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?
A)Normal
B)Slight loss
C)Moderate loss
D)Profound loss

Accepted Answer

The American Speech-Language-Hearing Association (ASHA) classifies a pure tone average of 52 dB as a moderate loss. Hearing loss is categorized based on the pure tone average (PTA) of thresholds at 500 Hz, 1000 Hz, and 2000 Hz. A moderate hearing loss is defined by ASHA as a PTA between 41 dB and 55 dB.

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

Accepted Answer

Elevated levels of AFP and presence of AChE are suggestive of a neural tube defect, such as spina bifida or anencephaly. Respiratory distress syndrome and fetal immaturity would not be indicated by these laboratory findings. Fetal hemolytic disease would result in elevated bilirubin levels, not AFP and AChE.

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

Accepted Answer

The patient's high WBC count puts them at increased risk for infection, making preventing infection the priority nursing intervention. Avoiding falls, managing pain, and promoting adequate nutrition are important interventions but are not the priority in this situation.

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?
A)"Based on these results, your diabetes will be controlled by oral medications and diet."
B)"If you lose weight, you may be able to manage your diabetes with diet alone."
C)"Since you are already an adult, this result confirms that you have type 2 diabetes."
D)"You will need to take insulin for the rest of your life."

Accepted Answer

A C-peptide level of 0.6 ng/mL and a serum glucose level of 256 mg/dL indicate low insulin production by the pancreas, which is typical of type 1 diabetes. Therefore, the patient will require insulin therapy for the rest of their life. Diet and exercise are important components of diabetes management, but in this case, they will not be sufficient to control blood glucose levels.

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?
A)Immunofixation electrophoresis (IFE)
B)Immunoglobulin E (IgE)
C)Immunoglobulin A (IgA)
D)Immunosuppressant cyclosporine

Accepted Answer

Immunofixation electrophoresis (IFE) is the most appropriate test to identify the individual types of immunoglobulins present in a suspected case of multiple myeloma. It is a sensitive and specific test that can detect abnormal monoclonal antibody (M-protein) in the blood or urine. IgE and IgA are types of immunoglobulins, but they are not specific to multiple myeloma. Immunosuppressant cyclosporine is a medication used to prevent organ rejection in transplant patients and is not relevant to the diagnosis of multiple myeloma.

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?
A)Orange juice
B)Milk
C)Water
D)Soda

Accepted Answer

Orange juice is acidic and can help simulate the conditions under which gastroesophageal reflux is most likely to occur, making it a suitable medium for mixing with a radionuclide for a GER scan.

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?
A)Eosinophils
B)Lymphocytes
C)Monocytes
D)Reticulocytes

Accepted Answer

Reticulocytes are immature red blood cells that indicate bone marrow production of new red blood cells. In iron-deficiency anemia, there is a decrease in the production of red blood cells, and the administration of iron should increase the production of reticulocytes. Monitoring reticulocyte counts can indicate whether the patient is responding to iron therapy. Monitoring eosinophils, lymphocytes, or monocytes would not provide specific information about the patient's response to iron therapy.

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?
A)Remove all metallic objects from the area to be examined.
B)Administer an antianxiety agent, as ordered.
C)Use a nonionic contrast medium.
D)Notify the health-care provider to cancel the procedure.

Accepted Answer

Using a nonionic contrast medium is the best choice in this situation. Nonionic contrast media are associated with lower rates of adverse reactions compared to ionic contrast media, which are more commonly associated with allergic reactions. Removing metallic objects or administering an antianxiety agent would not prevent an allergic reaction. Cancelling the procedure may not be necessary if a nonionic contrast medium is used.

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?
A)Maintaining a vegetarian diet
B)Training for a marathon
C)Recent febrile illness
D)Use of cranberry supplements daily

Accepted Answer

A urine pH of 7.2 is slightly more alkaline than neutral (7.0). Maintaining a vegetarian diet can cause the urine to have a more alkaline pH, as plant-based foods tend to have alkaline-forming effects on the body.

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?
A)Knee-chest
B)Sidelying
C)Prone
D)Standing

Accepted Answer

The answer of A nurse is preparing to perform a...

Question 11

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

Accepted Answer

The most appropriate test for assessing long-term glucose control in a patient with diabetes is the glycated hemoglobin (HbA1c) test. This test gives an average of the patient's blood sugar levels over the past 2-3 months by measuring the percentage of hemoglobin that has glucose attached to it. Glucose and G6PD tests measure blood sugar levels at the time of the test, and the glucose tolerance test measures how well the body regulates blood sugar levels over a certain time period.

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?
A)Activated partial thromboplastin time (aPTT)
B)Bleeding time
C)Platelet count and aPTT
D)PT and international normalized ratio (INR)

Accepted Answer

The PT and INR are the most appropriate blood tests to monitor the therapeutic range of warfarin (Coumadin) because they directly measure the clotting activity of the coagulation factors affected by this medication. The therapeutic range for warfarin therapy is typically expressed as an INR between 2.0 and 3.0. Monitoring these values regularly can help prevent either harmful bleeding events or the formation of dangerous blood clots.

Question 13

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

Accepted Answer

The answer of Which factor in a patient's history may...

Question 14

A patient is suspected of having increased risk for stroke.Which type of angiography should be performed to detect this condition?
A)Abdominal
B)Adrenal
C)Carotid
D)Coronary

Accepted Answer

Carotid angiography is the appropriate choice to detect increased risk for stroke since it provides visualization of the carotid arteries, which supply blood to the brain. The presence of plaque or narrowing in these arteries can increase the risk of stroke. Abdominal, adrenal, and coronary angiography are not typically used to assess stroke risk.

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:
A)Malignant hyperpraxia
B)Myasthenia gravis
C)Multiple myeloma
D)Muscular dystrophy

Accepted Answer

AChR antibodies are most commonly associated with myasthenia gravis, an autoimmune neuromuscular disorder characterized by muscular weakness and fatigue. The elevated level of AChR antibodies suggests that the patient may have developed myasthenia gravis and requires assessment for clinical manifestations associated with the disease. Malignant hyperpraxia, multiple myeloma, and muscular dystrophy are not typically associated with elevated AChR antibodies.

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: A)Begin a bowel prep 24 hours prior to the examination. B)Eliminate red meat from the diet for 72 hours before the test. C)Take nothing by mouth for 12 hours before the test is scheduled. D)Withhold vitamin B₁₂ for 48 hours before the test is scheduled.

Accepted Answer

Withholding vitamin B12 for 48 hours before the test is scheduled is the appropriate instruction for the patient. This ensures that the level of vitamin B12 in the blood is low, which allows for accurate testing of IF antibodies. The other options are not necessary or appropriate for this test.

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:
A)Alcohol withdrawal
B)Diabetic ketoacidosis (DKA)
C)Fibromyalgia
D)Lyme disease

Accepted Answer

A fruity odor in urine is a common sign of diabetic ketoacidosis (DKA). It is caused by the presence of ketones in the urine, which is a result of the body breaking down fat for energy instead of glucose. Therefore, the nurse should plan interventions to manage DKA, including administering insulin and fluids, monitoring blood glucose, and correcting electrolyte imbalances.

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?
A)6 hours
B)24 hours
C)48 hours
D)72 hours

Accepted Answer

The first scan for a gallium scan is typically done 6 hours after the administration of the IV nucleotide.

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:
A)Collect all urine during any 24-hour period by labeling the drainage collection bag with the date and time most recently emptied.
B)Clamp the urinary catheter and then drain all urine into the container specified by the lab and repeat every 6 hours times 4.
C)Empty all urine in the urinary drainage bag at 0600 and then save all urine until the next day at 0600.
D)Increase meat portions in the diet for at least 48 hours prior to the planned start of the collection.

Accepted Answer

To accurately perform a 24-hour urine creatinine clearance test, the nurse should start by emptying all urine in the urinary drainage bag at a specific time (e.g., 0600) and then save all urine produced for the next 24 hours until the same time the next day (e.g., 0600 the following day). This ensures that all urine produced in a 24-hour period is collected for the test.

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:
A)Early signs of renal insufficiency
B)Evidence of severe renal dysfunction
C)Hypertension secondary to renal disease
D)Normal renal function

Accepted Answer

A serum creatinine level of 1.9 mg/dL and 1+ proteinuria signifies early signs of renal insufficiency. This indicates impaired kidney function and the need for further evaluation and management to prevent further renal damage. It is essential to control hypertension to avoid its secondary effects on the kidneys. Thus, the nurse should advocate for interventions that lower blood pressure to preserve renal function.

Quiz 1: About This Book

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?

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 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?

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?

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?

Which laboratory test should a nurse monitor to determine if a patient is responding to the administration of iron for iron-deficiency anemia?

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?

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?

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?

A patient with diabetes requires assessment of long-term glucose control.Which test would be most appropriate for this patient?

Which blood tests should a nurse monitor to determine if a patient's blood level of warfarin (Coumadin) is within the therapeutic range?

Which factor in a patient's history may be associated with an elevated creatine phosphokinase (CK) level?

A patient is suspected of having increased risk for stroke.Which type of angiography should be performed to detect this condition?

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:

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:

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:

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?

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:

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: