Question 1

When explaining about a lumbar puncture,the nurse informs the patient that during the procedure,he or she will be asked to:

Accepted Answer

During a lumbar puncture, the patient should remain very still to minimize the risk of complications such as post-dural puncture headache or nerve damage. Coughing during the fluid aspiration or breathing deeply during the needle insertion can increase pressure in the spinal canal, which can also increase the risk of complications. Changing position may be necessary during the procedure, but the nurse will guide the patient and ask them to move slowly and carefully.

Question 2

The physician needs to visually examine a patient's esophagus,stomach,and duodenum.The nurse anticipates that the physician will order:

Accepted Answer

The procedure that allows for visual examination of the esophagus, stomach, and duodenum is an esophagogastroduodenoscopy (EGD), also referred to as a upper gastrointestinal endoscopy. Endoscopic retrograde cholangiopancreatography (ERCP) is used to examine the bile ducts and pancreatic ducts, esophagoscopy only examines the esophagus, and proctoscopy only examines the rectum and anus.

Question 3

The nurse is alert to a possible delayed reaction to the dye injected during an angiography.For which response should she monitor the patient?

Accepted Answer

Assess the patient for a possible delayed reaction to iodine dye,seen as dyspnea,hives,tachycardia,and rash.This reaction occurs up to 6 hours after injection of dye.Thirst,by itself,is not a major warning sign of reaction to the dye.Pallor,by itself,is not a major warning sign of reaction to the dye.A patient's report of any feelings of pain,dyspnea,numbness or tingling,or other untoward symptoms may indicate cardiac complications or procedure site complications,but not a reaction to the dye.

Question 4

The nurse is caring for a patient who has received moderate sedation for a procedure at the bedside.Which task can be delegated to the nursing assistive personnel (NAP)during this procedure?

Accepted Answer

Recording urine output is a task that can be delegated to NAPs as it does not require the NAP to assess the patient's level of consciousness or vital signs. Assessing sedation score, obtaining blood pressure, and monitoring respiratory rate are all tasks that require a higher level of assessment and decision-making skills, and should be performed by licensed nursing staff.

Question 5

In which position is the patient usually placed for a thoracentesis?

Accepted Answer

Place the patient in the orthopneic position (upright position with arms and shoulders raised and supported on a padded over-bed table).If the patient is unable to tolerate this position,assist the patient to a side-lying position with the affected lung positioned upward.This expands the intercostal space for needle insertions.

Question 6

The nurse is discussing the patient's upcoming elective lumbar puncture,and explains that the patient will probably need to undergo computed tomography of the brain before the procedure is done.What is the reason for this?

Accepted Answer

A computed tomography of the brain is usually done to rule out increased intracranial pressure before an elective lumbar puncture is performed. This is to prevent the risk of potentially fatal herniation of the brain due to the rapid removal of cerebrospinal fluid through the lumbar puncture.

Question 7

For an upper gastrointestinal endoscopy,a nurse should:

Accepted Answer

During an upper gastrointestinal endoscopy, dentures should be removed to minimize the risk of aspiration and to provide better access to the throat and esophagus.

Question 8

Which is the appropriate patient position for a lumbar puncture?

Accepted Answer

The appropriate patient position for a lumbar puncture is lateral recumbent position (also called the lateral decubitus position) with the knees drawn up to the chest. This position helps to open up the spaces between the vertebrae and allows for easier access to the spinal canal. The patient should be positioned with the side to be punctured facing upwards.

Question 9

The nurse is preparing to assist with a bone marrow aspiration on a 3-month-old infant.The nurse may expect that the physician will use which site to perform the aspiration?

Accepted Answer

In children,the anterior or posterior iliac crest is used,and in infants,the proximal tibia is used.

Question 10

The patient has undergone a cardiac catheterization.It has been 2 hours since the catheter and sheath have been removed.Which of the following would be a concern for the nurse recovering the patient after the procedure?

Accepted Answer

The answer of The patient has undergone a cardiac catheterization.It...

Question 11

When explaining what to expect during a bronchoscopy,the nurse informs the patient that:

Accepted Answer

Do not allow the patient to eat or drink until the tracheobronchial anesthesia has worn off and the gag reflex has returned-usually for 2 hours.Instruct the patient not to swallow the local anesthetic.The bronchoscope is introduced into the mouth,to the pharynx,to pass through the glottis.The patient should have taken nothing by mouth for at least 8 hours before a bronchoscopy.

Question 12

A patient who is a candidate for an upper gastrointestinal endoscopy has:

Accepted Answer

The patient must be NPO (nothing by mouth) for at least 8 hours before an upper gastrointestinal endoscopy to ensure that the stomach is empty and reduce the risk of aspiration of stomach contents. Evident respiratory distress may indicate a need for urgent medical intervention, but it would not be a requirement for an upper gastrointestinal endoscopy. Active gastrointestinal bleeding may be a reason for an urgent upper gastrointestinal endoscopy, but it is not a requirement for the procedure. An esophageal diverticulum may be identified during an upper gastrointestinal endoscopy, but it is not a requirement for the procedure.

Question 13

A nurse should contact the physician to postpone intravenous moderate sedation if the patient:

Accepted Answer

Verify that the patient has not ingested food or fluids,except for oral medications,for at least 4 hours.Verify specific agency requirements.Because a risk of moderate sedation is loss of airway protection,an empty stomach reduces the risk for aspiration.A history of substance abuse is not a contraindication to the procedure,although it usually requires dose adjustment of the sedative.With no history of latex allergy,allergic reactions are not a concern.An understanding of the procedure implies that consent was informed.

Question 14

The nurse is caring for a patient who underwent a cardiac catheterization.The sheaths have just been removed.You should assess the patient carefully for what potential complication?

Accepted Answer

After removal of the sheaths from a cardiac catheterization, the patient is at risk for a vasovagal reaction, which includes symptoms such as bradycardia, hypotension, diaphoresis, and/or nausea. This risk is higher in older patients or those with a history of vasovagal response. Hypertension and tachycardia are not common complications associated with sheath removal, and allergic reactions are rare but could occur with dye used during the procedure.

Question 15

Under which circumstances should a nurse contact the physician to postpone an angiography?

Accepted Answer

A patient needs to be NPO for 6 to 8 hours before the procedure to prevent possible aspiration because the patient is sedated.The site of catheter insertion needs to be shaved and prepped with antiseptic just before the procedure.Benadryl is used prophylactically to block histamine and decrease allergic responses.Elevated BUN or creatinine levels would place patients at risk for renal failure induced by contrast media.

Question 16

Which action should the nurse take after a procedure requiring intravenous moderate sedation?

Accepted Answer

After a procedure requiring intravenous moderate sedation, the nurse should monitor airway patency and vital signs every 5 minutes for 30 minutes to ensure the patient recovers safely from the sedation. This is in accordance with the American Society of Anesthesiologists' guidelines for post-anesthesia care. Option A is incorrect because a Ramsay sedation score less than 3 is desirable, indicating that the patient is responsive but sedated. Option C is incorrect because vital signs should be taken more frequently than every 15 minutes in the immediate post-procedure period. Option D is incorrect because vital signs should be taken more frequently than every 30 minutes in the immediate post-procedure period.

Question 17

The patient is a 56-year-old man who has terminal cirrhosis and severe ascites.He is lethargic but is demonstrating signs of discomfort and respiratory distress.The physician has spoken with the patient's wife and has obtained consent to perform an abdominal paracentesis on the patient.After the physician leaves to prepare for the procedure,the wife asks the nurse whether the procedure is really necessary.The nurse should respond by saying this:

Accepted Answer

Abdominal paracentesis is a procedure that involves removing excess fluid from the abdomen. In this patient's case, the severe ascites is causing discomfort and respiratory distress, and alleviating this excess fluid may help the patient feel better. It is not the first step in the patient's recovery, nor is it needed to detect increased intracranial pressure or analyze pleural fluid.

Question 18

The patient will be undergoing moderate intravenous (IV)sedation.The nurse needs to assess which of the following during the procedure?

Accepted Answer

The answer of The patient will be undergoing moderate intravenous...

Question 19

During an electrocardiogram,the patient should anticipate that:

Accepted Answer

During an electrocardiogram, the electrode sites will be cleaned with alcohol to ensure that there are no oils or lotions that could interfere with the electrocardiogram readings. Chest pain is not a common occurrence during an electrocardiogram, and talking and moving around should be minimized to ensure accurate readings. The electrodes are typically attached with adhesive pads or stickers, not ties or rubber straps.

Question 20

What action should the nurse take after an angiography?

Accepted Answer

After an angiography, the nurse should apply a pressure dressing to the vascular site to prevent bleeding and hematoma formation. The other options are not appropriate actions after angiography. The patient's fluid intake should be encouraged to prevent complications like dehydration, and they should not be maintained in a sitting position as this can increase the risk of bleeding. While the patient should eventually ambulate as part of their recovery, they should not do so immediately after angiography, as their blood vessels need time to heal.

Quiz 8: Diagnostic Procedures