Question 1

A patient seeks medical evaluation due to frequent episodes of palpitations that interfere with sleep and daily activities.A Holter monitor is ordered.Which instruction should the nurse give to this patient regarding the monitor?

Accepted Answer

The patient's record of symptoms is crucial for correlating with the Holter monitor's recordings to accurately interpret the data and identify any arrhythmias or issues.

Question 2

A patient who is about 16 weeks into her first pregnancy is scheduled for blood to be drawn for alpha-fetoprotein (AFP).The patient asks a nurse the reason for this procedure.Which is the best response by the nurse?

Accepted Answer

The alpha-fetoprotein (AFP) test is a screening test that is used to monitor fetal development. It is not used to identify maternal abnormalities or suggest abortion. Additionally, it is not rare for the test results to be abnormal, as there are many factors that can affect the AFP levels. It is important for the patient to be informed that this is a routine test used in conjunction with other data to monitor fetal development.

Question 3

A nurse has just completed venipuncture on a patient and collected a plasma specimen for bilirubin testing.Which of the following special precautions should the nurse take when transporting this specimen to the laboratory?

Accepted Answer

Bilirubin is light-sensitive, so the nurse should protect the specimen from light during transport to prevent degradation. A and B are not necessary for transporting plasma specimens and C is not relevant for protecting bilirubin.

Question 4

A nurse performs an Allen test.By performing an Allen test, the nurse is preparing to perform a (an):

Accepted Answer

The Allen test is used to assess the patency of the ulnar artery, which is important information to know before performing an arterial blood gas (ABG) test. It helps to ensure that the ulnar artery can adequately supply blood to the hand in case the radial artery needs to be used for the ABG.

Question 5

A patient is instructed to prepare for a colonoscopy by drinking 4 liters of GoLYTELY after taking metoclopramide (Reglan)10 mg by mouth.A nurse should explain that the purpose of the metoclopramide is to:

Accepted Answer

The purpose of metoclopramide (Reglan) is to decrease the risk of nausea that can occur with the use of GoLYTELY for colonoscopy prep.

Question 6

A nurse assists a patient to collect a sputum specimen.The nurse examines the specimen and determines it is satisfactory for a culture based on the observation that the specimen is:

Accepted Answer

A satisfactory sputum specimen for culture should be thick, viscous, and yellow or green in color, indicating the presence of white blood cells and potential pathogens. A clear and watery specimen is not ideal, as it may indicate inadequate collection or contamination with saliva. A pink color is also not desired, as it may indicate the presence of blood from an unrelated source.

Question 7

A patient has been diagnosed with hemolytic anemia.The nurse is aware that this condition is associated with a deficiency in which vitamin?

Accepted Answer

Hemolytic anemia is associated with a deficiency in vitamin E, which is a fat-soluble antioxidant that helps protect red blood cells from oxidative damage. Vitamin C (A) and vitamin K (D) are not directly related to hemolytic anemia, while vitamin D (B) is primarily involved in bone health and calcium absorption.

Question 8

A nurse is instructing a patient who is scheduled for a colonoscopy on preparations for the procedure.Which medication should the patient discontinue at least 1 week prior to the colonoscopy?

Accepted Answer

Oral iron preparations may cause the colon to darken, making it difficult for the healthcare provider to view the colon during the colonoscopy. It is usually recommended to stop taking oral iron preparations at least one week prior to the procedure. The other options (A, B, and C) are not typically contraindicated for colonoscopy preparations.

Question 9

A patient's laboratory test results indicate congestive heart failure.Which of the following is a sign or symptom of this condition that the nurse should expect to observe in this patient?

Accepted Answer

Decreased peripheral pulses are a sign of congestive heart failure due to decreased cardiac output and poor perfusion to the extremities. Increased urinary output is not typically seen in congestive heart failure as the body tries to compensate by retaining fluid. Warm, dry skin may indicate adequate perfusion and hydration, which is not typical in congestive heart failure. Bradypnea is not a specific sign of congestive heart failure.

Question 10

A 26-year-old college student having a routine screening completed at an annual gynecological examination has a negative varicella antibody titer.Which evaluation by the nurse is appropriate for this patient?

Accepted Answer

The appropriate evaluation for a patient with a negative varicella antibody titer is to administer varicella vaccination if there is no chance of pregnancy, and the patient needs to avoid pregnancy for at least 1 month afterward. This will help to prevent the patient from contracting varicella in the future. Choice A is incorrect because a positive history of varicella infection in childhood does not necessarily indicate immunity. Choice B is incorrect because repeating the test in 7 to 14 days will not change the fact that the patient currently has a negative titer. Choice C is incorrect because a negative result does not confirm that there is no susceptibility to varicella.

Question 11

A patient diagnosed with heart failure has a B-type natriuretic peptide (BNP)level of 945 pg/mL upon admission to the hospital.At discharge, the patient's BNP is 435 pg/mL.Which discharge instruction should the nurse emphasize for this patient?

Accepted Answer

BNP is a hormone released by the heart in response to increased pressure and volume. A decrease in BNP level from admission to discharge indicates improvement in heart failure. Therefore, the nurse should emphasize the importance of monitoring weight daily and reporting weight gain immediately to detect any signs of fluid retention and prevent readmission. Option A is a good instruction to alleviate dyspnea, but it is not the priority. Option B is not recommended because bedrest can lead to further deconditioning and increase the risk of thromboembolism. Option D is not evidence-based, and there is no data to support the use of vitamins E and C in heart failure management.

Question 12

A nurse is assisting with tuning fork tests to assess for hearing loss in a patient.Which of the following would indicate conduction hearing loss?

Accepted Answer

The Bing test involves occluding the ear canal; if there is no change in sound loudness, it suggests conductive hearing loss.

Question 13

A patient is undergoing a bone biopsy in which a serrated needle is inserted into the bone to remove a plug of bone.The nurse understands that this type of biopsy is known as which of the following?

Accepted Answer

A serrated needle indicates that a core-needle biopsy is being performed, in which a plug of bone is removed from the bone through the needle. Fine-needle biopsy uses a thinner needle and removes only a small amount of tissue, while open biopsy and surgical biopsy involve making incisions to access and remove tissue.

Question 14

Which characteristic alterations in urinalysis should a nurse identify as a sign of improvement for a patient being treated for acute glomerulonephritis (AGN)?

Accepted Answer

Decreased specific gravity indicates that the kidneys are filtering properly, and only slight proteinuria suggests that there is minimal damage to the glomeruli. Hematuria may still be present but at a decreasing amount. Therefore, choice B is the best answer.

Question 15

A patient undergoing a bladder biopsy with cystoscopy has just been given general anesthesia.Which position should the nurse now place the patient in for the remainder of the procedure?

Accepted Answer

The lithotomy position is the appropriate position for a bladder biopsy with cystoscopy procedure as it provides optimal visualization and access to the bladder. This position involves placing the patient on their back with their legs raised, supported by stirrups. It allows the healthcare provider to easily access the patient's genital and rectal areas while maintaining a clear view of the bladder through the cystoscope.

Question 16

A patient reports sudden onset of pain in the orbital area with blurred vision and a "halo." Based on symptoms and the finding of fixed and dilated pupil upon physical examination by the HCP, the patient is diagnosed with acute angle closure glaucoma.The patient's intraocular pressure (IOP)is 31 mm Hg.Which intervention by a nurse is appropriate?

Accepted Answer

Acute angle closure glaucoma is a medical emergency and requires immediate attention. The nurse should initiate the facility's procedure for medical emergencies that require transfer of a patient to the nearest ER. This is the best choice as it addresses the urgent situation and ensures prompt care for the patient. Applying an eye patch or instructing the patient on administering eyedrops would not address the medical emergency, and providing information about glaucoma treatment can be done at a later time.

Question 17

A patient requiring frequent blood samples tells the nurse preparing to obtain a specimen that "the best vein is here in my right elbow on the side." The nurse observes that the vein is visible and palpable and has mild ecchymosis, but no pain.Which action by the nurse is most appropriate?

Accepted Answer

The nurse should examine the site the patient indicates and attempt to obtain the specimen there first since the vein is visible and palpable, and the patient is comfortable with the site. The mild ecchymosis is not a contraindication for venipuncture. If the attempt is unsuccessful, then the nurse can try other sites.

Question 18

A nurse is preparing to administer a tuberculin skin test to a patient who has never had this test before.What should the nurse have available before administering the tuberculin intradermally?

Accepted Answer

Epinephrine 1:1000 should be available in case of an allergic reaction or anaphylaxis after administering the tuberculin skin test.

Question 19

A patient visiting a prenatal clinic has a negative result for toxoplasma antibody.Based on this result, a nurse should identify a need for patient teaching when the patient's history indicates that the patient:

Accepted Answer

Toxoplasma gondii is a parasite that can be found in the feces of infected cats. Therefore, having multiple cats increases the risk of exposure and potential infection. The other choices are not directly related to an increased risk of toxoplasmosis.

Question 20

Which intervention should a nurse plan to decrease pain when collecting a blood specimen from a neonate?

Accepted Answer

The use of a pacifier sweetened with sucrose can be an effective non-pharmacological intervention to decrease pain associated with a blood specimen collection in neonates. This technique works by stimulating the infant's natural sucking reflex which has been shown to decrease the perception of pain. EMLA cream and an ice pack are not recommended in neonates due to concerns about local tissue damage and potential interference with test results. Acetaminophen is not recommended for pain management in neonates unless there is a medical indication due to the potential risk of adverse effects.

Quiz 2: Preface