Question 1

The nurse is caring for a patient with serum magnesium = 1.1 mg/dL.Which of the following should be included in the patient's plan of care?

Accepted Answer

A) Limit intake of magnesium-containing foods. 
B) Monitor for ECG (electrocardiographic)changes. 
C) Maintain bedrest. 
D) Strain all urine.

Question 2

The nurse is providing care for a woman who recently gave birth to a full-term baby girl.The woman tells the nurse she is worried because her son had elevated bilirubin levels as an infant and had to be in an incubator with special lights.Which of the following statements by the nurse is best?

Accepted Answer

A) "Babies are often a little jaundice when they're born; I'm sure the doctor will order labs if you ask him to." 
B) "It's normal to be worried.Bilirubin levels are usually down to normal by the time the baby is 10 days old.It will be important to call the doctor if she seems lethargic or more jaundiced." 
C) "I'll bet your little guy is really excited to have a new baby sister at home." 
D) "Do you want me to give you directions to the outpatient lab so you can have her blood checked?"

Question 3

The nurse is caring for a patient who complains of morning stiffness with deforming arthritis of both hands and radiographic changes noted on x-ray.Which of the following would the nurse expect to find in the chart?

Accepted Answer

A) Elevated rheumatoid factor 
B) Decreased magnesium level 
C) Elevated reticulocyte count 
D) Presence of Bence-Jones proteins

Question 4

The nurse working in a health-care provider's office has just completed collection of a specimen for cold agglutinin titer.Which of the following actions should the nurse take next?

Accepted Answer

A) Refrigerate the specimen until laboratory comes for routine pickup. 
B) Place the specimen on an ice bath and call for immediate pickup. 
C) Leave the specimen at room temperature and arrange for delivery to the laboratory as quickly as possible. 
D) Refrigerate the specimen for 24 hours prior to delivery to the laboratory.

Question 5

The nurse is counseling a patient whose lab tests include intrinsic factor.The patient's response to which of the following questions should be documented to ensure accurate test results?

Accepted Answer

A) "Have you been fasting for the past 4 hours?" 
B) "Have you had any vitamin B12 in the past 2 days?" 
C) "When was your last menstrual cycle?" 
D) "What is your current weight?"

Question 6

A nurse is giving pre-test instructions to a patient who will be undergoing transabdominal bladder ultrasound.Which of the of the following should the nurse tell the patient? Select all that apply.

Accepted Answer

A) Refrain from eating 8 hours before the procedure. 
B) Drink three to four glasses of fluid 90 minutes before the procedure. 
C) Void immediately before the procedure. 
D) Remove all external metallic objects from the area to be examined. 
E) Discontinue all medications, as ordered, 12 hours before the procedure.

Question 7

A neighbor's daughter has recently decided to become a vegetarian.The neighbor tells the nurse, "I told my daughter she would have to take megavitamins to make up for anything she isn't getting on her crazy new diet." Which of the following responses by the nurse is best?

Accepted Answer

A) "It is possible to take too many vitamins, so you should probably consult a nutritionist." 
B) "That is a good idea since a well-rounded diet is important in growing children." 
C) "Vegetarian diets are really popular right now, so this is probably just a fad." 
D) "Why did she decide to change her diet?"

Question 8

A nurse is observing as an ultrasonographer images a patient's abdomen.The image seems obstructed and difficult to interpret.Which of the following factors might be impairing image quality? Select all that apply.

Accepted Answer

A) Food in the digestive tract 
B) Attenuation of the sound waves by the ribs 
C) Incorrect placement of the transducer 
D) Smoking before the procedure 
E) Metallic objects within the examination field

Question 9

A nurse is assessing a patient for suitability to undergo slit-lamp biomicroscopy with pupil dilation.Which of the following would be a contraindication for undergoing this test?

Accepted Answer

A) Cataracts 
B) Blepharitis 
C) Narrow-angle glaucoma 
D) Conjunctivitis

Question 10

The nurse is caring for a woman who is awaiting estradiol results as part of a fertility work-up.The patient states, "I keep hoping there is some easy fix so we can have a baby soon." Which of the following statements by the nurse is best?

Accepted Answer

A) "Sometimes we simply have to accept what we cannot control." 
B) "I imagine this is very hard.How are you and your husband coping with the strain?" 
C) "Are you hoping most for a girl or a boy?" 
D) "Have you and your husband discussed adoption?"

Question 11

The nurse is making follow-up phone calls.An individual with suspected mononucleosis has lab values that are negative for Epstein-Barr virus.Which of the following statements by the nurse is best?

Accepted Answer

A) "Your lab values indicate you have mononucleosis, so be sure to rest and get plenty of liquids." 
B) "Labs indicate you do not have mononucleosis.How are you feeling now?" 
C) "The antibiotics must be working, because the titers are negative." 
D) "You have mononucleosis, but you are not infectious anymore, so you may return to school."

Question 12

The nurse in the employee health department of the hospital is performing pre-employment tuberculosis screening via Mantoux testing.A future employee has a 4 mm wheal at the site of injection.Which of the following statements by the nurse is best?

Accepted Answer

A) "You will need to see your family health-care provider immediately to schedule a bronchoscopy." 
B) "This is considered a negative result." 
C) "This is considered a positive result, so you will not be able to care for patients." 
D) "We do not hire anyone with suspicious testing, so you will need to seek employment elsewhere."

Question 13

A nurse is providing instructions to a patient who is preparing to undergo bone radiography.Which of the following should the nurse recommend for the purpose of ensuring clear imaging? Select all that apply.

Accepted Answer

A) Advise the patient to not eat for 8 hours before the procedure. 
B) Instruct the patient to remove jewelry and other metallic objects from the area to be examined. 
C) Ask the patient to inhale deeply and hold his or her breath while the x-ray images are taken. 
D) Tell the client to avoid smoking for 4 hours before the procedure. 
E) Ask the patient to remain still throughout the procedure.

Question 14

A nurse is assisting as a physician performs transesophageal echocardiography (TEE)on a patient.The nurse should recognize that which of the following is a critical finding that should be communicated to the requesting health-care provider immediately?

Accepted Answer

A) Congenital heart defect 
B) Pulmonary hypertension 
C) Aortic aneurysm 
D) Ventricular hypertrophy

Question 15

The nurse is caring for a primigravida who is in for an initial prenatal visit.The patient asks, "Why do they want to draw blood for blood typing?" Which of the following response by the nurse is best?

Accepted Answer

A) "It is important for us to know your blood type in case you lose blood during delivery." 
B) "Knowing your blood type will tell us the baby's blood type." 
C) "Blood type is routinely done on your first visit so we can know if there is any risk that you could develop antibodies to the baby's blood." 
D) "We do a lot of tests early in your pregnancy, and we try to run everything we might need all at once so you don't have to be stuck again."

Question 16

An abdominal ultrasound procedure indicates that a patient has an aortic aneurysm.An aneurysm of what minimum diameter should be immediately reported to the requesting health-care provider as a critical finding?

Accepted Answer

A) 3 cm 
B) 5 cm 
C) 7 cm 
D) 9 cm

Question 17

The nurse is counseling a young woman who is hoping to become pregnant.Which of the following recommendations by the nurse is best?

Accepted Answer

A) "It will be important for you to get the flu vaccine once you find out you're pregnant." 
B) "Your childhood immunizations should provide all the immunity you need, so there is no reason for concern." 
C) "Because rubella can be harmful to an unborn baby, it is important to determine your immunity prior to or early in your pregnancy." 
D) "We generally only give live vaccines to pregnant women and infants."

Question 18

While caring for a patient in the intensive care unit, the nurse is concerned about the patient's kidney function.In order to estimate a glomerular filtration rate (eGFR), the nurse would need which of the following?

Accepted Answer

A) A current weight and height 
B) A total protein value 
C) A serum creatinine result 
D) A serum blood urea nitrogen result

Question 19

A nurse is assisting with a venous Doppler ultrasound study of the extremities.Which finding should the nurse recognize as critical and report to the requesting health-care provider immediately?

Accepted Answer

A) Deep vein thrombosis 
B) Chronic venous insufficiency 
C) Primary varicose veins 
D) Peripheral vascular disease

Question 20

A patient is suspected of having peripheral nerve damage secondary to advanced diabetes mellitus.Which test would be most appropriate for confirming this diagnosis?

Accepted Answer

A) Sinus endoscopy 
B) Electroneurography 
C) Esophageal manometry 
D) Esophagogastroduodenoscopy

Exam 4: Monographs