Question 1

A patient is suspected of having a severe, generalized granulomatous central nervous system disease caused by a protozoan.Which test would be most appropriate for confirming this suspicion?
A)Thyroglobulin
B)Thyroid-binding inhibitory immunoglobulin
C)Thyroxine-binding globulin
D)Toxoplasma antibody

Accepted Answer

Toxoplasma antibody test would be the most appropriate for confirming the suspicion of a severe, generalized granulomatous central nervous system disease caused by a protozoan, as toxoplasmosis is a common protozoan infection that affects the central nervous system and can cause such symptoms. The other options are not specific for protozoan infections or central nervous system diseases.

Question 2

A patient is scheduled to have blood drawn for a serum aldosterone level.Which additional laboratory order should a nurse anticipate for this patient?
A)Creatinine
B)Renin level
C)Uric acid
D)Urobilinogen

Accepted Answer

Renin is an enzyme that is released in response to low blood pressure or low blood volume. It plays a crucial role in regulating aldosterone secretion from the adrenal glands, which is why it is important to measure both levels together. Creatinine, uric acid, and urobilinogen are all unrelated to the renin-aldosterone system and therefore not necessary to measure specifically for this purpose.

Question 3

A patient is suspected of having intravascular hemolysis related to a transfusion reaction.Which test would be most appropriate to confirm this suspicion?
A)Ham's test for paroxysmal nocturnal hemoglobinuria (PNH)
B)Haptoglobin
C)Hemoglobin electrophoresis
D)Hemosiderin

Accepted Answer

Haptoglobin is a protein that binds to free hemoglobin in the blood and removes it from circulation. In the case of intravascular hemolysis, there is an excess of free hemoglobin that can deplete haptoglobin levels. Therefore, a low haptoglobin level is indicative of intravascular hemolysis related to a transfusion reaction. The other tests listed may be useful in other contexts, but they are not specific to transfusion reactions or intravascular hemolysis.

Question 4

A patient who reports palpitations and syncope is admitted to a hospital for observation.The patient has a methemoglobin level of 18%.Which diagnostic data should a nurse identify as most likely to be inaccurate for this patient?
A)Arterial blood gases
B)CT scan
C)Pulse oximetry
D)Serum lactate level

Accepted Answer

Pulse oximetry measures peripheral oxygen saturation (SpO2) which may be inaccurate in cases of methemoglobinemia. Methemoglobinemia is a condition where there is an abnormal amount of methemoglobin in the blood, which cannot carry oxygen efficiently, resulting in hypoxemia. However, pulse oximetry relies on the assumption that all hemoglobin in the blood is oxygenated, so it may overestimate SpO2 in patients with methemoglobinemia. Therefore, if a patient has methemoglobinemia, pulse oximetry is likely to be inaccurate. Arterial blood gases, CT scan, and serum lactate level are not affected by methemoglobinemia and are likely to be accurate measures for assessing oxygenation status and identifying the cause of the patient's symptoms.

Question 5

A patient is suspected of having congenital hypothyroidism.Which test would be most appropriate initially for confirming this suspicion?
A)Thyroxine, free
B)Transferrin
C)Triglycerides
D)Thyroid-stimulating hormone (TSH)

Accepted Answer

The most appropriate initial test for confirming congenital hypothyroidism is measurement of thyroid-stimulating hormone (TSH) levels. In this condition, TSH levels are elevated due to a lack of circulating thyroid hormone, which signals the pituitary gland to produce more TSH in an attempt to stimulate the thyroid gland. Thyroxine, free, transferrin, and triglycerides are not typically used in the initial diagnosis of congenital hypothyroidism.

Question 6

When collecting a blood specimen for prostate-specific antigen (PSA), which information should the nurse provide to the laboratory to ensure accurate interpretation of the results?
A)Time that the specimen was collected
B)Site from which specimen was obtained
C)Age of the patient
D)Medications the patient is taking

Accepted Answer

The answer of When collecting a blood specimen for prostate-specific...

Question 7

A nurse is preparing a patient with suspected osteomyelitis for a bone biopsy.Prior to beginning the procedure, the nurse should ensure that the:
A)Patient understands the purpose of the procedure
B)Health-care provider is credentialed to perform the procedure
C)Time of the patient's last food or fluid was at least 12 hours prior to the time of the procedure
D)Time-out to confirm the patient's identity, procedure to be done, and correct side/site is performed

Accepted Answer

The answer of A nurse is preparing a patient with...

Question 8

A nurse is preparing to collect a routine urine specimen for urinalysis from a patient with an indwelling urinary catheter.To collect the specimen, the nurse should:
A)Clean the catheter sample port with alcohol, aspirate the required amount of urine, and transfer the urine to a specimen cup.
B)Disconnect the collection tubing from the indwelling catheter and collect the specimen in a standard specimen cup using good aseptic technique.
C)Disconnect the collection tubing from the indwelling catheter and, using an irrigation syringe, aspirate the urine specimen; label the syringe.
D)Replace the urine collection bag with a clean bag; drain the urine into a specimen cup as soon as an adequate volume has accumulated.

Accepted Answer

The nurse should clean the catheter sample port with alcohol, aspirate the required amount of urine, and transfer the urine to a specimen cup. This method ensures the use of a closed system, decreasing the risk of infection and contamination. Disconnecting the collection tubing increases the risk of infection and contamination. Aspirating the urine with an irrigation syringe is not recommended because the syringe may not be sterile, and it may introduce air or contaminants into the system. Replacing the urine collection bag with a clean bag is not necessary and may increase the risk of infection.

Question 9

A patient who has limited exercise tolerance is scheduled for a thallium scan with dipyridamole.Which clinical parameter should a nurse identify as a possible contraindication for this procedure?
A)Blood pressure ranges from 136/90 mm Hg to 162/96 mm Hg
B)History of asthma
C)Myocardial infarction 1 month ago
D)Serum potassium is 4.5 mEq/L and patient receives potassium supplement daily

Accepted Answer

Dipyridamole can cause bronchoconstriction, which can be dangerous for patients with asthma, so this may be a contraindication for this procedure. The blood pressure range and serum potassium level are within normal limits and would not necessarily be contraindications. While a recent myocardial infarction may raise concerns, it is not an absolute contraindication unless the patient is unstable or has other contraindications.

Question 10

An adolescent patient is brought to an urgent-care center with complaints of increasing weakness and persistent vomiting of 3 days' duration.Which findings in a blood gas analysis should a nurse expect as a result of the patient's history of persistent vomiting? A)pH 7.32; PCO₂ 50 mm Hg; HCO₃ 20 mEq B)pH 7.40; PCO₂40 mm Hg; HCO₃ 23 mEq C)pH 7.47; PCO₂44 mm Hg; HCO₃ 30 mEq D)pH 7.60; PCO₂30 mm Hg; HCO₃ 24 mEq

Accepted Answer

Persistent vomiting can lead to a loss of stomach acid, which would result in metabolic alkalosis. This is characterized by an elevated blood pH and bicarbonate level, as seen in option C (pH 7.47; HCO3- 30 mEq/L).

Question 11

A patient with a history of inflammatory bowel disease is ready to return home from the radiology department following a gastrointestinal blood loss scan.Prior to discharge, a nurse should instruct the patient to:
A)Flush the toilet immediately after each void
B)Limit activity for the next 24 hours
C)Remain on a clear liquid diet until a follow-up with the health-care provider in 1 week
D)Restrict fluid intact

Accepted Answer

Flushing the toilet immediately after each void can reduce the risk of spreading infection or inflammation to others, which is important for patients with inflammatory bowel disease. Limiting activity, remaining on a clear liquid diet, or restricting fluid intake are not necessary instructions for a gastrointestinal blood loss scan.

Question 12

A patient with a history of kidney stones is scheduled for a renogram.Which medication should a nurse instruct the patient to stop at least 1 week prior to this procedure?
A)Clopidogrel bisulfate (Plavix)
B)Digoxin (Lanoxin)
C)Furosemide (Lasix)
D)Nitrofurantoin (Macrodantin)

Accepted Answer

Clopidogrel bisulfate (Plavix) is an antiplatelet medication that can increase the risk of bleeding. It is often recommended to stop such medications before procedures to minimize bleeding risk.

Question 13

A nurse obtains a rectal swab for culture on a patient admitted from a long-term care setting for elective orthopedic surgery in an acute care facility.The nurse should assist the patient to assume which of the following positions?
A)Lying on the left side
B)High Fowler's
C)Supine
D)Prone

Accepted Answer

The most appropriate position for obtaining a rectal swab is for the patient to lie on their left side with their knees flexed towards their chest. This position provides optimal access to the rectum for the nurse and is comfortable for the patient. The other positions listed are not appropriate for obtaining a rectal swab.

Question 14

A nurse is preparing to draw an arterial sample for blood gas analysis.Which equipment should the nurse have available?
A)High-flow oxygen facemask
B)Ice slurry in a cup or plastic bag
C)Tourniquet
D)Red-topped Vacutainer tube

Accepted Answer

An ice slurry is used to immediately cool the arterial blood sample to slow down metabolic processes, ensuring the accuracy of the blood gas analysis.

Question 15

A nurse is positioning a patient for hysterosalpingography.Which position should the patient be placed in?
A)Lithotomy
B)Supine
C)Upright
D)Side-lying

Accepted Answer

Hysterosalpingography requires the patient to be in a lithotomy position, which enables the healthcare provider to visualize the uterus and fallopian tubes using X-rays or ultrasound technology. This position involves the patient lying on their back with their legs elevated and positioned in stirrups.

Question 16

A nurse is assisting with a thoracentesis to obtain pleural fluid for analysis.Which additional diagnostic test should the nurse anticipate upon .
A)Chest x-ray
B)Complete blood count (CBC)
C)Blood cultures
D)Electrocardiogram

Accepted Answer

A chest x-ray should be obtained after a thoracentesis to confirm the removal of fluid and to evaluate for any pneumothorax or other complications. A CBC and blood cultures are not directly related to the procedure, and an electrocardiogram is not necessary unless the patient has a history of cardiovascular disease.

Question 17

A nurse is preparing a patient for an arterial Doppler carotid study.Which description of the purpose of this test is correct?
A)Determining presence of intracranial atriovenous malformation
B)Diagnosing aortic aneurysm
C)Identifying the abnormalities in cardiac blood flow
D)Measuring the amplitude and waveform of the carotid pulse

Accepted Answer

Arterial Doppler carotid study is used to measure the amplitude and waveform of the carotid pulse. It helps to identify any blockages or abnormalities in blood flow to the brain. It does not diagnose intracranial atriovenous malformation, aortic aneurysm, or abnormalities in cardiac blood flow.

Question 18

At an annual health screening, a patient's routine urinalysis is normal except for protein in the urine with "casts." The patient is in good health.Which factor in the patient's medical history should the nurse relate to this laboratory finding?
A)Drinks 6 to 8 glasses of water (12 ounces per glass)each day
B)Eats a low-protein, high-carbohydrate diet
C)Exercises daily and runs 4 to 5 miles per day
D)Sleeps at least 8 hours per day

Accepted Answer

The answer of At an annual health screening, a patient's...

Question 19

A nurse is obtaining blood specimens from a patient's central line.What measure should the nurse use to ensure correct identification of the specimens collected?
A)Confirm patient name and room number and then write these on the specimen tubes and confirm with patient.
B)Identify the patient using two unique identifiers before starting the sample collection, and then immediately affix the label with patient identification, time collected, and nurse's initials.
C)Place printed label with identification on all tubes before obtaining the specimens, and ask the patient to observe that this is done.
D)Request the presence of a laboratory technician to label the specimens as these are collected, and note date and time collected on the label.

Accepted Answer

The nurse should use two unique identifiers to confirm the patient's identity before collecting specimens from the central line. After collection, the nurse should immediately label the tubes with the patient's identification, time of collection, and nurse's initials. This helps maximize patient safety by ensuring accurate identification of collected specimens. Options A, C, and D do not provide for immediate labeling of specimens and may increase the risk of misidentification.

Question 20

A 16-year-old female is brought to an emergency room by her mother with "sharp, stabbing pain" for the last 4 hours in her lower back.The patient is nauseous and states there is no possibility of pregnancy.Urinalysis is positive for casts, blood with 5-100 RBCs, and fewer than 100 WBCs.An IV pyelogram is ordered.Prior to this procedure, the nurse should confirm that:
A)A urinary catheter is inserted.
B)Corticosteroid is administered.
C)The pregnancy test is negative.
D)The patient has signed a consent form.

Accepted Answer

The answer of A 16-year-old female is brought to an...

Quiz 2: Preface

A patient is suspected of having a severe, generalized granulomatous central nervous system disease caused by a protozoan.Which test would be most appropriate for confirming this suspicion?

A patient is scheduled to have blood drawn for a serum aldosterone level.Which additional laboratory order should a nurse anticipate for this patient?

A patient is suspected of having intravascular hemolysis related to a transfusion reaction.Which test would be most appropriate to confirm this suspicion?

A patient who reports palpitations and syncope is admitted to a hospital for observation.The patient has a methemoglobin level of 18%.Which diagnostic data should a nurse identify as most likely to be inaccurate for this patient?

A patient is suspected of having congenital hypothyroidism.Which test would be most appropriate initially for confirming this suspicion?

When collecting a blood specimen for prostate-specific antigen (PSA) , which information should the nurse provide to the laboratory to ensure accurate interpretation of the results?

A nurse is preparing a patient with suspected osteomyelitis for a bone biopsy.Prior to beginning the procedure, the nurse should ensure that the:

A nurse is preparing to collect a routine urine specimen for urinalysis from a patient with an indwelling urinary catheter.To collect the specimen, the nurse should:

A patient who has limited exercise tolerance is scheduled for a thallium scan with dipyridamole.Which clinical parameter should a nurse identify as a possible contraindication for this procedure?

An adolescent patient is brought to an urgent-care center with complaints of increasing weakness and persistent vomiting of 3 days' duration.Which findings in a blood gas analysis should a nurse expect as a result of the patient's history of persistent vomiting?

A patient with a history of inflammatory bowel disease is ready to return home from the radiology department following a gastrointestinal blood loss scan.Prior to discharge, a nurse should instruct the patient to:

A patient with a history of kidney stones is scheduled for a renogram.Which medication should a nurse instruct the patient to stop at least 1 week prior to this procedure?

A nurse obtains a rectal swab for culture on a patient admitted from a long-term care setting for elective orthopedic surgery in an acute care facility.The nurse should assist the patient to assume which of the following positions?

A nurse is preparing to draw an arterial sample for blood gas analysis.Which equipment should the nurse have available?

A nurse is positioning a patient for hysterosalpingography.Which position should the patient be placed in?

A nurse is assisting with a thoracentesis to obtain pleural fluid for analysis.Which additional diagnostic test should the nurse anticipate upon .

A nurse is preparing a patient for an arterial Doppler carotid study.Which description of the purpose of this test is correct?

At an annual health screening, a patient's routine urinalysis is normal except for protein in the urine with "casts." The patient is in good health.Which factor in the patient's medical history should the nurse relate to this laboratory finding?

A nurse is obtaining blood specimens from a patient's central line.What measure should the nurse use to ensure correct identification of the specimens collected?