Deck 24: Diagnostic Tests and Specimen Collection

Question 1

A patient wants to know what was meant when the doctor said that his white blood cell (WBC) count had a shift to the left. The nurse explains that a shift to the left indicates:

A) an improvement in an infectious process.
B) the relative effectiveness of the antibiotic therapy.
C) an increase in the number of immature WBCs.
D) that the infection is viral in nature.

Answer 1

an increase in the number of immature WBCs.

Question 2

A patient asks why the blood glucose meter directions state to wipe away the first drop of blood. The most informative response by the nurse would be:

A) "This eliminates microorganisms from the sample."
B) "The first drop is usually too small."
C) "The first drop is usually contaminated."
D) "The first drop has serous fluid that can dilute the specimen."

Answer 2

"The first drop has serous fluid that can dilute the specimen."

Question 3

The patient in the skilled nursing facility who is to have a colonoscopy tomorrow complains about his limited diet prior to the examination. The nurse may offer the patient:

A) lime Jell O.
B) strawberry soda.
C) oatmeal thinned with milk.
D) vanilla ice cream.

Answer 3

lime Jell O.

Question 4

The nurse instructing in the collection of a midstream urine catch would tell the patient to first cleanse the external genitalia and then to:

A) begin voiding into the specimen cup.
B) let a few drops of urine dribble into the specimen cup.
C) void until the bladder is almost empty and then collect the end portion of the voiding in the cup.
D) pass a small amount of urine into the toilet and then collect the specimen.

Question 5

An older adult patient has had a series of enemas in preparation for a gastrointestinal diagnostic procedure. Which electrolytes should be monitored following the enemas?

A) Calcium and chloride
B) Sodium and potassium
C) Magnesium and phosphorus
D) Selenium and zinc

Question 6

A patient who is scheduled for a cardiac catheterization asks what the catheterization will reveal that an electrocardiogram would not. The nurse explains that the catheterization shows:

A) the entire heart to find evidence of cancer.
B) heart rhythm.
C) electrical activity of the heart action.
D) oxygen concentration at various sites.

Question 7

Following a colonoscopy with polyp removal, the wife of the patient is distressed that there is slight bleeding from her husband's rectum. The nurse's most helpful response would be:

A) "This small amount of bleeding is expected after the removal of polyps."
B) "I will notify the primary care provider about this hemorrhage."
C) "I will watch your husband very carefully to assess any further hemorrhage."
D) "Don't worry. This small amount of blood happens with these procedures."

Question 8

For the patient who just had a liver biopsy performed, the nurse should position him:

A) prone for 1 hour.
B) on his right side lying for 2 hours.
C) supine for 3 hours.
D) on his left side lying for 4 hours.

Question 9

A patient will undergo endoscopic retrograde cholangiopancreatography (ERCP) to determine the cause of jaundice. Before the test, the nurse would assess this patient for an allergy to:

A) eggs.
B) pork.
C) aspirin.
D) shellfish.

Question 10

A patient who has undergone endoscopy is fully awake and asks the nurse for something to drink. After confirming that liquids are allowed on the primary care provider order sheet, the nurse should:

A) assist the patient to the bathroom to void.
B) listen to lung sounds.
C) take a blood pressure and pulse.
D) check for the return of gag and swallow reflexes.

Question 11

A patient has undergone cystoscopy and has a Foley catheter in place on return to the nursing unit. Immediately after the procedure, the nurse expects the urine color to be:

A) clear as water.
B) bright red with clots.
C) pink tinged.
D) cherry colored.

Question 12

When obtaining a capillary blood sample for blood glucose, the nurse will select the puncture site to cause the least amount of discomfort, which is:

A) the end of the index finger.
B) the ball of the third finger.
C) at right angles to the fingerprint lines.
D) the ball of the thumb.

Question 13

A patient who is to have a treadmill stress test at 11:00 AM today should not consume:

A) toast and jam.
B) coffee and cream.
C) oatmeal and sugar.
D) pancakes and syrup.

Question 14

A patient who is on an anticoagulant (Coumadin) asks, "What did the primary care provider mean when he said I was to have my blood tested every 2 weeks?" The nurse explains, "It is important to monitor the effects of the drug to see how long it takes your blood to clot. The blood test the primary care provider was talking about is the:

A) complete blood count (CBC)."
B) activated partial thromboplastin time (APTT)."
C) international normalized ratio (INR)."
D) erythrocyte sedimentation rate (ESR)."

Question 15

The nurse explains to the patient that the significance of the hematocrit is that it:

A) indicates the number of circulating white blood cells.
B) indicates the value of the hemoglobin.
C) refers to the separation of blood cells from plasma.
D) will decrease when the patient is in shock.

Question 16

The nurse instructs an outpatient female patient preparing for an abdominal ultrasonography that prior to the procedure, she should:

A) eat or drink nothing after midnight.
B) drink a liter of water.
C) empty the bladder fully.
D) use enemas at home to clear the bowel fully.

Question 17

The nurse preparing a patient for a magnetic resonance imaging (MRI) should determine if the patient has:

A) respiratory allergies.
B) claustrophobia.
C) fear of the dark.
D) dizziness.

Question 18

Prior to the nurse transporting the patient to have a magnetic resonance imaging (MRI), it is essential that the nurse confirms that the patient:

A) has eaten a meal.
B) has drunk a liter of fluid.
C) is not wearing anything with metal.
D) has a Foley catheter in place.

Question 19

A patient is scheduled to have a blood chemistry profile drawn at 8 AM tomorrow. The note should be added on the care plan and report provided to the oncoming shift to withhold food and drink after:

A) 6 AM.
B) 12 midnight tonight.
C) 4 AM today.
D) noon today.

Question 20

To improve the comfort of an older adult patient who is to be in the radiology department for several hours, the nurse should send a(n):

A) family member with the patient.
B) extra pillow.
C) blanket.
D) newspaper to read.

Question 21

The nurse is aware that a patient who is to have a colonoscopy is requested to stop taking drugs that contain iron for ______ days prior to the test.

Question 22

The nurse is aware that the medical record of a patient going for a cardiac catheterization should have: (Select all that apply.)

A) a signed consent form.
B) a complete history and physical examination.
C) evidence of the initiation of NPO status at least 2 hours prior.
D) evidence of patient education done before the consent form is signed.
E) report of kidney function tests.
F) administration of ordered preoperative medications.

Question 23

A patient is having an MRI for a knee injury. During the test, he complains of burning in his upper thigh and swelling. Which of the following is the most probable cause of this complaint?

A) Fluid is trapped in the leg due to the dependent positioning.
B) Discomfort most likely related to injury in the knee.
C) Trace metals in ink from a tattoo on the thigh.
D) Discomfort indicates an emergency and requires discontinuation of the MRI.

Question 24

A patient in the outpatient clinic has provided a urine sample. To perform a urine dipstick test accurately, the nurse wets the dipstick and starts timing:

A) immediately.
B) after 5 seconds.
C) after 10 seconds.
D) after 30 seconds.

Question 25

A major concern for an 86-year-old patient who has been NPO for 8 hours prior to a diagnostic test would be:

A) fatigue.
B) circulatory status.
C) hydration status.
D) nutritional status.

Question 26

The nurse is to collect a sample of blood for a laboratory test. Arrange the sequence of a phlebotomy. (Separate letters by a comma and space as follows: A, B, C, D, E, F, G, H.)

A) Place vacutainer tube inside holder.
B) Press tube stopper onto needle.
C) Puncture site.
D) Apply tourniquet and cleanse site.
E) Label tube.
F) Fill tube completely.
G) Loosen tourniquet and apply pressure to site.
H) Perform hand hygiene and apply gloves.

Question 27

The nurse informs the patient who is to have an electroencephalogram (EEG) that the technician will try to stimulate seizure activity by asking the patient to: (Select all that apply.)

A) close his eyes.
B) hyperventilate.
C) breathe in a rapid shallow fashion.
D) hold a flashing light over his face.
E) submerge his hands in cold water.

Question 28

The primary care provider has ordered the collection of a 24-hour urine specimen. The nurse's instructions to the patient for proper collection of the urine specimen include: (Select all that apply.)

A) keep the container refrigerated as needed.
B) empty the bladder into the toilet and begin timing the collection.
C) void a small amount of urine after external genitalia are cleansed.
D) keep the container on ice if instructed to do so.
E) save only the first voiding in the morning.

Question 29

The statement made by a patient that would delay a scheduled CT scan would be:

A) "I have terrible claustrophobia."
B) "I have just been started on metformin."
C) "I am allergic to penicillin."
D) "I have an implanted pacemaker."

Question 30

The nurse instructing a patient who is to have a Papanicolaou smear (Pap smear) in 2 days would tell the patient to avoid:

A) sexual intercourse.
B) douching.
C) eating shellfish.
D) taking a bubble bath.

Question 31

The patient who has just returned to the unit after an angiography test should be assessed immediately for:

A) swelling of tongue.
B) pulmonary congestion.
C) bleeding at insertion site.
D) hypotension.

Question 32

The nurse obtaining a wound culture would:

A) use clean gloves.
B) rotate the swab vigorously in the wound bed.
C) rinse the exudate on the swab with normal saline.
D) place the swab in the culture tube without touching the sides.

Question 33

The nurse evaluates a prothrombin time (PT/INR) for a patient who is taking heparin. The nurse's initial action should be to:

A) document the findings in the medical record.
B) notify the laboratory that they have made an error.
C) check the primary care provider's order.
D) notify the primary care provider of the laboratory finding.

Question 34

The nurse is aware that patients who are not candidates for magnetic resonance imaging (MRI) include patients with: (Select all that apply.)

A) a hip prosthesis.
B) bleeding tendencies.
C) allergy to iodine.
D) cardiac pacemakers.
E) previous radiological treatment.