Question 1

A patient's laboratory test results indicate the presence of fetal fibronectin.This finding is indicative of which of the following?

Accepted Answer

The presence of fetal fibronectin is indicative of premature labor. Fetal fibronectin is a protein found in fetal membranes and has been shown to be a reliable predictor of preterm labor. Its presence in the cervix between 22 to 37 weeks of gestation indicates that there is an increased risk of premature delivery within the next 7 to 10 days. It is not a marker for gestational diabetes, fetal Down syndrome or neural tube defect.

Question 2

A nurse is assessing a patient for suitability to undergo slit-lamp biomicroscopy with pupil dilation.Which of the following would be a contraindication for undergoing this test?

Accepted Answer

Slit-lamp biomicroscopy with pupil dilation increases intraocular pressure, which can be dangerous for individuals with narrow-angle glaucoma. Cataracts, blepharitis, and conjunctivitis are not contraindications for this test.

Question 3

Following refraction testing, a patient's point of focus is found to lie behind the retina.This finding indicates which of the following?

Accepted Answer

Hyperopia, also known as farsightedness, is a refractive error in which the point of focus is behind the retina. This can make it difficult to see objects that are nearby, but distant objects may be easier to see.

Question 4

The nurse is working in a gynecologist's office caring for a woman who is undergoing progesterone testing in an effort to become pregnant.Which of the following statements by the nurse is most therapeutic?

Accepted Answer

Option A is the most therapeutic because it demonstrates empathy and shows that the nurse is acknowledging the patient's emotions and providing a safe space to express any worries or concerns. It offers an opportunity for the patient to talk about her support system, which may be helpful during a stressful time. Option B is dismissive and does not address the patient's concerns. Option C shifts the focus from the patient to the nurse, which is not therapeutic. Option D may be interpreted as minimizing the importance of motherhood, and may not be helpful for a patient who is trying to conceive.

Question 5

The nurse is providing care for a woman who recently gave birth to a full-term baby girl.The woman tells the nurse she is worried because her son had elevated bilirubin levels as an infant and had to be in an incubator with special lights.Which of the following statements by the nurse is best?

Accepted Answer

This statement acknowledges the woman's concern, provides accurate information about normal bilirubin levels, and advises her on when to contact the doctor if she notices any concerning symptoms. The other options do not provide adequate or accurate information to address the woman's concerns.

Question 6

The nurse is caring for a patient who complains of morning stiffness with deforming arthritis of both hands and radiographic changes noted on x-ray.Which of the following would the nurse expect to find in the chart?

Accepted Answer

The presence of deforming arthritis of both hands and radiographic changes suggest rheumatoid arthritis. An elevated rheumatoid factor is a common diagnostic test for rheumatoid arthritis, seen in approximately 70-80% of patients. The other options are not typically associated with rheumatoid arthritis.

Question 7

The nurse is providing community education within a Jewish community.Which of the following laboratory tests would the nurse instruct individuals to use to screen for carrier status of Tay-Sachs disease?

Accepted Answer

Hexosaminidase A is the enzyme that is deficient in individuals with Tay-Sachs disease. Therefore, screening for carrier status would involve testing for the presence and activity level of this enzyme. The other laboratory tests listed are not relevant to screening for Tay-Sachs disease.

Question 8

A patient's laboratory test results indicate an increased level of blood urea nitrogen (BUN)secondary to imbalanced nutrition.The nurse should encourage this patient to decrease intake of which of the following, to achieve a more balanced diet?

Accepted Answer

Blood urea nitrogen (BUN) is a waste product that is formed when protein is metabolized by the liver and excreted by the kidneys. Therefore, an increased level of BUN indicates that there is an excess amount of protein being broken down and eliminated by the body. To achieve a more balanced diet, the nurse should encourage the patient to decrease intake of protein.

Question 9

While undergoing an exercise stress test, a patient complains of acute pain and cramping in the leg.Which condition should the nurse most suspect in this patient?

Accepted Answer

Acute pain and cramping in the leg during an exercise stress test is a typical symptom of peripheral artery disease, which is caused by the narrowing of peripheral arteries, leading to decreased blood flow to the muscles in the legs. Dysrhythmia, coronary artery disease, and tachycardia are not typically associated with leg pain or cramping during an exercise stress test.

Question 10

A couple who both carry the sickle cell trait have brought their 6-month-old daughter in for screening.Which of the following statements by the nurse is best?

Accepted Answer

The nurse should acknowledge the parents' anxiety and offer support. Sickle cell trait is a genetic condition and there is a 25% chance of their child inheriting two copies of the gene, resulting in sickle cell disease. The nurse can provide information about screening and management options, but should also offer emotional support to the parents. Option A is incorrect as sickle cell trait does not typically cause symptoms. Option B is incorrect as there is no need for the baby to stay in the hospital overnight for screening. Option D is incorrect as sickle cell testing can be done at any age, but DNA testing may not be accurate until the child is a few months old.

Question 11

A patient complains of frequent flare-ups of joint pain all over the body.Which test would be most appropriate for assessing this condition?

Accepted Answer

The symptoms described are suggestive of rheumatoid arthritis, an autoimmune disorder that leads to joint pain and inflammation throughout the body, so the most appropriate test would be the rheumatoid factor (RF) test. This test checks for the presence of antibodies that are common in people with rheumatoid arthritis.

Question 12

A nurse is positioning a patient for thyroid and parathyroid ultrasound imaging.Which position should the patient be placed in?

Accepted Answer

The supine position with the neck hyperextended is recommended for thyroid and parathyroid ultrasound imaging. This allows for easy access to the neck area and better visualization of the thyroid and parathyroid glands. Prone position is not appropriate as it will hinder access to the neck area. Side-lying with the neck flexed and knee-chest with the neck flexed may be uncomfortable for patients and are not required for this type of imaging.

Question 13

A patient's laboratory test results are negative for sickle cell disease.However, the nurse is aware that false-negative results may occur in which of the following situations?

Accepted Answer

False-negative results can occur in infants younger than 3 months because their body has not yet started producing enough hemoglobin for the test to detect sickle cell disease. Prostaglandins, blood transfusions from sickle cell-positive donors, and strenuous exercise do not affect the accuracy of sickle cell disease test results.

Question 14

As a nurse is assisting with fundus photography of a patient's eyes, the patient complains of suddenly seeing floaters and a veil that moves across the field of vision.The nurse should recognize these symptoms as critical findings, indicative of which of the following conditions?

Accepted Answer

Seeing floaters and a veil that moves across the field of vision are indicative of a detached retina, which can be a medical emergency if not treated promptly. Diabetic retinopathy, glaucoma, and macular degeneration may cause vision issues, but they do not typically present with floaters and a veil.

Question 15

The nurse is caring for a patient in the intensive care unit who is in a hepatic coma.The lactic acid level is 32 mg/dL.Which of the following symptoms would the nurse expect to see?

Accepted Answer

A high lactic acid level indicates metabolic acidosis, which can lead to Kussmaul respirations as the body tries to compensate by increasing breathing rate to get rid of excess acid. Bradycardia, fever, and flushing are not typically associated with hepatic coma or metabolic acidosis.

Question 16

While caring for a patient in the intensive care unit, the nurse is concerned about the patient's kidney function.In order to estimate a glomerular filtration rate (eGFR), the nurse would need which of the following?

Accepted Answer

To estimate a glomerular filtration rate (eGFR), the nurse would need a serum creatinine result. The eGFR is typically calculated using the serum creatinine level because creatinine is produced at a relatively constant rate and is freely filtered by the kidneys. Other factors, such as age, gender, and race, are also taken into consideration when calculating eGFR. Height and weight may be useful in determining body surface area, but they are not used in eGFR calculation. Total protein and blood urea nitrogen levels may be useful in evaluating kidney function but are not used in eGFR calculation.

Question 17

A nurse working in a primary care provider's office notes a client's follicle-stimulating hormone (FSH)levels are elevated.Which of the following reported symptoms would most likely correlate with this finding?

Accepted Answer

Elevated FSH levels are often associated with infertility and irregular menstruation cycles, which are symptoms reported by a 26-year-old woman. Option A is more likely associated with luteinizing hormone (LH) levels. Option C may be associated with low FSH levels, not high. Option D is associated with undescended testis, not FSH levels.

Question 18

The health-care provider caring for a patient with a suspected "septic knee" informs the patient that arthrocentesis will be necessary.The nurse recognizes that teaching has been effective by which of the following patient statements?

Accepted Answer

The patient demonstrates understanding of the purpose of arthrocentesis in suspected septic knee by stating that fluid will be drawn from their knee to check for an infection in the joint. Options B and C suggest a misunderstanding of the procedure, and option D is not relevant to the explanation of the procedure.

Question 19

The nurse is caring for a patient who recently underwent a paracentesis.The patient states, "I just know they'll find cancer and I'll die soon." Which of the following statements by the nurse is best?

Accepted Answer

Option D is the best choice as it acknowledges the patient's feelings and allows for open communication while also gathering information about the patient's coping mechanisms. Options A and B dismiss the patient's concerns and do not provide supportive communication. Option C invalidates the patient's feelings and may lead to defensiveness.

Question 20

A nurse is assisting with a venous Doppler ultrasound study of the extremities.Which finding should the nurse recognize as critical and report to the requesting health-care provider immediately?

Accepted Answer

Deep vein thrombosis is a critical finding that requires immediate notification of the health-care provider, as it can lead to potentially life-threatening complications such as pulmonary embolism. Chronic venous insufficiency, primary varicose veins, and peripheral vascular disease are important findings that require further evaluation and management but are not as urgent as deep vein thrombosis.

Quiz 4: Monographs