Question 1

A patient recently underwent kidney transplantation and needs to undergo testing to ensure that the medication he is on to prevent organ rejection does not reach toxic levels.Which test would be most appropriate for this purpose?

Accepted Answer

The immunosuppressant cyclosporine is the medication typically used to prevent organ rejection after transplantation. Therefore, measuring the levels of cyclosporine in the patient's blood would be the most appropriate test to ensure that the medication is not reaching toxic levels.

Question 2

A patient's laboratory test results are negative for D-dimers.However, the health-care provider is concerned that an interfering factor may be skewing the results of this test.Which of the following factors could cause a false-negative result in this case?

Accepted Answer

Warfarin can cause a false-negative result in a D-dimer test because it affects the coagulation pathway, potentially leading to lower levels of D-dimers than would be present if a clot were forming without the influence of anticoagulation therapy.

Question 3

A patient has an elevated aldolase level.This finding would be consistent with which of the following conditions?

Accepted Answer

An elevated aldolase level is commonly seen in patients with muscular dystrophy, specifically in Duchenne's muscular dystrophy due to the breakdown of muscle tissue. Cushing's disease is associated with elevated cortisol levels, dehydration with increased sodium concentrations and kidney disease with elevated creatinine levels.

Question 4

An adolescent patient is admitted to a hospital with hypotension and tachycardia.The patient's laboratory results include a serum potassium level of 1.9 mEq/L.Which question should a nurse ask to identify possible causes for this clinical presentation?

Accepted Answer

Low serum potassium levels can be associated with conditions such as bulimia or anorexia, which are related to body image and weight satisfaction issues. Asking about satisfaction with current weight can help identify if an eating disorder might be contributing to the electrolyte imbalance.

Question 5

A patient who is preparing to undergo a blood transfusion is suspected of having an immunoglobulin deficiency that could result in anaphylaxis when the blood is transfused.Which test would be most appropriate for confirming this suspicion?

Accepted Answer

The most appropriate test for confirming a suspicion of an immunoglobulin deficiency that could result in anaphylaxis during a blood transfusion is testing for Immunoglobulin A (IgA) deficiency. IgA deficiency is the most common immunoglobulin deficiency and can lead to severe allergic reactions when IgA is present in the transfused blood but absent or very low in the recipient.

Question 6

The nurse is caring for a patient who is recovering from a ventral hernia repair and has developed a fever.New orders have been given to obtain a sputum culture.Which of the following actions should the nurse take before collecting the specimen?

Accepted Answer

Before collecting a sputum culture, the nurse should assist the patient in performing oral hygiene to decrease the risk of contamination from bacteria that are normally present in the mouth. The other options are not necessary for collecting a sputum culture in this situation. Isolation precautions would only be necessary if the patient had a highly contagious infection. A clean specimen cup would be obtained by standard protocol for any specimen collection, and visitors wearing masks would only be necessary if the patient had a highly contagious respiratory infection.

Question 7

A nurse notes that a patient has tested positive for Helicobacter pylori (H.pylori)antibody, a finding that may reflect the presence of peptic ulcer disease.In response to this finding, the nurse should assess the patient for related manifestations, such as:

Accepted Answer

Gastric burning after meals and occult blood in the stool are both commonly associated with peptic ulcer disease, which can be caused by H. pylori infection. Choices A, B, and D are not typical manifestations of H. pylori or peptic ulcer disease.

Question 8

A 42-year-old patient, with no history of smoking, reports increasing dyspnea with cough and is diagnosed with chronic obstructive pulmonary disease (COPD).Laboratory results show that the patient has a decreased $\alpha$1-antitrypsin level ($\alpha$1AT).When planning care for this patient, which instruction should the nurse provide?

Accepted Answer

The answer of A 42-year-old patient, with no history of...

Question 9

A patient is undergoing venipuncture for collection of a blood sample for apolipoprotein testing.Which condition is this type of testing most useful in identifying?

Accepted Answer

Apolipoproteins are proteins that help transport lipids (fats) through the bloodstream. Certain types of apolipoproteins have been linked to an increased risk of coronary artery disease, making apolipoprotein testing useful in identifying this condition.

Question 10

A pediatric nurse is caring for a 9-month-old who is febrile, spitting up after feedings, and has had diarrhea for 2 days.The laboratory results show increased hemoglobin, hematocrit, and blood urea nitrogen.Urine-specific gravity is increased as well.Which clinical observation by the nurse correlates with this presentation?

Accepted Answer

The increased hemoglobin and hematocrit levels suggest dehydration, which could be due to the fever, vomiting, and diarrhea. The increased blood urea nitrogen also suggests dehydration as the kidneys conserve water by reabsorbing more urea. The increased urine-specific gravity also indicates dehydration. The weight loss of 1.5 lbs is further evidence of dehydration and is a concerning finding in an infant. The other choices do not provide important information related to the patient's condition.

Question 11

At an annual health visit, a 59-year-old female reports weight gain and fatigue.The patient exercises regularly and had a recent, normal stress test.Laboratory results are all normal, except for T4 of 0.4 ng/dL and TSH 21.2 micro international units/mL.For which clinical manifestations should a nurse assess this patient?

Accepted Answer

The laboratory values of low T4 and high TSH indicate hypothyroidism. Dry skin, constipation, and cold intolerance are common clinical manifestations of hypothyroidism. Exophthalmia, insomnia, diarrhea, fine tremor of the hands, tachycardia, irritability, heat intolerance, excess sweating, and increased thirst are associated with hyperthyroidism.

Question 12

Results from a patient's genetic testing indicate mutations in the factor V Leiden gene.This finding is most associated with which of the following?

Accepted Answer

Mutations in the factor V Leiden gene are most associated with a greater risk for thromboembolism, which can result in blood clots that can lead to serious complications such as stroke or heart attack.

Question 13

A patient on a ventilator has an order for arterial blood gases with an alveolar/arterial oxygen ratio (a/A ratio).When sending the specimen to the laboratory, which information about the patient should the nurse include?

Accepted Answer

The most important information to include when sending a specimen for arterial blood gas analysis with an a/A ratio is the patient's temperature. This is necessary to accurately calculate the alveolar oxygen tension (PAO2) which is used to calculate the a/A ratio. Age, gender, and weight are not directly relevant to this calculation.

Question 14

A patient suspects that he has an allergy to cats.Elevation of which of the following would tend to confirm this suspicion?

Accepted Answer

Immunoglobulin E (IgE) is an antibody produced by the immune system in response to an allergen. In cases of allergy, the level of IgE increases in response to the allergen. Therefore, if the level of IgE is elevated in a patient suspected of having a cat allergy, it would confirm the suspicion. Cortisol, aldosterone, and blood glucose levels are not specifically associated with allergic reactions.

Question 15

A patient has a serum calcium level of 7.5 mg/dL.Based on this information, a nurse should assess the patient for clinical signs and symptoms such as:

Accepted Answer

A serum calcium level of 7.5 mg/dL indicates hypocalcemia, which can present with clinical signs and symptoms such as lethargy, tetany, and tingling in the lips or hands. The other options (A, B, and D) are more indicative of conditions such as hyperthyroidism, hypoglycemia, and hyperadrenergic states, respectively.

Question 16

A patient is admitted to a hospital with a diagnosis of "acute onset abdominal pain." The patient's urine specimen shows increased levels of  $\delta$-aminolevulinic acid ( $\delta$-ALA).Based on this result, the nurse should plan care for which condition?

Accepted Answer

Increased levels of 5-aminolevulinic acid (ALA) in urine are typical in patients with acute porphyria, a group of rare genetic disorders characterized by abnormal production and metabolism of heme. Acute attacks are usually triggered by various factors, such as alcohol, drugs, infections, hormones, or stress, and cause abdominal pain, nausea, vomiting, constipation, and other symptoms. Therefore, the patient's diagnosis of "acute onset abdominal pain" and the increased ALA levels suggest that acute porphyria is the most likely condition, and the nurse should focus on managing the pain, preventing complications, monitoring urine output and fluid/electrolyte balance, administering glucose and hematin, and avoiding potential triggers.

Question 17

A nurse is preparing to discharge a patient from a hospital after being diagnosed and treated for heart failure.The patient has a B-type natriuretic peptide level of 445 pg/mL.When preparing discharge teaching for this patient, which medication will the nurse most likely discuss?

Accepted Answer

B-type natriuretic peptide (BNP) is a hormone released by the heart in response to increased pressure and volume. Elevated levels of BNP indicate heart failure. Angiotensin-converting enzyme (ACE) inhibitors are one of the cornerstone medications for treating heart failure, as they improve symptoms, slow disease progression, and reduce mortality. Therefore, the nurse is most likely to discuss the benefits and proper use of ACE inhibitors during discharge teaching for this patient.

Question 18

A patient is suspected of having a cardiac septal defect.Which type of angiography should be performed to detect this condition?

Accepted Answer

Coronary angiography is used to visualize the blood vessels of the heart. It can detect abnormalities in the septum between the two chambers of the heart, which could indicate a cardiac septal defect. The other types of angiography listed are not appropriate for detecting this condition.

Question 19

A health-care provider has ordered an acetylcholine receptor antibody test for a patient.The nurse should suspect that this test is being used to assist in confirming the diagnosis of which of the following conditions?

Accepted Answer

The acetylcholine receptor antibody test is used to assist in confirming the diagnosis of myasthenia gravis, an autoimmune neuromuscular disorder where antibodies attack the acetylcholine receptors at the neuromuscular junction leading to muscle weakness and fatigue. It is not used as a diagnostic tool for systemic lupus erythematosus, hyperthyroid disease, or Alzheimer's disease.

Question 20

A patient admitted with a hip fracture and scheduled for surgery has a prothrombin time of 20.2 seconds and an international normalized ratio (INR)of 2.65 resulting from warfarin administration.Based on these laboratory values, which order should the nurse anticipate?

Accepted Answer

A prothrombin time of 20.2 seconds and an INR of 2.65 indicate an increased risk for bleeding. Warfarin is an anticoagulant that inhibits Vitamin K-dependent clotting factor synthesis. Phytonadione (vitamin K) is the antidote for warfarin, and it should be administered to reverse the anticoagulant effect before surgery. Abciximab (ReoPro) and Ticlopidine (Ticlid) are antiplatelet medications and are not effective in addressing this issue. Protamine sulfate is the antidote for heparin, which is a different anticoagulant.

Quiz 1: About This Book

A patient recently underwent kidney transplantation and needs to undergo testing to ensure that the medication he is on to prevent organ rejection does not reach toxic levels.Which test would be most appropriate for this purpose?

A patient's laboratory test results are negative for D-dimers.However, the health-care provider is concerned that an interfering factor may be skewing the results of this test.Which of the following factors could cause a false-negative result in this case?

A patient has an elevated aldolase level.This finding would be consistent with which of the following conditions?

An adolescent patient is admitted to a hospital with hypotension and tachycardia.The patient's laboratory results include a serum potassium level of 1.9 mEq/L.Which question should a nurse ask to identify possible causes for this clinical presentation?

A patient who is preparing to undergo a blood transfusion is suspected of having an immunoglobulin deficiency that could result in anaphylaxis when the blood is transfused.Which test would be most appropriate for confirming this suspicion?

The nurse is caring for a patient who is recovering from a ventral hernia repair and has developed a fever.New orders have been given to obtain a sputum culture.Which of the following actions should the nurse take before collecting the specimen?

A nurse notes that a patient has tested positive for Helicobacter pylori (H.pylori) antibody, a finding that may reflect the presence of peptic ulcer disease.In response to this finding, the nurse should assess the patient for related manifestations, such as:

A patient is undergoing venipuncture for collection of a blood sample for apolipoprotein testing.Which condition is this type of testing most useful in identifying?

Results from a patient's genetic testing indicate mutations in the factor V Leiden gene.This finding is most associated with which of the following?

A patient on a ventilator has an order for arterial blood gases with an alveolar/arterial oxygen ratio (a/A ratio) .When sending the specimen to the laboratory, which information about the patient should the nurse include?

A patient suspects that he has an allergy to cats.Elevation of which of the following would tend to confirm this suspicion?

A patient has a serum calcium level of 7.5 mg/dL.Based on this information, a nurse should assess the patient for clinical signs and symptoms such as:

A patient is admitted to a hospital with a diagnosis of "acute onset abdominal pain." The patient's urine specimen shows increased levels of $\delta$ -aminolevulinic acid ( $\delta$ -ALA) .Based on this result, the nurse should plan care for which condition?

A nurse is preparing to discharge a patient from a hospital after being diagnosed and treated for heart failure.The patient has a B-type natriuretic peptide level of 445 pg/mL.When preparing discharge teaching for this patient, which medication will the nurse most likely discuss?

A patient is suspected of having a cardiac septal defect.Which type of angiography should be performed to detect this condition?

A health-care provider has ordered an acetylcholine receptor antibody test for a patient.The nurse should suspect that this test is being used to assist in confirming the diagnosis of which of the following conditions?

A patient admitted with a hip fracture and scheduled for surgery has a prothrombin time of 20.2 seconds and an international normalized ratio (INR) of 2.65 resulting from warfarin administration.Based on these laboratory values, which order should the nurse anticipate?

Quiz 1: About This Book

A patient recently underwent kidney transplantation and needs to undergo testing to ensure that the medication he is on to prevent organ rejection does not reach toxic levels.Which test would be most appropriate for this purpose?

A patient's laboratory test results are negative for D-dimers.However, the health-care provider is concerned that an interfering factor may be skewing the results of this test.Which of the following factors could cause a false-negative result in this case?

A patient has an elevated aldolase level.This finding would be consistent with which of the following conditions?

An adolescent patient is admitted to a hospital with hypotension and tachycardia.The patient's laboratory results include a serum potassium level of 1.9 mEq/L.Which question should a nurse ask to identify possible causes for this clinical presentation?

A patient who is preparing to undergo a blood transfusion is suspected of having an immunoglobulin deficiency that could result in anaphylaxis when the blood is transfused.Which test would be most appropriate for confirming this suspicion?

The nurse is caring for a patient who is recovering from a ventral hernia repair and has developed a fever.New orders have been given to obtain a sputum culture.Which of the following actions should the nurse take before collecting the specimen?

A nurse notes that a patient has tested positive for Helicobacter pylori (H.pylori) antibody, a finding that may reflect the presence of peptic ulcer disease.In response to this finding, the nurse should assess the patient for related manifestations, such as:

A patient is undergoing venipuncture for collection of a blood sample for apolipoprotein testing.Which condition is this type of testing most useful in identifying?

Results from a patient's genetic testing indicate mutations in the factor V Leiden gene.This finding is most associated with which of the following?

A patient on a ventilator has an order for arterial blood gases with an alveolar/arterial oxygen ratio (a/A ratio) .When sending the specimen to the laboratory, which information about the patient should the nurse include?

A patient suspects that he has an allergy to cats.Elevation of which of the following would tend to confirm this suspicion?

A patient has a serum calcium level of 7.5 mg/dL.Based on this information, a nurse should assess the patient for clinical signs and symptoms such as:

A patient is admitted to a hospital with a diagnosis of "acute onset abdominal pain." The patient's urine specimen shows increased levels of δ\deltaδ -aminolevulinic acid ( δ\deltaδ -ALA) .Based on this result, the nurse should plan care for which condition?

A nurse is preparing to discharge a patient from a hospital after being diagnosed and treated for heart failure.The patient has a B-type natriuretic peptide level of 445 pg/mL.When preparing discharge teaching for this patient, which medication will the nurse most likely discuss?

A patient is suspected of having a cardiac septal defect.Which type of angiography should be performed to detect this condition?

A health-care provider has ordered an acetylcholine receptor antibody test for a patient.The nurse should suspect that this test is being used to assist in confirming the diagnosis of which of the following conditions?

A patient admitted with a hip fracture and scheduled for surgery has a prothrombin time of 20.2 seconds and an international normalized ratio (INR) of 2.65 resulting from warfarin administration.Based on these laboratory values, which order should the nurse anticipate?

A patient is admitted to a hospital with a diagnosis of "acute onset abdominal pain." The patient's urine specimen shows increased levels of $\delta$ -aminolevulinic acid ( $\delta$ -ALA) .Based on this result, the nurse should plan care for which condition?