Question 1

A patient who recently started on new medications notices that his urine now has a bluish tint.Which medication is most likely contributing to this finding?

Accepted Answer

Triamterene, a component of the combination medication Hydrochlorothiazide with Triamterene (Maxzide, Dyazide), can cause a bluish tint to the urine. This is a known side effect and is not harmful.

Question 2

A patient with a history of coronary artery disease reports persistent muscle ache.Laboratory results show a creatine kinase (CK)level of 360 units/L with normal transaminase levels (ALT and AST).Which medication should the nurse relate to this finding?

Accepted Answer

Atorvastatin (Lipitor) is a type of medication known as a statin, which is used to lower cholesterol levels in patients with coronary artery disease. One of the potential side effects of statin therapy is muscle ache, and elevated CK levels can be a sign of muscle damage. Therefore, the patient's persistent muscle ache and elevated CK level are likely related to atorvastatin use. Digoxin (B), metformin (C), and tenormin (D) are not known to cause muscle ache or elevate CK levels.

Question 3

A young woman with a significant family history of coronary artery disease is planning a pregnancy in the next year.Prenatal screening results include a homocysteine level of 36 micromoles/L.The nurse should teach the patient to:

Accepted Answer

High levels of homocysteine have been linked to an increased risk of coronary artery disease. The recommended treatment for elevated homocysteine levels is to supplement with folic acid and vitamins B₆ and B₁₂, which can help lower homocysteine levels. Therefore, the nurse should teach the patient to take these supplements daily. Decreasing intake of calcium and monosaturated fats, increasing fluid intake, and scheduling monthly injections of B₁₂ and iron are not indicated treatments for high homocysteine levels.

Question 4

A patient's laboratory test results indicate increased levels of intrinsic factor antibodies.The nurse is aware that this finding is associated with which of the following conditions?

Accepted Answer

Increased levels of intrinsic factor antibodies are associated with pernicious anemia. Pernicious anemia is an autoimmune disorder in which the body attacks cells in the stomach that produce intrinsic factor, a protein necessary for the absorption of vitamin B12. Without intrinsic factor, B12 cannot be absorbed properly and leads to anemia.

Question 5

When assessing a patient with a methemoglobin level of 12%, a nurse should observe for:

Accepted Answer

Cyanosis is a common symptom of methemoglobinemia, as it causes the skin to turn blue-gray in color. Altered mental status, confusion, and headache may also occur, but they are less specific to methemoglobinemia and can be caused by a variety of other factors.

Question 6

A patient has orders for lactulose 30 mL by mouth every 4 hours and neomycin 250 mg by mouth every 4 hours.Which laboratory result should a nurse monitor to determine the effectiveness of these medications?

Accepted Answer

Lactulose and neomycin are commonly used to treat hepatic encephalopathy, which is caused by an accumulation of ammonia in the blood. Monitoring blood ammonia levels will help determine the effectiveness of these medications in lowering the serum ammonia levels. Glycosylated hemoglobin measures the average blood sugar over the past few months and is not relevant in monitoring the effectiveness of these medications. Serum creatinine is a measure of kidney function and is not relevant in this case. White blood cell count is a measure of immune function and is not relevant in monitoring the effectiveness of these medications in treating hepatic encephalopathy.

Question 7

A patient has orders to begin gentamicin intravenously every 12 hours.Prior to the first dose, a nurse reviews the patient's laboratory results.Which result should the nurse communicate to the requesting health-care provider prior to starting this medication?

Accepted Answer

Gentamicin is a known nephrotoxic drug, and renal function should be assessed prior to administering the medication. The serum creatinine level is a measure of kidney function, and a level of 1.8 mg/dL may indicate impaired renal function. The healthcare provider should be notified prior to administration of this medication. The other laboratory results are within normal ranges and do not need to be reported.

Question 8

A patient who is screened for resistant organisms on admission to a long-term care setting is found to have methicillin-resistant Staphylococcus aureus (MRSA)in the nares.Which intervention should a nurse use to manage this diagnostic finding?

Accepted Answer

The answer of A patient who is screened for resistant...

Question 9

A patient who has received multiple blood transfusions has a positive result for platelet antibodies.Which patient teaching should the nurse implement?

Accepted Answer

Patients with platelet antibodies are at risk for bleeding due to destruction of platelets. Using a soft-bristle toothbrush can prevent trauma to the gums and bleeding, while appropriate dietary measures can prevent constipation and straining during bowel movements which can also lead to bleeding. The other options are not relevant to platelet antibody presence.

Question 10

Following a minor surgical procedure with minimal blood loss, a patient's hemoglobin and hematocrit are increased slightly from the pre-op baseline.The patient has had nothing to eat or drink for 12 hours prior to the surgery.The nurse's initial response should be to:

Accepted Answer

The increase in hemoglobin and hematocrit levels can be attributed to hemoconcentration due to the patient's preoperative fasting. Therefore, administering a fluid bolus or preparing the patient for a blood transfusion is unnecessary at this time. Instructing the patient to take an iron supplement would not address the immediate concern of the increased levels. The nurse should monitor the patient's intake and output to ensure proper hydration and to rule out any potential complications.

Question 11

The nurse admits a woman who is 25 weeks pregnant who states, "I think I might be leaking fluid, but I can't tell." The nurse obtains a vaginal swab and tests the drainage with Nitrazine paper to rule out premature rupture of membranes.If only normal vaginal secretions are present, the nurse expects which of the following results?

Accepted Answer

Nitrazine paper turns blue in the presence of amniotic fluid. If only normal vaginal secretions are present, the paper will not change color.

Question 12

Which dietary instruction should the nurse plan for a patient with a potassium level of 3.2 mEq/L?

Accepted Answer

A potassium level of 3.2 mEq/L is below the normal range, indicating hypokalemia. Fresh fruits and vegetables, such as avocados, bananas, and cantaloupe, are high in potassium and can help increase potassium levels.

Question 13

A patient is undergoing venipuncture for collection of a blood sample for aspartate aminotransferase (AST)testing.Which condition is this type of testing most useful in identifying?

Accepted Answer

Aspartate aminotransferase (AST) testing is most useful in identifying liver damage or disease such as hepatitis. AST is an enzyme found mainly in the liver but also in other tissues, such as muscle and kidney. When the liver is damaged, AST is released into the bloodstream, and levels increase. Elevated AST levels can indicate liver inflammation or damage, which is commonly seen in cases of hepatitis.

Question 14

Which dietary instruction should a nurse plan for a patient who has a triglyceride level of 300 mg/dL?

Accepted Answer

High intake of alcohol can increase triglyceride levels, therefore reducing or avoiding intake of alcoholic beverages is recommended for someone with a triglyceride level of 300 mg/dL. Options A and B are not recommended as monounsaturated and polyunsaturated fats and omega-3 fatty acids have actually been shown to help lower triglyceride levels. Option C is not necessary as dairy products themselves are not a significant contributor to high triglyceride levels.

Question 15

The nurse is caring for a patient who is to have laboratory tests, including an HbA1c.Which of the following patient statements indicates teaching has been effective?

Accepted Answer

Option B correctly identifies that the HbA1c test is used to determine the effectiveness of diabetic medications. Option A is incorrect because the HbA1c measures the average blood sugar level over a period of approximately three months and consuming something sweet immediately before the test will not have a significant impact on the results. Option C is also incorrect as fasting is not typically required for an HbA1c test. Option D is also incorrect as the timing of the test is not related to the time of day that the patient wakes up.

Question 16

A child is brought to the emergency room with suspected lead poisoning.Which of the following tests, in addition to a blood lead level, would most likely be conducted to assess for lead poisoning?

Accepted Answer

Delta-aminolevulinic acid (ALA) is a test that measures the level of ALA in the urine, which can be an indicator of lead poisoning. ALA is produced by the body when it is exposed to lead and can be a useful marker for assessing lead toxicity. Ammonia, amylase, and anion gap tests are not typically used to assess for lead poisoning.

Question 17

Laboratory results indicate that a patient's anion gap is over 16.Which condition should the nurse plan to manage?

Accepted Answer

An anion gap over 16 indicates a pH imbalance known as metabolic acidosis, which needs to be managed by the nurse. Options A, C, and D are unrelated to the anion gap levels.

Question 18

A mother brings her infant to an emergency department reporting that the infant had a seizure.While taking the history, a nurse learns that the mother has been short of money and has been diluting the infant's formula with more water than the instructions recommend.Based on this information, which laboratory result should the nurse anticipate?

Accepted Answer

Diluting formula with excess water can lead to hyponatremia (low sodium levels) in infants, which can cause seizures. Therefore, the nurse should anticipate a low sodium level, which is option D. Blood glucose levels (option A) are unrelated to this scenario. Chloride (option B) levels may be affected by excessive sweating or vomiting, but not by diluting formula. Potassium (option C) levels may be affected by renal function, medication use, or diet, but not by diluting formula.

Question 19

A geriatric patient is hospitalized with anorexia and weakness secondary to persistent diarrhea.The stool culture is positive for Clostridium difficile (C.difficile).Which question should a nurse ask to identify information that may help determine the etiology of this patient's diarrhea?

Accepted Answer

C. difficile infection is commonly associated with antibiotic use, which disrupts the normal bacterial flora in the gut and allows C. difficile to overgrow. Therefore, knowing if the patient recently received antibiotics would be helpful in determining the etiology of their diarrhea. The other options (B, C, D) are not as relevant to the potential cause of C. difficile infection.

Question 20

A geriatric patient is admitted with hyponatremia and a decreased serum osmolality.Nursing interventions should include restricting intake of:

Accepted Answer

In hyponatremia with decreased serum osmolality, there is an excess of water in the body relative to sodium. The best nursing intervention is to restrict water intake to help correct the imbalance. Restricting sodium, potassium, or chloride would not be appropriate in this situation as the issue is excess water, not excess electrolytes.

Quiz 1: About This Book