Question 1

A patient admitted to a hospital with a possible overdose of aspirin has a serum acetylsalicylic level of 48 mg/dL.Which signs and symptoms should a nurse plan to manage initially?
A)Confusion, hypertension, and oliguria
B)Hypoactive bowel sounds, hypothermia, and fatigue
C)Hypothermia, bradycardia, and increased alertness
D)Increased respiratory rate, tinnitus, and flushed skin

Accepted Answer

An overdose of aspirin can result in hyperthermia, tinnitus, hyperventilation, and flushed skin due to respiratory alkalosis. Therefore, the nurse should initially manage the patient's increased respiratory rate, tinnitus, and flushed skin.

Question 2

The nurse is reviewing laboratory results for a woman with a history of breast cancer.The nurse would evaluate the possibility of bone metastasis using which of the following laboratory values?
A)Albumin
B)Folate
C)Ionized calcium
D)Alkaline phosphatase

Accepted Answer

Alkaline phosphatase is an enzyme that can be elevated in cases of bone metastasis, as it is released from the bone when there is increased bone turnover or damage.

Question 3

A patient with an exacerbation of Crohn's disease is started on corticosteroids.Which laboratory result should the nurse monitor for early indications that the treatment is working?
A)C-reactive protein (CRP)
B)Erythrocyte sedimentation rate (ESR)
C)Immunofixation electrophoresis (IFE)
D)Lactate dehydrogenase (LDH)

Accepted Answer

C-reactive protein (CRP) is an acute-phase reactant that is elevated during inflammation. Monitoring CRP levels can help indicate the effectiveness of corticosteroid treatment for an exacerbation of Crohn's disease. A decrease in CRP levels would indicate a decrease in inflammation and improvement in the patient's condition. Erythrocyte sedimentation rate (ESR) is also an indicator of inflammation, but it is less specific and takes longer to decrease than CRP levels. Immunofixation electrophoresis (IFE) and lactate dehydrogenase (LDH) are not relevant indicators for the effectiveness of corticosteroid treatment for Crohn's disease.

Question 4

A male patient with a history of an enlarged prostate has a prostate-specific antigen level that is increased from its baseline.Which pertinent information should the nurse identify that may cause an increase in prostate-specific antigen?
A)Administration of estrogen therapy
B)Excessive exercise in the day prior to the test
C)Ingestion of alcohol in the previous 24 hours
D)Recent prostatic needle biopsy

Accepted Answer

A recent prostatic needle biopsy can cause an increase in prostate-specific antigen due to trauma and inflammation of the prostate gland. Administration of estrogen therapy and excessive exercise or ingestion of alcohol in the previous 24 hours are not known to cause an increase in prostate-specific antigen.

Question 5

A middle-aged patient with a positive family history of heart disease has a total cholesterol level of 203 mg/dL with an HDL of 45 mg/dL and identified as having a Framingham 10-Year Risk of 5%.Which additional laboratory test results should a nurse identify as a marker of increased risk for coronary artery disease (CAD)?
A)Apolipoprotein A 110 mg/dL
B)Apolipoprotein B 120 mg/dL
C)C-reactive protein 2.9 mg/L
D)Triglyceride 150 mg/dL

Accepted Answer

C-reactive protein (CRP) is an inflammatory marker and has been found to be associated with an increased risk for CAD. Elevated levels of CRP may indicate underlying inflammation in the blood vessels and an increased risk for plaque build-up. Apolipoprotein A and B levels and triglyceride levels may also be useful in assessing CAD risk, but in this case, CRP is the best choice because it is specifically associated with inflammation and CAD risk.

Question 6

A patient is undergoing an arthrogram.Which condition is this type of testing most useful in identifying?
A)Coronary artery disease
B)Joint disease
C)Chronic obstructive pulmonary disease (COPD)
D)Hepatitis

Accepted Answer

An arthrogram is a medical imaging technique used mainly to evaluate joint disease.

Question 7

The nurse is caring for a patient who had a liver biopsy earlier in the day.Which of the following symptoms would be most concerning to the nurse?
A)Patient reports nausea.
B)The dressing site is dry and intact.
C)Patient's temperature is 99.9°F.
D)Patient states, "I don't know what I'll do if I have cancer."

Accepted Answer

A temperature of 99.9°F could indicate an infection or other complication following the liver biopsy, which would be concerning to the nurse.

Question 8

A patient's laboratory test results indicate toxic levels of the aminoglycoside antibiotic gentamicin.Which of the following complications associated with gentamicin toxicity should the nurse assess for?
A)Hearing loss
B)Arrhythmias
C)Dyspnea
D)Bronchospasm

Accepted Answer

One of the major complications of gentamicin toxicity is ototoxicity, or damage to the ear and hearing loss. Arrhythmia, dyspnea, and bronchospasm are not typically associated with gentamicin toxicity.

Question 9

Which laboratory result should the nurse identify as most indicative that a patient with type 1 diabetes needs assistance to improve diabetic management?
A)Fasting blood glucose of 108 mg/dL
B)Hemoglobin A1c 12.5%
C)Postprandial glucose of 140 mg/dL at 2 hours
D)Preprandial glucose of 82 mg/dL

Accepted Answer

Hemoglobin A1c (HbA1c) is a laboratory test that measures average blood glucose levels over the past 2-3 months. A level of 12.5% indicates poorly controlled diabetes and a need for assistance to improve diabetic management. The other options are within normal limits or near optimal control.

Question 10

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

Accepted Answer

Mutations in the KRAS gene are most commonly associated with resistance to certain medications used to treat colorectal cancer, as the KRAS protein is involved in a pathway that promotes cell division and growth. This mutation can limit the effectiveness of drugs that target this pathway, such as cetuximab and panitumumab.

Question 11

A nurse is caring for a patient who is preparing to undergo gonioscopy.Which of the following is the most likely indication for this test?
A)To assess visual acuity
B)To test peripheral vision
C)To detect glaucoma
D)To screen for color blindness

Accepted Answer

The answer of A nurse is caring for a patient...

Question 12

A nurse is starting a piggyback infusion of magnesium sulfate for a patient.Which laboratory data should the nurse identify as a possible contraindication to the infusion?
A)Arterial pH 7.40
B)Decreased uric acid and calcium
C)Elevated red blood cell (RBC)count and reticulocyte count
D)Increased blood urea nitrogen and creatinine

Accepted Answer

Increased blood urea nitrogen and creatinine levels may indicate impaired kidney function, which could make the patient more susceptible to magnesium sulfate toxicity. This could be a contraindication to the infusion, and the nurse should consult with the healthcare provider before proceeding.

Question 13

A nurse is drawing a plasma specimen from an infant for an amino acid screen.Which of the following conditions is this patient most likely being tested for?
A)Phenylketonuria (PKU)
B)Down syndrome
C)Sickle cell anemia
D)Cushing's disease

Accepted Answer

An amino acid screen is commonly used to test for PKU, which is an inherited disorder that causes a buildup of phenylalanine in the body. Babies with PKU need to follow a special diet to prevent brain damage and other complications. The other conditions listed do not typically require an amino acid screen for diagnosis.

Question 14

A patient is suspected of having hay fever.Which test would be most appropriate for confirming this suspicion?
A)Immunofixation electrophoresis (IFE)
B)Immunoglobulin E (IgE)
C)Immunoglobulin A (IgA)
D)Immunosuppressant cyclosporine

Accepted Answer

The most commonly used test for confirming hay fever is the measurement of Immunoglobulin E (IgE) levels in the blood. Elevated levels of IgE indicate an allergic response to specific allergens, such as pollen or dust mites, which are typically responsible for hay fever symptoms. IFE, IgA, and immunosuppressant cyclosporine are not relevant tests for diagnosing hay fever.

Question 15

A patient's laboratory test results indicate elevated levels of immunoglobulin (Ig)A and IgG gliadin antibodies.This finding most likely indicates which of the following?
A)Gluten-sensitive enteropathy
B)Peanut allergy
C)Lactose intolerance
D)Crohn's disease

Accepted Answer

Elevated levels of IgA and IgG gliadin antibodies are indicative of gluten-sensitive enteropathy, also known as celiac disease. This immune-mediated disorder is triggered by the ingestion of gluten, a protein found in wheat, rye, and barley. It is characterized by damage to the small intestine, which can result in malabsorption and various symptoms such as abdominal pain, bloating, diarrhea, and weight loss. Testing for gliadin antibodies is part of the diagnostic workup for celiac disease, along with other tests such as tissue transglutaminase antibodies and small bowel biopsy. Peanut allergy, lactose intolerance, and Crohn's disease are not related to gliadin antibodies.

Question 16

A nurse is assisting with a pulmonary angiography procedure for a patient with tuberculosis.Which of the following constitutes a critical finding that should be communicated to the patient's primary health-care provider immediately?
A)Aneurysm
B)Acute pulmonary embolism
C)Bleeding
D)Tumor

Accepted Answer

Acute pulmonary embolism is a life-threatening condition that requires immediate intervention, making it a critical finding that should be communicated to the patient's primary health-care provider immediately.

Question 17

A patient with a history of chronic obstructive pulmonary disease (COPD)has arterial blood gases with pH 7.36, PCO₂ 50 mm Hg, and HCO₃ 20 mEq/L.The patient has oxygen by nasal cannula at 2 L/min.Which order should a nurse anticipate for this patient? A)Discontinue oxygen. B)Begin oxygen by facemask. C)Increase oxygen by nasal cannula to 5 L/min. D)Start oxygen with Venturi mask at 28%.

Accepted Answer

The patient's arterial blood gases indicate respiratory acidosis (elevated PCO2) and compensated metabolic alkalosis (elevated HCO3-), common in chronic COPD patients. The goal is to improve oxygenation without worsening CO2 retention. A Venturi mask at 28% delivers a precise oxygen concentration, which is crucial for COPD patients to avoid oxygen-induced hypercapnia.

Question 18

A nurse is educating a patient prior to a 24-hour urine creatinine clearance test.Which response by the patient should the nurse identify as indicating a need for additional instruction?
A)"I do not have a way to refrigerate the container at work, so I will take a day off from work to do this test."
B)"That is a big container.I will have to drink a lot of fluid to fill it all the way!"
C)"I can adjust my exercise routine so I do not work out the day before and the day of this test."
D)"I follow a vegetarian diet, so it will not be a problem to avoid meat consumption!"

Accepted Answer

The patient's belief that they need to drink a lot of fluid to fill the container all the way indicates a misunderstanding. The 24-hour urine creatinine clearance test measures the amount of creatinine cleared from the body in a day, not the volume of urine produced. Drinking excessive amounts of fluid can dilute the urine and potentially affect the test results.

Question 19

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

Accepted Answer

Mutations in the BRAF gene are most commonly associated with melanoma, and testing for these mutations can help identify patients who might benefit from treatment with specific drugs, such as BRAF inhibitors. Mutations in the BRAF gene are not associated with the other options mentioned.

Question 20

A patient is scheduled to have blood drawn for antidiuretic hormone (ADH)levels.Based on this information, a nurse should assess the patient for a related clinical manifestation, such as:
A)Chest pain or dyspnea on exertion
B)Polyuria or altered serum osmolality
C)Exophthalmos or tachycardia
D)Decreased chest expansion or hypoactive bowel sounds

Accepted Answer

ADH is responsible for regulating water balance in the body by controlling the amount of water excreted in urine. A high level of ADH can cause water retention and lead to decreased urine output (polyuria) and altered serum osmolality.

Quiz 1: About This Book

A patient admitted to a hospital with a possible overdose of aspirin has a serum acetylsalicylic level of 48 mg/dL.Which signs and symptoms should a nurse plan to manage initially?

The nurse is reviewing laboratory results for a woman with a history of breast cancer.The nurse would evaluate the possibility of bone metastasis using which of the following laboratory values?

A patient with an exacerbation of Crohn's disease is started on corticosteroids.Which laboratory result should the nurse monitor for early indications that the treatment is working?

A male patient with a history of an enlarged prostate has a prostate-specific antigen level that is increased from its baseline.Which pertinent information should the nurse identify that may cause an increase in prostate-specific antigen?

A patient is undergoing an arthrogram.Which condition is this type of testing most useful in identifying?

The nurse is caring for a patient who had a liver biopsy earlier in the day.Which of the following symptoms would be most concerning to the nurse?

A patient's laboratory test results indicate toxic levels of the aminoglycoside antibiotic gentamicin.Which of the following complications associated with gentamicin toxicity should the nurse assess for?

Which laboratory result should the nurse identify as most indicative that a patient with type 1 diabetes needs assistance to improve diabetic management?

Results from a patient's genetic testing indicate mutations in the KRAS gene.This finding is most associated with which of the following?

A nurse is caring for a patient who is preparing to undergo gonioscopy.Which of the following is the most likely indication for this test?

A nurse is starting a piggyback infusion of magnesium sulfate for a patient.Which laboratory data should the nurse identify as a possible contraindication to the infusion?

A nurse is drawing a plasma specimen from an infant for an amino acid screen.Which of the following conditions is this patient most likely being tested for?

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

A patient's laboratory test results indicate elevated levels of immunoglobulin (Ig) A and IgG gliadin antibodies.This finding most likely indicates which of the following?

A nurse is assisting with a pulmonary angiography procedure for a patient with tuberculosis.Which of the following constitutes a critical finding that should be communicated to the patient's primary health-care provider immediately?

A patient with a history of chronic obstructive pulmonary disease (COPD) has arterial blood gases with pH 7.36, PCO₂ 50 mm Hg, and HCO₃ 20 mEq/L.The patient has oxygen by nasal cannula at 2 L/min.Which order should a nurse anticipate for this patient?

A nurse is educating a patient prior to a 24-hour urine creatinine clearance test.Which response by the patient should the nurse identify as indicating a need for additional instruction?

Results from a patient's genetic testing indicate mutations in the BRAF gene.This finding is most associated with which of the following?

A patient is scheduled to have blood drawn for antidiuretic hormone (ADH) levels.Based on this information, a nurse should assess the patient for a related clinical manifestation, such as: