Question 1

A patient is suspected of having Addison's disease.Which challenge test would be most appropriate to give this patient to confirm this suspicion?
A)Corticotropin-releasing hormone (CRH)stimulation
B)Dexamethasone suppression (overnight)
C)Adrenocorticotropic hormone (ACTH)stimulation, rapid test
D)Metyrapone stimulation (overnight)

Accepted Answer

In Addison's disease, the adrenal glands do not produce enough cortisol. ACTH stimulation test is used for the diagnosis of adrenal insufficiency. A rapid ACTH stimulation test can be used to evaluate the body's ability to produce cortisol in response to ACTH. In Addison's disease, there is a lack of response to ACTH stimulation, resulting in low cortisol levels. Therefore, option C is the most appropriate test to confirm Addison's disease.

Question 2

A prenatal patient has a negative rubella titer.Which patient education should the nurse provide?
A)"This result indicates that you are immune to rubella, so you do not need any follow-up."
B)"You need to avoid contact with anyone who could have rubella, and you will receive a vaccination immediately after delivering your baby."
C)"To protect you and your baby, you should have a rubella vaccination today."
D)"In the United States, rubella is rare, so you should not be concerned about this result unless you are traveling out of the continental United States."

Accepted Answer

A negative rubella titer indicates that the patient is not immune to rubella and is at risk for contracting the virus. Option B is the correct choice as the patient needs to avoid contact with anyone who could have rubella and will receive a vaccination immediately after delivering the baby to protect herself and the baby. Option A is incorrect as the patient is not immune. Option C is not recommended during pregnancy due to the risk of fetal infection. Option D is incorrect as rubella is not rare, and the patient should be concerned about potential exposure.

Question 3

The nurse is performing hearing screening to kindergarten students.For which of the following students would the nurse document a need for referral to an audiologist?
A)A girl whose test reveals normal air and bone conduction thresholds
B)A boy whose test reveals pure tone average of -8 dB
C)A boy whose test reveals an equally elevated threshold for air and bone conduction
D)A girl whose test reveals a pure tone average of 6 dB

Accepted Answer

DA pure tone average (PTA) of 6 dB indicates a slight hearing loss, as normal hearing threshold levels are typically between -10 dB and 15 dB. A PTA of -8 dB is within the normal range. An equally elevated threshold for air and bone conduction suggests a sensorineural hearing loss, which requires further evaluation by an audiologist. Normal air and bone conduction thresholds indicate normal hearing.

Question 4

A nurse is managing the care of a patient who is readmitted to a hospital with a diagnosis of deep vein thrombophlebitis (DVT)1 month after discharge following orthopedic surgery.The patient is receiving IV heparin.In addition to an activated partial thromboplastin time (aPTT), which laboratory result should the nurse monitor at least every other day?
A)Creatinine
B)Platelet count
C)ProTime
D)Reticulocyte count

Accepted Answer

When a patient is receiving heparin, it is important to monitor their platelet count as heparin-induced thrombocytopenia (HIT) is a potential complication which can occur 5 to 10 days after heparin therapy is initiated. Symptoms of HIT include a decrease in platelets and the development of new clots, which can be life-threatening. Monitoring the patient's platelet count every other day will help the nurse to detect early signs of HIT and take appropriate actions.

Question 5

A patient is preparing to undergo blood cortisol testing.This test is the best indicator of the function of which gland?
A)Adrenal
B)Pituitary
C)Thymus
D)Thyroid

Accepted Answer

Blood cortisol testing is used to assess the function of the adrenal gland, which produces cortisol. The other glands listed (pituitary, thymus, thyroid) produce different hormones and would not be indicated by this particular test.

Question 6

Which of the following statements read in the laparoscopy report would be considered normal?
A)"Endometriosis noted across uterine surface."
B)"Pelvic adhesions noted."
C)"Widespread salpingitis identified."
D)"Left ovary appears pearly white."

Accepted Answer

The statement "Left ovary appears pearly white" is a normal finding in a laparoscopy report. Endometriosis, pelvic adhesions, and salpingitis are all abnormal findings that can indicate potential issues or health concerns.

Question 7

The nurse is caring for an individual scheduled for a kidney, ureter, and bladder (KUB)study.The nurse would base instruction on knowledge that the test:
A)Will involve little or no pain
B)Requires the instillation of dye
C)Is completed in the surgical suite
D)Takes 60-90 minutes to complete

Accepted Answer

A KUB study is a simple radiographic procedure that involves taking X-rays of the kidney, ureter, and bladder. The test is non-invasive and painless, and does not involve the use of dye or any other contrast agents. It is usually completed in a radiology department rather than a surgical suite and takes only a few minutes to complete.

Question 8

A nurse is helping prepare a patient for blood chromosome analysis for a suspected chromosomal disorder.The nurse observes that the patient coughs continuously, producing a thick mucus.Which of the following autosomal chromosome defects is most associated with this finding?
A)Cystic fibrosis
B)Cri du chat
C)Down syndrome
D)Tay-Sachs

Accepted Answer

Cystic fibrosis is a genetic disorder caused by a defect in the CFTR gene on chromosome 7. This defect leads to the production of thick, sticky mucus in the lungs, which can cause coughing and difficulty breathing. Blood chromosome analysis would not be diagnostic for cystic fibrosis, but it may be ordered if there is concern about other chromosomal abnormalities.

Question 9

A patient's laboratory test results indicate the presence of the human papilloma virus (HPV).This finding most associated with which of the following conditions?
A)Genital warts
B)AIDS
C)Upper respiratory tract infection
D)Genital blisters and sores

Accepted Answer

The human papilloma virus (HPV) is most commonly associated with genital warts.

Question 10

A patient is suspected of having tuberculosis.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

The culture and smear for mycobacteria is the most appropriate test for diagnosing tuberculosis, as it specifically targets the Mycobacterium tuberculosis bacteria.

Question 11

The student nurse needs to obtain pulse oximetry readings for a newborn.Which of the following locations is best?
A)Big toe
B)Tip of the nose
C)Side of the hand
D)Earlobe

Accepted Answer

The big toe is a common and suitable location for obtaining pulse oximetry readings in newborns due to its accessibility and adequate blood flow.

Question 12

A nurse is collecting a urine specimen for urine calcium analysis.What type of collection is most commonly requested?
A)Post-prandial
B)Timed, unpreserved (12 or 24 hr)
C)Fasting
D)Timed, with formalin preservative (12 or 24 hr)

Accepted Answer

Timed, unpreserved (12 or 24 hr) collection is most commonly requested for urine calcium analysis. This type of collection involves collecting all urine produced over a specific period of time (usually 12 or 24 hours) without using any preservatives. This allows for accurate measurement of the amount of calcium being excreted in the urine.

Question 13

The nurse is working with a patient whose dual energy x-ray absorptiometry (DEXA)scan results included a T-score of -1.5.Which of the following would be documented in the chart?
A)"Normal bone density noted"
B)"Osteoporosis identified"
C)"Osteopenia present"
D)"Results indicate osteomalacia"

Accepted Answer

A T-score of -1.5 indicates a bone density that is lower than normal, but not low enough to be classified as osteoporosis. This level of bone density is considered "osteopenia," which is a milder form of bone loss.

Question 14

Which of the following nursing actions is the highest priority prior to sending a patient for a cardiac catheterization?
A)Ensure the consent has been signed.
B)Document the location and character of pedal pulses bilaterally.
C)Determine if the patient has a history of cardiac disease.
D)Identify the family member who will serve as contact liaison.

Accepted Answer

Documenting the location and character of pedal pulses bilaterally is important because it will provide baseline data to identify any changes post-procedure. This is essential because cardiac catheterization carries the risk of impaired arterial blood supply to the lower extremities. The other options are important but not as high a priority as the baseline assessment. Consent should be obtained before the procedure, the patient's history of cardiac disease is relevant but not an immediate concern before sending the patient for the procedure, and identifying the family member as a contact can be done at any time.

Question 15

A patient who is admitted to the hospital with a productive cough and fever has a positive result on a QuantiFERON-TB Gold blood test.When providing care for this patient, what personal protective equipment (PPE)should a nurse wear?
A)A fit-tested N-95 mask
B)Gloves and surgical mask
C)Isolation gown and surgical mask
D)No PPE is necessary as long as the nurse remains at least 3 feet away from the patient

Accepted Answer

A positive result on a QuantiFERON-TB Gold blood test suggests that the patient has been exposed to Mycobacterium tuberculosis and is at risk for developing active tuberculosis. Therefore, a nurse should wear a fit-tested N-95 mask to protect against droplet transmission during close contact with the patient. Gloves and isolation gown may also be necessary depending on the extent of contact with the patient and their bodily fluids.

Question 16

The nurse is providing care to a patient who returned from a mediastinoscopy 4 hours ago.The nurse recognizes further teaching is necessary if which of the following is observed?
A)The patient is resting in a semi-Fowler's position.
B)The patient's wife is offering sips of diet soda.
C)The nursing assistant is taking vital signs and pulse oximeter readings.
D)The patient reports mild itching.

Accepted Answer

After a mediastinoscopy, the patient's throat may be sore or swollen, and his or her swallowing reflex may be affected. Therefore, the patient should not be consuming anything orally until it is assured that the patient's swallowing reflex has returned to normal. The nursing assistant taking vital signs is appropriate, as is the patient resting in a semi-Fowler's position. Mild itching is a common symptom that can be relieved by administering an antihistamine, which can be ordered by the healthcare provider.

Question 17

The nurse is talking to a patient who is interested in pursuing LASIK surgery and is having a refraction test done.Which of the following statements by the nurse is best?
A)"Your health-care provider will perform a standard vision test and eye exam to determine your baseline vision."
B)"We will need to have conscious sedation for the test so accurate measurements can be taken."
C)"Your health-care provider will use non-stinging eye drops to moisten your eye to make the exam more comfortable."
D)"You should use your eye drops for glaucoma the day of the test."

Accepted Answer

The nurse should explain that the healthcare provider will perform a standard vision test and eye exam to determine the patient's baseline vision. This communicates that the patient's vision will be evaluated thoroughly and accurately by a professional. Conscious sedation is not necessary for a refraction test, non-stinging eye drops may be used to moisten the eye, and the nurse should advise the patient to follow their healthcare provider's instructions regarding medication use on the day of the test.

Question 18

A patient's kidney stone panel indicates the composition of the stones.The nurse should expect the majority of stones to contain which of the following substances?
A)Magnesium ammonium phosphate
B)Calcium
C)Uric acid
D)Cystine

Accepted Answer

Calcium stones are the most common type of kidney stones, accounting for 80% of all cases. Magnesium ammonium phosphate (struvite) stones, uric acid stones, and cystine stones are less common.

Question 19

The nurse receives a patient in the recovery room who just returned from a fiberoptic bronchoscopy under local anesthesia.Which of the following actions should the nurse take first?
A)Determine the type and rate of IV fluids.
B)Ensure the patient's head is elevated to at least 45°.
C)Verify postprocedure orders for pain control.
D)Encourage the patient's family members to visit quietly.

Accepted Answer

Elevating the patient's head to at least 45° immediately after a fiberoptic bronchoscopy can help prevent aspiration and promote oxygenation. Therefore, this action should be taken first. The other options can be addressed after the head is elevated.

Question 20

The nurse could safely schedule an intravenous pyelogram for which of the following patients?
A)A 42-year-old with a history of asthma
B)A 63-year-old with a creatinine of 1.9 mg/dL
C)A 22-year-old woman who is 12 weeks pregnant
D)A 51-year-old who reports an allergy to shellfish

Accepted Answer

An intravenous pyelogram involves the use of contrast dye and carries a risk of kidney damage. Therefore, it should be avoided in patients with impaired renal function (B) or during pregnancy (C). The history of allergy to shellfish (D) could raise concerns about an allergic reaction to the iodine-containing contrast dye. Patient A with a history of asthma can safely undergo the procedure, but caution should be exercised in case of any reaction during the procedure.

Quiz 3: Reviewers

A patient is suspected of having Addison's disease.Which challenge test would be most appropriate to give this patient to confirm this suspicion?

A prenatal patient has a negative rubella titer.Which patient education should the nurse provide?

The nurse is performing hearing screening to kindergarten students.For which of the following students would the nurse document a need for referral to an audiologist?

A patient is preparing to undergo blood cortisol testing.This test is the best indicator of the function of which gland?

Which of the following statements read in the laparoscopy report would be considered normal?

The nurse is caring for an individual scheduled for a kidney, ureter, and bladder (KUB) study.The nurse would base instruction on knowledge that the test:

A nurse is helping prepare a patient for blood chromosome analysis for a suspected chromosomal disorder.The nurse observes that the patient coughs continuously, producing a thick mucus.Which of the following autosomal chromosome defects is most associated with this finding?

A patient's laboratory test results indicate the presence of the human papilloma virus (HPV) .This finding most associated with which of the following conditions?

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

The student nurse needs to obtain pulse oximetry readings for a newborn.Which of the following locations is best?

A nurse is collecting a urine specimen for urine calcium analysis.What type of collection is most commonly requested?

The nurse is working with a patient whose dual energy x-ray absorptiometry (DEXA) scan results included a T-score of -1.5.Which of the following would be documented in the chart?

Which of the following nursing actions is the highest priority prior to sending a patient for a cardiac catheterization?

A patient who is admitted to the hospital with a productive cough and fever has a positive result on a QuantiFERON-TB Gold blood test.When providing care for this patient, what personal protective equipment (PPE) should a nurse wear?

The nurse is providing care to a patient who returned from a mediastinoscopy 4 hours ago.The nurse recognizes further teaching is necessary if which of the following is observed?

The nurse is talking to a patient who is interested in pursuing LASIK surgery and is having a refraction test done.Which of the following statements by the nurse is best?

A patient's kidney stone panel indicates the composition of the stones.The nurse should expect the majority of stones to contain which of the following substances?

The nurse receives a patient in the recovery room who just returned from a fiberoptic bronchoscopy under local anesthesia.Which of the following actions should the nurse take first?

The nurse could safely schedule an intravenous pyelogram for which of the following patients?