Deck 1: About This Book

Question 1

A nurse has just conducted hearing loss audiometry testing on a 10-year-old patient.The patient's pure tone average was 52 dB.Which category of hearing of the American Speech-Language-Hearing Association (ASHA)does this result represent?
1)Normal
2)Slight loss
3)Moderate loss
4)Profound loss

Answer 1

3

Question 2

A patient's laboratory test results following amniotic fluid analysis indicate elevated $\alpha$ ₁-fetoprotein (AFP)levels and presence of acetylcholinesterase (AChE).Which of the following diagnoses should the nurse most suspect given these findings?

A)Respiratory distress syndrome
B)Fetal hemolytic disease
C)Neural tube defect
D)Fetal immaturity

Answer 2

Neural tube defect

Question 3

A patient with a diagnosis of chronic myelogenous leukemia (CML)is admitted to an acute care unit with a temperature of 100.4 $\degree$ F (38 $\degree$ C)and weight loss over the past 2 to 3 months.A nurse notes that the patient's white blood cell (WBC)count is 230,000/mm³, and the physical examination shows splenomegaly.The priority nursing intervention should be:

A)Avoiding falls
B)Managing pain
C)Preventing infection
D)Promoting adequate nutrition

Answer 3

Preventing infection

Question 4

A college student who is admitted to the hospital with newly diagnosed diabetes mellitus has a C-peptide level of 0.6 ng/mL and serum glucose of 256 mg/dL.Based on these results, which instruction should the nurse provide to this patient?
1)"Based on these results, your diabetes will be controlled by oral medications and diet."
2)"If you lose weight, you may be able to manage your diabetes with diet alone."
3)"Since you are already an adult, this result confirms that you have type 2 diabetes."
4)"You will need to take insulin for the rest of your life."

Question 5

A patient is suspected of having multiple myeloma and needs to undergo testing to identify the individual types of immunoglobulins present to confirm a diagnosis.Which test would be most appropriate for this purpose?
1)Immunofixation electrophoresis (IFE)
2)Immunoglobulin E (IgE)
3)Immunoglobulin A (IgA)
4)Immunosuppressant cyclosporine

Question 6

A nurse is preparing to administer a radionuclide to an adult patient for a gastroesophageal reflux (GER)scan.What should the nurse mix the radionuclide with?
1)Orange juice
2)Milk
3)Water
4)Soda

Question 7

Which laboratory test should a nurse monitor to determine if a patient is responding to the administration of iron for iron-deficiency anemia?
1)Eosinophils
2)Lymphocytes
3)Monocytes
4)Reticulocytes

Question 8

A patient must undergo pulmonary angiography but has a history of allergic reaction to some medications.Which of the following actions should be taken in response to this finding?
1)Remove all metallic objects from the area to be examined.
2)Administer an antianxiety agent, as ordered.
3)Use a nonionic contrast medium.
4)Notify the health-care provider to cancel the procedure.

Question 9

A nurse notes that a patient has a urine pH of 7.2.Which information in the patient's history may be related to this result?
1)Maintaining a vegetarian diet
2)Training for a marathon
3)Recent febrile illness
4)Use of cranberry supplements daily

Question 10

A nurse is preparing to perform a lumbar puncture to collect a specimen for diagnosis of Alzheimer's disease.Which position should the nurse ask the patient to assume for this test?
1)Knee-chest
2)Sidelying
3)Prone
4)Standing

Question 11

A patient with diabetes requires assessment of long-term glucose control.Which test would be most appropriate for this patient?
1)Glycated hemoglobin
2)Glucose
3)Glucose-6-phosphate dehydrogenase (G6PD)
4)Glucose tolerance test

Question 12

Which blood tests should a nurse monitor to determine if a patient's blood level of warfarin (Coumadin)is within the therapeutic range?
1)Activated partial thromboplastin time (aPTT)
2)Bleeding time
3)Platelet count and aPTT
4)PT and international normalized ratio (INR)

Question 13

Which factor in a patient's history may be associated with an elevated creatine phosphokinase (CK)level?
1)Sedentary lifestyle
2)Early muscular dystrophy
3)Bedrest for 48 hours
4)History of chronic renal failure

Question 14

A patient is suspected of having increased risk for stroke.Which type of angiography should be performed to detect this condition?
1)Abdominal
2)Adrenal
3)Carotid
4)Coronary

Question 15

A nurse notes that a patient's laboratory results show an acetylcholine receptor antibody (AChR)of 2.46 nmol/L.Based on this information, the nurse should assess this patient for clinical manifestations of:
1)Malignant hyperpraxia
2)Myasthenia gravis
3)Multiple myeloma
4)Muscular dystrophy

Question 16

A patient with pernicious anemia has a laboratory order to test for intrinsic factor (IF)antibodies.A nurse scheduling this test should instruct the patient to:
1)Begin a bowel prep 24 hours prior to the examination.
2)Eliminate red meat from the diet for 72 hours before the test.
3)Take nothing by mouth for 12 hours before the test is scheduled.
4)Withhold vitamin B₁₂ for 48 hours before the test is scheduled.

Question 17

A nurse observes that a patient admitted to the emergency department with decreased level of consciousness has urine with a very fruity odor.Based on this observation, the nurse should plan interventions to manage:
1)Alcohol withdrawal
2)Diabetic ketoacidosis (DKA)
3)Fibromyalgia
4)Lyme disease

Question 18

A nurse has just administered an IV nucleotide to a patient before a gallium scan.The nurse should instruct the patient to return for the first scanning in how many hours, typically?
1)6 hours
2)24 hours
3)48 hours
4)72 hours

Question 19

A patient with an indwelling urinary catheter has an order for a 24-hour urine creatinine clearance test.To begin the test, the nurse should:
1)Collect all urine during any 24-hour period by labeling the drainage collection bag with the date and time most recently emptied.
2)Clamp the urinary catheter and then drain all urine into the container specified by the lab and repeat every 6 hours times 4.
3)Empty all urine in the urinary drainage bag at 0600 and then save all urine until the next day at 0600.
4)Increase meat portions in the diet for at least 48 hours prior to the planned start of the collection.

Question 20

A patient with a history of hypertension has a serum creatinine of 1.9 mg/dL and 1+ proteinuria.When assessing this patient, a nurse should interpret these results as an indication this patient may have:
1)Early signs of renal insufficiency
2)Evidence of severe renal dysfunction
3)Hypertension secondary to renal disease
4)Normal renal function

Question 21

When reviewing the laboratory results for an adult patient with elevated parathyroid hormone (PTH), which other laboratory result should the nurse interpret as significant?
1)Alanine aminotransferase (ALT)850 units/L
2)Alkaline phosphatase (ALP)250 units/L
3)Aspartate aminotransferase (AST)650 units/L
4)Creatine phosphokinase (CK)360 units/L

Question 22

A patient's laboratory test results indicate a negative finding on an infectious mononucleosis screen.The health-care provider, however, is concerned that this result could be a false-negative due to an interfering factor.Which of the following could cause such a false-negative finding?
1)Cocaine addition
2)Lymphoma
3)Hepatitis
4)Test conducted fewer than 6 days after exposure to the virus

Question 23

A patient diagnosed with hepatitis B reports easy bruising and bleeding with minor skin trauma.Which lab result should a nurse relate to this finding?
1)Hematocrit of 40%
2)Platelet count of 200,000/mm³
3)PT of 22 seconds
4)PTT of 35 seconds

Question 24

The results of a patient's adrenocorticotropic hormone (ACTH)test show a decreased cortisol level and an increased ACTH level.Which of the following conditions do these results most likely indicate?
1)Addison's disease
2)Cushing's disease
3)Cushing's syndrome related to ectopic source of ACTH
4)Cushing's syndrome (ACTH-independent)

Question 25

A patient with a serum phosphate level of 1.1 mg/dL is receiving IV sodium phosphate.When administering sodium phosphate, a nurse should monitor closely for:
1)Laryngeal stridor, dysphagia, and circumoral numbness
2)Lethargy, decreased deep tendon reflexes, and somnolence
3)Nausea, vomiting, and diarrhea
4)Weakness, confusion, and constipation

Question 26

A nurse assessing a patient with a history of inflammatory bowel disease notes bilateral pitting edema of both the ankles and feet.Which laboratory result is most likely related to this finding?
1)Decreased albumin
2)Elevated triglycerides
3)Elevated cholesterol
4)Elevated platelet count

Question 27

A patient who is maintained on total parenteral nutrition (TPN)due to an exacerbation of inflammatory bowel disease has a ceruloplasmin level of 17 mg/dL.For which clinical manifestation should a nurse assess this patient?
1)Arthralgia or migratory joint pain
2)Chest pain or mental status changes
3)Increased white blood cell (WBC)count and fever
4)Jaundice or change in eye color

Question 28

A patient is suspected of having Wegener's syndrome.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?
1)Anti-cyclic citrullinated peptide (Anti-CCP)
2)Anti-glomerular basement membrane (anti-GBM)
3)Actin (smooth muscle)and mitochondrial M2
4)Antineutrophilic cytoplasmic

Question 29

A patient diagnosed with coronary artery disease begins therapy with simvastatin (Zocor).Which laboratory result should the nurse monitor to determine the effectiveness of this treatment?
1)Aspartate aminotransferase (AST)
2)Alkaline phosphatase (ALP)
3)Alanine aminotransferase (ALT)
4)Total cholesterol

Question 30

A patient has an order for a blood test for antisperm antibodies.Which condition should a nurse plan to manage if this test is positive?
1)Infertility
2)Prostate cancer
3)Prostatic hypertrophy
4)Testicular cancer

Question 31

A patient diagnosed with type 1 diabetes mellitus is maintained on a nighttime dose of basal insulin with short-acting insulin prior to meals three times daily.The patient has had two consecutive glycated hemoglobin A1c (Hgb A1c)results that are less than 5%.Which question should a nurse ask when interpreting these results?
1)"Do you experience excessive fatigue during the daytime?"
2)"Have you noticed episodes of shakiness and profuse perspiration?"
3)"How often do you have to get up at night to void?"
4)"What time of day do you usually have your meals?"

Question 32

A patient with lymphadenopathy and splenomegaly is diagnosed with infectious mononucleosis.The patient's platelet count is 50,000 per mm³.As a result of this laboratory value, a nurse should instruct the patient to:
1)Avoid contact sports, vigorous exercise, and lifting heavy objects.
2)Brush teeth vigorously at least twice daily to maintain good oral hygiene.
3)Restrict use of fiber in the diet or bulk-forming laxatives.
4)Use aspirin or NSAIDs to manage pain.

Question 33

A patient maintained on furosemide (Lasix)is admitted with a serum potassium level of 2.9 mEq/L.Which clinical manifestation should the nurse expect to find on assessment?
1)Headache, muscle spasm, and weight gain
2)Muscle weakness, lethargy, and irregular heartbeat
3)Postural hypotension, thirst, and increased blood pressure
4)Twitching, cramping pain, and diarrhea

Question 34

A patient who is receiving chemotherapy has a white blood cell count of 7,200 cells/mm³ and a platelet count of 66.2 *10³/mm³.Which order should the nurse question for this patient?

A)Acetaminophen 650 mg by mouth every 4 hours as needed for pain
B)Docusate (Colace)1 to 2 tablets as needed
C)Eszopiclone (Lunesta)2 mg by mouth at bedtime as needed
D)Pneumococcal vaccine polyvalent (Pneumovax)0.5 mL intramuscularly

Question 35

A patient diagnosed with chronic obstructive pulmonary disease (COPD)has a carboxyhemoglobin level of 5%.When planning care for this patient, which question should a nurse ask to determine the significance of this result?
1)"Do you experience a headaches or dizziness?"
2)"How many cigarettes do you smoke each day?
3)"How often do you exercise outdoors?"
4)"What kind of heating do you have in your home?"

Question 36

A patient with a history of sickle cell disease has a total bilirubin level of 0.9 mg/dL with a direct bilirubin level of 0.3 mg/dL.Which additional data should the nurse obtain to plan care for this patient?
1)None, these results are normal.
2)Ultrasound of the gallbladder
3)Liver function tests
4)Serum electrolytes

Question 37

A patient is suspected of having biliary cirrhosis.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?
1)Anti-cyclic citrullinated peptide (anti-CCP)
2)Anti-glomerular basement membrane (anti-GBM)
3)Actin (smooth muscle)and mitochondrial M2
4)Antineutrophilic cytoplasmic

Question 38

A patient who is treated in an emergency department following a sexual assault is concerned about the possibility of infection with HIV.The patient requests a blood test to determine if HIV infection has occurred.The results are negative.Which action by the nurse is appropriate?
1)Inform the patient to monitor for symptoms, since false-negative results are common.
2)Instruct the patient to schedule a follow-up test in 6 months.
3)Reassure the patient that no infection with HIV has occurred.
4)Reinforce the need to use appropriate protection with intercourse in the future.

Question 39

A high school student is undergoing a required annual sports physical screening examination.A nurse notes that the student's serum creatinine level is 1.3 mg/dL.Which additional laboratory data should the nurse consider in order to assess the significance of this result?
1)Albumin level
2)Blood urea nitrogen
3)Hemoglobin level
4)Triglyceride level

Question 40

A nurse is assisting with a gastrointestinal (GI)blood loss scan of a 1-month-old to detect areas of active GI bleeding.Given this patient's age, the nurse should most suspect which of the following as the cause of the bleeding?
1)Ingested foreign body
2)Allergies to milk proteins
3)Ulcers produced by nonsteroidal anti-inflammatory drug (NSAID)use
4)Mallory-Weiss tears

Question 41

A patient has a serum albumin of 4.1 g/dL.Based on this lab value, a nurse should instruct this patient to:
1)Add more green leafy vegetables daily.
2)Continue with current dietary patterns.
3)Increase fiber and fluid in the diet.
4)Increase protein in the diet.

Question 42

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?
1)Glargine (Lantus)20 units subcutaneously at bedtime daily
2)Glyburide (Micronase, DiaBeta)5 mg by mouth daily before breakfast
3)Insulin aspart (NovoLog)10 units subcutaneously before meals
4)Insulin aspart (NovoLog)(CBG - 100)/30 units subcutaneously before meals and at bedtime for CBG more than 150 mg/dL

Question 43

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?
1)Albumin
2)Aldosterone
3)Alanine aminotransferase (ALT)
4)Adrenocorticotropic hormone (ACTH)

Question 44

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?
1)Discontinue the patient's metformin the day of the procedure and for 48 hours afterward.
2)Ask whether the patient is allergic to the contrast medium.
3)Have emergency equipment readily available.
4)Instruct the patient to void prior to the procedure.

Question 45

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?
1)Increased QRS complex with peaked T-waves
2)Paroxysmal atrial tachycardia (PAT)
3)Prolonged QT interval and bradycardia
4)ST depression and tachycardia

Question 46

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?
1)Parkinson's disease
2)Alzheimer's disease
3)Specific allergens
4)Conn's disease

Question 47

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?
1)"It is important to measure the immune response present in your lung tissue."
2)"The tests will help determine if you have pneumonia caused by bacteria or fungi so we can use the right medications."
3)"The test will identify if the cells in the lining of your lungs are functioning properly."
4)"The doctor wants to make sure you don't have Kaposi sarcoma of the lungs."

Question 48

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?
1)Diltiazem (Cardizem, Tiazac)
2)Glipizide (Glucotrol)
3)Hydrochlorothiazide (HydroDIURIL, Microzide)
4)Losartan (Cozaar)

Question 49

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:
1)0800, or at least 2 hours prior to the scheduled dose
2)0930, or immediately prior to beginning the scheduled 1000 dose
3)1000, as infusion of the next dose has started
4)1100, when the infusion is completed

Question 50

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?
1)Attended a party recently where others were smoking marijuana
2)Has smoked one pack of cigarettes per day for 5 years
3)Takes an NSAID for tendonitis
4)Usual breakfast is a muffin or bagel with sesame or poppy seeds

Question 51

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?
1)7)32
2)7)40
3)7)50
4)7)60

Question 52

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?
1)Two swabs are sent to the laboratory in case one is contaminated or lost in transit.
2)If the first swab tests negative, the screen is repeated on the second.
3)If the first swab tests negative, a traditional culture is performed on the second.
4)Each swab is sent to a different laboratory to ensure accuracy.

Question 53

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?
1)Decreased hemoglobin and potassium
2)Decreased serum creatinine and blood urea nitrogen (BUN)
3)Increased albumin and normal sodium
4)Increased hematocrit and BUN

Question 54

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?
1)Confirm the name and title of the person requesting the information and document the transmission of the information in the patient's record.
2)Inform the receptionist that this is an inappropriate request, and according to privacy guidelines the information can be sent only if the patient requests it directly.
3)Refuse to fax the information and notify the Department of Health and Human Services of this violation of patient privacy.
4)Request a release-of-information form signed by the patient before transmitting any information about this patient.

Question 55

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?
1)Increase intake of red meats.
2)Drink alcohol in moderation.
3)Avoid iron-rich foods.
4)Avoid eating cereals, tea, and coffee

Question 56

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?
1)Aplastic anemia
2)Hemolytic anemia
3)Folic acid-deficiency anemia
4)Iron-deficiency anemia

Question 57

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?
1)Encourage increased oral fluid intake and ambulation at least twice daily.
2)Keep patient NPO and monitor vital signs every 4 hours.
3)Promote adequate nutrition with small, frequent meals.
4)Provide low-fat, high-fiber diet and monitor serum glucose before meals.

Question 58

A patient is concerned about a "high sed rate" and asks a nurse what this means.Which response by the nurse is most accurate?
1)"A high sedimentation (sed)rate usually means that you have an inflammatory disease, so you should get a second opinion if your health-care provider is not treating you."
2)"The erythrocyte sedimentation rate is a nonspecific test that needs to be interpreted by your health-care provider based on your overall health."
3)"This test is used to determine if are responding to treatment with chemotherapy."
4)"You should not worry about this since your health-care provider is monitoring it."

Question 59

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?
1)Low allergy
2)Moderate allergy
3)High allergy
4)Very high allergy

Question 60

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?
1)Hemoglobin has increased by 1 g/dL.
2)Mean corpuscular hemoglobin concentration (MCHC)decreases.
3)Red blood cells are hypochromic.
4)Reticulocyte count decreases.

Question 61

A patient recently underwent kidney transplantation and needs to undergo testing to ensure that the medication he is on to prevent organ rejection does not reach toxic levels.Which test would be most appropriate for this purpose?
1)Immunofixation electrophoresis (IFE)
2)Immunoglobulin E (IgE)
3)Immunoglobulin A (IgA)
4)Immunosuppressant cyclosporine

Question 62

A patient's laboratory test results are negative for D-dimers.However, the health-care provider is concerned that an interfering factor may be skewing the results of this test.Which of the following factors could cause a false-negative result in this case?
1)Aspirin
2)Ovarian cancer
3)Warfarin
4)Rheumatoid arthritis

Question 63

A patient has an elevated aldolase level.This finding would be consistent with which of the following conditions?
1)Cushing's disease
2)Duchenne's muscular dystrophy
3)Dehydration
4)Kidney disease

Question 64

An adolescent patient is admitted to a hospital with hypotension and tachycardia.The patient's laboratory results include a serum potassium level of 1.9 mEq/L.Which question should a nurse ask to identify possible causes for this clinical presentation?
1)"Do you ever use someone else's prescriptions?"
2)"Are you satisfied with your current weight?"
3)"How many meals do you eat daily?"
4)"What are your favorite foods?"

Question 65

A patient who is preparing to undergo a blood transfusion is suspected of having an immunoglobulin deficiency that could result in anaphylaxis when the blood is transfused.Which test would be most appropriate for confirming this suspicion?
1)Immunofixation electrophoresis (IFE)
2)Immunoglobulin E (IgE)
3)Immunoglobulin A (IgA)
4)Immunosuppressant cyclosporine

Question 66

The nurse is caring for a patient who is recovering from a ventral hernia repair and has developed a fever.New orders have been given to obtain a sputum culture.Which of the following actions should the nurse take before collecting the specimen?
1)Move the patient to a private room and initiate isolation precautions.
2)Assist the patient to perform oral hygiene.
3)Obtain a clean specimen cup for collection.
4)Ask all visitors to don a mask.

Question 67

A nurse notes that a patient has tested positive for Helicobacter pylori (H.pylori)antibody, a finding that may reflect the presence of peptic ulcer disease.In response to this finding, the nurse should assess the patient for related manifestations, such as:
1)Abrupt onset of lower quadrant pain associated with flatulence
2)Epigastric pain that shifts to McBurney's point and is aggravated by activity
3)Gastric burning after meals and occult blood in the stool
4)Tenderness under the right scapula

Question 68

A 42-year-old patient, with no history of smoking, reports increasing dyspnea with cough and is diagnosed with chronic obstructive pulmonary disease (COPD).Laboratory results show that the patient has a decreased $\alpha$ 1-antitrypsin level ( $\alpha$ 1AT).When planning care for this patient, which instruction should the nurse provide?

A)"Genetic testing of family members is not necessary."
B)"Limit strenuous exercise."
C)"Plan to have $\alpha$ 1AT levels monitored at regular intervals."
D)"Use protein-calorie supplementation to maintain muscle mass."

Question 69

A patient is undergoing venipuncture for collection of a blood sample for apolipoprotein testing.Which condition is this type of testing most useful in identifying?
1)Coronary artery disease
2)Joint disease
3)Chronic obstructive pulmonary disease (COPD)
4)Hepatitis

Question 70

A pediatric nurse is caring for a 9-month-old who is febrile, spitting up after feedings, and has had diarrhea for 2 days.The laboratory results show increased hemoglobin, hematocrit, and blood urea nitrogen.Urine-specific gravity is increased as well.Which clinical observation by the nurse correlates with this presentation?
1)Patient is alert and playful.
2)Mucous membranes are moist and pink.
3)Urine is very dilute and colorless.
4)Weight is down 1.5 lbs from baseline 2 weeks ago.

Question 71

At an annual health visit, a 59-year-old female reports weight gain and fatigue.The patient exercises regularly and had a recent, normal stress test.Laboratory results are all normal, except for T4 of 0.4 ng/dL and TSH 21.2 micro international units/mL.For which clinical manifestations should a nurse assess this patient?
1)Dry skin, constipation, and cold intolerance
2)Exophthalmia, insomnia, and diarrhea
3)Fine tremor of the hands, tachycardia, and irritability
4)Heat intolerance, excess sweating, and increased thirst

Question 72

Results from a patient's genetic testing indicate mutations in the factor V Leiden gene.This finding is most associated with which of the following?
1)A greater risk for thromboembolism
2)A specific medication used to treat colorectal cancer being rendered ineffective
3)A higher risk for developing breast cancer
4)An ability to identify patients with melanoma who might benefit from treatment with specific drugs

Question 73

A patient on a ventilator has an order for arterial blood gases with an alveolar/arterial oxygen ratio (a/A ratio).When sending the specimen to the laboratory, which information about the patient should the nurse include?
1)Age
2)Gender
3)Temperature
4)Weight

Question 74

A patient suspects that he has an allergy to cats.Elevation of which of the following would tend to confirm this suspicion?
1)Cortisol
2)Aldosterone
3)Blood glucose
4)Immunoglobulin E

Question 75

A patient has a serum calcium level of 7.5 mg/dL.Based on this information, a nurse should assess the patient for clinical signs and symptoms such as:
1)Emotional lability, short attention span, and tremor
2)Increased appetite, weight loss, and heat intolerance
3)Lethargy, tetany, and tingling in the lips or hands
4)Tachycardia, increased systolic blood pressure, and weakness

Question 76

A patient is admitted to a hospital with a diagnosis of "acute onset abdominal pain." The patient's urine specimen shows increased levels of $\delta$ -aminolevulinic acid ( $\delta$ -ALA).Based on this result, the nurse should plan care for which condition?

A)Acute porphyria
B)Cirrhosis
C)Cholecystitis
D)Pancreatitis

Question 77

A nurse is preparing to discharge a patient from a hospital after being diagnosed and treated for heart failure.The patient has a B-type natriuretic peptide level of 445 pg/mL.When preparing discharge teaching for this patient, which medication will the nurse most likely discuss?
1)Acetaminophen
2)Angiotensin-converting enzyme (ACE)inhibitor
3)Enoxaparin
4)Warfarin

Question 78

A patient is suspected of having a cardiac septal defect.Which type of angiography should be performed to detect this condition?
1)Abdominal
2)Adrenal
3)Carotid
4)Coronary

Question 79

A health-care provider has ordered an acetylcholine receptor antibody test for a patient.The nurse should suspect that this test is being used to assist in confirming the diagnosis of which of the following conditions?
1)Systemic lupus erythematosus
2)Myasthenia gravis
3)Hyperthyroid disease
4)Alzheimer's disease

Question 80

A patient admitted with a hip fracture and scheduled for surgery has a prothrombin time of 20.2 seconds and an international normalized ratio (INR)of 2.65 resulting from warfarin administration.Based on these laboratory values, which order should the nurse anticipate?
1)Abciximab (ReoPro)
2)Phytonadione (vitamin K)
3)Protamine sulfate
4)Ticlopidine (Ticlid)