Question 1

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

Accepted Answer

Rubella is a disease that can cause severe birth defects if contracted during pregnancy. It is recommended that women determine their immunity to rubella prior to or early in pregnancy to minimize the risk of harm to the unborn baby. Therefore, option C is the best choice. Option A is partially correct as getting the flu vaccine is important during pregnancy, but it is not as crucial as determining immunity to rubella. Option B is incorrect as childhood immunizations may not provide adequate immunity throughout a person's lifetime. Option D is also incorrect as live vaccines are generally avoided during pregnancy due to concerns about safety.

Question 2

The nurse is providing care for a patient with a history of kidney stones.In addition to urine oxalate, which of the following labs would the nurse expect to be requested in the orders?
A)Urine protein
B)Urine calcium
C)Serum sodium
D)Serum alkaline phosphatase

Accepted Answer

Studies have shown that high levels of calcium in the urine increase the risk of kidney stones. Therefore, it is common to measure urine calcium levels in patients with a history of kidney stones. None of the other choices are directly related to kidney stone formation.

Question 3

The nurse is counseling a young woman whose syphilis serology is positive.The patient states, "I just can't believe this is happening to me." Which of the following statements by the nurse is best?
A)"Unprotected sex is definitely risky behavior.It's too bad this is the consequence."
B)"Why is this so hard for you to believe?"
C)"This is really frightening, but life's trials happen for a reason, and you'll get through it."
D)"You must be overwhelmed right now.That is a normal reaction to devastating news."

Accepted Answer

The best choice is D because it validates the patient's emotions and normalizes her reaction to the news. It is important to empathize with the patient and make her feel heard and supported. Option A could be perceived as blaming the patient and may make her feel judged. Option B is confrontational and insensitive. Option C has a dismissive tone and may be inappropriate for the situation.

Question 4

A patient is suspected of having disseminated intravascular coagulation (DIC).Which test would be most appropriate for confirming this suspicion?
A)Fibrinogen
B)Folate
C)Follicle-stimulating hormone (FSH)
D)Fructosamine

Accepted Answer

Fibrinogen is a clotting factor and decreased levels indicate that clotting factors are being consumed in the process of forming clots, which is a characteristic of DIC. Other tests may not be as specific for diagnosing DIC.

Question 5

A patient is suspected of having gastric ulcers.Which test would be most appropriate for confirming this diagnosis?
A)Sinus endoscopy
B)Electroneurography
C)Esophageal manometry
D)Esophagogastroduodenoscopy

Accepted Answer

Esophagogastroduodenoscopy is the most appropriate test for confirming a diagnosis of gastric ulcer. It involves the insertion of a flexible tube with a camera at the end through the mouth and down into the stomach and duodenum to examine the gastrointestinal tract for any abnormalities or signs of ulcers.

Question 6

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

Accepted Answer

Methemoglobin levels would be elevated in cases of carbon monoxide poisoning.

Question 7

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?
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."

Accepted Answer

The patient's symptoms and elevated D-dimer levels suggest a possible blood clot, which is a known complication of surgery. The venous ultrasound is ordered to confirm this suspicion and guide further treatment. It is important for the nurse to educate the patient about this potential complication in order to promote patient understanding and compliance with treatment recommendations. The nurse should also encourage the patient to follow any mobility or activity recommendations made by the healthcare provider in order to promote circulation and prevent clot formation. However, statement A is incorrect because unilateral leg swelling and discomfort are not typically caused by IV fluids alone. Statement B is also incorrect because the presence or absence of CHF is not directly relevant to the patient's symptoms or potential diagnosis. Statement D is partially correct in that mobility and activity are important interventions for preventing blood clots, but the focus should be on following specific recommendations made by the healthcare provider, rather than a specific number of laps around the hall.

Question 8

A nurse is performing a biophysical profile (BPP)of a fetus with ultrasound.The findings include the following: no movement-associated fetal heart rate (FHR)accelerations of 15 or more beats/minute above baseline in a 20-minute interval; two breathing movements lasting 20 to 60 seconds in a 30-minute interval; one discrete body or limb movement in a 30-minute interval; absent movement in limbs; and no pockets of fluid in the vertical axis.Which score should the nurse assign to the fetus?
A)0
B)2
C)4
D)6

Accepted Answer

The correct score is 2. The fetus has two breathing movements, one discrete body or limb movement, and no pockets of fluid in the vertical axis.

Question 9

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?
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."

Accepted Answer

Blood typing is routinely done on the first prenatal visit to determine if the patient has any risk of developing antibodies to the baby's blood. This is important because if the mother has Rh-negative blood and the baby has Rh-positive blood, there is a risk of the mother producing antibodies that could harm the baby. Knowing the blood type allows the healthcare provider to take preventive measures, such as administering Rh immunoglobulin.

Question 10

The nurse is providing care for a woman with extensive stage IV decubitus ulcers.In conferring with the dietician regarding supplemental nutrition, the nurse would be most concerned by which of the following?
A)Folate = 14.2 ng/mL
B)Total protein = 3.4 g/dL
C)Alkaline phosphatase = 42 U/L
D)Hemoglobin = 36 g/dL

Accepted Answer

Total protein levels are crucial for wound healing. A level of 3.4 g/dL is significantly low (normal range is approximately 6.4 to 8.3 g/dL), indicating malnutrition or malabsorption, which can severely impact the healing process of extensive stage IV decubitus ulcers.

Question 11

The nurse is reviewing laboratory values for a patient with celiac disease and notes a vitamin D-25-dihydroxy level of 18 ng/mL.To help promote sufficient dietary intake, the nurse informs the patient that primary dietary sources of vitamin D include:
A)Bran cereal
B)Whole wheat bread
C)Milk
D)Dried fruit

Accepted Answer

Milk is a primary dietary source of vitamin D. Bran cereal, whole wheat bread, and dried fruit do not contain significant amounts of vitamin D.

Question 12

The nurse is drawing specimens from a central venous access device.Specimens include a red-top tube for clot retraction.Which of the following actions should the nurse take to ensure accurate results?
A)Note the patient's gender on the lab slip.
B)Place the specimen in a warm water bath.
C)Place the specimen on ice.
D)Ensure specimen delivery within an hour of collection time.

Accepted Answer

Ensuring specimen delivery within an hour of collection time is crucial for accurate results, especially for tests like clot retraction, as prolonged time before analysis can affect the integrity of the sample and lead to inaccurate results. Options A, B, and C do not directly impact the accuracy of clot retraction test results.

Question 13

A patient's laboratory test results indicate acute rubella infection, with the presence of immunoglobulin M (IgM)antibodies.The patient is currently asymptomatic.The nurse should tell the patient to expect which of the following symptoms?
A)A pink, macular rash and fever
B)Nausea, vomiting, and diarrhea
C)Red papules and headache
D)Dizziness and abdominal cramping

Accepted Answer

Acute rubella infection typically presents with a rash (pink, macular) and fever. Nausea, vomiting, and diarrhea, red papules, headache, dizziness, and abdominal cramping are not typical symptoms of rubella.

Question 14

The nurse is providing care for an individual who has received a heart transplant.The patient is taking cyclosporine, which is due at 9:00 a.m.and has orders for cyclosporine levels to be drawn around the dose.Which of the following times should the laboratory test be collected?
A)At 12 noon
B)At 6:00 a.m.with routine a.m.labs
C)At 8:45 a.m.
D)At 9:00 a.m.the next day

Accepted Answer

The laboratory test for cyclosporine levels should be collected around the time of the dose, which is at 9:00 a.m. Therefore, option C (at 8:45 a.m.) is the best choice as it is closest to the time the medication is due to be given. Collecting the sample at 12 noon (option A) will not be ideal as it is already far off from the scheduled time for the medication. Option B suggests collecting the sample at 6:00 a.m. with routine morning labs, which is not close to the time the medication is being given, and hence not the ideal time to draw the test. Option D, collecting the test at 9:00 a.m. the next day, would miss the opportunity to measure the drug level at the optimal time, hence not the best choice.

Question 15

A nurse is administering the radionuclide iodine-123 (I-123)to a patient who is undergoing radioactive iodine uptake testing.How is the nurse to administer this contrast medium?
A)Orally, as a pill
B)Intravenously
C)Rectally, as an enema
D)By inhalation of a gas

Accepted Answer

Radionuclide iodine-123 is typically administered orally as a pill for radioactive iodine uptake testing. Intravenous, rectal, or inhalation routes are not indicated for this procedure.

Question 16

The nurse is providing care for a 68-year-old male whose prostate-specific antigen is 23 ng/mL.Which of the following statements by the nurse is best?
A)"Everything looks normal with your labs, so yearly follow-up is all you'll need."
B)"Do you have a history of colon cancer in your family?"
C)"The lab work is abnormal, so your health-care provider would like to schedule some additional testing."
D)"I will need a list of all medications and herbal substances taken routinely to help determine the significance of your lab values."

Accepted Answer

A prostate-specific antigen (PSA) level of 23 ng/mL is considered significantly elevated and may indicate prostate cancer or other prostate-related conditions. Therefore, the nurse should inform the patient that the lab work is abnormal and the healthcare provider would like to schedule additional testing to further evaluate the PSA level. Option A is incorrect as it overlooks the significance of the elevated PSA level. Option B is not relevant to the situation. Option D is important but not the best response to the situation presented.

Question 17

A patient has trouble swallowing and is suspected of having scleroderma.Which test would be most appropriate for confirming this diagnosis?
A)Sinus endoscopy
B)Electroneurography
C)Esophageal manometry
D)Esophagogastroduodenoscopy

Accepted Answer

Scleroderma commonly affects the esophagus and can cause difficulty in swallowing. Esophageal manometry is a test used to assess the motility and function of the esophagus and is commonly used to diagnose scleroderma-related esophageal dysfunction. The other tests listed are not as relevant in confirming this particular diagnosis.

Question 18

The nurse in a pediatrician's office is caring for a child with suspected fifth disease.Which of the following viral titers would the nurse recognize as most helpful in confirming this diagnosis?
A)Epstein Barr
B)Herpes simplex-1
C)Parvovirus B19
D)HIV

Accepted Answer

Parvovirus B19 is the virus that causes fifth disease, so a positive viral titer for this specific virus would confirm the diagnosis. The other viral titers listed are not associated with fifth disease.

Question 19

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?
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."

Accepted Answer

Renin is a protein that is naturally produced in the body and helps control blood pressure. An elevated level of renin may indicate hypertension. None of the other explanations are accurate or relevant to a renin laboratory value.

Question 20

The nurse caring for a patient who is taking Coumadin (warfarin)recognizes that treatment is effective based on which of the following lab results? A)Platelet count = 160,000/mm³ B)Prothrombin time (PT)= 18 seconds C)Potassium = 3.5 mEq/L D)Partial thromboplastin time (aPTT)= 28 seconds

Accepted Answer

Coumadin (warfarin) is an anticoagulant medication that works by inhibiting the production of vitamin K-dependent clotting factors (such as prothrombin) in the liver. Monitoring the PT is a common way to assess the effectiveness and safety of Coumadin therapy. The therapeutic range for PT with Coumadin is typically between 2.0 and 3.0 times the normal range (with 1.0 being the normal range). A PT of 18 seconds falls within this therapeutic range and indicates that the patient's coagulation time is appropriate for their medical condition. Platelet count, potassium, and aPTT are not directly affected by Coumadin therapy and are not reliable indicators of its effectiveness.

Quiz 4: Monographs

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

The nurse is providing care for a patient with a history of kidney stones.In addition to urine oxalate, which of the following labs would the nurse expect to be requested in the orders?

The nurse is counseling a young woman whose syphilis serology is positive.The patient states, "I just can't believe this is happening to me." Which of the following statements by the nurse is best?

A patient is suspected of having disseminated intravascular coagulation (DIC) .Which test would be most appropriate for confirming this suspicion?

A patient is suspected of having gastric ulcers.Which test would be most appropriate for confirming this diagnosis?

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?

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?

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?

The nurse is providing care for a woman with extensive stage IV decubitus ulcers.In conferring with the dietician regarding supplemental nutrition, the nurse would be most concerned by which of the following?

The nurse is reviewing laboratory values for a patient with celiac disease and notes a vitamin D-25-dihydroxy level of 18 ng/mL.To help promote sufficient dietary intake, the nurse informs the patient that primary dietary sources of vitamin D include:

The nurse is drawing specimens from a central venous access device.Specimens include a red-top tube for clot retraction.Which of the following actions should the nurse take to ensure accurate results?

A patient's laboratory test results indicate acute rubella infection, with the presence of immunoglobulin M (IgM) antibodies.The patient is currently asymptomatic.The nurse should tell the patient to expect which of the following symptoms?

The nurse is providing care for an individual who has received a heart transplant.The patient is taking cyclosporine, which is due at 9:00 a.m.and has orders for cyclosporine levels to be drawn around the dose.Which of the following times should the laboratory test be collected?

A nurse is administering the radionuclide iodine-123 (I-123) to a patient who is undergoing radioactive iodine uptake testing.How is the nurse to administer this contrast medium?

The nurse is providing care for a 68-year-old male whose prostate-specific antigen is 23 ng/mL.Which of the following statements by the nurse is best?

A patient has trouble swallowing and is suspected of having scleroderma.Which test would be most appropriate for confirming this diagnosis?

The nurse in a pediatrician's office is caring for a child with suspected fifth disease.Which of the following viral titers would the nurse recognize as most helpful in confirming this diagnosis?

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?

The nurse caring for a patient who is taking Coumadin (warfarin) recognizes that treatment is effective based on which of the following lab results?