(e it 'ro*ote(,
$. 8latelet aggregation
B. loni9ation of )lood calci&*
C. Fi)rinogen for*ation )y the liver
D. 8rothro*)in for*ation )y the liver
#
NURSEZONE
4
th
Floor Florentine Bldg. Bonifacio St., Davao City
Tel No. 300 !"0# and 303 0""3
30. The increa(ed tendency to%ard coronary and cere)ral thro*)o(e( (een in individ&al( %ith 'olycythe*ia vera i(
attri)&ta)le to the,
$. -ncrea(ed vi(co(ity
B. Fragility of the cell(
C. Elevated )lood 're((&re
D. -**at&rity of red )lood cell(
3!. $ (er&* )ilir&)in i( 'erfor*ed on a client %ho i( %ea/, dy('neic and Da&ndiced. $ )ilir&)in level a)ove # *g1!00 *l
)lood vol&*e co&ld indicate,
$. 3e*olytic ane*ia
B. 8ernicio&( ane*ia
C. Decrea(ed rate of red cell de(tr&ction
D. 7o% o+ygen5carrying ca'acity of erythrocyte(
3#. $( a re(&lt of a (erio&( a&to*o)ile accident, a client i( ad*itted %ith *&lti'le tra&*a incl&ding a r&'t&red ('leen. $
('lenecto*y i( 'erfor*ed )eca&(e,
$. The ('leen i( a highly va(c&lar organ
B. -t i( anato*ically adDacent to the dia'hrag*
C. The ('leen i( the large(t ly*'hoid organ in the )ody
D. R&'t&re of the ('leen can ca&(e di(ea(e( of the liver
33. -n the i**ediate 'o(to'erative 'eriod follo%ing a ('lenecto*y, the n&r(e ('ecifically (ho&ld o)(erve the client for,
$. Shoc/ and infection
B. -nte(tinal o)(tr&ction and )leeding
C. 3e*orrhage and a)do*inal di(tention
D. 8eritoniti( and '&l*onary co*'lication(
34. $ client ha( a ('lenecto*y follo%ing a *otor vehicle accident. The con(ideration that i( of 'ri*ary i*'ortance after a
('lenecto*y i(,
$. Early a*)&lation
B. 8&l*onary e*)oli(*
C. $de>&ate l&ng aeration
D. 8o(to'erative he*orrhage
30. ?cc&rrence of an ana'hylactic reaction after receiving 'enicillin indicate( that the client ha(,
$. $n ac>&ired ato'ic (en(iti9ation
B. 8a((ive i**&nity to the 'enicillin allergen
C. $nti)odie( to 'enicillin ac>&ired after earlier &(e of the dr&g
D. Develo'ed 'otent )ivalent anti)odie( %hen the -. ad*ini(tration %a( (tarted
3:. $ 305year5old 'rofe((ional golfer i( )ro&ght to the e*ergency roo* for a )ee (ting. The client ha( a hi(tory of allergie(
to )ee( and i( having tro&)le )reathing. The n&r(e i( a%are that thi( client can e+'ire fro*,
$. -(che*ia B. $('hy+ia C. 7actic acido(i( D. $ntihi(ta*enia
3". $ client ha( an ana'hylactic reaction %ithin the fir(t half ho&r after an -. inf&(ion containing a*'icillin i( (tarted. The
n&r(e &nder(tand( that the (y*'to*( occ&rring d&ring an ana'hylactic reaction are the re(&lt of,
$. Re('iratory de're((ion and cardiac (tand(till
B. Con(triction of ca'illarie( and decrea(ed cardiac o&t'&t
C. Bronchial con(triction and decrea(ed 'eri'heral re(i(tance
D. Decrea(ed cardiac o&t'&t and dilation of *aDor )lood ve((el(
3<. $ client %ho %a( e+'o(ed to he'atiti( $ i( given ga**a glo)&lin to 'rovide 'a((ive i**&nity %hich,
$. -ncrea(e( 'rod&ction of (hort5lived anti)odie(
B. 8rovide( anti)odie( that ne&trali9e the antigen
C. $ccelerate( antigen5anti)ody &nion at he'atic (ite(
D. Sti*&late( the ly*'hatic (y(te* to 'rod&ce large n&*)er( of anti)odie(
32. The ('o&(e of a co*ato(e client %ho ha( (evere internal )leeding ref&(e( to allo% tran(f&(ion( of %hole )lood
)eca&(e they are Gehovah6( 4itne((e(. The n&r(e involved in thi( (it&ation (ho&ld,
A. 8hone the 'hy(ician for a ('ecial ad*ini(trative order to give the )lood &nder the(e circ&*(tance(
B. 3ave the ('o&(e (ign a treat*ent ref&(al for* and notify the 'hy(ician (o a co&rt order can )e o)tained
C. ;ently e+'lain to the h&()and %hy the tran(f&(ion i( nece((ary, e*'ha(i9ing the i*'lication( of not having the
tran(f&(ion.
D. -n(tit&te the )lood tran(f&(ion any%ay, )eca&(e the 'hy(ician ordered it and the client6( (&rvival de'end( on
vol&*e re'lace*ent
40. $ client %ith hy'other*ia i( )ro&ght to the e*ergency roo*. The fa*ily (ho&ld )e ta&ght that treat*ent %ill incl&de,
$. Core re%ar*ing %ith %ar* fl&id(
B. $*)&lation to increa(e *eta)oli(*
C. Fre>&ent oral te*'erat&re a((e((*ent
D. ;a(tric t&)e feeding( to increa(e fl&id(
4!. 4hen it i( i*'o((i)le to deter*ine %hether a client ha( )een i**&ni9ed again(t tetan&(, the 're'aration of choice
&(ed to 'rod&ce 'a((ive i**&nity for (everal %ee/( %ith *ini*al danger of allergic reaction( i(,
$. DT8 vaccine
B. Tetan&( to+oid
C. Tetan&( antito+in
D. Tetan&( i**&ne glo)&lin
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NURSEZONE
4
th
Floor Florentine Bldg. Bonifacio St., Davao City
Tel No. 300 !"0# and 303 0""3
4#. $ client %ho i( (&('ected of having tetan&( a(/ the n&r(e a)o&t i**&ni9ation( again(t tetan&(. The n&r(e e+'lain(
that the *aDor )enefit in &(ing tetan&( antito+in i( that it,
$. Sti*&late( 'la(*a cell( directly
B. 8rovide( a high titer of anti)odie(
C. 8rovide( i**ediate active i**&nity
D. Sti*&late( long5la(ting 'a((ive i**&nity
43. $ fe*ale client ha( he*oglo)in of <.0 g1dl %hich i( attri)&ted to n&tritional deficiency. The food( that the n&r(e (ho&ld
reco**end )e increa(ed in the client6( diet incl&de,
$. Carrot(, )eef, and a''le(
B. S'inach, liver, and rai(in(
C. Broccoli, 'or/, and a'ricot(
D. 7i*a )ean(, (>&a(h, and 'r&ne(
44. 4hile )eing 're'ared for (&rgery for a r&'t&red ('leen, a client co*'lain( of feeling light headed. The client6( color i(
'ale and the '&l(e i( very ra'id. The n&r(e a((e((e( that the client *ay )e,
$. 3y'erventilating
B. ;oing into (hoc/
C. E+tre*ely an+io&(
D. Develo'ing an infection
4