Question 1

A nurse is preparing to administer barium sulfate to a patient as part of an upper gastrointestinal and small bowel series procedure.What should the nurse tell the patient about this intervention?
A)The barium will be administered intravenously, and will likely make the patient feel nauseated.
B)The barium will be administered rectally, as an enema, and might make the patient feel dizzy.
C)The barium will be administered orally, as a capsule, and should cause no discomfort.
D)The barium will be administered orally, as a milkshake, and will have a chalky taste.

Accepted Answer

Barium sulfate for an upper gastrointestinal and small bowel series is typically administered orally in a form that resembles a milkshake, although it is known for its chalky taste. This method allows for the barium to coat the lining of the upper GI tract, making it visible on X-rays.

Question 2

The nurse is caring for a young woman who entered the emergency room reporting that she had been raped.In additional to a full assessment, careful collection of evidence will include testing vaginal secretions for which of the following?
A)Clot retraction
B)C-peptide
C)Acid phosphatase
D)Viral culture

Accepted Answer

Acid phosphatase levels increase after sexual intercourse and can be used to detect semen in vaginal secretions. This information is important in cases of rape, where evidence must be carefully collected and preserved. Clot retraction, C-peptide, and viral culture are not relevant in this context.

Question 3

The nurse is caring for an individual who states, "I've been struggling with my weight my entire life, so I guess I shouldn't be surprised I have diabetes." Which of the following actions by the nurse is best?
A)Share the nurses' personal struggles with weight management.
B)Sit quietly and encourage the patient to verbalize her feelings.
C)Ask the patient what she wants to eat for dinner.
D)Inform the patient that the dietician will be available later that afternoon.

Accepted Answer

Sitting quietly and encouraging the patient to verbalize their feelings is the best action as it provides emotional support and allows the patient to express their concerns, which is essential in patient-centered care.

Question 4

The nurse is preparing to collect an arterial blood gas.Which of the following should be noted on the laboratory slip prior to collection to ensure accurate results are obtained upon analysis?
A)Pulse
B)Blood pressure
C)Temperature
D)Respiratory rate

Accepted Answer

Temperature should be noted on the laboratory slip prior to arterial blood gas collection as it can affect the results of the analysis. Factors such as fever, hypothermia, or local tissue temperature can lead to inaccurate readings. While pulse, blood pressure, and respiratory rate are all important vital signs to monitor, they have no direct impact on the analysis of arterial blood gases.

Question 5

While reviewing charts, which of the following would require an intervention by the nurse?
A)Albumin = 4.4 g/dL
B)Calcium = 9.3 mg/dL
C)Potassium = 2.7 mEq/L
D)Glucose = 88 mg/dL

Accepted Answer

A potassium level of 2.7 mEq/L is below the normal range (3.5-5.0 mEq/L) and indicates hypokalemia, which can lead to cardiac dysrhythmias and muscle weakness. It requires an intervention by the nurse, such as notifying the healthcare provider and monitoring the patient closely. The other values are within normal range and do not require intervention.

Question 6

The nurse is caring for an older woman receiving therapy for osteoporosis.Which of the following lab tests would be used to evaluate the patient's response to therapy?
A)Alkaline phosphatase
B)Collagen cross-linked N-telopeptide
C)Serum calcitonin
D)Serum ammonia

Accepted Answer

Collagen cross-linked N-telopeptide is a biomarker used to evaluate treatment response in patients with osteoporosis. It reflects the amount of bone breakdown and is used to monitor the effectiveness of therapies that slow down bone loss. Alkaline phosphatase is a less specific marker for bone formation and can be affected by non-bone related factors like liver or kidney disease. Serum calcitonin is a hormone produced by the thyroid gland and does not play a significant role in evaluating osteoporosis therapy response. Serum ammonia is a marker for liver function and is not directly related to bone health.

Question 7

While reviewing medications taken by a patient scheduled to have a liver biopsy, the nurse would be most concerned if the patient reported taking which of the following?
A)Aspirin (acetylsalicylic acid)
B)Tylenol (acetaminophen)
C)Mucinex (guaifenesin)
D)Protonix (pantoprazole)

Accepted Answer

Aspirin can increase bleeding risk, and a liver biopsy is a procedure that carries a risk of bleeding, so taking aspirin can increase the risk of complications. Tylenol, Mucinex, and Protonix do not have the same potential risk for bleeding.

Question 8

A patient has a positive finding on the urea breath test.The nurse understands that finding indicates that the patient has which of the following infections?
A)Escherichia coli
B)Helicobacter pylori
C)Mycobacterium tuberculosis
D)Streptococcus pneumoniae

Accepted Answer

The urea breath test is used to detect the presence of Helicobacter pylori, a bacterial infection that can cause ulcers in the stomach and small intestine. The test involves drinking a solution containing urea and then breathing into a special bag. If the bacteria are present in the stomach, they will metabolize the urea and produce carbon dioxide, which can be detected in the breath sample. Escherichia coli, Mycobacterium tuberculosis, and Streptococcus pneumoniae are not associated with a positive urea breath test.

Question 9

A patient is demonstrating symptoms of toxicity following exposure to a pesticide.Which test would be most appropriate for assessing this condition?
A)Renin
B)Reticulocyte count
C)Red blood cell (RBC)cholinesterase
D)Rheumatoid factor (RF)

Accepted Answer

RBC cholinesterase levels are used to assess for toxicity following exposure to pesticides, as they inhibit the activity of this enzyme. Renin levels are used to assess for kidney function, reticulocyte count is used to assess for red blood cell production, and rheumatoid factor is used to diagnose autoimmune diseases such as rheumatoid arthritis.

Question 10

The nurse is counseling a patient newly diagnosed with muscular dystrophy whose LDH (lactate dehydrogenase)is elevated.Which of the following statements by the nurse is best?
A)"LDH values are used to help evaluate the degree of muscle wasting caused by your disease."
B)"LDH is used to detect any cardiac dysfunction."
C)"LDH elevation is a side effect commonly seen in people who take multivitamins."
D)"You don't need to worry about the lab results.Your health-care provider tracks a lot of things associated with your care."

Accepted Answer

LDH is an enzyme found in cells throughout the body, including muscle cells. An elevated LDH level can indicate muscle damage or wasting, which is common in muscular dystrophy. Option B is incorrect because although LDH can be used to detect cardiac dysfunction, it is not relevant to this particular patient's diagnosis of muscular dystrophy. Option C is incorrect because while LDH elevation can occur as a side effect of certain medications or supplements, this is not the case for multivitamins. Option D is incorrect because it dismisses the patient's concerns and does not provide useful information.

Question 11

The nurse is caring for a patient who takes a loop diuretic and supplemental potassium.Follow-up lab results indicate the patient's potassium is 4.8 mEq/L.Which of the following statements by the nurse is best?
A)"You should stop taking your potassium supplement."
B)"The doctor will probably reduce the dose of your diuretic."
C)"It will be important for you to increase the number of bananas you eat."
D)"Your lab values are right where we want them, so keep doing what you're doing."

Accepted Answer

The patient's potassium level of 4.8 mEq/L is within the normal range (3.5 to 5.0 mEq/L), indicating that the current management plan, including the use of a loop diuretic with potassium supplementation, is effective. Therefore, encouraging the patient to continue with the current regimen is appropriate.

Question 12

A 42-year-old woman is being treated for acute myelogenous leukemia.Which of the following results from the bone marrow biopsy indicates she is responding well to chemotherapy treatments? A)Platelets = 250,000/mm³ B)Neutrophils = 20% C)Myeloid to lymphocyte ratio = 6:1 D)Red blood cells = 4.2 * 10⁶ cells/mm³

Accepted Answer

Neutrophils are a type of white blood cell that play a key role in the immune response. In acute myelogenous leukemia, the bone marrow produces immature white blood cells that prevent the production of mature cells, including neutrophils. Therefore, a low percentage of neutrophils indicates poor response to treatment. However, if the percentage of neutrophils increases, it indicates that the bone marrow is producing more mature cells, which is a sign of a positive response to treatment. Platelet counts, myeloid to lymphocyte ratios, and red blood cell counts may also be affected in leukemia, but they do not necessarily indicate a positive response to chemotherapy.

Question 13

The nurse is caring for a child with positive mumps serology.Which of the following would be most concerning?
A)Noted bilateral swelling of the neck near the ears
B)Presence of immunoglobin M antibodies on laboratory results
C)Lethargy and minimal response to stimulation
D)Fever of 100.6°F

Accepted Answer

Lethargy and minimal response to stimulation could indicate potential complications of mumps, such as meningitis or encephalitis. The other options are all typical symptoms of mumps and would be expected in a child with positive serology.

Question 14

A nurse screening for diabetes would be most interested in which of the following laboratory values?
A)Urine ketones
B)Serum protein
C)Serum pH
D)Urine specific gravity

Accepted Answer

Urine ketones are indicative of a diabetic state where the body is breaking down fats for energy, and the presence of ketones in urine is a sign of uncontrolled blood glucose levels. This makes urine ketones a useful laboratory value for screening and monitoring diabetes. Serum protein, serum pH, and urine specific gravity are not directly related to diabetes screening.

Question 15

A health-care provider has decided to perform transesophageal echocardiography (TEE)on a patient to determine the severity of a valvular abnormality.Which of the following conditions in the patient would most likely cause the provider to choose this method over conventional echocardiography?
A)Obesity
B)Bleeding disorder
C)Esophageal varices
D)Unstable cardiac status

Accepted Answer

Transesophageal echocardiography (TEE) is often chosen over conventional transthoracic echocardiography in obese patients because obesity can limit the quality of images obtained through the chest wall. TEE provides clearer images of the heart by bypassing the chest wall and lungs, using an ultrasound probe inserted into the esophagus.

Question 16

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH).Which of the following levels would indicate that the patient has responded well to treatment?
A)Glucose
B)Hemoglobin
C)Total protein
D)Urine osmolality

Accepted Answer

In SIADH, there is excessive secretion of antidiuretic hormone (ADH) leading to increased water reabsorption in the kidneys, leading to hyponatremia and concentrated urine. The treatment aims at correcting the underlying cause of SIADH and addressing hyponatremia. The response to treatment is evaluated by measuring serum sodium levels and urine osmolality. Urine osmolality reflects the concentration of solutes in urine, and if the treatment is effective, urine osmolality should decrease as the kidneys excrete more water. Glucose, hemoglobin, and total protein levels are not specific for monitoring the treatment response in SIADH.

Question 17

The nurse is providing instructions for a woman who is 35 weeks pregnant undergoing treatment for pre-eclampsia.The health-care provider has ordered a urine protein for follow-up.Which of the following instructions is best?
A)"You will need to void now and then collect all of your urine for the next 24 hours."
B)"Here is a sterile specimen cup.Make sure to clean yourself three times with the wipes provided, and do not allow anything to touch the inside of the container."
C)"You may collect urine into this specimen cup after cleaning yourself; there is no need to keep it sterile."
D)"You will need to drink a special solution and then wait 2 hours prior to providing a urine sample."

Accepted Answer

The answer of The nurse is providing instructions for a...

Question 18

A young woman who has just been diagnosed with a urinary tract infection was given a prescription for Cipro (ciprofloxacin)and Pyridium (phenazopyridine hydrochloride).The woman states, "It just hurts so badly and I feel like I have to go all the time." Which of the following responses by the nurse is best?
A)"Once you take the first antibiotic, your pain will start to go away."
B)"I had a urinary tract infection once, too, so I know what you mean; that pain is awful."
C)"Try to limit how much fluid you drink so the antibiotic can stay in your bladder and help fight the bacteria."
D)"The Pyridium will help with the symptoms and drinking plenty of fluids will help, too."

Accepted Answer

The best response would be D as it acknowledges the patient's discomfort and offers appropriate advice. Pyridium will help with the symptoms like pain and urgency, and drinking fluids is important for flushing out the bacteria. Option A is not entirely accurate as the pain relief may take some time. Option B shows empathy but doesn't provide helpful advice. Option C suggests limiting fluid intake, which is not recommended as hydration is important in urinary tract infections.

Question 19

The nurse is reviewing labs on a patient whose C-peptide stimulation level is 22 ng/mL.Which of the following interpretations will direct the patient's plan of care?
A)The patient's diabetes is very labile; blood glucose will need to be monitored at least three times per day.
B)The patient will need a combination of short- and long-acting insulin.
C)The patient has a normal response to a glucose challenge and is not considered diabetic.
D)The patient's diabetes can be managed without insulin at this time.

Accepted Answer

The answer of The nurse is reviewing labs on a...

Question 20

The nurse draws blood for a patient with coagulation studies ordered, including protein C.Which of the following actions could result in erroneous results?
A)The tourniquet is left on for longer than 1 minute prior to specimen collection.
B)The nurse draws blood from the arm that does not have a running IV.
C)The nurse draws blood from a patient who has already eaten breakfast.
D)Additional lab specimens for complete blood count and electrolyte panel are drawn prior to collection of the coagulation studies.

Accepted Answer

Leaving the tourniquet on for longer than 1 minute can result in hemoconcentration, leading to falsely elevated protein C levels.

Quiz 4: Monographs

A nurse is preparing to administer barium sulfate to a patient as part of an upper gastrointestinal and small bowel series procedure.What should the nurse tell the patient about this intervention?

The nurse is caring for a young woman who entered the emergency room reporting that she had been raped.In additional to a full assessment, careful collection of evidence will include testing vaginal secretions for which of the following?

The nurse is caring for an individual who states, "I've been struggling with my weight my entire life, so I guess I shouldn't be surprised I have diabetes." Which of the following actions by the nurse is best?

The nurse is preparing to collect an arterial blood gas.Which of the following should be noted on the laboratory slip prior to collection to ensure accurate results are obtained upon analysis?

While reviewing charts, which of the following would require an intervention by the nurse?

The nurse is caring for an older woman receiving therapy for osteoporosis.Which of the following lab tests would be used to evaluate the patient's response to therapy?

While reviewing medications taken by a patient scheduled to have a liver biopsy, the nurse would be most concerned if the patient reported taking which of the following?

A patient has a positive finding on the urea breath test.The nurse understands that finding indicates that the patient has which of the following infections?

A patient is demonstrating symptoms of toxicity following exposure to a pesticide.Which test would be most appropriate for assessing this condition?

The nurse is counseling a patient newly diagnosed with muscular dystrophy whose LDH (lactate dehydrogenase) is elevated.Which of the following statements by the nurse is best?

The nurse is caring for a patient who takes a loop diuretic and supplemental potassium.Follow-up lab results indicate the patient's potassium is 4.8 mEq/L.Which of the following statements by the nurse is best?

A 42-year-old woman is being treated for acute myelogenous leukemia.Which of the following results from the bone marrow biopsy indicates she is responding well to chemotherapy treatments?

The nurse is caring for a child with positive mumps serology.Which of the following would be most concerning?

A nurse screening for diabetes would be most interested in which of the following laboratory values?

A health-care provider has decided to perform transesophageal echocardiography (TEE) on a patient to determine the severity of a valvular abnormality.Which of the following conditions in the patient would most likely cause the provider to choose this method over conventional echocardiography?

The nurse is caring for a patient with syndrome of inappropriate antidiuretic hormone (SIADH) .Which of the following levels would indicate that the patient has responded well to treatment?

The nurse is providing instructions for a woman who is 35 weeks pregnant undergoing treatment for pre-eclampsia.The health-care provider has ordered a urine protein for follow-up.Which of the following instructions is best?

The nurse is reviewing labs on a patient whose C-peptide stimulation level is 22 ng/mL.Which of the following interpretations will direct the patient's plan of care?

The nurse draws blood for a patient with coagulation studies ordered, including protein C.Which of the following actions could result in erroneous results?