Deck 1: Mosbys Canadian Manual of Diagnostic and Laboratory Tests, 1st Canadian Edition

Question 1

What is the best time of the day for obtaining a sputum specimen?

A)Early morning
B)After breakfast
C)Evening
D)The time does not matter

Answer 1

A
Explanation: Obtaining an early-morning specimen is best because secretions pool and collect in the lungs during sleep.
Reference

Question 2

During a patient's exercise stress test, his blood pressure dropped.Which of the following activities should be avoided in the 2-hour period after the test?

A)Walking
B)Taking a hot shower
C)Eating a light meal
D)Resting in his bed

Answer 2

B
Explanation: A hot shower may cause an increase in cutaneous vasodilation and lead to orthostatic hypotension.
Reference

Question 3

A patient is scheduled for a cardiac catheterization.Which of the following activities is a postprocedure nursing priority?

A)Ambulating the patient
B)Encouraging coughing and deep-breathing exercises
C)Keeping the patient on NPO status (nothing by mouth)
D)Keeping the involved extremity immobilized

Answer 3

D
Explanation: The extremity in which the catheter was placed must be kept straight and immobilized for several hours after catheterization to prevent bleeding.Ice packs may minimize any swelling or hematoma at the catheter insertion site.
Reference

Question 4

After a lumbar puncture, a nursing priority is to prevent a spinal headache.Which of the following activities is to be avoided?

A)Ambulating the patient in the room
B)Drinking fluids through a straw
C)Keeping the patient on bed rest
D)Keeping the patient's head flat

Question 5

A patient with diabetes was taken to the emergency department.His arterial blood gas results were as follows: pH: 7.25
Partial pressure of carbon dioxide (PCO₂): 38 mm Hg
HCO₃⁻ 19 mmol/L
Partial pressure of oxygen (PO₂): 95 mm Hg
What do these results indicate?

A)Respiratory acidosis
B)Respiratory alkalosis
C)Metabolic acidosis
D)Metabolic alkalosis

Question 6

Blood urea nitrogen (BUN) levels may be abnormally low in which patients?

A)Overly hydrated patients
B)Patients with liver disease
C)Malnourished patients in negative nitrogen balance
D)All the above

Question 7

The serum creatinine level is usually elevated in patients with which of the following?

A)Renal disease
B)Liver disease
C)Lung disease
D)Muscular disease

Question 8

A patient had a lipid profile documented and asks about her results.Which of the following is considered the ideal high-density lipoprotein (HDL)/total cholesterol ratio?

A)1:2
B)1:3
C)1:4
D)1:5

Question 9

Which of the following activities should be avoided before electroencephalography (EEG)?

A)Washing the hair the night before the procedure
B)Taking anticonvulsant medications
C)Drinking caffeinated fluids such as regular coffee, tea, or cola
D)None of the above

Question 10

For a patient with severe bone destruction from tumour or osteomalacia, what serum laboratory results would the nurse expect to assess?

A)Decreased serum alkaline phosphatase (ALP) level
B)Increased serum ALP level
C)Decreased erythrocyte sedimentation rate
D)Increased red blood cell count

Question 11

One of the blood studies used to detect a myocardial infarction is creatine kinase (CK).What value is most helpful for diagnosing a myocardial infarction?

A)Total CK
B)Isoenzyme CK-MM
C)Isoenzyme CK-MB
D)Isoenzyme CK-BB

Question 12

Which of these instructions should a nurse give an elderly, dehydrated patient after computed tomography (CT) of the kidney with intravenous iodine contrast material?

A)Drink plenty of fluids for 24 hours.
B)Avoid heavy lifting for 2 days.
C)Use a laxative to clear the contrast from the bowel.
D)None of the above.

Question 13

A patient presents with upper gastrointestinal bleeding from a suspected peptic ulcer.Which of the following is the most appropriate test?

A)Upper gastrointestinal radiography
B)Gastric bleeding scan
C)Esophagogastroduodenoscopy (EGD)
D)None of the above

Question 14

A patient is admitted for evaluation of perforated diverticulitis.Which of the following is the most appropriate test?

A)CT of the abdomen
B)Barium enema
C)Colonoscopy
D)All the above

Question 15

A patient's laboratory reports indicate the presence of Bence-Jones proteins.These levels are increased in the urine of patients who have:

A)Multiple myeloma
B)Carcinoid syndrome
C)Breast cancer
D)Colorectal cancer

Question 16

A patient is scheduled for magnetic resonance imaging (MRI).Which of the following factors is a contraindication to this procedure?

A)Iodine allergy
B)Severe visual impairment
C)Cardiac pacemaker
D)None of the above

Question 17

A patient is scheduled for a cardiac exercise stress test to evaluate chest pain.While obtaining the patient history, the clinician notes that the patient has intermittent claudication when walking two blocks.On the basis of this finding, which of the following is indicated?

A)The test will be performed as scheduled.
B)The test is contraindicated because of the intermittent claudication.
C)The test will be rescheduled after resolution of the claudication.
D)The patient is a candidate for the dipyridamole-thallium (nonexercise) stress test.

Question 18

A patient is admitted with abdominal pain.Ultrasonography of the abdomen, CT of the abdomen, and a barium enema study have been ordered.In what order should these tests be performed?

A)Ultrasonography, barium enema, CT
B)Ultrasonography, CT, barium enema
C)Barium enema, CT, ultrasonography
D)CT, barium enema, ultrasonography

Question 19

A patient has just returned from the endoscopy suite, where he underwent bronchoscopy.Which of the following is not a nursing priority after the procedure?

A)Observing the sputum for hemorrhage
B)Monitoring the vital signs frequently
C)Observing the patient closely for laryngospasm
D)Encouraging cool fluids to comfort his throat

Question 20

A patient underwent a tuberculin skin test 48 hours ago.He returns to the clinic for the nurse to read the test results.Which of the following is considered a positive result?

A)A reddened area measuring 20 mm
B)A flat, red area measuring 10 mm
C)An indurated area measuring 8 mm
D)An indurated area measuring 12 mm

Question 21

After returning from colonoscopy, a patient complains of increasing abdominal pain.What is an appropriate nursing intervention?

A)Limiting her diet to clear liquids
B)Assisting her with a warm bath to soothe the anorectal area
C)Administering a gentle enema to assist in evacuation of colon contents and air
D)Administering a laxative to assist in evacuation of excess colon contents
E)None of the above

Question 22

Which of the following factors may cause an increase in hematocrit concentration?

A)Hemorrhage
B)Bone marrow failure
C)Pregnancy
D)Dehydration

Question 23

Which of the following statements is false with regard to the semen analysis test?

A)A single sperm analysis can be conclusive evidence of male infertility.
B)Men with little or no sperm should be evaluated for pituitary, thyroid, adrenal, or testicular aberrations.
C)A 2- to 3-day period of sexual abstinence is necessary before collection of the semen specimen.
D)For best results, a semen sample should be collected in the physician's office or laboratory by means of masturbation.

Question 24

Symptoms that may indicate hypocalcemia include which of the following?

A)Nausea, vomiting, and anorexia
B)Polyuria and dehydration
C)Muscle weakness and coma
D)Tetany and carpal pedal spasms

Question 25

A patient has been diagnosed with primary hypothyroidism.Her triiodothyronine (T3) and thyroxine (T4) levels are decreased.What would a clinician expect the thyroid-stimulating hormone (TSH) levels to be?

A)Normal
B)Increased
C)Decreased
D)Near zero

Question 26

Often during a fetal nonstress test (fetal activity determination test), fetal activity must be stimulated.Which of the following stimuli is not part of this test?

A)Rubbing the mother's abdomen
B)Administering intravenous oxytocin
C)Ringing a bell near the abdomen
D)Compressing the mother's abdomen

Question 27

Which of the following statements regarding a glycosylated hemoglobin test is false?

A)The test provides an accurate long-term index of the patient's average blood glucose level.
B)The test aids in determining the duration of hyperglycemia in a patient with newly diagnosed diabetes.
C)No fasting is required for this test.
D)Short-term physiologic variations (e.g., those caused by food intake, exercise, and stress) affect the test result.

Question 28

After a liver biopsy, the patient should:

A)Ambulate to maintain mobility
B)Lie on the left side
C)Lie on the right side
D)Lie prone

Question 29

Which of the following tests is used to monitor warfarin administration?

A)Activated partial thromboplastin time
B)Platelet count
C)Bleeding time
D)International normalized ratio (INR)

Question 30

A woman in her first trimester of pregnancy develops pain consistent with gallbladder disease.What is the most appropriate diagnostic test?

A)Gallbladder ultrasonography
B)Gallbladder radioscintigraphy scan
C)Oral cholecystography
D)Computed tomography

Question 31

The physician orders a blood culture for a patient with suspected bacteremia.Which of the following statements is incorrect with regard to the collection of this specimen?

A)Blood culture specimens should be drawn at the time the patient has a fever or chills.
B)If the patient is receiving antibiotics already, the laboratory should be notified, and the blood culture specimen should be collected shortly before the next dose of antibiotic is administered.
C)Two culture specimens should be obtained and from different sites.
D)The culture specimen can be drawn at any time without regard to medications and vital signs.

Question 32

A patient is scheduled for lumbar puncture.Which of the following conditions is a contraindication to this procedure?

A)Meningitis
B)Neurosyphilis
C)Multiple sclerosis
D)Increased intracranial pressure (ICP)

Question 33

A patient has an elevated glucose level.Which of the following factors in his history may cause hyperglycemia?

A)Insulinoma
B)Corticosteroid therapy
C)Hypothyroidism
D)Addison's disease

Question 34

Which of the following is a possible cause of hyperkalemia?

A)Diarrhea and vomiting
B)Diuretic drug therapy
C)Cushing's syndrome
D)Acidosis

Question 35

After returning from an esophagogastroduodenoscopy (EGD) and dilation of an esophageal stricture, a patient began to complain of fever and chest pain.What should the nurse suspect, and what is the most appropriate action?

A)Myocardial infarction, and obtaining electrocardiography (ECG) immediately
B)Gastroesophageal reflux, and administering an antacid
C)Esophageal perforation, and notifying the physician immediately
D)Dyspepsia from not eating before the procedure, and allowing the patient to eat bland food

Question 36

A "shift to the left" in white blood cell production indicates an acute bacterial infection.Which of the following cells are increased in this situation?

A)Mature neutrophils
B)Monocytes
C)Lymphocytes
D)Band (or stab) cells

Question 37

Which of the following statements best describes the Sims-Huhner test?

A)This test is an evaluation of the quality of cervical mucus.
B)This test is an examination of cervical mucus for colour, viscosity, and tenacity.
C)This test is an assessment of the number of motile sperm per high-power microscopic field.
D)This test is an evaluation of the interaction between the sperm and cervical mucus.

Question 38

Which of the following tests is used to screen blood for antibody compatibility before a blood transfusion?

A)Direct Coombs test
B)Indirect Coombs test
C)Complete blood cell count
D)Serum haptoglobin test

Question 39

After undergoing a barium enema study, what instruction should patients be given?

A)Take an oral laxative to completely evacuate the barium.
B)Try to retain the barium in case additional radiographic studies are needed the same day or the following day.
C)Await normal bowel function.
D)None of the above.

Question 40

Cortisol levels normally rise and fall during the day.This fluctuation is referred to as the diurnal variation.At what time of the day are levels the highest?

A)8 am
B)Noon
C)4 pm
D)Midnight

Question 41

Which of the following foods may interfere with determining the results of urinary vanillylmandelic acid or catecholamines?

A)Potatoes and red meat
B)Coffee and licorice
C)Beer and salted pretzels
D)All the above

Question 42

Immediately after undergoing kidney biopsy, a patient notices gross hematuria.What is the most appropriate nursing intervention?

A)Collecting serial urine specimens
B)Dehydrating the patient to diminish urine output and bleeding
C)Notifying the physician immediately and obtaining a specimen for blood typing and crossmatching
D)All the above

Question 43

A nurse should ask the patient which of the following questions before scheduling IVP?

A)"Are you allergic to shellfish or iodine?"
B)"Have you ever undergone IVP before?"
C)"Are you able to drink a lot of fluids?"
D)All the above

Question 44

A patient's leg has become swollen 1 week after arthroscopy.For what should he be evaluated?

A)Hemarthrosis
B)Joint stiffness after prolonged immobilization
C)Postoperative thrombophlebitis
D)Joint dislocation

Question 45

Which of the following instructions should the nurse give a client after an upper gastrointestinal study?

A)"Expect your stools to be chalky white for at least a day."
B)"Take a cathartic (such as milk of magnesia)."
C)"Drink plenty of fluids when you get home."
D)All the above.

Question 46

What drug should be discontinued before the serum gastrin level is measured?

A)Hydrochlorothiazide
B)Propranolol (Inderal)
C)Cimetidine (Tagamet)
D)All the above

Question 47

What is the most accurate method of screening for breast cancer?

A)MRI of the breast
B)Mammography
C)Ultrasonography of the breast
D)Physical examination

Question 48

A nurse has been stuck by a needle from a patient being treated for hepatitis.What is the most appropriate action or actions?

A)Immediate enteric and blood product precautions to isolate the involved nurse
B)Immediately obtaining hepatitis viral studies on the affected nurse
C)Hospitalizing the nurse for bed rest
D)All the above
E)None of the above

Question 49

Intravenous pyelography (IVP) may be contraindicated in patients with what condition?

A)Shellfish allergy
B)Severe dehydration
C)Renal insufficiency
D)All the above

Question 50

Specific gravity in the urine is increased in patients with what condition?

A)Dehydration
B)Diabetes insipidus
C)Chronic renal failure
D)All the above

Question 51

A 5-year-old patient has fallen and injured her right arm during play therapy.Why does the physician order radiographs of both arms?

A)The noninjured arm could have been injured in the fall.
B)Fracture lines of long bones in children are difficult to distinguish from normal growth lines, which make comparison films necessary.
C)The battered child syndrome can be diagnosed by documenting multiple fractures.
D)All the above.

Question 52

Which of the following test results would indicate a complication of endoscopic retrograde cholangiopancreatography (ERCP)?

A)Red blood cells in the urine
B)Elevated serum amylase level
C)Elevated serum calcium level
D)All the above

Question 53

Carcinoembryonic antigen (CEA) is used to monitor patients with what condition?

A)Colon cancer
B)Breast cancer
C)Gastric cancer
D)All the above

Question 54

What is the most specific test for identifying recurrent prostate cancer?

A)Prostatic acid phosphatase measurement
B)Prostate-specific antigen (PSA) measurement
C)Digital rectal examination
D)Transrectal ultrasonography

Question 55

A patient has just undergone diagnostic arthroscopy and has mild discomfort.Which of the following interventions is most appropriate?

A)Ambulating the patient
B)Notifying the physician
C)Administering a mild analgesic (e.g., acetaminophen)
D)Administering an intramuscular narcotic

Question 56

Before mammography, which of the following is or are appropriate information to give a patient?

A)Mammography involves a low dose of radiation and therefore can safely be performed annually.
B)Mammography can reveal breast cancer 1 to 2 years before a tumour is clinically palpable.
C)Although mammography is an accurate means of detecting breast cancer, it is only 85% accurate.
D)All the above.

Question 57

Which of the following tumour markers is associated with breast cancer?

A)Alpha-fetoprotein
B)Human chorionic gonadotropin
C)CA-15-3
D)CA-125

Question 58

A "no added salt" diet is necessary for patients before which of the following studies?

A)Urine specific gravity
B)IVP
C)Plasma renin assay
D)Renal scanning