Question 1

A nurse notes that laboratory results for a patient include T- and B-lymphocyte assays that are lower than normal.Which intervention should the nurse include in this patient's care plan?

Accepted Answer

T- and B-lymphocytes are important components of immune function, and low levels of these cells can indicate immunodeficiency. Placement in reverse isolation, which involves protecting the patient from contact with potentially harmful germs through strict infection control measures, would be appropriate to reduce the risk of infection. Avoiding injections and promoting a high-iron diet are not directly related to this patient's immunodeficiency, and bedrest may not be necessary unless the patient is also experiencing other symptoms.

Question 2

After administering gallium intravenously to a patient before a gallium scan, the nurse realizes that the IV catheter is not fully in the vein and that the radionuclide tracer has seeped deep into the muscle tissue.The nurse should expect which of the following to occur as a result of this error?

Accepted Answer

When the radionuclide tracer seeps into muscle tissue, it can result in erroneous hot spots on the imaging scan. Anaphylactic shock, tissue necrosis, and hypotensive crisis are not expected outcomes from this error.

Question 3

A patient who is receiving D5/0.45% normal saline at 100 mL/hr has a potassium level of 3.2 mEq/L.A nurse notifies the requesting health-care provider and receives a telephone order to "administer potassium chloride (KCl)40 mEq IV now." Which action by the nurse is most appropriate?

Accepted Answer

The nurse should clarify the desired route and rate of administration with the requesting health-care provider to ensure the safe administration of KCl. KCl is a high-alert medication, and its administration requires close monitoring of the patient's electrolyte levels and cardiac status. It is essential to confirm the correct route and rate of administration to prevent adverse reactions such as hyperkalemia or cardiac arrhythmias. The nurse should also assess the patient's renal function, as KCl should be used with caution in patients with impaired renal function. Administering KCl without clarifying the route and rate of administration is inappropriate and can be dangerous for the patient.

Question 4

Results from a patient's genetic testing indicate mutations in the HER-2-NEU gene.This finding is most associated with which of the following?

Accepted Answer

Mutations in the HER-2-NEU gene are most commonly associated with a higher risk of developing breast cancer. HER-2-NEU mutations can cause the gene to produce too much of the protein HER-2, which can drive the growth of certain types of breast cancer. Testing for HER-2-NEU mutations can help guide treatment decisions for patients with breast cancer.

Question 5

A 40-year-old patient's albumin level is 6.5 g/dL.Which of the following conditions would most likely explain this finding?

Accepted Answer

Dehydration can lead to hemoconcentration, which increases the concentration of albumin in the blood, explaining the high albumin level of 6.5 g/dL.

Question 6

A patient, who is a Jehovah's Witness, is scheduled for an elective knee arthroplasty.The patient has a hemoglobin (Hgb)10.4 g/dL and hematocrit (HCT)30.8%.Which medication should be administered prior to surgery to improve the patient's Hgb and HCT?

Accepted Answer

Epoetin alpha is a medication that stimulates the production of red blood cells, which can improve a patient's Hgb and HCT levels prior to surgery. This is the best choice for a Jehovah's Witness patient who refuses blood transfusions. Efavirenz, Enalapril, and Erythromycin do not have any effect on Hgb or HCT levels.

Question 7

A patient's laboratory test results indicate an increased level of zinc in the blood.The nurse is aware that this finding is consistent with which of the following conditions?

Accepted Answer

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

Question 8

A patient is undergoing venipuncture for collection of a specimen for B-type natriuretic peptide (BNP)testing.Which condition is this test used to diagnose and monitor?

Accepted Answer

B-type natriuretic peptide (BNP) testing is used to diagnose and monitor congestive heart failure (CHF). BNP is released by the heart in response to fluid overload or pressure overload. Elevated levels of BNP can indicate the presence of CHF.

Question 9

A full-term newborn exhibits jaundice that is noted in the first 24 hours after birth.Laboratory tests reveal a serum bilirubin level of 7.2 mg/dL.The newborn's parents are both first-generation immigrants from Greece.Based on this information, a nurse should review the patient's neonatal screening laboratory results to determine the presence of an inborn error in carbohydrate or amino acid metabolism:

Accepted Answer

The newborn's early-onset jaundice and the parents' Greek heritage suggest a potential for Glucose-6-phosphate dehydrogenase (G6PD) deficiency, a condition more prevalent in Mediterranean populations. G6PD deficiency can lead to hemolytic anemia and jaundice in newborns.

Question 10

A nurse is assisting with a gastric emptying scan.How should the nurse administer the radionuclide to this patient?

Accepted Answer

The radionuclide should be administered by having the patient drink a solution for a gastric emptying scan. This allows for the substance to move through the digestive system and provide an accurate assessment of gastric emptying time. Intravenous injection or enema would not be appropriate routes of administration for this type of scan. A capsule may be used in some cases, but a solution is typically preferred.

Question 11

A couple have been trying unsuccessfully to get pregnant for 2 years and suspect that the husband is infertile.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?

Accepted Answer

The most appropriate antibody test to confirm male infertility is an antisperm antibody test. This measures the presence of antibodies that attack sperm and prevents its movement or ability to fertilize an egg. Antinuclear, antistreptolysin O, and antithyroglobulin tests are unrelated to fertility and would not provide information about male infertility.

Question 12

An adult patient being treated for a chronic wound infection has a zinc level of 45 mcg/dL.Based on this information, the nurse should instruct this patient to:

Accepted Answer

Increasing intake of zinc-rich foods such as shellfish, wheat germ, and canned foods, such as pork and beans or chili, can help increase zinc levels in the body. Tea, coffee, and iron do not significantly affect zinc absorption. High-fiber foods and whole grains are important for overall health but do not specifically affect zinc levels.

Question 13

A laboratory technician notifies a nurse that a patient who is receiving an IV heparin drip per weight-based protocol at a rate of 700 units/hour has an activated partial thromboplastin time (aPTT)of 130 seconds (control is 35 seconds).Which intervention by the nurse is most appropriate initially?

Accepted Answer

An aPTT of 130 seconds is significantly above the therapeutic range for heparin, which is typically between 60-80 seconds. The most appropriate initial intervention would be to stop the heparin and recheck the aPTT in 1 hour. This is necessary to determine if the heparin is causing an excessive anticoagulant effect resulting in a higher risk of bleeding. Based on the new aPTT result, the healthcare provider can adjust the heparin dosage or decide to stop the infusion altogether. Continuing the heparin at the current rate or monitoring for bleeding would not address the issue of potentially excessive anticoagulation. Preparing an injection of vitamin K for emergency injection is inappropriate because vitamin K does not reverse the anticoagulant effect of heparin.

Question 14

A patient who seeks treatment at an urgent care center for arthralgia and fever has a history of a tick bite 2 weeks prior.On assessment the nurse observes a circular, red rash.Which laboratory test correlates with these clinical manifestations?

Accepted Answer

The presence of a tick bite, arthralgia, fever, and a circular, red rash is highly suspicious for Lyme disease. The laboratory test that correlates with these clinical manifestations is the Lyme antibody test, which checks for the presence of antibodies against Borrelia burgdorferi, the bacterium that causes Lyme disease. A positive result confirms the diagnosis. The other laboratory tests mentioned are not specific to Lyme disease and do not correlate with the clinical manifestations described.

Question 15

A patient with increased gastrin level is found to have a pyloric obstruction.The nurse should understand that pyloric obstruction causes an increase in gastrin level due to which of the following?

Accepted Answer

Gastric distention, as seen in pyloric obstruction, stimulates G cells in the stomach to produce more gastrin, leading to increased levels of this hormone.

Question 16

A nurse is providing teaching to a patient who has been found to have advanced cirrhosis following alkaline phosphatase (ALP)testing.Which of the following diets would be most appropriate to recommend to this patient?

Accepted Answer

Patients with advanced cirrhosis often have difficulty metabolizing proteins, which can lead to complications such as hepatic encephalopathy. A low protein diet is recommended to help manage these risks.

Question 17

An adult male patient who is suspected of having prostate cancer has just undergone testing for prostate-specific antigen (PSA).Which of the following ratios of free to complexed PSA would be consistent with a diagnosis of prostatic cancer?

Accepted Answer

A lower ratio of free to complexed PSA (such as 8%) is more consistent with prostate cancer, as cancerous cells tend to produce more complexed PSA.

Question 18

A nurse is explaining laboratory test results to the parent of a 12-month-old patient.The results show a low level of immunoglobulin A (IgA).Which of the following is the most accurate interpretation of these results?

Accepted Answer

Low levels of immunoglobulin A (IgA) in a 12-month-old can be considered normal because IgA levels increase with age, reaching adult levels typically by 4 to 6 years of age.

Question 19

A patient has a hemoglobin level of 11.3 g/dL and a red blood cell count of 3.76 *10⁶ cells/mm³.Based on this information, a nurse should calculate that the hematocrit is approximately:

Accepted Answer

The hematocrit can be calculated by multiplying the red blood cell count by the mean corpuscular volume (MCV), which is typically around 80-100 fL. Therefore, with a red blood cell count of 3.76 x 10^12 cells/mm^3 and assuming an MCV of 90 fL, the hematocrit would be approximately 33.9%.

Question 20

A patient is admitted to a hospital with a diagnosis of dehydration secondary to acute gastroenteritis.The patient also has polycythemia vera.Which results of a complete blood count (CBC)should the nurse identify as consistent with this clinical presentation?

Accepted Answer

Polycythemia vera is a condition characterized by an increase in the number of red blood cells, hematocrit, and hemoglobin. Therefore, the nurse should expect to see increased levels of RBC, hematocrit, and hemoglobin on the CBC, even in the presence of dehydration secondary to acute gastroenteritis. Choice A and B are inconsistent with polycythemia vera, and choice C describes a normal CBC result.

Quiz 1: About This Book

A nurse notes that laboratory results for a patient include T- and B-lymphocyte assays that are lower than normal.Which intervention should the nurse include in this patient's care plan?

After administering gallium intravenously to a patient before a gallium scan, the nurse realizes that the IV catheter is not fully in the vein and that the radionuclide tracer has seeped deep into the muscle tissue.The nurse should expect which of the following to occur as a result of this error?

A patient who is receiving D5/0.45% normal saline at 100 mL/hr has a potassium level of 3.2 mEq/L.A nurse notifies the requesting health-care provider and receives a telephone order to "administer potassium chloride (KCl) 40 mEq IV now." Which action by the nurse is most appropriate?

Results from a patient's genetic testing indicate mutations in the HER-2-NEU gene.This finding is most associated with which of the following?

A 40-year-old patient's albumin level is 6.5 g/dL.Which of the following conditions would most likely explain this finding?

A patient, who is a Jehovah's Witness, is scheduled for an elective knee arthroplasty.The patient has a hemoglobin (Hgb) 10.4 g/dL and hematocrit (HCT) 30.8%.Which medication should be administered prior to surgery to improve the patient's Hgb and HCT?

A patient's laboratory test results indicate an increased level of zinc in the blood.The nurse is aware that this finding is consistent with which of the following conditions?

A patient is undergoing venipuncture for collection of a specimen for B-type natriuretic peptide (BNP) testing.Which condition is this test used to diagnose and monitor?

A nurse is assisting with a gastric emptying scan.How should the nurse administer the radionuclide to this patient?

A couple have been trying unsuccessfully to get pregnant for 2 years and suspect that the husband is infertile.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?

An adult patient being treated for a chronic wound infection has a zinc level of 45 mcg/dL.Based on this information, the nurse should instruct this patient to:

A laboratory technician notifies a nurse that a patient who is receiving an IV heparin drip per weight-based protocol at a rate of 700 units/hour has an activated partial thromboplastin time (aPTT) of 130 seconds (control is 35 seconds) .Which intervention by the nurse is most appropriate initially?

A patient who seeks treatment at an urgent care center for arthralgia and fever has a history of a tick bite 2 weeks prior.On assessment the nurse observes a circular, red rash.Which laboratory test correlates with these clinical manifestations?

A patient with increased gastrin level is found to have a pyloric obstruction.The nurse should understand that pyloric obstruction causes an increase in gastrin level due to which of the following?

A nurse is providing teaching to a patient who has been found to have advanced cirrhosis following alkaline phosphatase (ALP) testing.Which of the following diets would be most appropriate to recommend to this patient?

An adult male patient who is suspected of having prostate cancer has just undergone testing for prostate-specific antigen (PSA) .Which of the following ratios of free to complexed PSA would be consistent with a diagnosis of prostatic cancer?

A nurse is explaining laboratory test results to the parent of a 12-month-old patient.The results show a low level of immunoglobulin A (IgA) .Which of the following is the most accurate interpretation of these results?

A patient has a hemoglobin level of 11.3 g/dL and a red blood cell count of 3.76 *10⁶ cells/mm³.Based on this information, a nurse should calculate that the hematocrit is approximately:

A patient is admitted to a hospital with a diagnosis of dehydration secondary to acute gastroenteritis.The patient also has polycythemia vera.Which results of a complete blood count (CBC) should the nurse identify as consistent with this clinical presentation?

Quiz 1: About This Book

A nurse notes that laboratory results for a patient include T- and B-lymphocyte assays that are lower than normal.Which intervention should the nurse include in this patient's care plan?

After administering gallium intravenously to a patient before a gallium scan, the nurse realizes that the IV catheter is not fully in the vein and that the radionuclide tracer has seeped deep into the muscle tissue.The nurse should expect which of the following to occur as a result of this error?

A patient who is receiving D5/0.45% normal saline at 100 mL/hr has a potassium level of 3.2 mEq/L.A nurse notifies the requesting health-care provider and receives a telephone order to "administer potassium chloride (KCl) 40 mEq IV now." Which action by the nurse is most appropriate?

Results from a patient's genetic testing indicate mutations in the HER-2-NEU gene.This finding is most associated with which of the following?

A 40-year-old patient's albumin level is 6.5 g/dL.Which of the following conditions would most likely explain this finding?

A patient, who is a Jehovah's Witness, is scheduled for an elective knee arthroplasty.The patient has a hemoglobin (Hgb) 10.4 g/dL and hematocrit (HCT) 30.8%.Which medication should be administered prior to surgery to improve the patient's Hgb and HCT?

A patient's laboratory test results indicate an increased level of zinc in the blood.The nurse is aware that this finding is consistent with which of the following conditions?

A patient is undergoing venipuncture for collection of a specimen for B-type natriuretic peptide (BNP) testing.Which condition is this test used to diagnose and monitor?

A nurse is assisting with a gastric emptying scan.How should the nurse administer the radionuclide to this patient?

A couple have been trying unsuccessfully to get pregnant for 2 years and suspect that the husband is infertile.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?

An adult patient being treated for a chronic wound infection has a zinc level of 45 mcg/dL.Based on this information, the nurse should instruct this patient to:

A patient who seeks treatment at an urgent care center for arthralgia and fever has a history of a tick bite 2 weeks prior.On assessment the nurse observes a circular, red rash.Which laboratory test correlates with these clinical manifestations?

A patient with increased gastrin level is found to have a pyloric obstruction.The nurse should understand that pyloric obstruction causes an increase in gastrin level due to which of the following?

A nurse is providing teaching to a patient who has been found to have advanced cirrhosis following alkaline phosphatase (ALP) testing.Which of the following diets would be most appropriate to recommend to this patient?

An adult male patient who is suspected of having prostate cancer has just undergone testing for prostate-specific antigen (PSA) .Which of the following ratios of free to complexed PSA would be consistent with a diagnosis of prostatic cancer?

A nurse is explaining laboratory test results to the parent of a 12-month-old patient.The results show a low level of immunoglobulin A (IgA) .Which of the following is the most accurate interpretation of these results?

A patient has a hemoglobin level of 11.3 g/dL and a red blood cell count of 3.76 *106 cells/mm3.Based on this information, a nurse should calculate that the hematocrit is approximately:

A patient is admitted to a hospital with a diagnosis of dehydration secondary to acute gastroenteritis.The patient also has polycythemia vera.Which results of a complete blood count (CBC) should the nurse identify as consistent with this clinical presentation?

A patient has a hemoglobin level of 11.3 g/dL and a red blood cell count of 3.76 *10⁶ cells/mm³.Based on this information, a nurse should calculate that the hematocrit is approximately: