Question 1

A patient is suspected of having pheochromocytoma.Which type of angiography should be performed to detect this condition?

Accepted Answer

Adrenal angiography should be performed to detect pheochromocytoma as it would visualize the blood vessels supplying the adrenal gland where the tumor is located. Abdominal angiography may not specifically focus on the adrenal gland, and carotid or coronary angiography are not relevant to the diagnosis of pheochromocytoma.

Question 2

A patient is suspected of having systemic lupus erythematosus (SLE).Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?

Accepted Answer

Antinuclear antibodies are commonly found in patients with systemic lupus erythematosus (SLE) and can help confirm the suspicion of the disease. Antisperm antibodies, ASO, and antithyroglobulin tests are not specific to SLE.

Question 3

A nurse has just collected a specimen for an adrenocorticotropic hormone (ACTH)test.Which of the following actions should the nurse take next?

Accepted Answer

ACTH is a peptide hormone and is sensitive to temperature. It degrades quickly at room temperature, so it must be kept cold to preserve its integrity until it can be analyzed in the laboratory. Placing the specimen in a plastic bag and then in an ice slurry for immediate transportation to the laboratory is the best way to ensure the sample remains viable for accurate testing.

Question 4

In preparing a patient to undergo indirect gonioscopy, a nurse explains that the optometrist will place a contact lens on the patient's eye while a narrow beam of light is focused on the eye.The patient asks, "Why do you need to put a contact in my eye?" The nurse should give which of the following as the rationale for this action?

Accepted Answer

The contact lens will reflect light back into the eye, allowing the optometrist to see the internal structures of the eye more clearly during the indirect gonioscopy exam. None of the other options accurately reflect the rationale for using the contact lens.

Question 5

A patient's serum calcium level is 11.6 mg/dL and serum phosphorus is 2.5 mg/dL.Electrolytes and CBC are all within normal limits.Which additional laboratory tests should the nurse anticipate?

Accepted Answer

The elevated serum calcium level and normal phosphorus level suggest hyperparathyroidism, thus the nurse should anticipate a parathormone level (PTH) test, which is used to diagnose and monitor hyperparathyroidism. Prolactin, TSI, and TBG are not relevant in this situation.

Question 6

A patient who has been taking the aminoglycoside antibiotic gentamicin is exhibiting signs of toxicity.Which of the following interventions would be most appropriate for assessing for one of the major complications associated with toxicity?

Accepted Answer

Monitoring BUN and creatinine levels is important in assessing for nephrotoxicity, a major complication associated with gentamicin toxicity.

Question 7

A patient has a homocysteine level of 25 mmol/L.Which additional laboratory results should a nurse review to determine if the patient needs nutritional education?

Accepted Answer

High levels of homocysteine are associated with increased risk for cardiovascular disease. Reviewing cholesterol and triglyceride levels would help determine if the patient is at increased risk for cardiovascular disease due to dyslipidemia.

Question 8

A patient is suspected of having scarlet fever.Which of the following antibody tests should the nurse expect to conduct on this patient to confirm this suspicion?

Accepted Answer

Antistreptolysin O (ASO) is a blood test used to detect streptococcal infections, including scarlet fever. When a person has a streptococcal infection, their body produces ASO antibodies in response. Identifying the presence and amount of ASO antibodies can help diagnose and monitor treatment for the infection. The other antibody tests mentioned (antinuclear, antisperm, antithyroglobulin) are not used to diagnose scarlet fever.

Question 9

The nurse is reviewing lab results for a 37-year-old female who was admitted with muscular weakness and syncope.The patient is undergoing testing for a number of neuromuscular disorders, including myasthenia gravis.Which of the following lab values would the nurse expect?

Accepted Answer

Acetylcholine receptor antibodies are specific to myasthenia gravis and would be expected to be elevated in a patient being tested for this disorder. Adrenocorticotropic hormone, amylase, and aldosterone are not directly related to neuromuscular disorders.

Question 10

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

Accepted Answer

Alkaline phosphatase is an enzyme found in high concentrations in bone, liver and intestine. An elevated level of alkaline phosphatase could be an indication of bone or liver disease, but a healing fracture is most likely the cause. As the body heals the fracture, the bones will produce more alkaline phosphatase, causing the elevation in levels.

Question 11

A nurse observes that a patient's urine has a red-to-pink color, but the urinalysis is negative for occult blood.The patient is not receiving any medications that are associated with changes in the color of the urine.A test for porphyrins is ordered.For which physical manifestations, suggestive of porphyria, should the nurse assess?

Accepted Answer

Abdominal pain and photodermatitis are common physical manifestations of porphyria. Burning on urination and urinary urgency are not typically associated with porphyria. Changes in vision and altered gait may be seen in some types of porphyria, but they are less specific. Decreased tactile sensation and photophobia are not commonly associated with porphyria.

Question 12

A patient's laboratory test results indicate an elevated amylase level.This finding most likely indicates which of the following diseases?

Accepted Answer

An elevated amylase level is a common finding in patients with acute pancreatitis, as pancreatic cells release amylase into the bloodstream when the pancreas is damaged or inflamed. Elevated amylase levels may also occur in other conditions such as mumps, bowel obstruction, and salivary gland disease, but in this case, the other answer choices do not suggest these conditions, making A the most likely answer.

Question 13

A nurse is preparing to draw a plasma sample for an amino acid screen.Which color of tube top should the nurse use for this test?

Accepted Answer

A green tube top is used for collecting plasma specimens that are needed for chemistry testing, including amino acid screens. The green top tube contains the anticoagulant heparin and a gel separator that separates the plasma from the blood cells. This allows for easy and accurate testing of the plasma without interference from the cells. The other tube tops listed (lavender, red, gray) are not typically used for amino acid testing.

Question 14

A patient is due to receive a scheduled dose of warfarin 2.5 mg by mouth.A nurse notes that the patient's prothrombin time (PT)is 24.1 seconds and international normalized ratio (INR)is 3.77.Which action by the nurse is most appropriate?

Accepted Answer

The patient's PT and INR levels are significantly elevated, indicating that the patient is at high risk for bleeding. Therefore, the nurse should hold the dose of warfarin and notify the healthcare provider immediately for further instructions. Administering or increasing the dose of warfarin could lead to excessive bleeding and harm the patient. Giving one-half the dose may not be appropriate, given the patient's high INR level. Prompt communication with the healthcare provider is essential to ensure safe and effective medication management.

Question 15

A nurse is assisting with an intraocular muscle function test of a patient.During the test, the nurse observes that the patient cannot see with one eye, despite the absence of any organic pathological condition of the eye or optic nerve.The nurse should suspect the patient of having which of the following conditions?

Accepted Answer

The patient's inability to see with one eye despite the absence of any organic pathological condition of the eye or optic nerve indicates amblyopia, also known as lazy eye. This condition occurs when the brain favors one eye over the other, leading to reduced vision in the less-favored eye. Intraocular muscle function tests help to assess for eye muscle imbalances that can contribute to the development of amblyopia, among other conditions. Strabismus refers to the misalignment of the eyes, while heterophoria and heterotropia are variations of eye muscle imbalances that can cause double vision, eye strain, or difficulty with depth perception.

Question 16

A patient's laboratory test results indicate an elevated blood ammonia level.Disease in which of the following organs would best explain this finding?

Accepted Answer

Elevated blood ammonia levels are most commonly associated with liver disease or dysfunction, as the liver plays a key role in removing ammonia from the blood.

Question 17

A geriatric patient residing in a long-term care facility has documented weight loss.A diagnostic work-up has identified no pathological reason, so a high-protein, high-carbohydrate diet is implemented.Which laboratory result should a nurse monitor to evaluate if the dietary measures are improving the patient's nutritional status?

Accepted Answer

Prealbumin is a more sensitive and immediate indicator of nutritional status than albumin, total protein, or transferrin, making it the best choice for monitoring the effectiveness of dietary interventions in the short term.

Question 18

A patient has an increased lactate level.After reviewing the patient's medical record, which medication should a nurse suspect as contributing factor?

Accepted Answer

Metformin, a medication commonly used for diabetes, is known to cause an increase in lactate levels as a side effect. Digoxin, hydrochlorothiazide, and warfarin do not typically cause an increase in lactate levels.

Question 19

A patient has a blood ammonia level of 115 mcg/dL.As a result of this lab value, a nurse should assess the patient for clinical signs and symptoms such as:

Accepted Answer

A blood ammonia level of 115 mcg/dL indicates a potential liver dysfunction, and a high level of ammonia in the blood can lead to neurological symptoms. Confusion, combativeness, and decreased level of consciousness are common signs and symptoms of hyperammonemia. Agitation, anxiety, excessive weight gain are not associated with hyperammonemia. Decreased breath sounds, hyperactivity, and diarrhea are also not typical of hyperammonemia. Hypertension, headache, and hyporeflexia are also not specific to hyperammonemia.

Question 20

A nurse observes that a patient's potassium level is 5.5 mEq/L.In response to this potassium level, the nurse's first action should be to:

Accepted Answer

A potassium level of 5.5 mEq/L indicates hyperkalemia, which can affect cardiac function. The nurse should first assess the patient's apical heart rate and cardiac rhythm to check for any cardiac abnormalities.

Quiz 1: About This Book