Question 1

A client has had a positive reaction to PPD. The client asks the nurse what this means. The nurse should indicate that the client?

Accepted Answer

Answer reason: A positive PPD indicates prior exposure or latent infection with Mycobacterium tuberculosis; it does not diagnose active TB.

Question 2

In reviewing the assessment data of a client suspected of having diabetes insipidus, the nurse expects which of the following after a water deprivation test?

Accepted Answer

Answer reason: In diabetes insipidus, inadequate ADH action prevents urine concentration even when fluids are withheld. During a water deprivation test, the urine remains dilute and its specific gravity stays low/unchanged. Edema, proteinuria, or hypokalemia are not expected findings.

Question 3

Components of Fetal Biophysical Profile?

Accepted Answer

Answer reason: The biophysical profile includes five parameters: fetal tone, gross body movement, fetal breathing movement, amniotic fluid volume, and a non-stress test. Therefore all listed components are included.

Question 4

_____ test assess for arterial sufficiency in the radial and ulnar arteries?

Accepted Answer

Answer reason: Allen’s test evaluates patency of the radial and ulnar arteries by occluding both and observing hand reperfusion; Homan’s is for DVT, Buerger test is for lower-extremity arterial insufficiency, and Phalen’s is for carpal tunnel.

Question 5

What is the definitive test used to diagnose an abdominal aortic aneurysm?

Accepted Answer

Answer reason: CT scan (often CTA) provides the most accurate confirmation and sizing of an AAA; ultrasound is best for screening, abdominal X-ray is insensitive, and arteriography can underestimate aneurysm size.

Question 6

A client is receiving intravenous heparin for deep vein thrombosis. What laboratory value should the nurse monitor closely?

Accepted Answer

Answer reason: Heparin therapy is monitored with aPTT to titrate dose and assess bleeding risk; INR is used for warfarin.

Question 7

Which diagnostic tool is most commonly used to determine location of myocardial damage?

Accepted Answer

Answer reason: ECG lead patterns localize myocardial ischemia/infarction (e.g., inferior vs anterior wall) via ST changes/Q waves. Enzymes indicate presence, not location; echo shows wall-motion but is not the most commonly used; catheterization visualizes coronaries but is invasive and not the standard for localizing myocardial damage.

Question 8

Too narrow cuff will cause what change in the Client's BP?

Accepted Answer

Answer reason: A cuff that is too narrow requires greater pressure to occlude the artery, producing a falsely elevated blood pressure reading.

Question 9

Which diagnostic test is indicated by the abbreviation NST in a nursing study?

Accepted Answer

Answer reason: NST stands for non-stress test, an antepartum diagnostic test of fetal well-being; the other options are different tests (EMG, amniocentesis, Doppler).

Question 10

Lumbar puncture is contraindicated in which of the following conditions?

Accepted Answer

Answer reason: Lumbar puncture is contraindicated with increased ICP because rapid CSF removal can precipitate brain herniation. Headache, back pain, or mild fever are not absolute contraindications.

Question 11

An obstetrical client with diabetes has an amniocentesis at 28 weeks gestation. Which test indicates the degree of fetal lung maturity?

Accepted Answer

Answer reason: Fetal lung maturity is assessed by the lecithin:sphingomyelin (L:S) ratio in amniotic fluid; a ratio around 2:1 indicates adequate surfactant production (often higher threshold in diabetic pregnancies).

Question 12

The nurse is reviewing the lab results of a client's arterial blood gases. The PaCO2 indicates effective functioning of the?

Accepted Answer

Answer reason: PaCO2 reflects the partial pressure of carbon dioxide and is the respiratory component of ABGs, indicating ventilation effectiveness of the lungs. (HCO3− reflects renal/metabolic function.).

Question 13

The physician has ordered lab work for a client with suspected disseminated intravascular coagulation (DIC). Which lab finding would provide a definitive diagnosis of DIC?

Accepted Answer

Answer reason: Elevated fibrin degradation products/D-dimer (fibrin split products) are a hallmark of DIC and provide strong diagnostic evidence. ESR and WBC are nonspecific, and prolonged clotting time alone is not definitive.

Question 14

The Mantoux test is used to determine whether a person has been exposed to tuberculosis. If the test is positive, the nurse will find a?

Accepted Answer

Answer reason: A positive PPD/Mantoux test is determined by the presence and measurement of induration, not erythema, vesicles, or blanching.

Question 15

The nurse is caring for a client receiving supplemental oxygen. The effectiveness of the oxygen therapy is best determined by?

Accepted Answer

Answer reason: Arterial blood gases provide the most accurate objective assessment of oxygenation and ventilation (PaO2, PaCO2), making them the best measure of oxygen therapy effectiveness compared with clinical signs like respiratory rate, cyanosis, or LOC.

Question 16

A client is admitted to the emergency room with complaints of substernal chest pain radiating to the left jaw. Which ECG finding is suggestive of acute myocardial infarction?

Accepted Answer

Answer reason: Acute myocardial infarction typically shows ST-segment changes (often elevation) on ECG indicating myocardial injury. Peaked P waves suggest atrial enlargement, prominent U waves suggest hypokalemia, and a minimal QRS is not characteristic of acute MI.

Question 17

A child suspected of having cystic fibrosis is scheduled for a quantitative sweat test. The nurse knows that the quantitative sweat test will be analyzed using?

Accepted Answer

Answer reason: The sweat chloride test for cystic fibrosis uses pilocarpine iontophoresis to stimulate sweat production, after which chloride concentration is measured.

Question 18

Which activity is not recorded by a pulse oximeter?

Accepted Answer

Answer reason: A pulse oximeter provides pulse rate and peripheral oxygen saturation (SpO2). It does not record or display ECG rhythm or changes.

Question 19

Which device is used to measure oxygen saturation?

Accepted Answer

Answer reason: A pulse oximeter noninvasively measures peripheral oxygen saturation (SpO2). A manometer measures pressure, a pulse transducer detects pulse waveforms, and a thermometer measures temperature.

Question 20

A diabetic multigravida is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1 and the presence of phosphatidylglycerol is noted. The nurse's assessment of this data is?

Accepted Answer

Answer reason: An L/S ratio of 2:1 is the classic threshold for fetal lung maturity. At 32 weeks an L/S of 1:1 indicates immature surfactant and increased risk for RDS; despite reported phosphatidylglycerol, the subthreshold L/S still suggests significant RDS risk.

Question 21

A client with AIDS has a viral load of 200 copies per ml. The nurse should interpret this finding as?

Accepted Answer

Answer reason: A viral load of 200 copies/mL is very low, indicating effective suppression of circulating HIV. It does not determine CD4 count or opportunistic infection risk, and one cannot state the client is no longer communicable in absolute terms.

Question 22

A client with diabetes has an order for ultrasonography. Preparation for an ultrasound includes?

Accepted Answer

Answer reason: Abdominal ultrasonography typically requires the client to be NPO for about 8 hours to reduce bowel gas and improve visualization. Increasing fluids is for pelvic ultrasound, enemas are not required, and ambulation is unrestricted.

Question 23

A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonstress test?

Accepted Answer

Answer reason: An NST evaluates fetal heart rate reactivity to fetal movement; a reactive pattern indicates adequate oxygenation and an intact central nervous system, reflecting fetal neurological well-being. It does not assess lung maturity (amniocentesis L/S ratio) or effects of contractions (contraction stress test).

Question 24

The physician has ordered a thyroid scan to confirm the diagnosis of a goiter. Before the procedure, the nurse should?

Accepted Answer

Answer reason: A thyroid scan uses a radiotracer; the nurse should screen for allergies/contraindications to the agent. Sedation, IV fluid bolus, and urinary catheterization are not required for this test.

Question 25

Which lead is typically used to provide continuous rhythm monitoring in a patient with lead placement issues?

Accepted Answer

Answer reason: Lead II is the standard telemetry lead for continuous rhythm monitoring because it best displays P waves and overall rhythm. V5 is mainly for ischemia detection, V3 is not typical for rhythm monitoring, and an 'atrial lead' is not a standard surface ECG option.

Question 26

A client is admitted with suspected acute pancreatitis. Which lab finding confirms the diagnosis?

Accepted Answer

Answer reason: Acute pancreatitis is confirmed by markedly elevated pancreatic enzymes, especially serum amylase (typically >3× normal). A level of 600 strongly supports the diagnosis; hyperglycemia and leukocytosis may occur but are not diagnostic.

Question 27

The nurse is reviewing the results of a sweat test taken from a child with cystic fibrosis. Which finding supports the client's diagnosis?

Accepted Answer

Answer reason: Cystic fibrosis is confirmed by an elevated sweat chloride level; values ≥60 mEq/L are diagnostic. Potassium levels are not the criterion.

Question 28

The physician has ordered intubation and mechanical ventilation for a client with periods of apnea following a closed head injury. Arterial blood gases reveal a pH of 7.47, PCO2 of 28, and HCO3 of 23. These findings indicate that the client has?

Accepted Answer

Answer reason: PH > 7.45 indicates alkalemia; PaCO2 is low (28), while HCO3− is normal, indicating a primary respiratory alkalosis.

Question 29

Which of the following nursing interventions has the highest priority for the client scheduled for an intravenous pyelogram?

Accepted Answer

Answer reason: IV pyelogram uses iodine-based contrast; screening for iodine/shellfish allergy is the highest-priority safety assessment to prevent a severe contrast reaction.

Question 30

The physician has ordered a blood test for H. pylori. The nurse should prepare the client by?

Accepted Answer

Answer reason: Pylori blood testing is a serologic assay for antibodies and requires no special preparation. NPO is unnecessary, isotopes are used for the urea breath test, and glucose is unrelated.

Question 31

The physician has ordered cultures for cytomegalovirus (CMV). Which statement is true of the collection of cultures for cytomegalovirus?

Accepted Answer

Answer reason: CMV is labile, so prompt transport and fresh specimens are needed for accurate culture. Stool is not preferred, pregnant caregivers should avoid exposure, and multiple specimens are often required for detection.

Question 32

The nurse caring for a client scheduled for an angiogram should prepare the client for the procedure by telling him to expect?

Accepted Answer

Answer reason: During angiography, injection of iodinated contrast commonly causes a transient warm or flushed sensation; the other options are not expected normal effects.

Question 33

In the Mantoux test, by which route is the purified protein derivative injected?

Accepted Answer

Answer reason: The Mantoux tuberculin skin test is administered by intradermal injection of 0.1 mL PPD into the forearm to create a small wheal.

Question 34

The hospital administrator had undergone percutaneous transhepatic cholangiography. Which assessment finding indicates complication after the operation?

Accepted Answer

Answer reason: Post–percutaneous transhepatic cholangiography, fever and chills suggest infection/cholangitis or sepsis, a serious complication. The other findings are nonspecific and less indicative of a procedure-related complication.

Question 35

When is the best time to collect urine specimen for routine urinalysis and C/S?

Accepted Answer

Answer reason: First-void early morning urine is most concentrated and has highest bacterial count after overnight retention, improving accuracy for routine urinalysis and culture/sensitivity.

Question 36

Which blood test is recommended for a client on warfarin therapy?

Accepted Answer

Answer reason: Warfarin affects vitamin K–dependent clotting factors, prolonging PT. The standardized measure for monitoring and dosing warfarin is the INR, which adjusts PT across laboratories.

Question 37

The nurse understands that the diagnosis of oral cancer is confirmed with?

Accepted Answer

Answer reason: Cancer is definitively diagnosed by histopathologic examination of tissue obtained via biopsy. Gram stain and culture identify infections; cytology washings can screen but are not confirmatory.

Question 38

The nurse is caring for a patient with suspected diverticulitis. The nurse would be most prudent in questioning which of the following diagnostic tests?

Accepted Answer

Answer reason: In suspected acute diverticulitis, contrast enemas (barium enema) and colonoscopy are avoided due to risk of perforation. CT scan and ultrasound help diagnose, and CBC assesses leukocytosis.

Question 39

The client is scheduled to have an intravenous cholangiogram. Before the procedure, the nurse should assess the patient for?

Accepted Answer

Answer reason: An IV cholangiogram uses iodinated contrast. Standard pre-procedure assessment is for iodine/seafood (shellfish) allergy due to risk of contrast reaction.

Question 40

The child with a history of respiratory infections has an order for a sweat test to be done. Which finding would be positive for cystic fibrosis?

Accepted Answer

Answer reason: Sweat chloride ≥60 mEq/L is diagnostic/positive for cystic fibrosis in children; the other listed lab values are within normal ranges and not diagnostic for CF.

Question 41

The physician has ordered a culture for the client with suspected gonorrhea. The nurse should obtain a culture of?

Accepted Answer

Answer reason: Neisseria gonorrhoeae infects mucous membranes of the genitourinary tract; diagnosis is made by culture/NAAT of urethral or cervical/genital secretions. Blood, nasopharyngeal, or stool specimens are not appropriate for suspected gonorrhea.

Question 42

The nurse is preparing a client for mammography. To prepare the client for a mammogram, the nurse should tell the client?

Accepted Answer

Answer reason: Topical products on the breasts/axillae can appear as artifacts or calcifications on mammography and should be avoided. Diet restriction is unnecessary, mammography does not replace self-exams, and it uses low-dose x-rays.

Question 43

A client with suspected renal disease is to undergo a renal biopsy. The nurse plans to include which statement in the teaching session?

Accepted Answer

Answer reason: Renal biopsy is typically done prone under local anesthesia; the client remains awake and may feel pain or discomfort. Fluids are encouraged postprocedure, not restricted.

Question 44

The client is having a cardiac catheterization. During the procedure, the client tells the nurse, "I’m feeling really hot." Which response would be best?

Accepted Answer

Answer reason: During cardiac catheterization, injection of iodinated contrast commonly causes a transient warm or hot sensation; reassuring the client that it is expected is the best response.

Question 45

The nurse is caring for a client suspected to have Tuberculosis (TB). Which of the following diagnostic tests is essential for determining the presence of active TB?

Accepted Answer

Answer reason: Sputum culture confirms active TB by identifying Mycobacterium tuberculosis. Skin testing indicates exposure, chest x-ray suggests disease but is not definitive, and WBC count is nonspecific.

Question 46

A client is scheduled to have a blood test for cholesterol and triglycerides the next day. The nurse would tell the client?

Accepted Answer

Answer reason: Lipid profile, especially triglycerides, requires a fasting sample; patients should avoid all food and beverages except water for about 12 hours prior. The other options either allow eating, specify non-fasting timing, or unnecessary repeat sampling.

Question 47

A child and his family were exposed to Mycobacterium tuberculosis about two months ago; to confirm the presence or absence of an infection, it is MOST important for all family members to have a?

Accepted Answer

Answer reason: The tuberculin skin test (PPD) is the standard screening to detect TB infection in contacts and turns positive 3–8 weeks post-exposure. Chest x-ray and sputum culture are not the initial test for all exposed, asymptomatic family members; blood culture is not used for TB screening.

Question 48

The nurse is caring for a trauma victim with a significant blood loss. Immediately following multiple transfusions, what is the MOST accurate indicator of oxygenation?

Accepted Answer

Answer reason: Arterial blood gases directly measure PaO2 and SaO2 and thus most accurately assess oxygenation; pulse oximetry can be unreliable in shock/transfusion states, and hemoglobin/hematocrit reflect oxygen-carrying capacity, not oxygenation.

Question 49

A client is scheduled for an Intravenous Pyelogram (IVP). In order to prepare the client for this test, the nurse would?

Accepted Answer

Answer reason: IVP preparation includes bowel cleansing the evening before to improve visualization of the urinary tract. Regular diet or fluid restriction close to the test are not standard, and multiple films are usually taken, not just one.

Question 50

The nurse is caring for a client with peripheral vascular disease. To correctly assess the oxygen saturation level, the monitor may be placed on the?

Accepted Answer

Answer reason: In peripheral vascular disease, finger or toe perfusion may be poor, giving inaccurate pulse oximetry. Alternative central sites such as the earlobe provide better perfusion and more reliable readings.

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