Question 1

A nurse is helping prepare a patient for blood chromosome analysis for a suspected chromosomal disorder.The nurse observes that the patient presents with a catlike cry, microcephaly, and intellectual disability.Which of the following autosomal chromosome defects is most associated with these findings?

Accepted Answer

Cri du chat syndrome is caused by a deletion of the short arm of chromosome 5. The characteristic features include a high-pitched cry resembling a cat, microcephaly, and intellectual disability. Cystic fibrosis is an autosomal recessive disorder that affects the lungs and digestive system. Down syndrome is caused by a trisomy of chromosome 21, leading to intellectual disability and characteristic physical features. Tay-Sachs is an autosomal recessive disorder that affects the nervous system. None of these disorders are typically associated with a catlike cry, microcephaly, and intellectual disability.

Question 2

A patient has signs of acute pharyngitis and is suspected of having a streptococcal infection.Which test would be most appropriate for helping diagnose this condition?

Accepted Answer

The most appropriate test for diagnosing streptococcal infection in a patient with acute pharyngitis is a throat culture. This test involves swabbing the back of the throat to collect a sample of the bacteria, which can then be grown in a laboratory and tested for the presence of streptococcal bacteria. Stool culture, urine culture, and throat culture for fungi are not appropriate tests for diagnosing streptococcal pharyngitis.

Question 3

The nurse is caring for a patient who recently started taking amiodarone hydrochloride (Pacerone).Which of the following diagnostic tests would help determine the effectiveness of the treatment regimen?

Accepted Answer

An exercise stress test can help determine the effectiveness of amiodarone, which is used to treat arrhythmias, by assessing the heart's response to physical exertion and checking for improvements in heart rhythm.

Question 4

A nurse is preparing a patient for computed tomography (CT)of the pancreas.About 1 hour before the procedure, the nurse has the patient drink 450 mL of a dilute barium solution.Which of the following is the correct rationale for this intervention?

Accepted Answer

The dilute barium solution is used as a contrast agent to help distinguish gastrointestinal organs from other abdominal organs on the CT images.

Question 5

The nurse receives a report on several patients on a medical-surgical unit.Which of the following patients should the nurse see first?

Accepted Answer

Nausea and vomiting after a bronchoscopy could indicate complications such as bleeding or aspiration. This patient needs to be assessed immediately to prevent any further complications. The other patients' conditions are concerning, but they do not require immediate assessment compared to the patient reporting nausea and vomiting.

Question 6

The nurse is caring for a patient with diabetes who reports numbness and tingling in his right foot.The patient is scheduled for arterial plethysmography of both lower limbs.The patient asks the nurse, "Why are they testing both legs instead of just the one that hurts?" Which of the following responses by the nurse is best?

Accepted Answer

Arterial plethysmography is used to assess blood flow and detect changes in the arteries, such as blockages or narrowing, that can affect circulation. Testing both legs allows for comparison between the affected and unaffected leg to better understand the extent and nature of the vascular issues.

Question 7

The nurse is providing care for a woman undergoing laparoscopy to evaluate infertility.Which of the following statements by the nurse is best?

Accepted Answer

Option C is the best choice because it directly addresses the patient's immediate needs and concerns regarding the laparoscopy procedure. It is supportive, informative, and opens the door for the patient to express any uncertainties or seek clarification about what to expect, which is a key aspect of providing patient-centered care.

Question 8

A nurse is helping prepare a patient for blood chromosome analysis for a suspected chromosomal disorder.The nurse observes that the patient presents with epicanthal folds, a simian crease of the palm, a flat nasal bridge, and intellectual disability.Which of the following autosomal chromosome defects is most associated with these findings?

Accepted Answer

Down syndrome, also known as trisomy 21, is associated with intellectual disability and physical characteristics such as epicanthal folds, a simian crease of the palm, and a flat nasal bridge. Cystic fibrosis is an autosomal recessive disorder that affects the lungs and digestive system. Cri du chat is a rare genetic disorder caused by a deletion of a portion of chromosome 5. Tay-Sachs is a rare inherited disorder that progressively destroys nerve cells in the brain and spinal cord. None of these disorders are associated with the described physical characteristics in the patient.

Question 9

The nurse is caring for a patient with diabetic retinopathy.Which of the following procedures would best help determine the progression of the disease?

Accepted Answer

Fundus photography is a non-invasive procedure that captures images of the retina, which can help determine the extent and progression of diabetic retinopathy. This procedure can detect changes in blood vessels and identify any damage or abnormalities in the retina. Refraction test is used to determine the refractive error of the eye and is not specific to diabetic retinopathy. Positron emission tomography of the brain and otoscope examination are not relevant to the assessment of diabetic retinopathy.

Question 10

The nurse is completing a chart review of patients who received a proctosigmoidoscopy in the past 3 months.Which of the following findings would indicate a need for additional investigation?

Accepted Answer

The patient's history of colorectal cancer, current chemotherapy, and low platelet count indicate a need for further investigation as these factors may increase the risk of complications during and after the procedure. The other options are normal or expected findings.

Question 11

The nurse is caring for a 3-year-old child whose computed tomography of the abdomen revealed Wilms tumor.The nurse discovers the child's mother sitting in the lounge sobbing.Which of the following actions by the nurse is best?

Accepted Answer

The best action by the nurse in this situation is to provide emotional support to the mother. Going to sit next to the mother and placing a hand on her shoulder is a compassionate and empathetic response that acknowledges the mother's distress and provides comfort. It is important for nurses to be sensitive to the emotional needs of family members during a difficult time. Ignoring the mother (A) or directing her to a private parent lounge (C) does not provide emotional support. While it may be appropriate to ask if the mother needs assistance in contacting someone (D), providing immediate emotional support should be the first priority.

Question 12

The nurse is providing care for a 37-year-old woman who is scheduled for a thallium stress test.The woman asks, "I'm still breastfeeding my baby.Is that okay?" Which of the following responses by the nurse is best?

Accepted Answer

Thallium used in stress tests can be excreted into breast milk and potentially harm the infant. Pumping and discarding breast milk for at least 3 days after the test minimizes the risk of exposing the baby to thallium.

Question 13

Which statement by a 55-year-old female patient should a nurse identify as indicating a need for further education?

Accepted Answer

The statement "Now that I no longer have periods I don't need to have mammograms or do breast self-examinations" indicates a lack of understanding about the need for mammograms and breast self-examinations, particularly as women older than 50 are at an increased risk for breast cancer. The patient should be educated on the importance of continued screening and monitoring. The other options show that the patient has some understanding of breast health and screening practices.

Question 14

The nurse is providing care for a patient who is scheduled for a mediastinoscopy.Which of the following patient statements indicates the need for further teaching?

Accepted Answer

The correct statement that indicates a need for further teaching is C, as patients undergoing a mediastinoscopy typically do not need to stay flat on their back for 8 hours post-procedure. This is more characteristic of procedures involving the spinal column or certain types of cardiac interventions. Mediastinoscopy is a relatively less invasive procedure and usually allows for more mobility post-operation.

Question 15

A patient is suspected of having copper intoxication.Which of the following tests would be most appropriate for confirming this suspicion?

Accepted Answer

Ceruloplasmin is the most appropriate test to confirm copper intoxication suspicion. Ceruloplasmin is an enzyme that contains approximately 90% of the copper in plasma and is essential for the proper incorporation of copper into iron metabolism. Low ceruloplasmin levels are indicative of copper deficiency, while high levels are indicative of copper toxicity.

Question 16

The nurse is providing care for a patient who just returned from a barium enema and states, "I wish they would have told me what they found, I'm just so worried." Which of the following responses by the nurse is best?

Accepted Answer

This response shows empathy and allows the patient to express their concerns, fears, and feelings. It also opens up a dialogue where the nurse can address the patient's worries and provide them with education and support as needed.

Question 17

The nurse working in the oncology center would question the order for a stereotactic breast biopsy in which of the following individuals?

Accepted Answer

A stereotactic breast biopsy involves using X-rays to guide the biopsy needle to the suspicious area in the breast. It may not be appropriate for individuals with a bleeding disorder like hemophilia due to the risk of significant bleeding. The other options are appropriate for a stereotactic breast biopsy.

Question 18

The nurse is caring for a patient who is to undergo a proctosigmoidoscopy.Which of the following statement indicates that further patient teaching is needed?

Accepted Answer

The presence of gas after a proctosigmoidoscopy is normal due to air being introduced into the colon during the procedure. This does not typically require contacting a health-care provider, indicating a misunderstanding of post-procedure expectations.

Question 19

The nurse is caring for a patient who has returned from a liver and spleen scan.Results of the test read, "Greater uptake of radionuclide in the spleen than in the liver." Which of the following conclusions can the nurse draw from these results?

Accepted Answer

The greater uptake of radionuclide in the spleen than in the liver is suggestive of portal hypertension, which is a condition where there is increased pressure in the portal vein causing backup of blood flow into the spleen. This can be caused by several conditions such as liver cirrhosis, chronic hepatitis, or obstruction of the portal vein. Options A, B, and D are not suggested by the test results.

Question 20

The nurse is caring for a patient with a colostomy who is to undergo a barium enema.Which of the following statements by the nurse is best?

Accepted Answer

The correct statement is that the contrast for a barium enema in a patient with a colostomy will be inserted into the stoma using a catheter. This method allows for the examination of the colon via the stoma, accommodating the patient's altered anatomy.

Quiz 3: Reviewers