NCLEX Review Course

Selected Lab & Diagnostic Tests Nursing Considerations & Safety
Questions and Answers

1. A client¶s laboratory results reveal a hemoglobin of 6 g/dL. Which foods should be encouraged for this client? A. B. C. D. Broiled fish Whole grains Dried fruits Steamed vegetables

1. A client¶s laboratory results reveal a hemoglobin of 6 g/dL. Which foods should be encouraged for this client? A. B. C. D. Broiled fish Whole grains Dried fruits Steamed vegetables

C. With a low hemoglobin, the oxygen-carrying capacity of the blood is diminished resulting in client fatigue. The preserving agent for dried fruits adds iron, making the fruits excellent sources for this mineral.

C. Fluid volume excess Decreased tissue perfusion Impaired tissue integrity Risk for activity intolerance .0 mg/dL and a hematocrit of 29%? A.2. D. Which nursing diagnosis is most appropriate for a female adult client with a hemoglobin of 12. B.

Fluid volume excess Decreased tissue perfusion Impaired tissue integrity Risk for activity intolerance A.0 mg/dL and a hematocrit of 29%? A. it indicates over hydration or hemodilution.2. Hemoglobin is normal. D. B. If it is less than that. Hematocrit should be 3 times the hemoglobin. . Which nursing diagnosis is most appropriate for a female adult client with a hemoglobin of 12. C.

D. In planning care. The reticulocyte count is elevated in a client with recent blood loss due to severe skin laceration. Maintain fluid intake at 2-3 liters per day Obtain consent for bone marrow biopsy Institute iron restricted diet Prepare client for plasmaphoresis .3. B. C. the RN anticipates which physician order? A.

Maintain fluid intake at 2-3 liters per day Obtain consent for bone marrow biopsy Institute iron restricted diet Prepare client for plasmaphoresis A. In planning care. the RN anticipates which physician order? A. C.3. The reticulocyte count is elevated in a client with recent blood loss due to severe skin laceration. D. It indicates the bone marrow is working to replace lost RBCs by producing immature RBCs and sending them into the circulation. B. . Increased reticulocyte count is normal after blood loss or in anemia.

C. B. Which statement would be true of platelets? A. D.4. Are formed and stored in the spleen Repair damage to small blood vessels Cause red blood cells to clump forming clots Circulate for 4-6 weeks before dying .

Which statement would be true of platelets? A.4. B. They live 1-2 weeks. Are formed and stored in the spleen Repair damage to small blood vessels Cause red blood cells to clump forming clots Circulate for 4-6 weeks before dying B. They are formed in the bone marrow but are stored in the spleen and clump together to form clots. Platelets repair damage to small blood vessels. C. . D.

Which is an explanation for a shift-to-the-left in the neutrophil count? A. Stem cells are being over produced B.5. Bone marrow is releasing fewer mature cells into the circulating blood C. Bone marrow is responding to overproduction of lymphocytes D. The thymus gland is unable to produce T-cells .

Bone marrow is responding to overproduction of lymphocytes D. . Which is an explanation for a shift-to-the-left in the neutrophil count? A. Stem cells are being over produced B. This is the only response related to neutrophil shift-to-theleft. The thymus gland is unable to produce T-cells B.5. Bone marrow is releasing fewer mature cells into the circulating blood C.

D. Hemoglobin level of 15. B.4 mg/dL BUN of 30 mg/dL and creatinine of 1.6 seconds Total calcium level of 9.9 g/dL Coumadin with a prothrombin time (PT) of 35.1 mg/dL . C.6. Which of these clients should the nurse assess first? A.

D. Which of these clients should the nurse assess first? A.6.5 times greater.9 g/dL Coumadin with a prothrombin time (PT) of 35. This client has 3 times greater time and so is at risk.6 seconds Total calcium level of 9.1 mg/dL B.5-2. C. Normal prothrombin time is<13 seconds and on coumadin therapy. B.4 mg/dL BUN of 30 mg/dL and creatinine of 1. . Hemoglobin level of 15. it should be 1.

C. B. D.7. Congestive heart failure Glaucoma Hypertension Pregnancy . Which client is most likely to have an elevated erythrocyte sedimentation rate? A.

. This is the only correct answer. Congestive heart failure Glaucoma Hypertension Pregnancy D. C.7. D. Which client is most likely to have an elevated erythrocyte sedimentation rate? A. B.

B.8. C. Which does not specifically increase HDL cholesterol levels? A. D. Smoking cessation Nicotinic acid Lipitor (atorvastatin) Exercise .

and exercise raise HDL levels. D. nicotinic acid or niacin.8. B. Stopping smoking. . C. Smoking cessation Nicotinic acid Lipitor (atorvastatin) Exercise C. Lipitor decreases LDL and triglycerides. Which does not specifically increase HDL cholesterol levels? A.

starting with the sickest client . Call physician to request antiemetic for client who has been vomiting B. Call a potassium level of 5. which task should the nurse complete first? A. Begin routine assessment rounds. After receiving report of four clients at 7:00 a.m. Notify family of a client¶s transfer to ICU for chest pain C..9.9 to the attention of the physician D.

.m. A potassium level of 5. After receiving report of four clients at 7:00 a. Call a potassium level of 5. Notify family of a client¶s transfer to ICU for chest pain C.9.. which task should the nurse complete first? A.9 is life threatening. Call physician to request antiemetic for client who has been vomiting B. Begin routine assessment rounds.9 to the attention of the physician D. starting with the sickest client C.

C. D. Which result causes the nurse the most concern? A. Blood urea nitrogen of 18 mg/dL Serum creatinine level of 1.10.2 mg/dL White blood cell count of 9000/cu mm Serum potassium of 6. B.0 mEq/dL .The nurse is reviewing laboratory test results for a client with severe crush injuries of both lower extremities secondary to a motor vehicle accident.

The other lab values are within acceptable parameters. Hyperkalemia can lead to serious cardiac dysrhythmias such as ventricular fibrillation or cardiac standstill. Blood urea nitrogen of 18 mg/dL Serum creatinine level of 1.The nurse is reviewing laboratory test results for a client with severe crush injuries of both lower extremities secondary to a motor vehicle accident. C.2 mg/dL White blood cell count of 9000/cu mm Serum potassium of 6.10. .0 mEq/dL D. Which result causes the nurse the most concern? A. D. B.

What is the most likely cause of the symptoms? A. B. C. A 27-year-old construction worker is admitted to the Urgent Care Center with tachycardia. the urine specific gravity is 1. The client¶s skin is moist and warm. D.11. and loose stools have occurred. and agitation. The outside temperature is 98o F (36. hypotension. weakness. headache. Hypokalemia Hyponatremia Hypercalcemia Hypomagnesemia .67o C) and the client has consumed 1. decreased DTRs.5 liters of water in the last 30 minutes.030.

The client¶s skin is moist and warm. With heat. The outside temperature is 98o F (36. The water consumed has no electrolytes and the symptoms are consistent with hyponatremia and hypovolemia. headache. What is the most likely cause of the symptoms? A.030. decreased DTRs. weakness. hypotension.67o C) and the client has consumed 1.5 liters of water in the last 30 minutes. and loose stools have occurred. B. the urine specific gravity is 1. C. excessive sweating produces sodium and water loss. and agitation. A 27-year-old construction worker is admitted to the Urgent Care Center with tachycardia. Hypokalemia Hyponatremia Hypercalcemia Hypomagnesemia B. D.11. .

1 mg/dL is at risk for which problem? A. B. D. Renal calculi Osteoporosis Dental caries Rickets . A client with a calcium level of 12.12. C.

Renal calculi Osteoporosis Dental caries Rickets A. A client with a calcium level of 12. . D.1 mg/dL is at risk for which problem? A.12. B. C. This is an elevated level of calcium and may contribute to the formation of kidney stones.

13. Major trauma to skeletal muscle tissue would not cause an increase in which lab value? A. B. C. D. Alkaline phosphatase CK-MM LDH AST

13. Major trauma to skeletal muscle tissue would not cause an increase in which lab value? A. B. C. D. Alkaline phosphatase CK-MM LDH AST

A. Alkaline phosphatase increases with bone trauma. The other values increase with muscle trauma or necrosis.

14. A voided urinalysis result shows numerous epithelial cells, bacteria, and leukocytes, but all other indices are normal. Which intervention is appropriate at this time? A. B. C. D. Notify the physician as this indicates an infection Assess for allergy to antibiotics Obtain a 2nd urinalysis using a clean-catch method Perform a catheterized urinalysis

bacteria. Notify the physician as this indicates an infection Assess for allergy to antibiotics Obtain a 2nd urinalysis using a clean-catch method Perform a catheterized urinalysis C. D. Which intervention is appropriate at this time? A. B. . but all other indices are normal. and leukocytes. This is most likely a contaminated specimen without proper cleansing before collection. A voided urinalysis result shows numerous epithelial cells.14. C.

Demerol 50 mg IM every 3-4 hours PRN severe pain Glucophage (metformin) 500 mg PO every day Carafate (sucralfate) 1 gm PO qid 1 hour ac and hs Lopressor (metoprolol) 100 mg PO every day . A client is admitted for a cholecystectomy with a creatinine level of 1. C. D. B. Which medication order would the nurse question? A.0 mg/dL and BUN of 22 mg/dL.15.

C.0 mg/dL and BUN of 22 mg/dL. D. B.15. Demerol 50 mg IM every 3-4 hours PRN severe pain Glucophage (metformin) 500 mg PO every day Carafate (sucralfate) 1 gm PO qid 1 hour ac and hs Lopressor (metoprolol) 100 mg PO every day B. . Glucophage can lead to liver failure if the client goes into metabolic acidosis (related to renal compromise). A client is admitted for a cholecystectomy with a creatinine level of 1. Which medication order would the nurse question? A.

´ D. so I avoid it.´ B.´ C. ³I received penicillin as a child and it has made me sick ever since.16. ³The last time I had a special test. ³My doctor says I shouldn¶t eat eggs because they can help clog my arteries.´ . ³I had a bad experience after eating seafood last year. there was a salty taste when they gave me the dye. The nurse is completing the admission history of a client who is to undergo an intravenous pyelogram (IVP). Which client statement would be cause for concern? A.

16. ³I had a bad experience after eating seafood last year. are allergic to iodine. ³My doctor says I shouldn¶t eat eggs because they can help clog my arteries. The nurse is completing the admission history of a client who is to undergo an intravenous pyelogram (IVP). Which client statement would be cause for concern? A. so I avoid it.´ B. If this allergy is present. Iodine-containing contrast media may be used for the IVP.´ C.´ B. ³The last time I had a special test. ³I received penicillin as a child and it has made me sick ever since.´ D. . an anaphylactic reaction can occur during the IVP. there was a salty taste when they gave me the dye. Many people who are allergic to seafood.

´ B. The client asks the nurse about special preparation for an ultrasound of the kidneys. ³Radiopaque dye will be used to help visualize the kidney. ³There will be no food or fluid for 12 hours prior to the test.´ C. ³The puncture site will be monitored frequently for bleeding.17. ³No special preparation is required for this test.´ D.´ . Which response by the nurse is most appropriate? A.

´ C.17. in most cases. The client asks the nurse about special preparation for an ultrasound of the kidneys.´ ³The puncture site will be monitored frequently for bleeding. . requires no special preparation except a full bladder.´ ³There will be no food or fluid for 12 hours prior to the test. B.´ ³No special preparation is required for this test. D. ³Radiopaque dye will be used to help visualize the kidney. C. An ultrasound exam is a noninvasive test that. Which response by the nurse is most appropriate? A.

Assess client understanding of the procedure before witnessing the consent form B. Client may have only clear liquids the evening before the procedure D. Teach client that general anesthesia will likely be used C. A 43-year-old anxious client is to receive teaching prior to a cystoscopy. Which part of the teaching plan indicates the need for clarification prior to talking to the client? A. A bowel prep with laxatives will be completed before the procedure .18.

18. Client may have only clear liquids the evening before the procedure D. then will be NPO after midnight if general anesthesia is used. A bowel prep with laxatives will be completed before the procedure C. The client may have a light evening meal. Assess client understanding of the procedure before witnessing the consent form B. Teach client that general anesthesia will likely be used C. A 43-year-old anxious client is to receive teaching prior to a cystoscopy. Which part of the teaching plan indicates the need for clarification prior to talking to the client? A. .

Urinary frequency and dysuria Hypertension and polydipsia Hematuria and hypotension Orange discoloration to urine and bladder spasm . After cystoscopy. the RN monitors the client for development of post-procedural complications. C.19. B. D. Which symptom would be most expected? A.

19. the RN monitors the client for development of post-procedural complications. . D. Urinary frequency and dysuria Hypertension and polydipsia Hematuria and hypotension Orange discoloration to urine and bladder spasm A. Which symptom would be most expected? A. B. After cystoscopy. The most common complication is urinary tract infection due to instrumentation in the procedure. C.

Weight gain. fatigue and bradycardia Headache.3 mU/L. The RN would expect which symptoms? A. D. C. A client with a goiter has a TSH of 0. diplopia and tinnitis Bruit upon auscultation of thyroid and hypertension Hypernatremia and decreased urine specific gravity . B.20.

D. A is hypothyroidism.4-4.20.2 mU/L. Normal TSH is 0. A client with a goiter has a TSH of 0. B. diplopia and tinnitis Bruit upon auscultation of thyroid and hypertension Hypernatremia and decreased urine specific gravity C. Bruits are often heard with goiter and the hyperthyroidism causes increase in systolic blood pressure and decrease in thyroid stimulating hormone (TSH). C. fatigue and bradycardia Headache. The RN would expect which symptoms? A. . Weight gain.3 mU/L.

Synthroid (levothyroxine) works primarily by converting T3 into T4 and as blood levels rise.21. Which is true concerning abnormal TSH levels? A. As the TSH level rises after treatment is started with Synthroid (levothyroxine). TSH also decreases as a result of the positive feedback loop B. After initiation of Synthroid (levothyroxine) the TSH level decreases gradually as a result of the negative feedback loop C. TSH levels drop D. A client with hypothyroidism is on hormone replacement. As the T3 and T4 levels drop. calcitonin levels rise and thyroid function normalizes .

Synthroid (levothyroxine) works primarily by converting T3 into T4 and as blood levels rise. As the TSH level rises after treatment is started with Synthroid (levothyroxine). Which is true concerning abnormal TSH levels? A. TSH levels drop D. This is the only true statement. calcitonin levels rise and thyroid function normalizes B. After initiation of Synthroid (levothyroxine) the TSH level decreases gradually as a result of the negative feedback loop C. . A client with hypothyroidism is on hormone replacement.21. As the T3 and T4 levels drop. TSH also decreases as a result of the positive feedback loop B.

Allergic to shellfish and betadine 24 weeks pregnant Breastfeeding a 6 week old baby Completed steroid treatment 3 weeks ago .22. B. Which client could have a thyroid scan? A. D. C.

Allergic to shellfish and betadine 24 weeks pregnant Breastfeeding a 6 week old baby Completed steroid treatment 3 weeks ago D. Which client could have a thyroid scan? A. D. B. . C. Radioactive iodine may be used 21 days after discontinuing corticosteroids.22.

Potential for hypoglycemia Risk for injury related to hyperglycemia Knowledge deficit related to disease process Potential for ineffective individual coping . C. B. A 43-year-old obese female client has a fasting blood sugar of 140 mg/dL and states her blood glucose has never been elevated before. D. Which is the top priority? A.23.

B. D. Which is the top priority? A. C. Potential for hypoglycemia Risk for injury related to hyperglycemia Knowledge deficit related to disease process Potential for ineffective individual coping C. A 43-year-old obese female client has a fasting blood sugar of 140 mg/dL and states her blood glucose has never been elevated before. . Potential problems and risks are secondary priorities.23. The client has an existing knowledge deficit related to this newly diagnosed diabetes mellitus (FBS>126 mg/dL is diagnostic).

B. D.5% . C.9% Hgb A1C has dropped from 4% to 2. Which glycosylated hemoglobin would indicate a need for more teaching? A. A 16-year-old client with type I Diabetes Mellitus is sporadically non-compliant with diet and today¶s FBS was 116 mg/dL.5% Hgb A1C has increased from 5.5% Hgb A1C is 6.9% to 7. Hgb A1C is 2.24.

Normal Hgb A1C for a diabetic in good control is 6-7%.5% C. . An increase of 2% and over the normal indicates a need for more teaching. D.5% Hgb A1C is 6. Which glycosylated hemoglobin would indicate a need for more teaching? A.9% to 7.5% Hgb A1C has increased from 5. C.24.9% Hgb A1C has dropped from 4% to 2. Hgb A1C is 2. A 16-year-old client with type I Diabetes Mellitus is sporadically non-compliant with diet and today¶s FBS was 116 mg/dL. B.

25. A pregnant client at 28 weeks gestation has a fasting 1 hour glucose challenge test with a result of 156 mg/dL. Tell her she has diabetes mellitus and plan teaching Order a 3 hour glucose tolerance test per protocol Continue to monitor her as this is normal Continue to monitor the elevated placental lactogen . D. C. Which would be the best response by the nurse? A. B.

Tell her she has diabetes mellitus and plan teaching Order a 3 hour glucose tolerance test per protocol Continue to monitor her as this is normal Continue to monitor the elevated placental lactogen B. C. Also. B. Which would be the best response by the nurse? A.25. A pregnant client at 28 weeks gestation has a fasting 1 hour glucose challenge test with a result of 156 mg/dL. If the GCT is above 140 mg/dL. it should be done non-fasting. a 3 hour GTT is indicated. . D.

B. D.26. Irrigate the wound and then collect sample Place sample in sterile container for transport Start the ordered antibiotic and then collect sample Swab the skin around the wound to collect sample . What procedure would be best? A. C. The nurse is asked to collect a sample of exudate from a client¶s wound for a culture and sensitivity.

D. Irrigate the wound and then collect sample Place sample in sterile container for transport Start the ordered antibiotic and then collect sample Swab the skin around the wound to collect sample B. . The nurse is asked to collect a sample of exudate from a client¶s wound for a culture and sensitivity.26. What procedure would be best? A. C. All specimens must be collected using sterile methods and placed in a sterile container. Antibiotics should be started after specimen collection. B.

B. D.27. Diabetic with an implanted insulin pump Pregnant primigravida at 34 weeks gestation Client with heart failure and a pacemaker Auto accident victim on life support systems . C. Which client would the nurse send for an MRI without questioning the order? A.

C. Which client would the nurse send for an MRI without questioning the order? A. . D. Diabetic with an implanted insulin pump Pregnant primigravida at 34 weeks gestation Client with heart failure and a pacemaker Auto accident victim on life support systems B. The other options have equipment containing metal which would cause the MRI equipment to malfunction. Pregnancy is not a contraindication for MRI. B.27.

28. B. Client has Huntington disease Client has chronic renal failure Client had hives following an IVP Client ate lunch 5 hours ago . Which consideration would be least important when a client is to have computed tomography (CT) scan with contrast medium? A. D. C.

. Which consideration would be least important when a client is to have computed tomography (CT) scan with contrast medium? A. C. Clients are usually NPO for no more than 4 hours before the test.28. D. Client has Huntington disease Client has chronic renal failure Client had hives following an IVP Client ate lunch 5 hours ago D. B. The client must lie still and must be able to clear the contrast medium without reacting negatively to it.

Normal report and requires no special follow-up B. Abnormal report. client will have an immediate colonoscopy C. What follow-up care is needed for a client with PAP (Papanicolaou test) results of "atypical squamous cells of undetermined significance³ (ASCUS)? A.29. Indicates cancerous cells. client will require a hysterectomy . Indicates cancerous cells. client will need follow-up evaluation D.

Indicates cancerous cells. What follow-up care is needed for a client with PAP (Papanicolaou test) results of "atypical squamous cells of undetermined significance³ (ASCUS)? A. This is not a normal report and indicates that further information is needed before a diagnosis of cancer is made. Indicates cancerous cells. Abnormal report. client will need follow-up evaluation D. Normal report and requires no special follow-up B. client will require a hysterectomy C. client will have an immediate colonoscopy C. .29.

´ ³Begin having annual mammograms now. C.´ . A 42-year-old female client asks the RN when she should have a mammogram.30. D. B.´ ³Begin having mammograms every other year now. ³Have a baseline mammogram between age 40 and 45.´ ³Begin having annual mammograms at age 50. What is the RN¶s best reply based on current American Cancer Society recommendations? A.

A 42-year-old female client asks the RN when she should have a mammogram.30. ³Have a baseline mammogram between age 40 and 45. .´ ³Begin having annual mammograms now. B. What is the RN¶s best reply based on current American Cancer Society recommendations? A.´ B. women should begin having annual mammograms at age 40.´ ³Begin having mammograms every other year now.´ ³Begin having annual mammograms at age 50. D. According to the American Cancer Society. C.

³I will be asked to remove my clothing from the waist up prior to this procedure.´ . ³I will experience some discomfort from the compression of the tissue during the procedure.´ B. ³I will not apply deodorant before the procedure. Which client statement indicates a need for further teaching regarding a mammogram? A.´ C.´ D. ³I will not bathe on the morning of the procedure.31.

´ C. .´ D. ³I will experience some discomfort from the compression of the tissue during the procedure. Which client statement indicates a need for further teaching regarding a mammogram? A.´ A. ³I will be asked to remove my clothing from the waist up prior to this procedure. However. they should be instructed not to wear lotions. ³I will not apply deodorant before the procedure. ³I will not bathe on the morning of the procedure.´ B. Clients may bathe before a mammogram.31. powders. or deodorants as these may contain metallic salts.

Facilitates inspection of axillary lymph nodes Triggers spontaneous nipple discharge Elevates nipple and areolar area Reveals changes in breast contour and symmetry . C. What is the rationale for including the step of inspection of the breasts with the arms raised above the head when performing breast self examination? A. D. B.32.

B. Changes in shape or contour are emphasized when the arms are raised over the head. What is the rationale for including the step of inspection of the breasts with the arms raised above the head when performing breast self examination? A. Facilitates inspection of axillary lymph nodes Triggers spontaneous nipple discharge Elevates nipple and areolar area Reveals changes in breast contour and symmetry D.32. D. C. .

C. D.33. B. How would the nurse best teach a client about an endometrial biopsy? A. Will require an overnight hospital stay A tube will be inserted into the uterus through the abdomen There will be cramping during the procedure A magnifying instrument will allow tissue visualization .

D. How would the nurse best teach a client about an endometrial biopsy? A.33. Will require an overnight hospital stay A tube will be inserted into the uterus through the abdomen There will be cramping during the procedure A magnifying instrument will allow tissue visualization C. . C. Tissue is not visualized. There will be cramping when the biopsy is taken. The procedure is done in an office or clinic by placing a tube thru the cervix into the uterine body. B.

34. A colposcopy is scheduled for a client. In reviewing the client¶s chart, which would the RN expect in the history? A. B. C. D. History of infertility History of abnormal PAP smear Family history of ovarian cancer History of cervical laceration

34. A colposcopy is scheduled for a client. In reviewing the client¶s chart, which would the RN expect in the history? A. B. C. D. History of infertility History of abnormal PAP smear Family history of ovarian cancer History of cervical laceration

B. Colposcopy is used to locate the exact site of precancerous and malignant lesions for tissue biopsy following an abnormal PAP smear.

35. A client had a laparoscopic tubal ligation this morning. Which nursing diagnosis has the highest priority? A. B. C. D. Pain related to CO2 insufflation Activity intolerance related to post-anesthesia fatigue Risk for infection related to surgical incision Risk for altered tissue perfusion related to surgical procedure

Carbon dioxide gas is used to separate the internal structures for better visualization and the remaining gas stimulates the diaphragm resulting in left shoulder pain. . Pain related to CO2 insufflation Activity intolerance related to post-anesthesia fatigue Risk for infection related to surgical incision Risk for altered tissue perfusion related to surgical procedure A. C. D.35. B. Which nursing diagnosis has the highest priority? A. A client had a laparoscopic tubal ligation this morning.

³The amount of CSF removed will be rapidly replaced by the body. ³The physician will monitor the CSF pressure closely during the procedure to minimize any danger.´ B. Choose the best response by the nurse to lower anxiety levels. was told by friends that ³the brain sinks´ when cerebrospinal fluid is removed. ³Removing the small amount of CSF during the procedure has absolutely no effect on the brain. ³The body has more fluid than is necessary and the amount removed is insignificant. A teenage client who is scheduled for a lumbar puncture.´ C.36. A.´ D.´ .

³The physician will monitor the CSF pressure closely during the procedure to minimize any danger.´ B. ³The body has more fluid than is necessary and the amount removed is insignificant. was told by friends that ³the brain sinks´ when cerebrospinal fluid is removed.´ C.´ ‡ Clarification of how the body works is reassuring to the client. . ³The amount of CSF removed will be rapidly replaced by the body.36. A teenage client who is scheduled for a lumbar puncture. A. Choose the best response by the nurse to lower anxiety levels. ³Removing the small amount of CSF during the procedure has absolutely no effect on the brain.´ D.

Which statement would best assist a client to prepare for a cerebral angiogram? A. ³A contrast dye will be injected to help visualize the blood vessels.37.´ D. ³This X-ray will help assess the circulation around your heart. ³The catheter will be inserted in your left arm close to the heart. ³You will have a regular breakfast before the test.´ C.´ B.´ .

´ B.37.´ ‡ A contrast dye will be inserted through the groin to visualize the vessels in the brain.´ D. ³A contrast dye will be injected to help visualize the blood vessels. . Which statement would best assist a client to prepare for a cerebral angiogram? A. Clients are either NPO or have only clear liquids 6-8 hours before the procedure.´ C. ³The catheter will be inserted in your left arm close to the heart. ³You will have a regular breakfast before the test. ³This X-ray will help assess the circulation around your heart.

Which statement would be representative of a normal electrocardiogram (EKG)? A.05 seconds P wave of .14 seconds Total heart beat of 4 seconds . B.38. QRS complex of . D. C.08 seconds PR interval of .

The normal heart beat is about . B.06-.10 seconds. QRS complex of . PR interval should be . .40 seconds. D.20-.11 seconds.08 seconds PR interval of . Which statement would be representative of a normal electrocardiogram (EKG)? A. C.20 seconds and P wave should be less than .05 seconds P wave of .12-.14 seconds Total heart beat of 4 seconds ‡ The normal QRS complex is .38.

Decrease in serum troponin level C. Elevation in blood urea nitrogen level D. The nurse is reviewing laboratory tests of a client who was admitted with chest pain.39. Elevation in serum troponin level B. Decrease in serum creatinine level . Which result should the nurse report to the physician immediately? A.

39. The nurse is reviewing laboratory tests of a client who was admitted with chest pain. C. Cardiac troponin is virtually undetectable in the serum of healthy people. Which result should the nurse report to the physician immediately? ‡ A. D. It is especially useful in the early diagnosis of acute MI and in detection of ³silent´ MI. Elevation in serum troponin level Decrease in serum troponin level Elevation in blood urea nitrogen level Decrease in serum creatinine level ‡ A. . but rises to a detectable level within 1 hour of myocardial injury. B.

40. Stop the test. Continue the test at a slower rate and notify the physician D. During a treadmill stress test. Offer a glass of cool water to help replace fluid lost by sweating B. have the client sit or lie down and assess vital signs . What is the nurse¶s first action? A. a middle-aged client becomes extremely diaphoretic and complains of pressure in the mid-chest. Have the client take a break and give the morning dose of digoxin (Lanoxin) C. The nurse notes the ST segment is elevated on the EKG.

What is the nurse¶s first action? A. Offer a glass of cool water to help replace fluid lost by sweating B. .40. Stop the test. a middle-aged client becomes extremely diaphoretic and complains of pressure in the mid-chest. The nurse notes the ST segment is elevated on the EKG. These symptoms and EKG changes may indicate the onset of an MI and any farther activity will worsen the condition. Continue the test at a slower rate and notify the physician D. Have the client take a break and give the morning dose of digoxin (Lanoxin) C. During a treadmill stress test. have the client sit or lie down and assess vital signs ‡ D.

´ .´ D.41.´ C. Which client statement indicates that the teaching was successful? A. ³I will avoid physical strain while I am wearing the monitor. ³I will avoid using caffeine while wearing the monitor.´ B. ³I should remain as still as possible while wearing the monitor. ³I will keep a log of daily activities while I am wearing the monitor. The nurse is teaching a client who is scheduled for 24-hour Holter monitoring.

´ ‡ B. ³I should remain as still as possible while wearing the monitor. The nurse is teaching a client who is scheduled for 24-hour Holter monitoring. for comparison of the activities with EKG tracings during analysis of the data.´ D. It is important for the client to record all activities while being monitored. ³I will avoid physical strain while I am wearing the monitor. . and should continue the usual diet.´ C.41. ³I will keep a log of daily activities while I am wearing the monitor. The client should maintain a daily schedule as close to normal as possible while wearing a Holter monitor. Which client statement indicates that the teaching was successful? A. ³I will avoid using caffeine while wearing the monitor.´ B.

42. What statement would best describe an echocardiogram? A. C. Percussive tapping of the chest over the heart Noninvasive ultrasound of the lungs Invasive electroconduction examination Sonographic examination of the heart . B. D.

B. D. C. . Echocardiogram is a noninvasive ultrasound or sonograph of the heart for visualization purposes. Percussive tapping of the chest over the heart Noninvasive ultrasound of the lungs Invasive electroconduction examination Sonographic examination of the heart ‡ D.42. What statement would best describe an echocardiogram? A.

what nursing diagnosis would be the most appropriate? A. B. Risk for clot displacement Risk for fluid volume deficit Risk for situational fear Risk for disturbed individual coping . Following cardiac catheterization. D. C.43.

Risk for clot displacement Risk for fluid volume deficit Risk for situational fear Risk for disturbed individual coping ‡ B. C. Bleeding at the site of catheter introduction is a potential complication leading to fluid volume deficit. B. D.43. Following cardiac catheterization. what nursing diagnosis would be the most appropriate? A. Clot displacement is not a nursing diagnosis .

Residual volume is the maximum amount of air that can be expired B.44. Which statement would be appropriate for a pulmonary function test? A. Tidal volume is the amount of air exchanged D. Vital capacity is the amount of air left after expiration C. Pulmonary function may be used to diagnose early stage lung cancer .

Vital capacity is the amount of air left after expiration C.44. Tidal volume is the amount of air exchanged D. This is the only correct statement. Pulmonary function may be used to diagnose early stage lung cancer ‡ C. . Which statement would be appropriate for a pulmonary function test? A. Residual volume is the maximum amount of air that can be expired B.

Identify the highest priority nursing action. A post-bronchoscopy client develops wheezing. and becomes cyanotic.45. A. Call the client¶s physician about the symptoms C. Assess breath sounds and maintain the airway D. stridor. Encourage the client to cough and deep-breathe to reduce secretions . Check the gag reflex to make sure the local anesthetic has worn off B.

While all four measures may be appropriate nursing actions. A post-bronchoscopy client develops wheezing. stridor. Assess breath sounds and maintain the airway D. Call the client¶s physician about the symptoms C. Encourage the client to cough and deep-breathe to reduce secretions ‡ C. Identify the highest priority nursing action. A. and becomes cyanotic.45. Check the gag reflex to make sure the local anesthetic has worn off B. . at this time assessing and maintaining the airway have the highest priority. The client is developing respiratory distress from irritation and swelling of the respiratory mucosa.

³A feeling of pressure may be experienced during the procedure.´ D.´ C.´ B.46. ³No eating or drinking will be allowed until your gag reflex returns.´ .? A. ³Peripheral pulses will be assessed frequently following the procedure. Which instruction is appropriate when providing education to the client who is scheduled for a thoracentesis. ³Bedrest with the head elevated is required for 24 hours after the procedure.

? A.46. . ³Bedrest with the head elevated is required for 24 hours after the procedure.´ D.´ ‡ B. A feeling of pressure may occur when the physician inserts the large-bore needle into the pleural space.´ B. Choices A. ³A feeling of pressure may be experienced during the procedure.´ C. ³Peripheral pulses will be assessed frequently following the procedure. Which instruction is appropriate when providing education to the client who is scheduled for a thoracentesis. C and D are not accurate. ³No eating or drinking will be allowed until your gag reflex returns.

D. Jejunoscopy Laparoscopy Gastroscopy Lower GI series .47. A client is complaining of discomfort 1-2 hours after eating with feelings of fullness. B. How might this best be assessed? A. C.

C. B. How might this best be assessed? A. D. Gastroscopy is the direct visualization of the stomach. A client is complaining of discomfort 1-2 hours after eating with feelings of fullness. . Jejunoscopy Laparoscopy Gastroscopy Lower GI series ‡ C. Another possible assessment would be an upper GI series.47.

48. C. Select the physician order that would require clarification. B. Administration of a cleansing enema Clear liquid diet the day before the procedure Obtaining a client signature on a consent form A regular breakfast ordered before the procedure . A. The nurse is preparing a client for a colonoscopy scheduled for the next morning. D.

it doesn¶t make sense for the client to have regular food prior to the procedure. The nurse is preparing a client for a colonoscopy scheduled for the next morning. The other choices are appropriate orders prior to a colonoscopy. Administration of a cleansing enema Clear liquid diet the day before the procedure Obtaining a client signature on a consent form A regular breakfast ordered before the procedure ‡ D. C. . B. A. Select the physician order that would require clarification. Since the intestinal system is the focus of this diagnostic procedure. D.48.

D. What would be the best client position for a sigmoidoscopy? A. B. Left lateral Sims Right lateral Sims Knee-chest Trendelenburg .49. C.

Knee-chest D. This is the correct position. . Trendelenburg ‡ C. Right lateral Sims C. What would be the best client position for a sigmoidoscopy? A. Left lateral Sims B.49.

B.50. C. After paracentesis. Hypotension and flushed skin Eupnea and increased bowel sounds Peripheral edema and thirst Nausea and fatigue . On which should the RN focus the care first? A. all of the assessment data is identified. D.

C. After paracentesis. On which should the RN focus the care first? A. they do not place the client in immediate danger. Hypotension and flushed skin Eupnea and increased bowel sounds Peripheral edema and thirst Nausea and fatigue ‡ A. B.50. all of the assessment data is identified. These are symptoms of hypovolemia with vasodilatation and shock and need immediate attention. . While the other symptoms will require attention. D.

´ B.´ . Which statement by the certified nursing assistant indicates understanding of the correct procedure for obtaining a stool specimen for culture and sensitivity? A.´ C. ³A special preservative must be placed in the container with the specimen. ³Apply a thin smear of the stool specimen to a guaiacimpregnated card.51.´ D. ³I need to give a small enema to evacuate stool from the bowel for collection. ³A sterile container must be used for specimen collection.

´ D. Which statement by the certified nursing assistant indicates understanding of the correct procedure for obtaining a stool specimen for culture and sensitivity? A. ³Apply a thin smear of the stool specimen to a guaiacimpregnated card.51. ³I need to give a small enema to evacuate stool from the bowel for collection.´ D. ³A special preservative must be placed in the container with the specimen. . All specimens for culture and sensitivity must be placed in sterile containers to eliminate the possibility of contamination by outside organisms.´ C.´ B. ³A sterile container must be used for specimen collection.

³After I receive the medicine.´ . Which client statement about conscious sedation (moderate sedation) for a colonoscopy indicates that teaching by the nurse has been effective? A.52.´ D. ³This kind of sedation will help me relax. I¶ll be µout like a light¶ and will sleep soundly through the whole procedure. ³I will need to be hospitalized the night before the colonoscopy to be observed for any side effects to a test dose of the conscious sedation medicine. ³The medicine I¶ll be given for this type of sedation is Stadol (butorphanol). the same medicine I took for pain after my hernia operation.´ B. so I can cooperate with the doctor during the colonoscopy.´ C.

Conscious sedation or ³twilight sleep´ facilitates decrease in anxiety and promotes cooperation and relaxation.´ ‡ D. The protective airway reflexes are maintained.´ B. the same medicine I took for pain after my hernia operation.52. .´ D. Midazolam (Versed) is one agent commonly used for conscious sedation. Which client statement about conscious sedation (moderate sedation) for a colonoscopy indicates that teaching by the nurse has been effective? A. ³I will need to be hospitalized the night before the colonoscopy to be observed for any side effects to a test dose of the conscious sedation medicine. ³This kind of sedation will help me relax.´ C. ³After I receive the medicine. I¶ll be µout like a light¶ and will sleep soundly through the whole procedure. ³The medicine I¶ll be given for this type of sedation is Stadol (butorphanol). so I can cooperate with the doctor during the colonoscopy.

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