Question 1

What is the best time of the day for obtaining a sputum specimen?

Accepted Answer

Obtaining an early-morning specimen is best because secretions pool and collect in the lungs during sleep.
Reference

Question 2

During a patient's exercise stress test, his blood pressure dropped.Which of the following activities should be avoided in the 2-hour period after the test?

Accepted Answer

A hot shower may cause an increase in cutaneous vasodilation and lead to orthostatic hypotension.
Reference

Question 3

A patient is scheduled for a cardiac catheterization.Which of the following activities is a postprocedure nursing priority?

Accepted Answer

The extremity in which the catheter was placed must be kept straight and immobilized for several hours after catheterization to prevent bleeding.Ice packs may minimize any swelling or hematoma at the catheter insertion site.
Reference

Question 4

After a lumbar puncture, a nursing priority is to prevent a spinal headache.Which of the following activities is to be avoided?

Accepted Answer

Walking immediately after lumbar puncture may induce a headache.It is best for the patient to remain in bed at rest for about 30 minutes.
Reference

Question 5

A patient with diabetes was taken to the emergency department.His arterial blood gas results were as follows: pH: 7.25
Partial pressure of carbon dioxide (PCO₂): 38 mm Hg
HCO₃⁻ 19 mmol/L
Partial pressure of oxygen (PO₂): 95 mm Hg
What do these results indicate?

Accepted Answer

The pH indicates acidosis.The lower HCO₃⁻ value indicates a metabolic problem.
Reference

Question 6

Blood urea nitrogen (BUN) levels may be abnormally low in which patients?

Accepted Answer

BUN levels can decrease normally in patients who are well hydrated.Because liver function must be adequate to make urea, severe liver dysfunction is associated with decreased BUN levels.Because BUN also is a measure of protein nutrition, this level can be diminished in starving patients.
Reference

Question 7

The serum creatinine level is usually elevated in patients with which of the following?

Accepted Answer

An elevated serum creatinine level indicates renal disease.No other diseased organ causes elevation of the serum creatinine level.
Reference

Question 8

A patient had a lipid profile documented and asks about her results.Which of the following is considered the ideal high-density lipoprotein (HDL)/total cholesterol ratio?

Accepted Answer

The ideal ratio of HDL/total cholesterol is 1:3.An acceptable ratio is at least 1:5.
Reference

Question 9

Which of the following activities should be avoided before electroencephalography (EEG)?

Accepted Answer

Regular coffee, tea, and cola are not permitted on the morning of the study because of their stimulating effect.
Reference

Question 10

For a patient with severe bone destruction from tumour or osteomalacia, what serum laboratory results would the nurse expect to assess?

Accepted Answer

Patients with destructive bone diseases commonly have elevated ALP levels as a result of bone cell destruction and regeneration.
Reference

Question 11

One of the blood studies used to detect a myocardial infarction is creatine kinase (CK).What value is most helpful for diagnosing a myocardial infarction?

Accepted Answer

The isoenzyme CK-MB provides a unique marker for damaged myocardial cells.
Reference

Question 12

Which of these instructions should a nurse give an elderly, dehydrated patient after computed tomography (CT) of the kidney with intravenous iodine contrast material?

Accepted Answer

Elderly patients often are chronically dehydrated and therefore especially susceptible to renal impairment after receiving intravenous iodine contrast material.Not only is the use of laxatives unnecessary to eliminate the contrast material, but it will also further dehydrate the patient.No physical limitations are required.
Reference

Question 13

A patient presents with upper gastrointestinal bleeding from a suspected peptic ulcer.Which of the following is the most appropriate test?

Accepted Answer

EGD is the most accurate diagnostic test.Furthermore, transendoscopic coagulation of active bleeding can be performed with EGD.
Reference

Question 14

A patient is admitted for evaluation of perforated diverticulitis.Which of the following is the most appropriate test?

Accepted Answer

CT is accurate for identifying an abdominal abscess.Colonoscopy and barium enema are contraindicated in patients with suspected perforated viscus.
Reference

Question 15

A patient's laboratory reports indicate the presence of Bence-Jones proteins.These levels are increased in the urine of patients who have:

Accepted Answer

Bence-Jones proteins are immunoglobulins that are commonly excreted in the urine of patients with multiple myeloma.
Reference

Question 16

A patient is scheduled for magnetic resonance imaging (MRI).Which of the following factors is a contraindication to this procedure?

Accepted Answer

An implantable metal pacemaker is a contraindication for this procedure because the magnet may move the object within the body and cause damage.
Reference

Question 17

A patient is scheduled for a cardiac exercise stress test to evaluate chest pain.While obtaining the patient history, the clinician notes that the patient has intermittent claudication when walking two blocks.On the basis of this finding, which of the following is indicated?

Accepted Answer

The patient's peripheral vascular disease will cause calf pain during exercise.This pain probably will precede exercise-induced chest pain and cause the test to be terminated prematurely.
Reference

Question 18

A patient is admitted with abdominal pain.Ultrasonography of the abdomen, CT of the abdomen, and a barium enema study have been ordered.In what order should these tests be performed?

Accepted Answer

Ultrasonography should be performed first because intraabdominal barium will distort the sound waves and thus decrease the accuracy.Also, if the ultrasonography of the abdomen includes water distension of the stomach, the patient will need to void before proceeding to CT to prevent discomfort.Likewise, barium within the bowel will distort the CT image.Therefore ultrasonography should be done first, CT second, and barium enema last.
Reference

Question 19

A patient has just returned from the endoscopy suite, where he underwent bronchoscopy.Which of the following is not a nursing priority after the procedure?

Accepted Answer

The patient is kept on NPO status until the tracheobronchial anaesthesia has worn off and the gag reflex has returned.This usually occurs within 2 hours.A patient who drinks or eats before this time could aspirate and develop pneumonia.
Reference

Question 20

A patient underwent a tuberculin skin test 48 hours ago.He returns to the clinic for the nurse to read the test results.Which of the following is considered a positive result?

Accepted Answer

An indurated (hardened) area measuring more than 10 mm is a positive result.This means that the patient has been exposed to tuberculosis.
Reference

Quiz 1: Mosbys Canadian Manual of Diagnostic and Laboratory Tests, 1st Canadian Edition