Question 1

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

A) "It will help assess your visual acuity." 
B) "It will reflect light back into the eye so we can see its internal structures." 
C) "It will protect your eye from damage by the bright light." 
D) "It will anesthetize your eye."

Question 2

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) Lavender 
B) Green 
C) Red 
D) Gray

Question 3

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

A) Adrenocorticotropic hormone = 3 pmol/L 
B) Amylase = 45 units/L 
C) Aldosterone = 4 ng/dL 
D) Acetylcholine receptor antibodies = 0.8 nmol/L

Question 4

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

A) "Genetic testing of family members is not necessary." 
B) "Limit strenuous exercise." 
C) "Plan to have $\alpha$1AT levels monitored at regular intervals." 
D) "Use protein-calorie supplementation to maintain muscle mass."

Question 5

A patient's laboratory test results indicate an elevated level of glucagon.The nurse should suspect which of the following conditions? Select all that apply.

Accepted Answer

A) Glucagonoma 
B) Chronic pancreatitis 
C) Hypoglycemia 
D) Cystic fibrosis 
E) Trauma

Question 6

A 2-year-old child has a lead level of 25 mcg/dL from a fingerstick specimen obtained at a health department screening.Which instruction should a nurse provide to the child's parent or caregiver?

Accepted Answer

A) "A follow-up test with a venous specimen needs to be completed within 1 month." 
B) "Anyone in your family who has contact with this child will need treatment." 
C) "No additional action is needed at this time since this is a normal result." 
D) "This result is high enough to require hospitalization and immediate treatment."

Question 7

A patient's laboratory test results indicate elevated levels of D-dimers.Although not specific to these conditions, this finding would provide presumptive evidence of which of the following? Select all that apply.

Accepted Answer

A) Hemophilia 
B) Disseminated intravascular coagulation 
C) Deep vein thrombosis (DVT) 
D) Pulmonary embolism 
E) Von Willebrand disease

Question 8

A patient with a history of sickle cell disease has a total bilirubin level of 0.9 mg/dL with a direct bilirubin level of 0.3 mg/dL.Which additional data should the nurse obtain to plan care for this patient?

Accepted Answer

A) None, these results are normal. 
B) Ultrasound of the gallbladder 
C) Liver function tests 
D) Serum electrolytes

Question 9

Laboratory results indicate that a patient's anion gap is over 16.Which condition should the nurse plan to manage?

Accepted Answer

A) Appendicitis 
B) Metabolic acidosis 
C) Myocardial infarction 
D) Pulmonary embolism

Question 10

A nurse is providing teaching to a patient who has been found to have advanced cirrhosis following alkaline phosphatase (ALP)testing.Which of the following diets would be most appropriate to recommend to this patient?

Accepted Answer

A) Low carbohydrate 
B) Low protein 
C) Low fat 
D) Soft foods

Question 11

A patient has a serum albumin of 4.1 g/dL.Based on this lab value, a nurse should instruct this patient to:

Accepted Answer

A) Add more green leafy vegetables daily. 
B) Continue with current dietary patterns. 
C) Increase fiber and fluid in the diet. 
D) Increase protein in the diet.

Question 12

The nurse is reviewing laboratory results for a woman with a history of breast cancer.The nurse would evaluate the possibility of bone metastasis using which of the following laboratory values?

Accepted Answer

A) Albumin 
B) Folate 
C) Ionized calcium 
D) Alkaline phosphatase

Question 13

A geriatric patient is admitted with hyponatremia and a decreased serum osmolality.Nursing interventions should include restricting intake of:

Accepted Answer

A) Sodium 
B) Potassium 
C) Chloride 
D) Water

Question 14

A college student who is admitted to the hospital with newly diagnosed diabetes mellitus has a C-peptide level of 0.6 ng/mL and serum glucose of 256 mg/dL.Based on these results, which instruction should the nurse provide to this patient?

Accepted Answer

A) "Based on these results, your diabetes will be controlled by oral medications and diet." 
B) "If you lose weight, you may be able to manage your diabetes with diet alone." 
C) "Since you are already an adult, this result confirms that you have type 2 diabetes." 
D) "You will need to take insulin for the rest of your life."

Question 15

A nurse is providing teaching on nutrition to a patient who has just been diagnosed with type 2 diabetes following insulin response to glucose testing.Which of the following types of diets should the nurse recommend to this patient, based on recommendations from the American Heart Association (AHA)and other organizations? Select all that apply.

Accepted Answer

A) Atkins diet 
B) Mediterranean diet 
C) South Beach diet 
D) Dietary Approaches to Stop Hypertension (DASH) 
E) Weight Watchers

Question 16

A patient has orders for lactulose 30 mL by mouth every 4 hours and neomycin 250 mg by mouth every 4 hours.Which laboratory result should a nurse monitor to determine the effectiveness of these medications?

Accepted Answer

A) Blood ammonia 
B) Glycosylated hemoglobin 
C) Serum creatinine 
D) White blood cell count

Question 17

A patient is suspected of having hay fever.Which test would be most appropriate for confirming this suspicion?

Accepted Answer

A) Immunofixation electrophoresis (IF
E)  
B) Immunoglobulin E (Ig
E)  
C) Immunoglobulin A (Ig
A)  
D) Immunosuppressant cyclosporine

Question 18

A young woman with a significant family history of coronary artery disease is planning a pregnancy in the next year.Prenatal screening results include a homocysteine level of 36 micromoles/L.The nurse should teach the patient to:

Accepted Answer

A) Take folic acid and vitamins B6 and B12 daily. 
B) Decrease intake of calcium and monosaturated fats. 
C) Increase fluid intake and take an aspirin daily. 
D) Schedule monthly injections of B12 and iron.

Question 19

A patient diagnosed with type 1 diabetes mellitus is maintained on a nighttime dose of basal insulin with short-acting insulin prior to meals three times daily.The patient has had two consecutive glycated hemoglobin A1c (Hgb A1c)results that are less than 5%.Which question should a nurse ask when interpreting these results?

Accepted Answer

A) "Do you experience excessive fatigue during the daytime?" 
B) "Have you noticed episodes of shakiness and profuse perspiration?" 
C) "How often do you have to get up at night to void?" 
D) "What time of day do you usually have your meals?"

Question 20

A patient is exhibiting signs of carbamazepine (an anticonvulsant)toxicity.The patient is seizing, hypertensive, and has ileus.Which of the following interventions would be appropriate? Select all that apply.

Accepted Answer

A) Gastric lavage 
B) Airway protection 
C) Administration of diazepam 
D) Administration of an emetic 
E) Administration of fluids and vasopressors

Exam 1: About This Book