Question 1

A geriatric resident in a nursing home has persistent hyponatremia with a serum sodium level of 132 mEq/L and urine osmolality of 300 mmol/kg.Which interventions should the nurse include in the plan of care for this patient? Select all that apply.

Accepted Answer

A) Encourage water intake to at least 1,000 mL daily. 
B) Maintain strict intake and output. 
C) Observe for decreased level of consciousness. 
D) Provide low-sodium diet. 
E) Restrict fluid intake to 600 mL per day.
F)Weigh daily.

Question 2

A patient is scheduled for a clonidine suppression test.For which clinical manifestations should the nurse assess this patient? Select all that apply.

Accepted Answer

A) Diaphoresis 
B) Headache 
C) Hypertension 
D) Hypotension 
E) Palpitations
F)Weight gain

Question 3

A patient is preparing to undergo a lung perfusion scan.The nurse is aware that this test is most useful in diagnosing which of the following conditions?

Accepted Answer

A) Pulmonary embolism 
B) Asthma 
C) Bronchitis 
D) Pneumonia

Question 4

A nurse is assessing a patient who will be undergoing magnetic resonance imaging of the pancreas with a gadolinium-based contrast agent (GBCA).Given the use of this contrast medium, the nurse should especially evaluate the patient for which of the following?

Accepted Answer

A) Pancreatitis 
B) Cirrhosis 
C) Renal dysfunction 
D) Cardiac disease

Question 5

The nurse is providing instructions to a patient who is being screened for colorectal cancer.Which of the following instructions should the nurse provide? Select all that apply.

Accepted Answer

A) "You will need to avoid red meat for the next 3 days and throughout the specimen-collection period." 
B) "You must cook all fruits and vegetables consumed throughout the testing period." 
C) "Please provide a list of all medication and supplements you typically use." 
D) "Do not use laxatives, enemas, or suppositories for 3 days prior to the testing." 
E) "You must avoid all sexual activity for a full week before the testing."
F)"I will give you a list of foods to avoid since many can interfere with occult blood testing."

Question 6

A patient's laboratory results indicate a negative finding for cervical cancer following a Papanicolaou (Pap)smear.The health-care provider, however, is concerned that the results may have been compromised by an interfering factor.Which of the following factors could have interfered with the test's results? Select all that apply.

Accepted Answer

A) Air drying the smear before fixation 
B) Specimen collected from the cervix 
C) Sexual intercourse 8 hours before specimen collection 
D) Collection of other specimens after the collection of the Pap smear 
E) Contamination with blood from the patient's menstrual period

Question 7

A nurse is assisting with a Meckel's diverticulum scan.The IV radionuclide has just been administered to the patient.How should the scanning proceed?

Accepted Answer

A) The abdomen should be scanned in 1 hour and then every 10 minutes for the next 2 hours. 
B) The abdomen should be scanned in 24 hours and then every 5 minutes for the next hour. 
C) The abdomen should be scanned immediately and then every 5 minutes for the next hour. 
D) The abdomen should be scanned in 48 hours and then every 10 minutes for the next 2 hours.

Question 8

A geriatric patient with a coronary artery disease, unstable angina, and heart failure is scheduled for a cardiac catheterization with contrast.The patient has a serum creatinine level of 1.32 mg/dL, and urinary output is within normal limits.Which medications, administered during the procedure, should a nurse identify as indicated to minimize the risk of renal compromise during this procedure? Select all that apply.

Accepted Answer

A) Diphenhydramine (Benadryl) 
B) Dopamine 
C) Furosemide (Lasix) 
D) Iodixanol (Visipaque) 
E) Midazolam (Versed) 6)Nifedipine (Procardia)

Question 9

The student nurse is reviewing lab results for a patient on a medical-surgical floor who has an elevated LDH (lactate dehydrogenase)level.The student learns LDH may be elevated in which of the following conditions? Select all that apply.

Accepted Answer

A) Cirrhosis 
B) Congestive heart failure 
C) Leukemia 
D) Myocardial infarction 
E) Hepatitis
F)Myopia

Question 10

A nurse is performing pulse oximetry on an infant.Which of the following are appropriate sites for applying the probe in this patient? Select all that apply.

Accepted Answer

A) Forehead 
B) Big toe 
C) Mouth 
D) Top or bottom of the foot 
E) Sides of the heel

Question 11

The nurse is caring for a patient who recently underwent a thallium stress test.Which of the following instructions should be provided? Select all that apply.

Accepted Answer

A) "You need to keep your leg straight with this sandbag on it for 6 hours." 
B) "You should increase your fluid intake to help clear the dye from your system." 
C) "Some patients have a delayed allergic reaction, so let me know if you have any hives or itching." 
D) "I'll be checking your vital signs frequently over the next few hours to make sure you're doing well after the test." 
E) "You won't be able to eat or drink anything for the next 4 hours to ensure your swallowing reflex has returned to normal."
F)"The health-care provider will talk to you about the test results and if you should change any of your seizure medications based on the results."

Question 12

A patient's laboratory results indicate a critical finding of highly elevated lactic acid level.The nurse should observe for which of the following signs and symptoms associated with this finding? Select all that apply.

Accepted Answer

A) Hyperactivity 
B) Elevated glucose level 
C) Kussmaul's breathing 
D) Hypertension 
E) Increased pulse rate

Question 13

The nurse is caring for a patient who recently returned from a ventilation/perfusion (V/Q)scan.Which of the following would be included in the patient's plan of care? Select all that apply.

Accepted Answer

A) Vital signs q 15 minutes *4 
B) Restrict fluid intake to 500 mL per shift 
C) Oxygen 2L NC prn to keep O2 saturation > 92% 
D) Instruct patient to flush toilet immediately after voiding * 24 hours 
E) Droplet precautions * 48 hours

Question 14

A nurse is preparing a patient to undergo a myocardial perfusion heart scan.The nurse understands that this scan is indicated for which of the following? Select all that apply.

Accepted Answer

A) Aid in the diagnosis of coronary artery disease 
B) Aid in the diagnosis of acute myocardial infarction when electrocardiogram and enzyme testing are inconclusive 
C) Evaluate bypass graft patency and general cardiac status after surgery 
D) Differentiate between a new and old myocardial infarction 
E) Determine rest defects and reperfusion with delayed imaging in unstable angina

Question 15

A patient is preparing to undergo LASIK surgery and needs to have the thickness of the cornea assessed.Which test would be appropriate for this purpose?

Accepted Answer

A) Pachymetry 
B) Parathyroid hormone (PTH) 
C) Activated partial thromboplastin time (aPTT) 
D) Parvovirus B19 immunoglobulin G and M antibodies

Question 16

A patient in her 30th week of gestation needs to undergo routine screening to detect risk for pre-eclampsia.Which test would be most appropriate for this purpose?

Accepted Answer

A) Protein C, blood 
B) Protein S, blood 
C) Total protein, urine 
D) Total protein, blood

Question 17

The nurse recognizes that abnormal results for a positron emission tomography (PET)scan of the heart would be noted for which of the following individuals? Select all that apply.

Accepted Answer

A) A 52-year-old with a suspected myocardial infarction 
B) A 61-year-old with chronic obstructive pulmonary disease 
C) A 68-year-old with Crohn's disease 
D) A 49-year-old with left-sided heart failure 
E) A 55-year-old with diabetes insipidus
F)A 76-year-old with coronary artery disease

Question 18

A nurse is providing discharge teaching to a patient following musculoskeletal magnetic resonance imaging with contrast medium.The nurse should instruct the patient to immediately notify the health-care provider of which of the following conditions? Select all that apply.

Accepted Answer

A) Chest pain 
B) Fast heart rate 
C) Difficulty breathing 
D) Edema at the IV puncture site 
E) Skin rash

Question 19

A patient is preparing to undergo positron emission tomography (PET)of the brain.The nurse is aware that this procedure has the greatest clinical impact in patients with which of the following conditions? Select all that apply.

Accepted Answer

A) Skull fracture 
B) Epilepsy 
C) Dementia 
D) Viral meningitis 
E) Parkinson's disease

Question 20

A nurse observes that a patient has a positive Chvostek's test and a serum calcium level of 6.8 mg/dL.Based on this information, for which clinical signs should the nurse assess? Select all that apply.

Accepted Answer

A) Confusion 
B) Hyporeflexia 
C) Muscle flaccidity 
D) Paresthesia 
E) Prolonged QT interval on EKG
F)Stridor

Exam 5: System Tables