1. Which of these instructions should a nurse give an elderly, dehydrated patient after computed tomography (CT) of the kidney with intravenous iodine contrast material?
a. Drink plenty of fluids for 24 hours b. Avoid heavy lifting for 2 days
c. Use a laxative to clear the contrast from the bowel d. None of the above
Read: Test Bank For Mosby’s Canadian Manual Of Diagnostic And Laboratory
2. For a patient with severe bone destruction from tumour or osteomalacia, what serum laboratory results would the nurse expect to assess?
a. Decreased serum alkaline phosphatase (ALP) level b. Increased serum ALP level
c. Decreased erythrocyte sedimentation rate d. Increased red blood cell count
3. A patient’s laboratory reports indicate the presence of Bence-Jones proteins. These levels are increased in the urine of patients who have:
a. Multiple myeloma
b. Carcinoid syndrome c. Breast cancer
d. Colorectal cancer
4. A patient is admitted for evaluation of perforated diverticulitis. Which of the following is the most appropriate test?
a. CT of the abdomen b. Barium enema
c. Colonoscopy d. All the above
5. Blood urea nitrogen (BUN) levels may be abnormally low in which patients?
a. Overly hydrated patients b. Patients with liver disease
c. Malnourished patients in negative nitrogen balance d. All the above
6. The serum creatinine level is usually elevated in patients with which of the following?
a. Renal disease b. Liver disease c. Lung disease
d. Muscular disease
7. A patient presents with upper gastrointestinal bleeding from a suspected peptic ulcer.
Which of the following is the most appropriate test?
a. Upper gastrointestinal radiography b. Gastric bleeding scan
c. Esophagogastroduodenoscopy (EGD)
d. None of the above
8. A patient is admitted with abdominal pain. Ultrasonography of the abdomen, CT of the abdomen, and a barium enema study have been ordered. In what order should these tests be performed?
a. Ultrasonography, barium enema, CT b. Ultrasonography, CT, barium enema c. Barium enema, CT, ultrasonography d. CT, barium enema, ultrasonography
9. A patient is scheduled for a cardiac exercise stress test to evaluate chest pain. While obtaining the patient history, the clinician notes that the patient has intermittent claudication when walking two blocks. On the basis of this finding, which of the following is indicated?
a. The test will be performed as scheduled
b. The test is contraindicated because of the intermittent claudication c. The test will be rescheduled after resolution of the claudication
d. The patient is a candidate for the dipyridamole-thallium (nonexercise) stress test
10. A patient is scheduled for a cardiac catheterization. Which of the following activities is a postprocedure nursing priority?
a. Ambulating the patient
b. Encouraging coughing and deep-breathing exercises
c. Keeping the patient on NPO status (nothing by mouth)
d. Keeping the involved extremity immobilized
11. One of the blood studies used to detect a myocardial infarction is creatine kinase (CK). What value is most helpful for diagnosing a myocardial infarction?
a. Total CK
b. Isoenzyme CK-MM c. Isoenzyme CK-MB d. Isoenzyme CK-BB
12. During a patient’s exercise stress test, his blood pressure drops and he complains of feeling dizzy. What should the nurse do?
a. Encourage the patient to take deep breaths b. Terminate the test immediately
c. Take the vital signs d. Lay the patient flat
13. A patient had a lipid profile documented and asks about her results. Which of the following is considered the ideal high-density lipoprotein (HDL)/total cholesterol ratio?
a. 1:2 b. 1:3
c. 1:4 d. 1:5
14. A patient underwent a tuberculin skin test 48 hours ago. He returns to the clinic for the nurse to read the test results. Which of the following is considered a positive result?
a. A reddened area measuring 20 mm b. A flat, red area measuring 10 mm
c. An indurated area measuring 8 mm d. An indurated area measuring 12 mm
15. A patient with diabetes was taken to the emergency department. His arterial blood gas results were as follows:
pH: 7.25
Partial pressure of carbon dioxide (PCO2): 38 mm Hg
HCO3- 19 mmol/L
Partial pressure of oxygen (PO2): 95 mm Hg
What do these results indicate?
a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis
d. Metabolic alkalosis
16. A patient has just returned from the endoscopy suite, where he underwent bronchoscopy. Which of the following is not a nursing priority after the procedure?
a. Observing the sputum forNhemRorrIhagGe b. Monitoring the vital signs frequently
c. Observing the patient closely for laryngospasm d. Encouraging cool fluids to comfort his throat
17. What is the best time of the day for obtaining a sputum specimen?
a. Early morning b. After breakfast c. Evening
d. The time does not matter
18. A patient is scheduled for magnetic resonance imaging (MRI). Which of the following factors is a contraindication to this procedure?
a. Iodine allergy
b. Severe visual impairment c. Cardiac pacemaker
d. None of the above
19. Which of the following activities should be avoided before electroencephalography
(EEG)?
a. Washing the hair the night before the procedure b. Taking anticonvulsant medications
c. Drinking caffeinated fluids such as regular coffee, tea, or cola
d. None of the above
20. After a lumbar puncture, a nursing priority is to prevent a spinal headache. Which of the following activities is to be avoided?
a. Ambulating the patient in the room b. Drinking fluids through a straw
c. Keeping the patient on bed rest d. Keeping the patient’s head flat
21. A patient is scheduled for lumbar puncture. Which of the following conditions is a contraindication to this procedure?
a. Meningitis
b. Neurosyphilis
c. Multiple sclerosis
d. Increased intracranial pressure (ICP)
22. Which of the following statements regarding a glycosylated hemoglobin test is false?
a. The test provides an accurate long-term index of the patient’s average blood glucose
level.
b. The test aids in determining the duration of hyperglycemia in a patient with newly diagnosed diabetes.
c. No fasting is required for this test.
d. Short-term physiologic variations (e.g., those caused by food intake, exercise, and stress) affect the test result.
23. A patient has an elevated glucose level. Which of the following factors in his history may cause hyperglycemia?
a. Insulinoma
b. Corticosteroid therapy c. Hypothyroidism
d. Addison’s disease
24. Cortisol levels normally rise and fall during the day. This fluctuation is referred to as the
diurnal variation. At what time of the day are levels the highest?
a. 8 AM b. Noon c. 4 PM
d. Midnight
25. Symptoms that may indicate hypocalcaemia include which of the following?
a. Nausea, vomiting, and anorexia b. Polyuria and dehydration
c. Muscle weakness and coma
d. Tetany and carpal pedal spasms
26. A patient has been diagnosed with primary hypothyroidism. Her triiodothyronine (T3)
and thyroxine (T4) levels are decreased. What would a clinician expect the
thyroid-stimulating hormone (TSH) levels to be?
a. Normal
b. Increased c. Decreased d. Near zero
27. Often during a fetal nonstress test (fetal activity determination test), fetal activity must be stimulated. Which of the following stimuli is not part of this test?
a. Rubbing the mother’s abdomen
b. Administering intravenous oxytocin c. Ringing a bell near the abdomen
d. Compressing the mother’s abdomen
28. Which of the following statements best describes the Sims-Huhner test?
a. This test is an evaluation of the quality of cervical mucus.
b. This test is an examination of cervical mucus for colour, viscosity, and tenacity.
c. This test is an assessment of the number of motile sperm per high-power microscopic field.
d. This test is an evaluation of the interaction between the sperm and cervical mucus.
29. Which of the following tests is used to screen blood for antibody compatibility before a blood transfusion?
a. Direct Coombs test
b. Indirect Coombs test
c. Complete blood cell count d. Serum haptoglobin test
30. Which of the following statements is false with regard to the semen analysis test?
a. A single sperm analysis can be conclusive evidence of male infertility.
b. Men with little or no sperm should be evaluated for pituitary, thyroid, adrenal, or testicular aberrations.
c. A 2- to 3-day period of sexual abstinence is necessary before collection of the semen specimen.
d. For best results, a semen sample should be collected in the physician’s office or
laboratory by means of masturbation.
31. Which of the following tests is used to monitor warfarin administration?
a. Activated partial thromboplastin time b. Platelet count
c. Bleeding time
d. International normalized ratio (INR)
32. Which of the following factors may cause an increase in hematocrit concentration?
a. Hemorrhage
b. Bone marrow failure c. Pregnancy
d. Dehydration
33. A “shift to the left” in white blood cell production indicates an acute bacterial infection. Which of the following cells are increased in this situation?
a. Mature neutrophils b. Monocytes
c. Lymphocytes
d. Band (or stab) cells
34. The physician orders a blood culture for a patient with suspected bacteremia. Which of the following statements is incorrect with regard to the collection of this specimen?
a. Blood culture specimens should be drawn at the time the patient has a fever or chills. b. If the patient is receiving antibiotics already, the laboratory should be notified, and
the blood culture specimen should be collected shortly before the next dose of antibiotic is administered.
c. Two culture specimens should be obtained and from different sites.
d. The culture specimen can be drawn at any time without regard to medications and vital signs.
35. Which of the following is a possible cause of hyperkalemia?
a. Diarrhea and vomiting b. Diuretic drug therapy c. Cushing’s syndrome
d. Acidosis
36. After returning from an esophNagUoRgaSstIroNdGuoTdBen.oCscopMy (EGD) and dilation of an esophageal stricture, a patient began to complain of fever and chest pain. What should the nurse suspect, and what is the most appropriate action?
a. Myocardial infarction, and obtaining electrocardiography (ECG) immediately b. Gastroesophageal reflux, and administering an antacid
c. Esophageal perforation, and notifying the physician immediately
d. Dyspepsia from not eating before the procedure, and allowing the patient to eat bland food
37. After undergoing a barium enema study, what instruction should patients be given?
a. Take an oral laxative to completely evacuate the barium.
b. Try to retain the barium in case additional radiographic studies are needed the same day or the following day.
c. Await normal bowel function. d. None of the above.
38. After returning from colonoscopy, a patient complains of increasing abdominal pain. What is an appropriate nursing intervention?
a. Limiting her diet to clear liquids
b. Assisting her with a warm bath to soothe the anorectal area
c. Administering a gentle enema to assist in evacuation of colon contents and air d. Administering a laxative to assist in evacuation of excess colon contents
e. None of the above
39. A woman in her first trimester of pregnancy develops pain consistent with gallbladder disease. What is the most appropriate diagnostic test?
a. Gallbladder ultrasonography
b. Gallbladder radioscintigraphy scan c. Oral cholecystography
d. Computed tomography
40. After a liver biopsy, the patient should:
a. Ambulate to maintain mobility b. Lie on the left side
c. Lie on the right side d. Lie prone
41. A nurse has been stuck by a needle from a patient being treated for hepatitis. What is the most appropriate action or actions?
a. Immediate enteric and blood product precautions to isolate the involved nurse b. Immediately obtaining hepatitis viral studies on the affected nurse
c. Hospitalizing the nurse for bed rest d. All the above
e. None of the above
42. A patient’s leg has become swollen 1 week after arthroscopy. For what should he be evaluated?
a. Hemarthrosis
b. Joint stiffness after prolonged immobilization
c. Postoperative thrombophlebitis
d. Joint dislocation
43. A 5-year-old patient has fallen and injured her right arm during play therapy. Why does the physician order radiographs of both arms?
a. The noninjured arm could have been injured in the fall.
b. Fracture lines of long bones in children are difficult to distinguish from normal growth lines, which make comparison films necessary.
c. The battered child syndrome can be diagnosed by documenting multiple fractures. d. All the above.
44. A patient has just undergone diagnostic arthroscopy and has mild discomfort. Which of the following interventions is most appropriate?
a. Ambulating the patient b. Notifying the physician
c. Applying ice to reduce swelling and pain d. Administering an intramuscular narcotic
45. What drug should be discontinued before the serum gastrin level is measured?
a. Hydrochlorothiazide b. Propranolol (Inderal)
c. Cimetidine (Tagamet)
d. All the above
46. Which of the following instructions should the nurse give a client after an upper gastrointestinal study?
a. “Expect your stools to be chalky white for at least a day.”
b. “Take a cathartic (such as milk of magnesia).”
c. “Drink plenty of fluids when you get home.”
d. All the above.
47. Which of the following test results would indicate a complication of endoscopic retrograde cholangiopancreatography (ERCP)?
a. Red blood cells in the urine
b. Elevated serum amylase level c. Elevated serum calcium level d. All the above
48. Carcinoembryonic antigen (CEA) is used to monitor patients with what condition?
a. Colon cancer b. Breast cancer c. Gastric cancer d. All the above
49. Specific gravity in the urine is increased in patients with what condition?
a. Dehydration
b. Diabetes insipidus
c. Chronic renal failure d. All the above
50. Intravenous pyelography (IVP) may be contraindicated in patients with what condition?
a. Shellfish allergy
b. Severe dehydration c. Renal insufficiency d. All the above
51. Immediately after undergoing kidney biopsy, a patient notices gross hematuria. What is the most appropriate nursing intervention?
a. Collecting serial urine specimens
b. Dehydrating the patient to diminish urine output and bleeding
c. Notifying the physician immediately and obtaining a specimen for blood typing and crossmatching
d. All the above
52. Which of the following foods may interfere with determining the results of urinary vanillylmandelic acid or catecholamines?
a. Potatoes and red meat b. Coffee and licorice
c. Beer and salted pretzels d. All the above
53. A “no added salt” diet is necessary for patients before which of the following studies?
a. Urine specific gravity b. IVP
c. Plasma renin assay d. Renal scanning
54. What is the most specific test for identifying recurrent prostate cancer?
a. Prostatic acid phosphatase measurement
b. Prostate-specific antigen (PSA) measurement c. Digital rectal examination
d. Transrectal ultrasonography
55. A nurse should ask the patient which of the following questions before scheduling an
IVP?
a. “Are you allergic to shellfish or iodine?” b. “Have you ever undergone IVP before?” c. “Are you able to drink a lot of fluids?”
d. All the above
56. Before mammography, which of the following is or are appropriate information to give a patient?
a. Mammography involves aNloUwRdSoIseNoGf TraBdi.atCion Mand therefore can safely be performed annually.
b. Mammography can reveal breast cancer before a tumour is clinically palpable.
c. Although mammography is an accurate means of detecting breast cancer, it can result in false positives.
d. All the above.
57. What is the most accurate method of screening for breast cancer?
a. MRI of the breast b. Mammography
c. Ultrasonography of the breast d. Physical examination
58. Which of the following tumour markers is associated with breast cancer?
a. Alpha-fetoprotein
b. Human chorionic gonadotropin c. CA–15-3
d. CA–125
Practice Test Answer Key
1. Which of these instructions should a nurse give an elderly, dehydrated patient after computed tomography (CT) of the kidney with intravenous iodine contrast material?
a. Drink plenty of fluids for 24 hours b. Avoid heavy lifting for 2 days
c. Use a laxative to clear the contrast from the bowel d. None of the above
Answer: a
Rationale: Elderly patients are often chronically dehydrated and therefore especially
susceptible to renal impairment after receiving intravenous iodine contrast material. Not only is the use of laxatives unnecessary to eliminate the contrast material, but it will also further dehydrate the patient. No physical limitations are required.
Reference page: 1018
2. For a patient with severe bone destruction from tumour or osteomalacia, what serum laboratory results would the nurse expect to assess?
a. Decreased serum alkaline phosphatase (ALP) level b. Increased serum ALP level
c. Decreased erythrocyte sedNimUentSatioNn raTte
d. Increased red blood cell count
Answer: b
Rationale: Patients with destructive bone diseases commonly have elevated ALP levels
as a result of bone cell destruction and regeneration.
Reference page: 53
3. A patient’s laboratory reports indicate the presence of Bence-Jones proteins. These levels are increased in the urine of patients who have:
a. Multiple myeloma
b. Carcinoid syndrome c. Breast cancer
d. Colorectal cancer
Answer: a
Rationale: Bence-Jones proteins are immunoglobulins that are commonly excreted in the
urine of patients with multiple myeloma.
Reference page: 943
4. A patient is admitted for evaluation of perforated diverticulitis. Which of the following is the most appropriate test?
a. CT of the abdomen
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