Question 1

A patient's genetic test results related to thyroid cancer indicate high levels of the genetic marker BRAF.Which type of thyroid cancer does this marker indicate?
A)Follicular
B)Medullary
C)Papillary
D) Multiple endocrine neoplasia

Accepted Answer

The BRAF genetic marker is commonly associated with papillary thyroid cancer.

Question 2

A nurse is assisting with cystoscopy for a patient undergoing bladder biopsy.The urologist has just inserted the cystoscope into the patient's urethra.Which of the following is the next step the nurse should expect in this procedure?
A)Cleaning of the external genitalia with a suitable antiseptic solution
B)Irrigation of the bladder with saline
C)Examination of the bladder and urethra by direct and lighted visualization
D)Removal of a tissue sample using a cytology brush or biopsy forceps

Accepted Answer

The answer of A nurse is assisting with cystoscopy for...

Question 3

A nurse reviews the carcinoembryonic antigen (CEA)results for a patient who is undergoing treatment for colon cancer.The nurse notes that, after a period of decrease, the results of the CEA are now increasing.Which additional question should the nurse ask before interpreting the significance of this result?
A)"Does the patient have any new symptoms?"
B)"Has the patient been compliant with the treatment regimen?"
C)"Has the patient's health-care provider indicated that cancer is in remission?"
D)"Is the patient smoking?"

Accepted Answer

Smoking can increase CEA levels, so it's important to know if the patient is smoking before interpreting the significance of the increased CEA results.

Question 4

nurse is preparing to collect a capillary blood glucose specimen from a neonate.Which site is most appropriate for the nurse to use? 
A)A (label on medial aspect of plantar surface of heel)
B)B (label on midposterior curvature directly over calcaneus)
C)C (label on ball of the foot)
D)D (label over arch of foot)

Accepted Answer

The most appropriate site for capillary blood glucose collection in neonates is the medial aspect of the plantar surface of the heel. This site is less painful and less likely to cause injury compared to other sites.

Question 5

A patient who recently completed a multigated blood pool imaging (MUGA)scan asks what it means that the test showed an ejection fraction of 65%.Which answer by the nurse is most accurate?
A)"This scan shows that your heart was affected by a heart attack at some time in the past, since your ejection fraction is below average."
B)"The ejection fraction shows the effectiveness of the pumping function of the ventricles.A normal ejection fraction is 55% to 65%."
C)"Since the ejection fraction is so low, these results indicate that your heart does not pump as effectively as it should when you are exercising."
D)"Your health-care provider will follow up with you, but your results will require treatment since your ejection fraction was so high."

Accepted Answer

The ejection fraction is a measure of the effectiveness of the pumping function of the heart. A normal ejection fraction is typically between 55% and 65%. Option A is not accurate since a low ejection fraction does not necessarily indicate a past heart attack. Option C is also not accurate as there is no indication that the patient was exercising during the MUGA scan. Option D is not accurate since a high ejection fraction is actually a good thing and does not require treatment.

Question 6

A patient presents with complaints of red-tinged urine in the mornings and symptoms of anemia.The health-care provider suspects a rare form of intravascular hemolytic anemia.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

The symptoms of red-tinged urine in the mornings and symptoms of anemia, along with suspicion of a rare form of intravascular hemolytic anemia indicate the need for a Ham's test for paroxysmal nocturnal hemoglobinuria (PNH). This test specifically looks for the presence of PNH clone in the red blood cells, which is responsible for the intravascular hemolysis. Haptoglobin levels can also be decreased in hemolytic anemia, but it is not specific to PNH. Hemoglobin electrophoresis is used to diagnose hemoglobinopathies, not intravascular hemolysis. Hemosiderin levels may be elevated in cases of hemolysis or other conditions, but it is not specific to PNH.

Question 7

During a lactose-tolerance test, a patient's fasting glucose level of 98 mg/dL increases by 10 mg/dL.For which clinical manifestations should a nurse assess this patient?
A)Abdominal bloating, pain, flatus, and diarrhea
B)Constipation, pain on defecation, and cramping
C)Cramping, increased frequency of urination, and blood in the stool
D)Loose, greasy stools with alternating diarrhea and constipation

Accepted Answer

The lactose-tolerance test is used to measure the body's ability to digest lactose, a type of sugar found in milk and other dairy products. An increase in glucose level after drinking a lactose solution indicates that the body is able to digest lactose. However, if the body cannot digest lactose properly, it can lead to gastrointestinal symptoms such as abdominal bloating, pain, flatus, and diarrhea. Therefore, the nurse should assess the patient for these symptoms. Choices B, C, and D are not associated with lactose intolerance.

Question 8

A patient has blood drawn for a TORCH serological screen.Which assessment finding is a nurse most likely to document for this patient?
A)Blood donor
B)Diabetic with nephropathy
C)Pregnant female
D)Transfusion recipient

Accepted Answer

TORCH serological screening is used to detect antibodies for Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus, and other infections, which are all dangerous for pregnant women and the fetus. Therefore, a pregnant female is most likely to undergo this screening.

Question 9

A nurse is preparing to draw blood from a patient who is deaf.A family member who is present has been using sign language to assist staff with communication.Which action by the nurse is most appropriate?
A)Ask the family member if the patient will cooperate with the procedure.
B)Discuss the procedure and the patient's preferences with the family member before beginning the procedure.
C)Face the patient while explaining the procedure to the family member and maintaining eye contact while the family member interprets.
D)Provide written information and use a whiteboard so the patient can communicate without violating the patient's privacy.

Accepted Answer

Facing the patient while explaining the procedure, maintaining eye contact, and allowing the family member to interpret respects the patient's autonomy and ensures they are directly involved in their care, which is a key aspect of patient-centered communication.

Question 10

A patient needs to undergo initial testing of thyroid function.Which test, in addition to TSH, would be most appropriate for this purpose?
A)Thyroxine, free
B)Triiodothyronine, free
C)Thyroid-stimulating immunoglobulins (TSI)
D)Troponins I and T

Accepted Answer

Thyroxine, free (or FT4) is another test that is commonly used to evaluate thyroid function. It measures the amount of unbound thyroxine in the blood, which can give an indication of how much thyroid hormone the thyroid gland is producing. This test is often used in conjunction with TSH to get a more complete picture of thyroid function. Triiodothyronine, free (FT3) may also be useful, but is not typically ordered as an initial screening test. Thyroid-stimulating immunoglobulins (TSI) are not typically ordered as part of routine thyroid testing, but may be used to help diagnose certain autoimmune thyroid disorders. Troponins I and T are markers of heart muscle damage and would not be relevant to thyroid function testing.

Question 11

A patient diagnosed with type 1 diabetes has orders for fluorodeoxyglucose (FDG)-positron emission tomography (PET)as part of a diagnostic work-up for possible Parkinson's disease.The nurse should plan for this procedure to occur:
A)First thing in the morning before the patient has insulin or eats
B)Four hours after the patient has a pretest dose of insulin and a meal
C)Late in the day after the patient has exercised
D)Whenever there is a time available, since there are no restrictions related to food or drink

Accepted Answer

The patient should have a stable blood glucose level during the PET scan, which is best achieved by having a meal and insulin dose beforehand.

Question 12

A patient reports to an emergency department with a sudden onset of shortness of breath and right-sided chest pain.The patient has a negative D-dimer test.Based on this result, a nurse should plan interventions to manage:
A)Acute myocardial infarction (MI)
B)Deep vein thrombosis (DVT)
C)Pulmonary embolism (PE)
D)Spontaneous pneumothorax

Accepted Answer

A negative D-dimer test helps to rule out a diagnosis of pulmonary embolism, which causes chest pain and shortness of breath. However, D-dimer is not a diagnostic test and cannot be used to rule out other possible causes of these symptoms, such as spontaneous pneumothorax. Therefore, interventions should be planned based on the suspected diagnosis of spontaneous pneumothorax.

Question 13

A patient's laboratory test results following urine analysis for bladder cancer markers demonstrate a positive finding for bladder cancer based on an nuclear matrix protein (NMP)22 level of 11 units/mL.However, the requesting provider is concerned that this could be a false positive.Which of the following interfering factors would most likely result in a false-positive of this marker?
A)Incorrect fixative
B)Inadequate number of bladder cells in the specimen
C)Inflammation of the bladder
D)Gross contamination from blood

Accepted Answer

Inflammation of the bladder can lead to a false-positive result for bladder cancer markers. This is because inflammation can cause increased cellular turnover and release of the nuclear matrix proteins, including NMP22, which can be detected in a urine sample. Incorrect fixative, inadequate number of bladder cells in the specimen, and gross contamination from blood are unlikely to interfere with the NMP22 marker and result in a false-positive finding.

Question 14

A patient has been diagnosed with scurvy.The nurse is aware that this condition is associated with a deficiency in which vitamin?
A)Vitamin C
B)Vitamin D
C)Vitamin E
D)Vitamin K

Accepted Answer

Scurvy is caused by a deficiency of vitamin C, which affects the synthesis of collagen and causes symptoms such as fatigue, joint pain, and bleeding gums.

Question 15

A nurse is collecting morning blood specimens from a geriatric patient with small veins that collapse or disappear when the nurse tries to insert the needle.The patient has IV fluids infusing through a peripherally inserted central catheter (PICC)in the left antecubital area.After two attempts in the right antecubital space using a Vacutainer, the nurse is unable to obtain the required specimens.Which action is most appropriate for the nurse to take next?
A)Attempt again using a syringe attached to a butterfly needle.
B)Confirm the requesting health-care provider's order and institutional policy regarding the use of a PICC for specimen collection.
C)Request assistance from a more experienced nurse to attempt venipuncture again.
D)Using a 5 mL syringe, withdraw a sample from the Y-port closest to the patient's PICC insertion point.

Accepted Answer

The nurse should confirm the ordering healthcare provider's order and institutional policy regarding the use of a PICC for specimen collection. Depending on the policy, the nurse may be required to use the PICC for blood draws, or a separate order may be needed to use the PICC for this purpose. If using the PICC is not an option or against policy, alternative methods such as drawing from a different vein or using a different method of collection such as a syringe attached to a butterfly needle may need to be attempted. However, confirming the policy and order first is the appropriate first step. Requesting assistance from another nurse or attempting another venipuncture may also be appropriate options in addition to confirming the policy. Withdrawing a sample from the Y-Port may not provide accurate results, so that option is not appropriate.

Question 16

A patient is suspected of having congenital hypothyroidism, but the primary test used for this purpose provided insufficient information.Which complementary test would be most appropriate for confirming this suspicion?
A)Thyroxine, free
B)Transferrin
C)Triglycerides
D)Thyroid-stimulating hormone (TSH)

Accepted Answer

The answer of A patient is suspected of having congenital...

Question 17

A patient admitted with a fever of unknown origin has orders for "blood cultures x 3." The nurse should inform the patient that this procedure involves:
A)Collecting three samples daily in the morning, with one venipuncture when other daily blood work is obtained.
B)Obtaining three samples from different sites, with each sample requiring venipuncture.
C)Obtaining sufficient blood to prepare three sets of culture vials with one venipuncture.
D)Using random specimens, collected at the time any other blood sample is obtained, to minimize the number of venipunctures required.

Accepted Answer

When a patient has orders for "blood cultures x 3," it involves obtaining three samples from different sites, with each sample requiring a separate venipuncture. This approach is used to increase the likelihood of detecting the presence of bacteria in the bloodstream, while also minimizing the risk of contamination from a single site. Collecting samples from different sites can help differentiate between a true bloodstream infection and contamination from the skin.

Question 18

A patient is preparing to undergo intestinal biopsy.Which of the following conditions would be a contraindication for this procedure?
A)Celiac disease
B)Intestinal malignancy
C)Bleeding disorder
D)Parasitic infection

Accepted Answer

Intestinal biopsy involves taking a small sample of tissue from the lining of the intestine. This procedure carries a small risk of bleeding, which can be exacerbated in patients with bleeding disorders. Therefore, a bleeding disorder is a contraindication for an intestinal biopsy. Celiac disease, intestinal malignancy, and parasitic infection do not necessarily preclude a patient from undergoing an intestinal biopsy.

Question 19

A patient is suspected of having thalassemia.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

Hemoglobin electrophoresis is the most appropriate test to confirm the suspicion of thalassemia, as it allows for the identification of the specific type of abnormal hemoglobin present in the patient's blood. This test can differentiate between alpha and beta thalassemia and can provide information about the severity of the disease. Ham's test is used to diagnose paroxysmal nocturnal hemoglobinuria, haptoglobin levels are decreased in hemolytic anemia, and hemosiderin is a breakdown product of hemoglobin that can be seen in conditions such as iron overload.

Question 20

A patient with a positive Papanicolaou (Pap)smear is scheduled for a colposcopy.The nurse should explain to the patient that the purpose of this procedure is to:
A)Obtain another sample for repeat Pap smear
B)Identify areas of cellular dysplasia
C)Remove products of conception
D)Treat a suspected malignancy

Accepted Answer

A colposcopy is performed to identify areas of cellular dysplasia and determine if a biopsy is needed to further evaluate the abnormal cells. It is not performed to obtain another sample for a repeat Pap smear, remove products of conception, or treat a suspected malignancy.

Quiz 2: Preface

A patient's genetic test results related to thyroid cancer indicate high levels of the genetic marker BRAF.Which type of thyroid cancer does this marker indicate?

A nurse is assisting with cystoscopy for a patient undergoing bladder biopsy.The urologist has just inserted the cystoscope into the patient's urethra.Which of the following is the next step the nurse should expect in this procedure?

nurse is preparing to collect a capillary blood glucose specimen from a neonate.Which site is most appropriate for the nurse to use?

A patient who recently completed a multigated blood pool imaging (MUGA) scan asks what it means that the test showed an ejection fraction of 65%.Which answer by the nurse is most accurate?

A patient presents with complaints of red-tinged urine in the mornings and symptoms of anemia.The health-care provider suspects a rare form of intravascular hemolytic anemia.Which test would be most appropriate to confirm this suspicion?

During a lactose-tolerance test, a patient's fasting glucose level of 98 mg/dL increases by 10 mg/dL.For which clinical manifestations should a nurse assess this patient?

A patient has blood drawn for a TORCH serological screen.Which assessment finding is a nurse most likely to document for this patient?

A nurse is preparing to draw blood from a patient who is deaf.A family member who is present has been using sign language to assist staff with communication.Which action by the nurse is most appropriate?

A patient needs to undergo initial testing of thyroid function.Which test, in addition to TSH, would be most appropriate for this purpose?

A patient diagnosed with type 1 diabetes has orders for fluorodeoxyglucose (FDG) -positron emission tomography (PET) as part of a diagnostic work-up for possible Parkinson's disease.The nurse should plan for this procedure to occur:

A patient reports to an emergency department with a sudden onset of shortness of breath and right-sided chest pain.The patient has a negative D-dimer test.Based on this result, a nurse should plan interventions to manage:

A patient has been diagnosed with scurvy.The nurse is aware that this condition is associated with a deficiency in which vitamin?

A patient is suspected of having congenital hypothyroidism, but the primary test used for this purpose provided insufficient information.Which complementary test would be most appropriate for confirming this suspicion?

A patient admitted with a fever of unknown origin has orders for "blood cultures x 3." The nurse should inform the patient that this procedure involves:

A patient is preparing to undergo intestinal biopsy.Which of the following conditions would be a contraindication for this procedure?

A patient is suspected of having thalassemia.Which test would be most appropriate to confirm this suspicion?

A patient with a positive Papanicolaou (Pap) smear is scheduled for a colposcopy.The nurse should explain to the patient that the purpose of this procedure is to: