Question 1

Based on the diagnostic results in the following exhibit, which medication should a nurse anticipate will be prescribed? Laboratory Report Excerpt
Cholesterol:
240 mg/dL
Triglycerides:
103 mg/dL
HDL:
67 mg/dL
LDL:
151 mg/dL

Accepted Answer

Atorvastatin (Lipitor) is commonly prescribed to lower LDL cholesterol, which is elevated in this patient.

Question 2

The nurse working on a medical-surgical floor recognizes that test results for platelet antibodies are most likely to be positive for which of the following individuals?

Accepted Answer

Individuals with AIDS often have immune system abnormalities, including the production of antibodies against their own platelets, leading to a positive test for platelet antibodies.

Question 3

A nurse on the cardiac unit notes increased frequency of premature ventricular contractions for a patient who was recently started on digitalis.Which of the following laboratory results would the nurse evaluate first?

Accepted Answer

Digitalis can cause hypokalemia, which increases the risk of premature ventricular contractions. Therefore, the nurse should evaluate the patient's potassium level first. Red blood cell count, LDH, and total protein are not directly related to the risk of premature ventricular contractions in a patient on digitalis.

Question 4

When interpreting the L/S ratio (lecithin sphingomyelin)for a woman who is 37 weeks gestation, the nurse recognizes fetal maturity is present with which of the following results?

Accepted Answer

The L/S ratio (lecithin/sphingomyelin) is a test used to assess fetal lung maturity. A ratio of 2:1 or greater is generally considered indicative of mature fetal lungs, suggesting that the fetus is less likely to suffer from respiratory distress syndrome if born at this time. This ratio typically reaches 2:1 or greater by about 35 weeks of gestation in most pregnancies.

Question 5

The nurse is scheduling follow-up labs ordered by the health-care provider that include lipoprotein electrophoresis.The patient asks, "Why do I have to have more blood drawn?" Which of the following findings would indicate the need for this additional testing?

Accepted Answer

Lipoprotein electrophoresis is a test used to determine the specific types of lipoproteins present in the blood. It is often ordered in patients with high cholesterol levels to further evaluate their risk for cardiovascular disease. Lipase level, LDH level, and alkaline phosphatase levels are not specifically related to lipoproteins or lipid metabolism.

Question 6

The nurse is caring for a patient who was admitted with chest pain to rule out a myocardial infarction.After receiving nitroglycerin and morphine, the patient is resting in bed comfortably with oxygen at 2 L.The initial troponin I level is 0.40 ng/mL.Which of the following interpretations of this lab value is best?

Accepted Answer

Troponin I is a highly specific and sensitive biomarker for myocardial injury. Elevated levels indicate damage to the heart muscle, which can occur during a heart attack. The initial value of 0.40 ng/mL is above the normal range, which is less than or equal to 0.04 ng/mL. However, it is not high enough to definitively diagnose a heart attack. Troponin levels typically begin to rise between 2 and 6 hours after the onset of symptoms, so additional testing may be needed before the patient can be discharged. Therefore, choice C, which explains the time frame for troponin elevation and the need for further testing, is the best answer. Choices A and B are incorrect because they provide incomplete or inaccurate information. Choice D is incorrect because the troponin level is not high enough to warrant intensive care unit admission.

Question 7

A patient is suspected of having pernicious anemia.Which test would be most appropriate for confirming this suspicion?

Accepted Answer

The most appropriate test for confirming pernicious anemia is a reticulocyte count, which measures the number of immature red blood cells in the bloodstream. In pernicious anemia, the bone marrow fails to produce enough mature red blood cells due to a deficiency in vitamin B12, which is necessary for red blood cell production. This leads to an increase in the number of immature red blood cells. Renin, RBC cholinesterase, and rheumatoid factor are not relevant tests for diagnosing pernicious anemia.

Question 8

A nurse counseling an individual who is attempting to follow a restricted carbohydrate diet would monitor which of the following lab values?

Accepted Answer

Monitoring urine ketones is important when following a restricted carbohydrate diet because the body produces ketones when it is burning fat for energy instead of carbohydrates. High levels of urine ketones can indicate that the individual is successfully following the diet and has entered a state of ketosis.

Question 9

A diabetic patient is suspected of having poor long-term glucose control.Which test would be most appropriate for confirming this suspicion?

Accepted Answer

Fructosamine levels reflect the average blood glucose over the previous 2-3 weeks, making it a useful indicator for long-term glucose control in diabetic patients. Fibrinogen, folate, and FSH are not indicative of glucose control.

Question 10

A patient is suspected of having megaloblastic anemia.Which test would be most appropriate for confirming this suspicion?

Accepted Answer

The most specific test for megaloblastic anemia is measurement of serum folate levels or red blood cell folate levels. Megaloblastic anemia is caused by a deficiency in vitamin B12 or folate, both of which may lead to macrocytosis or enlarged red blood cells. However, folate levels tend to decrease earlier and more quickly than B12 levels, making it a better choice for initial testing.

Question 11

The nurse is caring for a woman who is awaiting estradiol results as part of a fertility work-up.The patient states, "I keep hoping there is some easy fix so we can have a baby soon." Which of the following statements by the nurse is best?

Accepted Answer

Option B shows empathy towards the patient's struggles and acknowledges the strain that infertility can cause on relationships. It opens up a conversation for the patient to express their emotions and concerns, allowing the nurse to provide appropriate support. Option A is dismissive and not helpful. Option C is irrelevant and may cause the patient to feel unheard. Option D may be premature at this point in the patient's care and may come across as insensitive.

Question 12

A student nurse is caring for a patient with community-acquired pneumonia.Which of the following lab results may be expected and would indicate a left shift in the differential?

Accepted Answer

A left shift in the differential refers to an increase in the number of immature neutrophils (band neutrophils) in the blood. This is commonly seen in infections, such as community-acquired pneumonia, as the bone marrow produces more immature neutrophils to help fight the infection. A decrease in red blood cells (anemia) is not directly related to a left shift in the differential, while an increase in eosinophils and basophils may indicate other conditions such as allergies or parasitic infections.

Question 13

The nurse is caring for a 28-year-old primigravida who is undergoing a glucose tolerance test.The fasting glucose result is 132 mg/dL.Which of the following actions by the nurse is best?

Accepted Answer

A fasting glucose level of 132 mg/dL is above the normal range, indicating potential gestational diabetes. Continuing with the glucose tolerance test may not be appropriate, and further evaluation by a healthcare provider is needed.

Question 14

While assessing a patient before an ultrasound of the spleen, the nurse learns that the patient recently underwent a barium enema procedure.The nurse knows that there should be at least how many hours between administration of barium and this test?

Accepted Answer

Ultrasound of the spleen requires clear images of the area, which may be affected by the presence of barium in the colon from the recent enema. Therefore, it is essential to wait for at least 24 hours before performing the ultrasound to ensure that the barium is eliminated from the body, allowing for accurate results. Waiting for 48 hours might be unnecessary in most cases, but the other options (6 or 12 hours) would not be enough time for the barium to clear out from the body.

Question 15

A nurse observes mucous in a patient's stool specimen.Which of the following is the most likely cause of this finding?

Accepted Answer

Inflammation of the intestinal walls can cause the production and presence of mucous in the stool. Malignancy, malabsorption, and obstruction are not commonly associated with the presence of mucous in stool.

Question 16

The nurse is working with a nursing student in the care of an individual with colorectal cancer.The student asks, "Why did the health-care provider order plasminogen labs?" Which of the following is the best response?

Accepted Answer

Plasminogen labs may be ordered to monitor for disseminated intravascular coagulation (DIC), which is a potential complication of colorectal cancer. DIC can cause blood clots, bleeding, and organ dysfunction. Monitoring plasminogen levels can help identify early signs of DIC and allow for prompt treatment. Plasminogen is not a tumor marker for colorectal cancer, and ordering it for a patient on Coumadin would not be necessary as it is not directly related to blood clotting.

Question 17

A patient is suspected of having nasal polyps.Which test would be most appropriate for confirming this diagnosis?

Accepted Answer

Sinus endoscopy is the most appropriate test for confirming the diagnosis of nasal polyps as it allows direct visualization of the nasal cavity and sinuses. Electroneurography is used to diagnose nerve damage or dysfunction, esophageal manometry is used to assess the function of the esophagus, and esophagogastroduodenoscopy is used to examine the upper gastrointestinal tract.

Question 18

The nurse is providing care for a patient whose stool sample for ova and parasites was negative.Which of the following statements by the nurse is best?

Accepted Answer

One negative result for ova and parasites does not necessarily mean the absence of parasitic infection, as some parasites have sporadic shedding in the stool. Therefore, repeat testing in 3 days is recommended to increase the sensitivity of the test.

Question 19

A patient is suspected of having an acute infection related to tissue necrosis.Which test would be most appropriate for confirming this diagnosis?

Accepted Answer

The erythrocyte sedimentation rate (ESR) is a nonspecific test that can indicate tissue necrosis and inflammation. It measures the rate at which red blood cells settle in a test tube over a period of one hour. In conditions such as infections or tissue necrosis, the ESR is usually elevated due to the increase in certain proteins in the blood that cause the red blood cells to clump together and settle faster. Therefore, an elevated ESR is a useful indicator of acute infections related to tissue necrosis.

Question 20

The nurse is assisting in the collection of vaginal samples from a woman who was recently raped.After the specimen has been collected, which of the following actions should the nurse take first?

Accepted Answer

The priority is to preserve the integrity of the evidence by delivering the specimens to the lab immediately.

Quiz 4: Monographs

Based on the diagnostic results in the following exhibit, which medication should a nurse anticipate will be prescribed? Laboratory Report Excerpt Cholesterol: 240 mg/dL Triglycerides: 103 mg/dL HDL: 67 mg/dL LDL: 151 mg/dL