Question 1

A patient has a serum albumin of 4.1 g/dL.Based on this lab value, a nurse should instruct this patient to:

Accepted Answer

A serum albumin level of 4.1 g/dL falls within the normal range (3.5-5.0 g/dL), so the patient does not need to make any significant changes to their diet. Continuing with their current dietary patterns is appropriate. A low serum albumin level (below 3.5 g/dL) indicates malnutrition or liver disease, and in those cases, an increased protein intake may be recommended. However, that is not the case here. Increasing fiber and fluid intake or adding more green leafy vegetables is not necessary based on this lab value.

Question 2

A patient with type 1 diabetes is scheduled for a procedure at 0700 and must remain NPO after midnight.The patient's capillary blood glucose (CBG)at 2100 is 96 mg/dL.Which medication should the nurse administer as ordered?

Accepted Answer

Glargine (Lantus) is a long-acting insulin that maintains blood glucose levels and is appropriate for overnight control, especially when fasting for a procedure. Glyburide is not suitable for type 1 diabetes, and insulin aspart is a rapid-acting insulin used before meals or for correction, not suitable for overnight fasting conditions.

Question 3

A nurse is working with a patient who has demonstrated hypertension of unknown cause.The patient also has hypokalemia that was not induced by diuretics.Which of the following diagnostic tests would be most appropriate for evaluating this patient's hypertension?

Accepted Answer

Hypokalemia and hypertension can be caused by excess aldosterone secretion from the adrenal gland. Therefore, measuring serum aldosterone levels can help determine if this is the cause of the patient's hypertension. Choice A, Albumin, is not directly related to hypertension or hypokalemia. Choice C, ALT, is a liver enzyme and is not related to hypertension or hypokalemia. Choice D, ACTH, is a hormone produced by the pituitary gland that can affect cortisol secretion but is not directly related to hypertension or hypokalemia.

Question 4

A nurse is preparing a patient with type 2 diabetes to undergo an adrenal gland scan that requires administration of an iodinated contrast medium.Which of the following interventions should the nurse take specifically related to this patient's diabetes?

Accepted Answer

Patients with diabetes who are taking metformin should discontinue the medication the day of the procedure and for 48 hours afterward to avoid the risk of developing lactic acidosis when the contrast medium is administered. The other options are also important, but not specific to the patient's diabetes.

Question 5

A patient has a parathormone (PTH)level of 6 pg/mL.Which observations should a nurse relate to this finding when interpreting the patient's electrocardiogram?

Accepted Answer

Prolonged QT interval and bradycardia are related to hypocalcemia, which can result from low parathormone (PTH) levels, as PTH helps regulate calcium levels in the blood.

Question 6

The results of the analysis of a cerebrospinal fluid specimen show that the patient's tau protein level is increased.This is a marker associated with which of the following conditions?

Accepted Answer

Increased tau protein levels in cerebrospinal fluid are a characteristic feature of Alzheimer's disease, a progressive neurodegenerative disorder that primarily affects memory and cognition. This marker is not indicative of Parkinson's disease, specific allergens, or Conn's disease.

Question 7

The nurse is caring for a patient who is HIV positive admitted with a fever and cough.The physician has ordered sputum culture and cytology.Which of the following statements best explains the reason for these tests to the patient?

Accepted Answer

Sputum culture and cytology are tests used to determine the presence of bacteria or fungi that may cause pneumonia. This information is important in selecting the appropriate treatment for the patient's condition.

Question 8

A patient with a history of type 2 diabetes has a serum creatinine level of 1.4 mg/dL and a random urine sample that shows +4 for protein.What medication does the nurse anticipate will be prescribed for this patient?

Accepted Answer

Losartan (Cozaar) is an angiotensin receptor blocker (ARB) that is often prescribed for patients with diabetes and proteinuria to decrease the progression of renal disease. It helps to lower blood pressure and reduce proteinuria by blocking the action of angiotensin II, which can cause constriction of blood vessels and increase blood pressure. Diltiazem (Cardizem, Tiazac) is a calcium channel blocker that is used to treat hypertension and angina but does not have a specific indication for proteinuria in diabetes. Glipizide (Glucotrol) is a Type 2 diabetes medication that helps lower blood glucose levels by stimulating insulin release from the pancreas but does not have effects on proteinuria. Hydrochlorothiazide (HydroDIURIL, Microzide) is a diuretic that is used to treat hypertension and fluid retention but may not be the best choice for patients with diabetes who have proteinuria since it can increase the risk of electrolyte imbalances.

Question 9

A patient receiving IV vancomycin has orders for "vancomycin trough levels." The patient's next dose of vancomycin is due at 1000.Based on this information, the nurse should plan for the specimen to be drawn at:

Accepted Answer

Vancomycin trough levels are typically drawn immediately before the next dose is due to ensure that the drug concentration does not fall below the therapeutic range. Drawing the specimen at 0930, right before the 1000 dose, allows for the most accurate measurement of the lowest concentration of the drug in the patient's bloodstream.

Question 10

A patient who denies any history of drug use has a pre-employment urine drug screen that is positive for opiates.Which information provided by the patient should a nurse relate to this laboratory finding?

Accepted Answer

Sesame and poppy seeds contain trace amounts of opiates, which can lead to a positive result on a urine drug screen. It is important for healthcare providers to be aware of this and to ask patients about their dietary habits before assuming drug use.

Question 11

A nurse is reviewing a newborn patient's arterial blood gas results.Which pH result should the nurse identify as a "critical" value that should be reported immediately to the requesting health-care provider?

Accepted Answer

The answer of A nurse is reviewing a newborn patient's...

Question 12

A nurse vigorously swabs the tonsillar pillars and posterior throat of a patient to obtain a specimen for a group A streptococcal screen and then repeats this process with a second swab.What is the correct rationale for obtaining two specimens?

Accepted Answer

If the first swab tests negative for group A streptococcus using a rapid antigen detection test, a traditional culture is often performed on the second swab to confirm the result, as rapid tests can have lower sensitivity.

Question 13

A nurse is reviewing laboratory data for a geriatric patient admitted to a hospital with diagnoses of dementia and dehydration.Which laboratory data should the nurse assess in relation to this diagnosis?

Accepted Answer

Increased hematocrit and blood urea nitrogen (BUN) levels are indicative of dehydration, which aligns with the patient's diagnosis. Hematocrit levels increase as the plasma portion of the blood decreases (due to dehydration), and BUN levels increase due to reduced renal perfusion.

Question 14

A nurse receives a phone call from a receptionist in another organization who requests a faxed copy of recent laboratory results for a patient.Which response by the nurse receiving this call is most appropriate?

Accepted Answer

Requesting a release-of-information form signed by the patient ensures that the patient has consented to the sharing of their information, adhering to privacy laws and protecting patient confidentiality.

Question 15

A nurse is providing teaching on nutrition to a patient who has just been diagnosed with acute pernicious anemia.Which instruction is most important for the nurse to give?

Accepted Answer

The answer of A nurse is providing teaching on nutrition...

Question 16

A patient undergoing assessment for anemia has a haptoglobin level of 25 mg/dL and an increased reticulocyte count.Which type of anemia should a nurse plan to manage?

Accepted Answer

The low haptoglobin level and increased reticulocyte count suggest hemolytic anemia, in which there is premature destruction of red blood cells, leading to a low haptoglobin level and increased production of immature red blood cells (reticulocytes) in response.

Question 17

A patient admitted with epigastric pain describes the pain as "steady" with onset about 3 days prior.The patient's serum lipase level is 230 units/L.Which intervention should a nurse include in the patient's initial plan of care?

Accepted Answer

The patient's symptoms and elevated lipase level suggest acute pancreatitis, which typically requires withholding oral intake and monitoring closely for signs of complications. Option A may be appropriate later in the course of treatment, but at this time the patient needs to rest the digestive system. Option C may be appropriate after symptoms subside, but not initially. Option D is not relevant to the current presentation.

Question 18

A patient is concerned about a "high sed rate" and asks a nurse what this means.Which response by the nurse is most accurate?

Accepted Answer

The erythrocyte sedimentation rate is a nonspecific test and needs to be interpreted by a healthcare provider based on the patient's overall health. A high sed rate is often an indication of inflammation in the body, but it does not provide specific information about the underlying cause of inflammation. The nurse should encourage the patient to discuss the results with their healthcare provider for appropriate interpretation and further management.

Question 19

A patient has an allergen-specific immunoglobulin E (IgE)level of 65 kU/L.This is indicative of which of the following radioimmunoassay (RAST)scores?

Accepted Answer

A patient with an allergen-specific IgE level of 65 kU/L is indicative of a very high allergy. RAST scores categorize the level of allergen-specific IgE antibodies in the blood, with higher levels indicating a stronger allergic response. A level of 65 kU/L falls into the category of very high allergy according to standard classifications.

Question 20

An adolescent female patient diagnosed with iron-deficiency anemia is started on oral iron supplements.Which laboratory result should the nurse identify as an indication that the patient is responding to treatment after 1 month?

Accepted Answer

An increase in hemoglobin by at least 1 g/dL after one month of treatment with oral iron supplements is a good indication that the patient is responding well to the treatment. Hemoglobin is the main component of red blood cells and is responsible for carrying oxygen to the body tissues. An increase in hemoglobin indicates an increase in the number of red blood cells, which is the goal of iron supplementation in iron-deficiency anemia. The other options are not specific indicators of response to iron supplementation.

Quiz 1: About This Book