Question 1

A nurse is caring for a patient scheduled for a colonoscopy who has orders for tap water enemas until clear.The nursing assistant administers a soap suds enema.Which of the following is the best documentation of this event?
A)"Nursing assistant gave the wrong type of enema, patient is currently stable."
B)"Soap suds enema given by nursing assistant, moderate amount liquid stool with brown flecks noted with returns.Patient denies abdominal cramping."
C)"Incident report completed due to provision of soap suds enema by the nursing assistant."
D)"Tap water enema ordered, soap suds enema given, physician notified."

Accepted Answer

The best documentation is option B as it clearly states what happened, what was observed, and the patient's response. The incident report is not necessary for the documentation but should still be completed. Option A is not appropriate as it does not provide any useful information for the patient's care or potential follow-up. Option D is not appropriate as it implies that the physician was notified of the wrong enema being given, which is not stated in the scenario.

Question 2

On assessment of a patient scheduled for cystoscopy, a nurse suspects that the patient likely has acute urethritis.On confirmation of this suspicion, the nurse notifies the health-care provider so that the procedure may be rescheduled after the patient has recovered from this condition.Which of the following is the best rationale for this action?
A)The patient is at risk for excessive bleeding from the lower urinary tract.
B)The procedure would be too painful for the patient.
C)The patient is at greater risk for trauma.
D)The patient is at risk of bacteria entering the bloodstream as a result of instrumentation.

Accepted Answer

Acute urethritis is an inflammation of the urethra typically caused by infection. During cystoscopy, the urinary tract is instrumented, which can lead to bacteria entering the bloodstream and potentially causing bacteremia or sepsis. Therefore, it is best to reschedule the procedure until the patient has fully recovered to reduce the risk of complications associated with instrumentation.

Question 3

A nurse is applying povidone-iodine to a patient's back in preparation for a puncture procedure to obtain a cerebrospinal fluid specimen.The nurse should apply this solution to the area between which of the following vertebrae?
A)C2 and C3
B)T8 and T9
C)L3 and L4
D)S1 and S2

Accepted Answer

The lumbar puncture is performed between the lumbar vertebrae. The L3-L4 inter-vertebral space is commonly used as it is below the level of the spinal cord termination, reducing the risk of spinal cord trauma. Povidone-iodine should be applied to the area to reduce the risk of infection during the procedure.

Question 4

The nurse is caring for a patient undergoing cardiac catheterization who states, "My father died of a massive heart attack when he was 50, so I do everything I can to stay fit." Which of the following statements by the nurse is best?
A)"That is great.Staying healthy isn't easy these days."
B)"You look pretty healthy.Does your wife work out with you, too?"
C)"I'm sure the death of your father at a young age is concerning.What specific things do you do to stay healthy?"
D)"Wow, 50 is really young.How old were you when he died?"

Accepted Answer

This response shows empathy for the patient's concerns and invites them to share more about their health habits, while also acknowledging the impact of their father's death. A and B are not as focused on the patient's concerns, while D risks being insensitive or triggering for the patient.

Question 5

A woman is scheduling an annual mammogram.Which question should a nurse ask in order to schedule this procedure at the best time for the patient?
A)"Are you using oral contraceptives?"
B)"Have you gained weight recently?"
C)"How much radiation exposure have you had this year?"
D)"When do you expect your next menstrual period to end?"

Accepted Answer

The timing of a mammogram is important, as the breast tissue can be more sensitive and tender during certain times of the menstrual cycle. It is best to schedule the mammogram for the week after the menstrual period has ended, when the breast tissue is least likely to be tender or swollen. Therefore, asking when the patient expects their next menstrual period to end will help in scheduling the mammogram at the best time for the patient. Questions A and B are not relevant to scheduling a mammogram, and question C should be directed to the patient's healthcare provider.

Question 6

A patient is suspected of having septicemia.Which test would be most appropriate for helping diagnose this condition?
A)Anal/genital culture, bacteria
B)Culture and smear, mycobacteria
C)Blood culture, bacteria
D)Sputum culture, bacteria

Accepted Answer

Blood culture is the best choice for diagnosing septicemia as it allows for the detection of bacteria in the bloodstream. Anal/genital culture and sputum culture may be useful in diagnosing other infections, while culture and smear for mycobacteria are more appropriate for diagnosing tuberculosis.

Question 7

A patient's laboratory test results indicate an increased ionized calcium level, but the health-care provider is concerned that an interfering factor may be causing a false-positive reading.Which of the following factors could cause such a reading?
A)Calcitonin
B)Citrates
C)Foscarnet
D)Antacids

Accepted Answer

The answer of A patient's laboratory test results indicate an...

Question 8

The nurse is providing care to a patient who is undergoing cystoscopy with retrograde ureteropyelography.Which of the following statements best explains this procedure?
A)"The health-care provider will inject dye into your kidney to examine where urine is collected before moving into your bladder."
B)"The health-care provider will inject dye into your bladder to make sure you are not experiencing reflux into the ureters."
C)"The health-care provider will inject dye into your arm and then take pictures that show how it is excreted in your body."
D)"The health-care provider will take a series of three-dimensional pictures that can be seen slice by slice to examine your pelvic organs."

Accepted Answer

Cystoscopy with retrograde ureteropyelography involves injecting dye into the patient's kidney to examine where urine is collected before moving into the bladder. This allows for visualization and identification of any abnormalities or blockages in the ureter or renal pelvis.

Question 9

The nurse is caring for an individual with a colostomy who just completed a barium enema.Which of the following patient statements indicates the need for further teaching?
A)"My stool may be white or light for a while."
B)"If my stool is not a normal color within 48 hours, I need to call my health-care provider."
C)"I can take a mild laxative if I need one."
D)"Irrigation with tap water may help move the barium through my system."

Accepted Answer

The statement in option B indicates a need for further teaching because it is normal for the stool to remain discolored for a few days after a barium enema, not just 48 hours.

Question 10

The nurse is caring for a patient with breast cancer who has metastasis to the liver.The health-care providers are recommending radiofrequency ablation of the liver lesions.Which of the following statements indicates the patient understands this procedure?
A)"Dyes will be used to locate the blood flow pattern, and then the blood supply will be blocked so the tumor dies."
B)"Three-dimensional films will help isolate the tumors so the health-care provider can beam radiation directly to them."
C)"A special needle will be placed into each tumor, and then current will heat the needle to kill the cancer cells."
D)"Cancer-killing drugs will be infused through the vein that leads to my liver and directly into the tumor area, so I won't have as many side effects."

Accepted Answer

Radiofrequency ablation is a procedure in which a special needle is placed into each tumor, and then current is sent through the needle to heat and kill the cancer cells. This is an effective treatment for liver metastasis from breast cancer. Option A describes a treatment called embolization, which may also be used to treat liver cancer. Option B describes stereotactic radiation therapy, which may also be used to treat liver cancer. Option D describes systemic chemotherapy, which is not the recommended treatment for liver metastasis from breast cancer.

Question 11

A nurse is reviewing a patient's computed tomography (CT)scan of the pelvis.Which of the following is a critical finding that the nurse should report to the requesting health-care provider immediately?
A)Bladder calculi
B)Ectopic pregnancy
C)Fibroid tumor
D)Hydrosalpinx

Accepted Answer

An ectopic pregnancy is a medical emergency that could result in life-threatening complications if not treated immediately. The other findings listed are significant but not considered critical or urgent.

Question 12

Which of the following diagnostic procedures would most likely be included in the plan of care for an individual with suspected Hodgkin's disease?
A)Chest x-ray
B)Lymphangiography
C)MUGA scan
D)Thallium stress test

Accepted Answer

The answer of Which of the following diagnostic procedures would...

Question 13

The nurse is caring for a patient with metastatic ovarian cancer who has been receiving chemotherapy.The patient is scheduled to have an MRI of the pelvis to evaluate tumor response to the therapy.Which of the following statements by the nurse is best?
A)"Have you had this test before?"
B)"Do you have a family history of ovarian cancer?"
C)"They should be coming to take you down shortly; I'll give you some privacy."
D)"I imagine the hardest part of treatment is waiting for test results.What have you done to cope with that tension before?"

Accepted Answer

Option D is the best choice because it acknowledges the emotional stress associated with waiting for test results and invites the patient to share their coping strategies. This approach supports emotional health and patient engagement.

Question 14

The nurse is providing care for a patient with a heart murmur detected during his annual physical.Which of the following diagnostic tests would the nurse expect to be ordered?
A)Chest x-ray
B)Holter monitor
C)Echocardiogram
D)Myocardial perfusion scan

Accepted Answer

The presence of a heart murmur indicates the potential for underlying heart conditions, such as valvular disease or congenital defects. An echocardiogram is a non-invasive diagnostic test that uses ultrasound technology to evaluate the structure and function of the heart, including the heart valves. It would be the most appropriate test to assess the patient's heart murmur. A chest x-ray, Holter monitor, and myocardial perfusion scan may also be ordered as part of the comprehensive cardiac assessment, but their utility would depend on the patient's specific presentation and any additional symptoms or risk factors.

Question 15

The nurse is checking off orders in a patient's chart and notes the following: "Abdominal flat plate today." To enter this order in the computer, the nurse would choose which of the following procedures?
A)Voiding cystography
B)Computed tomography of the abdomen
C)Liver and spleen scan
D)Kidney, ureter, and bladder study

Accepted Answer

An abdominal flat plate is another term for a Kidney, Ureter, and Bladder (KUB) study, which is an X-ray that evaluates the abdominal area including the kidneys, ureters, and bladder.

Question 16

A patient's laboratory test results indicate an increased level of C-reactive protein (CRP).Which of the following conditions is associated with this finding?
A)Diabetes mellitus
B)Hypertension
C)Acute inflammation
D)HIV

Accepted Answer

CRP is a protein that is produced by the liver in response to inflammation. Therefore, an increased level of CRP in laboratory test results is associated with acute inflammation. Diabetes mellitus, hypertension, and HIV are not necessarily associated with elevated CRP levels, although they may be seen in some cases.

Question 17

While reviewing charts, the nurse would expect to read which of the following notations in the chart of a patient who received a gastroesophageal reflux scan?
A)"Oral contrast provided in orange juice."
B)"Intravenous contrast provided 15 minutes prior to procedure."
C)"Fleet enema given 1 hour prior to the test; stools clear."
D)"Patient reports following a clear liquid diet x 24 hours."

Accepted Answer

A gastroesophageal reflux scan typically involves the patient ingesting a radioisotope mixed with orange juice to visualize the movement of the material through the esophagus and stomach. This is typically noted in the chart. Option B refers to intravenous contrast, which would not be used in this type of scan. Option C refers to a preparation for colonoscopy, which is not relevant to a gastroesophageal reflux scan. Option D refers to a clear liquid diet, which may be recommended prior to certain diagnostic exams but does not specifically relate to a gastroesophageal reflux scan.

Question 18

The nurse is conducting education for adult women on the importance of health screening at the local YMCA.Which of the following indicates teaching has been effective?
A)A 52-year-old woman signs up for a baseline mammogram.
B)A 40-year-old signs up for a smoking-cessation class.
C)A 25-year-old signs up for a three sessions with a personal trainer.
D)A 38-year-old signs up for a tai chi course.

Accepted Answer

The most appropriate response indicating that teaching has been effective is the 52-year-old woman signing up for a baseline mammogram, as this is a recommended health screening for women in this age group. The other options do not necessarily relate to health screening or the education provided by the nurse.

Question 19

A nurse is helping prepare a 9-month-old patient for blood chromosome analysis for a suspected chromosomal disorder.The patient's mother is concerned because he is not able to turn over from his back to his belly, sit upright, or crawl.The nurse observes that the patient startles dramatically to loud noises.Which of the following autosomal chromosome defects is most associated with these findings?
A)Cystic fibrosis
B)Cri du chat
C)Down syndrome
D)Tay-Sachs

Accepted Answer

The answer of A nurse is helping prepare a 9-month-old...

Question 20

The nurse is providing care for a patient returning from a transesophageal echocardiogram.Which of the following should be included in the patient's plan of care?
A)Provide lozenges once the gag reflex has returned.
B)Keep patient NPO for 12 hours after the procedure.
C)Monitor blood glucose levels hourly for 4 hours.
D)Instruct the patient to increase the intake of saturated fats.

Accepted Answer

After a transesophageal echocardiogram (TEE), the patient may experience a sore throat due to the presence of the transducer probe in the esophagus. Providing lozenges can alleviate the discomfort once the gag reflex has returned to normal. Keeping the patient NPO is not necessary after a TEE, and monitoring blood glucose levels and increasing intake of saturated fats are not relevant to this procedure.

Quiz 3: Reviewers

A nurse is caring for a patient scheduled for a colonoscopy who has orders for tap water enemas until clear.The nursing assistant administers a soap suds enema.Which of the following is the best documentation of this event?

A nurse is applying povidone-iodine to a patient's back in preparation for a puncture procedure to obtain a cerebrospinal fluid specimen.The nurse should apply this solution to the area between which of the following vertebrae?

The nurse is caring for a patient undergoing cardiac catheterization who states, "My father died of a massive heart attack when he was 50, so I do everything I can to stay fit." Which of the following statements by the nurse is best?

A woman is scheduling an annual mammogram.Which question should a nurse ask in order to schedule this procedure at the best time for the patient?

A patient is suspected of having septicemia.Which test would be most appropriate for helping diagnose this condition?

A patient's laboratory test results indicate an increased ionized calcium level, but the health-care provider is concerned that an interfering factor may be causing a false-positive reading.Which of the following factors could cause such a reading?

The nurse is providing care to a patient who is undergoing cystoscopy with retrograde ureteropyelography.Which of the following statements best explains this procedure?

The nurse is caring for an individual with a colostomy who just completed a barium enema.Which of the following patient statements indicates the need for further teaching?

The nurse is caring for a patient with breast cancer who has metastasis to the liver.The health-care providers are recommending radiofrequency ablation of the liver lesions.Which of the following statements indicates the patient understands this procedure?

A nurse is reviewing a patient's computed tomography (CT) scan of the pelvis.Which of the following is a critical finding that the nurse should report to the requesting health-care provider immediately?

Which of the following diagnostic procedures would most likely be included in the plan of care for an individual with suspected Hodgkin's disease?

The nurse is caring for a patient with metastatic ovarian cancer who has been receiving chemotherapy.The patient is scheduled to have an MRI of the pelvis to evaluate tumor response to the therapy.Which of the following statements by the nurse is best?

The nurse is providing care for a patient with a heart murmur detected during his annual physical.Which of the following diagnostic tests would the nurse expect to be ordered?

The nurse is checking off orders in a patient's chart and notes the following: "Abdominal flat plate today." To enter this order in the computer, the nurse would choose which of the following procedures?

A patient's laboratory test results indicate an increased level of C-reactive protein (CRP) .Which of the following conditions is associated with this finding?

While reviewing charts, the nurse would expect to read which of the following notations in the chart of a patient who received a gastroesophageal reflux scan?

The nurse is conducting education for adult women on the importance of health screening at the local YMCA.Which of the following indicates teaching has been effective?

The nurse is providing care for a patient returning from a transesophageal echocardiogram.Which of the following should be included in the patient's plan of care?