Question 1

The nurse is collecting a urine sample from a patient with an indwelling Foley catheter and notes the urine has a strange odor.To determine the significance of these findings, which question should the nurse ask this patient?
A)"Do you smoke cigarettes or use tobacco in any form?"
B)"Have you had sexual intercourse in the past month?"
C)"Have you had a Foley catheter before?"
D)"Have you eaten any onions or garlic lately?"

Accepted Answer

Strange odor in urine can be caused by certain foods, such as onions or garlic. Therefore, asking the patient if they have eaten any onions or garlic lately can provide insights into the cause of the odor. Smoking, sexual intercourse, or previous Foley catheter use may not necessarily be related to the strange odor in this case.

Question 2

A nurse has orders to obtain urine for urinalysis, but the patient has voided only a small amount.What is the minimal volume of urine that the nurse can send for a routine urinalysis?
A)15 mL
B)30 mL
C)50 mL
D)100 mL

Accepted Answer

A minimum of 15 mL of urine is typically sufficient for a routine urinalysis.

Question 3

Which description correctly describes the correct technique that a nurse should use to obtain a throat culture?
A)Instruct the patient to gargle with saltwater to remove normal oral flora and then obtain the culture by first eliciting a gag reflex and then swabbing the posterior oropharynx.
B)Rub the swab firmly but gently over the back of the throat and around both tonsils while avoiding contact with the tongue and lips.
C)Swab only areas where there is evidence of inflammation, exudate, or ulceration.
D)Tilt the patient's head back and gently swab all surfaces, starting from the tonsils and moving outward to the cheeks and tongue.

Accepted Answer

Rubbing the swab firmly but gently over the back of the throat and around both tonsils is the correct technique for obtaining a throat culture. It is important to avoid contact with the tongue and lips to prevent contamination of the culture.

Question 4

A patient has an increased parathyroid hormone (PTH)level.Based on this information, a nurse should also assess for:
A)Decreased serum calcium and serum phosphate levels
B)Decreased serum sodium and potassium
C)Increased serum calcium and decreased serum phosphate levels
D)Increased serum glucose and uric acid

Accepted Answer

Increased PTH levels cause increased serum calcium and decreased serum phosphate levels due to the actions of PTH on bone and renal reabsorption of calcium and phosphate. This is known as hyperparathyroidism. Elevated PTH levels do not directly affect serum sodium, potassium, glucose, or uric acid levels.

Question 5

A patient is undergoing a standard barium swallow.Which of the following structures is the focus of this test?
A)Mouth
B)Esophagus
C)Stomach
D)Small intestine

Accepted Answer

A standard barium swallow is a radiological test used to evaluate the structure and functionality of the esophagus. The patient ingests a barium solution, which coats the lining of the esophagus and is then imaged using fluoroscopy to assess for any abnormalities or dysfunctions. The test does not focus on the mouth, stomach, or small intestine.

Question 6

A nurse reviews the Gram stain results from a patient's sputum culture.Which finding indicates that the specimen is contaminated by oral flora?
A)Presence of polymorphonuclear neutrophils
B)More than 25 squamous epithelial cells per lower power field
C)Positive for gram-negative bacteria and white blood cells
D)Presence of homogeneous microbial flora

Accepted Answer

Squamous epithelial cells are normally present in the oral cavity and can contaminate sputum specimens, leading to a higher count than expected. The presence of squamous epithelial cells in a sputum specimen suggests contamination by oral flora rather than a true respiratory infection. Polymorphonuclear neutrophils and gram-negative bacteria with white blood cells are findings that suggest a respiratory infection. The presence of homogeneous microbial flora can indicate a pure culture without contamination, but it does not indicate specifically if the contamination is from oral flora.

Question 7

During collection of a venous blood sample, a nurse finds it difficult to locate a patient's vein while wearing gloves.Which action by the nurse is most appropriate?
A)Identify landmarks where the vein is palpable and attempt venipuncture with gloves on.
B)Obtain assistance from another nurse to perform venipuncture.
C)Remove one glove from the dominant hand to palpate the vein.
D)Tear off one or two fingertips from the glove to make the fingertips accessible for palpation.

Accepted Answer

Identifying landmarks where the vein is palpable and attempting venipuncture with gloves on is the most appropriate action because it maintains safety and infection control standards while addressing the difficulty in locating the vein.

Question 8

A nurse notes that a patient has orders for an endoscopy, abdominal ultrasound, gastrointestinal (GI)scintigraphy, and lower GI series.Which of these procedures should the nurse schedule last?
A)Abdominal ultrasound
B)Endoscopy
C)Lower GI series
D)GI scintigraphy

Accepted Answer

The answer of A nurse notes that a patient has...

Question 9

A nurse is collecting blood from a patient for natriuretic peptide testing.This test assists in diagnosing which of the following?
A)Congestive heart failure
B)Stroke
C)Leukemia
D)Chronic obstructive pulmonary disease (COPD)

Accepted Answer

Natriuretic peptide levels in the blood can indicate the presence of congestive heart failure, a condition in which the heart is unable to pump blood effectively. It is not used for diagnosing stroke, leukemia or COPD.

Question 10

A patient is undergoing evaluation for possible Addison's disease.Which test should the nurse anticipate?
A)Adrenocorticotropic hormone (ACTH)
B)Growth hormone (GH)stimulation test
C)Serum prolactin test
D)Thyroid-stimulating hormone (TSH)

Accepted Answer

The adrenocorticotropic hormone (ACTH) stimulation test is commonly used to diagnose Addison's disease. It involves administering synthetic ACTH and measuring the patient's cortisol levels before and after. In patients with Addison's disease, cortisol levels will not increase after ACTH administration.

Question 11

A young woman who is planning to become pregnant is informed that she has tested positive for hepatitis B core antibody (HBcAb).The patient asks a nurse what this means.Which response by the nurse is correct?
A)"If you have a baby, there is a high risk that the baby will develop hepatitis, so it would be better if you decided not to have children."
B)"The presence of this antibody means you were exposed to hepatitis B in the past, but you are not infected and cannot infect others."
C)"This antibody indicates that you are a carrier of hepatitis B, and your baby will need vaccination immediately at birth."
D)"You currently have an active infection, and you should avoid sexual contact until you are treated for the infection."

Accepted Answer

The presence of hepatitis B core antibody (HBcAb) indicates past or ongoing infection with hepatitis B virus. It does not necessarily mean the person is currently infectious, but it does indicate that the virus has been in their system. In the context of pregnancy, it's important to protect the newborn from potential infection, hence the recommendation for immediate vaccination of the baby at birth.

Question 12

A patient is undergoing a hepatobiliary scan, including assessment of bile reflux.As part of this procedure, the nurse must give the patient which of the following 60 minutes after injection of the radionuclide?
A)A high-fat meal
B)A high-protein meal
C)A high-glucose beverage
D)A high-fiber meal

Accepted Answer

A high-fat meal is the best choice to stimulate bile secretion and assess bile reflux during a hepatobiliary scan. Fat stimulates the release of cholecystokinin (CCK), which in turn stimulates the gallbladder to contract and release bile. This allows for better visualization of the bile ducts and detection of any reflux. High-protein and high-fiber meals can also stimulate CCK release but not as effectively as high-fat meals. High-glucose beverages do not stimulate CCK release and can interfere with the results of the scan.

Question 13

A patient is suspected of having iron-deficiency anemia.Which test would be most appropriate for confirming this suspicion?
A)Thyroxine, free
B)Transferrin
C)Triglycerides
D)Thyroid-stimulating hormone (TSH)

Accepted Answer

Transferrin is a protein that binds to and transports iron in the blood. Low levels of transferrin indicate that there is likely a low level of iron in the body, confirming the suspicion of iron-deficiency anemia. Thyroxine, free, triglycerides, and thyroid-stimulating hormone (TSH) are all unrelated to the diagnosis of iron-deficiency anemia.

Question 14

Due to the congenital deficiency of a particular vitamin in newborns, a nurse routinely administers a prophylactic shot of this vitamin to all newborns to prevent hemorrhagic disease of the newborn.Which vitamin is this nurse administering?
A)Vitamin C
B)Vitamin D
C)Vitamin E
D)Vitamin K

Accepted Answer

The nurse is administering Vitamin K. Hemorrhagic disease of the newborn occurs due to a deficiency of Vitamin K, which is necessary for the clotting of blood. Newborns are given a prophylactic shot of Vitamin K to prevent bleeding complications. Vitamin C deficiency causes scurvy, Vitamin D deficiency can lead to rickets, while Vitamin E deficiency can lead to neurological issues.

Question 15

A patient's laboratory test results indicate a positive finding for varicella antibodies in the blood.The nurse knows that this finding is associated with which of the following?
A)Chickenpox
B)Measles
C)Mumps
D)Scarlet fever

Accepted Answer

The presence of varicella antibodies indicates that the patient has been exposed to the varicella virus, most commonly known as chickenpox.

Question 16

Which instruction should a nurse give to a patient who is scheduled for an electroencephalography?
A)"Avoid washing the hair for at least 24 hours prior to the procedure."
B)"Fast for 12 hours before the time of the procedure."
C)"Hold all medications for 48 hours before the test."
D)"Limit sleep to 5 hours the night before the examination."

Accepted Answer

Limiting sleep the night before an electroencephalography (EEG) can help to ensure that the brain activity can be more easily monitored during the test, especially if the purpose is to observe sleep patterns or to induce sleep during the EEG. Washing hair, fasting, or holding medications are not standard instructions for EEG preparation unless specifically advised by the healthcare provider for particular reasons.

Question 17

A sickle cell screen ordered for a 2-month-old based on a family history of sickle cell trait returns with a negative result.Which action by the nurse is most appropriate?
A)Discuss the importance of birth control to avoid exposing another child to the risk of this disorder.
B)Instruct the family in strategies to decrease the risk of sickle cell crisis for this infant.
C)Reassure the family that the infant will not develop sickle cell disease since the family history is for sickle cell trait.
D)Review the need for further evaluation to confirm this result.

Accepted Answer

A negative sickle cell screen in a 2-month-old, especially with a family history of sickle cell trait, may not be conclusive. Hemoglobin F (fetal hemoglobin) is predominant in infants and can interfere with some sickle cell screening tests, potentially leading to false-negative results. Therefore, further evaluation is necessary to confirm the initial screening result.

Question 18

A patient is suspected of having thyroid cancer.Which test would be most appropriate for confirming this suspicion?
A)Thyroglobulin
B)Thyroid-binding inhibitory immunoglobulin
C)Thyroxine-binding globulin
D)Toxoplasma antibody

Accepted Answer

Thyroglobulin is a protein produced by the thyroid gland and is a marker for thyroid cancer. Elevated levels of thyroglobulin can suggest the presence of thyroid cancer. The other tests listed are not specific to thyroid cancer.

Question 19

A patient is suspected of having an ovarian carcinoid tumor.Which test would be most appropriate for confirming this suspicion?
A)Homovanillic acid (HVA)
B)5-Hydroxyindoleacetic acid (5-HIAA)
C)Homocysteine and methylmalonic acid
D)Hexosaminidase A and B

Accepted Answer

5-Hydroxyindoleacetic acid (5-HIAA) is a product of serotonin metabolism, and ovarian carcinoid tumors can secrete serotonin. Therefore, measuring serum or urine levels of 5-HIAA can be a useful test in confirming the suspicion of an ovarian carcinoid tumor. The other options listed are not specific for ovarian carcinoid tumors. HVA is a metabolite of dopamine and can be elevated in neuroendocrine tumors, but it is not specific for ovarian carcinoids. Homocysteine and methylmalonic acid are markers of vitamin B12 deficiency, and hexosaminidase A and B are enzymes used in the diagnosis of Tay-Sachs disease.

Question 20

A patient is suspect of having sarcoidosis.Which type of biopsy should the nurse expect this patient to undergo?
A)Liver
B)Lung
C)Kidney
D)Intestinal

Accepted Answer

Sarcoidosis most commonly affects the lungs and is usually diagnosed by a biopsy of the lung tissue.

Quiz 2: Preface

The nurse is collecting a urine sample from a patient with an indwelling Foley catheter and notes the urine has a strange odor.To determine the significance of these findings, which question should the nurse ask this patient?

A nurse has orders to obtain urine for urinalysis, but the patient has voided only a small amount.What is the minimal volume of urine that the nurse can send for a routine urinalysis?

Which description correctly describes the correct technique that a nurse should use to obtain a throat culture?

A patient has an increased parathyroid hormone (PTH) level.Based on this information, a nurse should also assess for:

A patient is undergoing a standard barium swallow.Which of the following structures is the focus of this test?

A nurse reviews the Gram stain results from a patient's sputum culture.Which finding indicates that the specimen is contaminated by oral flora?

During collection of a venous blood sample, a nurse finds it difficult to locate a patient's vein while wearing gloves.Which action by the nurse is most appropriate?

A nurse notes that a patient has orders for an endoscopy, abdominal ultrasound, gastrointestinal (GI) scintigraphy, and lower GI series.Which of these procedures should the nurse schedule last?

A nurse is collecting blood from a patient for natriuretic peptide testing.This test assists in diagnosing which of the following?

A patient is undergoing evaluation for possible Addison's disease.Which test should the nurse anticipate?

A young woman who is planning to become pregnant is informed that she has tested positive for hepatitis B core antibody (HBcAb) .The patient asks a nurse what this means.Which response by the nurse is correct?

A patient is undergoing a hepatobiliary scan, including assessment of bile reflux.As part of this procedure, the nurse must give the patient which of the following 60 minutes after injection of the radionuclide?

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

Due to the congenital deficiency of a particular vitamin in newborns, a nurse routinely administers a prophylactic shot of this vitamin to all newborns to prevent hemorrhagic disease of the newborn.Which vitamin is this nurse administering?

A patient's laboratory test results indicate a positive finding for varicella antibodies in the blood.The nurse knows that this finding is associated with which of the following?

Which instruction should a nurse give to a patient who is scheduled for an electroencephalography?

A sickle cell screen ordered for a 2-month-old based on a family history of sickle cell trait returns with a negative result.Which action by the nurse is most appropriate?

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

A patient is suspected of having an ovarian carcinoid tumor.Which test would be most appropriate for confirming this suspicion?

A patient is suspect of having sarcoidosis.Which type of biopsy should the nurse expect this patient to undergo?