Question 1

A nurse is assessing a patient for potential contraindications to a scheduled fluorescein angiography procedure with pupil dilation.Which of the following findings, if present, should prompt the nurse to immediately notify the health-care provider to cancel the procedure?

Accepted Answer

A) Diabetic neuropathy 
B) Narrow-angle glaucoma 
C) Macular degeneration 
D) Arterial occlusion

Question 2

A patient is suspected of having disseminated intravascular coagulation (DIC).The nurse is aware that two different tests-D-dimer and fibrinogen degradation products (FDP)-can be used to differentiate and treat suspected cases of fibrinolysis.Which of the following test results would be consistent with a diagnosis of DIC?

Accepted Answer

A) Normal FDP and increased D-dimer 
B) Increased FDP and normal D-dimer 
C) Increased FDP and increased D-dimer 
D) Decreased FDP and increased D-dimer

Question 3

A nurse is assessing a patient for suitability to undergo radiofrequency ablation (RFA)of the liver.Which of the following conditions would be contraindications for this procedure in this patient? Select all that apply.

Accepted Answer

A) Tumors less than 2 inches in diameter 
B) Chronic dehydration 
C) Renal failure 
D) Tumors that have recurred after initial surgery 
E) Significant extrahepatic disease

Question 4

The nurse is collecting a cold agglutinin titer on a patient recently admitted for pneumonia who is not responding well to antibiotics.The patient's wife asks what the test will do.Which of the following responses by the nurse is best?

Accepted Answer

A) "The test will help determine why your husband's fever is staying so high." 
B) "The test helps identify your husband's resistance to current drug therapy." 
C) "The test is designed to detect proteins around the red blood cells resulting from an autoimmune process." 
D) "The test is used to identify atypical pneumonias that don't respond quickly to standard antibiotic treatments."

Question 5

The nurse is caring for a patient who takes a loop diuretic and supplemental potassium.Follow-up lab results indicate the patient's potassium is 4.8 mEq/L.Which of the following statements by the nurse is best?

Accepted Answer

A) "You should stop taking your potassium supplement." 
B) "The doctor will probably reduce the dose of your diuretic." 
C) "It will be important for you to increase the number of bananas you eat." 
D) "Your lab values are right where we want them, so keep doing what you're doing."

Question 6

A nurse is assessing a patient for suitability to undergo an upper gastrointestinal (GI)and small bowel series.Which of the following conditions would make this procedure contraindicated for this patient? Select all that apply.

Accepted Answer

A) Age of 2 months 
B) Pregnancy 
C) Upper GI perforation 
D) Gastroesophageal reflux (GER) 
E) Chronic dehydration in an elderly patient

Question 7

The nurse is working with a nursing student in the care of an individual with colorectal cancer.The student asks, "Why did the health-care provider order plasminogen labs?" Which of the following is the best response?

Accepted Answer

A) "Plasminogen serves as a tumor marker in colorectal cancer." 
B) "People with colorectal cancer can be at increased risk for disseminated intravascular coagulation." 
C) "I think the health-care provider may need to provide a blood transfusion in the future." 
D) "This patient is on Coumadin, and the health-care provider is following labs to ensure effective treatment."

Question 8

A nurse working in the psychiatric unit is providing care for a young woman diagnosed with anorexia nervosa.The woman's uric acid level is 9.4 mg/dL.Based on this result, which of the following statements by the nurse is best?

Accepted Answer

A) "You need to eat things that have a high vitamin C level to help promote healing." 
B) "Your labs indicate tissue is being destroyed because you are starving your body." 
C) "It is important that you increase your intake of iron-rich foods since your body is not making enough red blood cells." 
D) "You are dehydrated, so the doctor may want to order IV fluids if you don't start drinking at least 1,000 mL each day."

Question 9

The nurse is scheduling follow-up labs ordered by the health-care provider that include lipoprotein electrophoresis.The patient asks, "Why do I have to have more blood drawn?" Which of the following findings would indicate the need for this additional testing?

Accepted Answer

A) Cholesterol level indicates high risk for cardiac arterial disease. 
B) Lipase level indicates a high risk for pancreatitis. 
C) LDH level indicates a high risk for hepatitis. 
D) Alkaline phosphatase level indicates a high risk for muscular dystrophy.

Question 10

The nurse is caring for a patient who reports unilateral leg swelling and discomfort one day after a total abdominal hysterectomy.D-dimer results are elevated and the patient has an order for a venous ultrasound.Which of the following statements by the nurse is best?

Accepted Answer

A) "Don't worry; it is probably just because of the IV fluids." 
B) "Do you have a history of congestive heart failure?" 
C) "Surgery increases the risk of blood clot formation, so these tests will help confirm that suspicion." 
D) "It is important that you walk in the hall at least four times today to get your circulation moving."

Question 11

A patient's laboratory test results indicate the presence of fetal fibronectin.This finding is indicative of which of the following?

Accepted Answer

A) Gestational diabetes 
B) Fetal Down syndrome 
C) Neural tube defect 
D) Premature labor

Question 12

A woman is brought to the emergency room having been found in her car in a closed garage; attempted suicide via carbon monoxide poisoning is suspected.Which of the following labs would be useful in confirming this diagnosis?

Accepted Answer

A) Microalbumin 
B) Kleihauer-Betke testing 
C) Methemoglobin 
D) Metanepherines

Question 13

The nurse is providing care for an individual whose laboratory test for renin was 6 ng/mL/hr.Which of the following explanations by the nurse is best?

Accepted Answer

A) "Renin is an enzyme produced by your pancreas that helps digest your food; your value is very low, which may be why you aren't absorbing nutrients well." 
B) "Renin is the protein produced naturally that helps control blood pressure.You have an elevated level, which may be the cause of your hypertension." 
C) "Renin is often secreted by tumor cells and is used as a tumor marker in some types of cancer; your value is normal, so there is nothing to worry about." 
D) "Renin is a byproduct of anaerobic metabolism; your level is low, indicating you are experiencing starvation-type catabolism due to your overly restrictive diet."

Question 14

A newborn's laboratory test results indicate decreased production of the hormone thyroxine.This finding is consistent with which of the following conditions?

Accepted Answer

A) Congenital adrenal hyperplasia 
B) Sickle cell disease 
C) Congenital hypothyroidism 
D) Cystic fibrosis

Question 15

While undergoing an exercise stress test, a patient complains of acute pain and cramping in the leg.Which condition should the nurse most suspect in this patient?

Accepted Answer

A) Dysrhythmia 
B) Coronary artery disease 
C) Peripheral artery disease 
D) Tachycardia

Question 16

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

Accepted Answer

A) Renin 
B) Reticulocyte count 
C) Red blood cell (RB
C) cholinesterase 
D) Rheumatoid factor (RF)

Question 17

A nurse is providing pre-test instructions to a patient who will be undergoing liver and biliary system ultrasound.The nurse should tell the patient to fast and restrict fluids for how many hours prior to the procedure?

Accepted Answer

A) 6 hours 
B) 8 hours 
C) 10 hours 
D) 12 hours

Question 18

A nurse observes that a patient's stool specimen is black.Which of the following is the most likely explanation for this finding?

Accepted Answer

A) Iron therapy 
B) Bile duct obstruction 
C) Antibiotics 
D) Lower gastrointestinal bleeding

Question 19

The nurse is caring for an individual who states, "I've been struggling with my weight my entire life, so I guess I shouldn't be surprised I have diabetes." Which of the following actions by the nurse is best?

Accepted Answer

A) Share the nurses' personal struggles with weight management. 
B) Sit quietly and encourage the patient to verbalize her feelings. 
C) Ask the patient what she wants to eat for dinner. 
D) Inform the patient that the dietician will be available later that afternoon.

Question 20

A nurse is providing pre-test instructions to a patient who is preparing to undergo breast ultrasonography.Which of the following should the nurse tell the patient? Select all that apply.

Accepted Answer

A) Drink three to four glasses of fluid 90 minutes before the procedure. 
B) Do not apply lotions or deodorant to the chest and breast area before the examination. 
C) Remove jewelry and other metallic objects from the area to be examined. 
D) Do not void before the procedure. 
E) Avoid strenuous exercise for 12 hours before the procedure.

Exam 4: Monographs