Question 1

What is the best initial action for the nurse when a patient presents with a chest pain.?

Accepted Answer

Answer reason: A 12-lead ECG should be obtained immediately to rapidly identify life-threatening ischemia or STEMI and guide time-sensitive interventions. Diagnostic confirmation drives safe sequencing of therapies (e.g., nitrates can be contraindicated in right ventricular infarct or recent PDE-5 inhibitor use). While pain assessment and antiplatelet therapy are important, they should not delay immediate cardiac evaluation when chest pain suggests acute coronary syndrome. Early ECG also establishes a baseline for ongoing comparison if symptoms evolve.
Category reason: This is a patient-care prioritization question focused on the nurse’s first action and urgent evaluation of chest pain, emphasizing timely diagnostic testing to reduce risk.

Question 2

Which diagnostic test is commonly done before thoracentesis?

Accepted Answer

Answer reason: It is used to confirm the presence and approximate location/size of a pleural effusion and to help guide planning for the procedure to reduce complication risk (e.g., pneumothorax, organ puncture). Bedside ultrasound is often preferred for real-time guidance, but among the listed choices this is the standard pre-procedure test. ECG does not localize pleural fluid, CT is not routinely required for most uncomplicated effusions, and colonoscopy is unrelated.
Category reason: This tests selection of an appropriate pre-procedure diagnostic study to reduce risk and guide a thoracentesis, aligning with NCLEX content on diagnostic tests and preventing complications.

Question 3

A client is scheduled for a Holter monitor test. Which instruction should the nurse include?

Accepted Answer

Answer reason: A Holter monitor correlates the heart rhythm tracing with the client’s activities and any symptoms such as palpitations, dizziness, or chest discomfort. Keeping a detailed activity/symptom diary allows the provider to match events to ECG changes and improves diagnostic accuracy. Clients are typically encouraged to continue usual daily activities (unless otherwise instructed) to capture rhythms during real-life exertion rather than restricting movement. Eating and drinking are generally allowed; the key is keeping electrodes/monitor dry and intact.
Category reason: This is a nursing education question about preparing a client for a cardiac diagnostic test and ensuring accurate data collection, which fits Diagnostic Tests under Reduction of Risk Potential.

Question 4

Scenario: A nurse needs to collect a sputum specimen for culture. What instruction will the nurse give the patient?

Accepted Answer

Answer reason: A sputum culture requires specimen from the lower respiratory tract, so the patient should take deep breaths and cough forcefully to bring up sputum, rather than saliva. Collecting saliva can contaminate the specimen and reduce the accuracy of the culture results. Typical best practice is to collect in a sterile container, ideally first thing in the morning after oral rinsing (without antiseptic mouthwash) and before eating or drinking.
Category reason: This question tests a nursing instruction for collecting a diagnostic specimen to ensure accurate laboratory testing, which fits Diagnostic Tests under Reduction of Risk Potential.

Question 5

Lilia is scheduled to have a hysterosalpingogram. Which of the following instructions would you give her regarding this procedure?

Accepted Answer

Answer reason: D. She may feel some cramping when the dye is inserted An HSG involves instilling contrast through the cervix to outline the uterine cavity and fallopian tubes under fluoroscopy; uterine distention commonly causes transient cramping similar to menstrual cramps. Teaching about expected sensations helps reduce anxiety and promotes cooperation during the test. It does not require avoiding conception for months, and the procedure is not a sonogram. While light spotting can occur, the key pre-procedure expectation to emphasize is cramping with contrast injection.
Category reason: This item asks what patient teaching/instruction to provide for a diagnostic procedure (hysterosalpingogram), which fits nursing care around Diagnostic Tests under Reduction of Risk Potential.

Question 6

Hyperbilirubinemia in Newborns A nurse is caring for a newborn with jaundice at 24 hours. What is the priority action?

Accepted Answer

Answer reason: Jaundice appearing within the first 24 hours is pathologic until proven otherwise and requires prompt evaluation. Measuring a total serum bilirubin (or validated transcutaneous bilirubin with confirmatory serum if indicated) determines severity, risk of kernicterus, and guides treatment thresholds for phototherapy or exchange transfusion. Phototherapy is initiated based on age-in-hours nomograms and risk factors rather than appearance alone. Breastfeeding support is important but does not replace immediate diagnostic assessment in early-onset jaundice.
Category reason: This question asks for the nurse’s priority action and emphasizes obtaining a diagnostic value to guide safe treatment decisions, which aligns with Diagnostic Tests under Reduction of Risk Potential.

Question 7

A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse?

Accepted Answer

Answer reason: Preoperative nursing responsibility prioritizes identifying and reducing perioperative risk through verification of required diagnostics and readiness for anesthesia/surgery. Reviewing laboratory results helps detect issues such as anemia, electrolyte abnormalities, pregnancy status, or coagulation problems that could require postponement or specific interventions to prevent complications. Vital signs are important but are a routine task and do not by themselves confirm surgical readiness or uncover critical contraindications. Obtaining the surgical consent and explaining the procedure are primarily the provider’s responsibilities, while the nurse’s role is to verify the consent is present and clarify questions within scope.

Question 8

A client is preparing to undergo a cystoscopy for stones. Which of the following statements indicates that the client understands the procedure?

Accepted Answer

Answer reason: Cystoscopy commonly causes transient dysuria and mild hematuria due to urethral/bladder mucosal irritation from instrumentation. Recognizing a small amount of blood in the urine as an expected short-term finding reflects accurate understanding of normal post-procedure effects. In contrast, patients are typically encouraged to increase oral fluids after the test (not restrict them), and cystoscopy is often outpatient rather than requiring multiple inpatient days. Discomfort is also common, so assuming no need for pain relief is unrealistic and suggests misunderstanding.

Question 9

Which of the following methods would the nurse use to collect a urine sample for culture and sensitivity testing in a 16-month-old client?

Accepted Answer

Answer reason: A perineal urine collection bag has a high contamination rate from skin flora and commonly yields false-positive cultures. Sampling from an indwelling catheter collection bag is unreliable because urine can sit and become contaminated, and specimen should be taken from the catheter sampling port using sterile technique. Cotton balls in a diaper are not sterile and can introduce fibers/skin organisms, making the sample unsuitable for culture.

Question 10

Position given to patient during sigmoidoscopy??

Accepted Answer

Answer reason: This positioning uses gravity and natural anatomic curvature to help advance the scope and reduce looping. It also allows better access to the anus and supports patient stability and privacy during the procedure. Supine and prone positions make insertion and maneuvering more difficult, while lithotomy is more commonly used for gynecologic exams and is not the standard for sigmoidoscopy.

Question 11

A client is admitted for an MRI. The nurse should question the client regarding?

Accepted Answer

Answer reason: MRI screening focuses on identifying conditions that could increase risk from the magnetic field and, when used, gadolinium-based contrast. Pregnancy is a key pre-procedure screening question because elective imaging decisions and contrast use are handled more cautiously due to potential fetal risk and limited safety data, especially early in gestation. A titanium hip replacement is typically MRI-compatible and is not the primary “question/contraindication” concern compared with ferromagnetic implants or devices. Antibiotic allergies are not directly relevant to MRI unless a medication/contrast reaction history is being assessed, and inability to move the feet is a clinical symptom rather than an MRI safety screening issue.

Question 12

A female client admitted to the hospital with a neurological problem asks the nurse whether magnetic resonance imaging may be done. The nurse interprets that the client may be ineligible for this diagnostic procedure based on the client's history of?

Accepted Answer

Answer reason: A history of valve replacement raises concern for an older or non–MRI-conditional prosthetic valve, which may be a contraindication or require careful verification of device type before scanning. The nurse’s key safety role is to screen for implanted metal and ensure the MRI team has exact device information (manufacturer, model, MRI compatibility) prior to proceeding. In contrast, conditions like hypertension or heart failure are not inherent MRI contraindications, and COPD mainly affects positioning/ability to lie flat rather than magnetic safety.

Question 13

Sigmoidoscopy done in which position?

Accepted Answer

Answer reason: The knee-chest position achieves this by flexing the hips and elevating the pelvis, helping the sigmoidoscope pass more easily and improving visualization. It also helps reduce looping and discomfort compared with positions that do not align the distal colon as well. Lithotomy is more typical for gynecologic/perineal procedures, while Fowler’s is primarily for respiratory comfort and does not facilitate lower GI scope insertion.

Question 14

A nurse is preparing to obtain a sputum specimen from a male client. Which of the following nursing actions will facilitate obtaining the specimen?

Accepted Answer

Answer reason: A high-quality sputum specimen should come from the tracheobronchial tree, so measures that enhance lung expansion and loosen mucus improve yield. In contrast, simply spitting into a container often results in an oral saliva sample that is not diagnostically useful. Limiting fluids can thicken secretions and make expectoration harder, and obtaining the specimen after eating increases contamination risk and may trigger nausea or emesis.

Question 15

A patient is having a colonoscopy procedure performed. How should the patient be instructed to prepare for the procedure?

Accepted Answer

Answer reason: Colonoscopy requires a clear colon so the mucosa can be visualized and lesions are not missed. A bowel-prep regimen using a stimulant laxative plus an osmotic agent the day before is an appropriate instruction to achieve adequate cleansing. Being NPO alone does not clean the colon; it mainly reduces aspiration risk around sedation and is incomplete preparation by itself. Stopping antihypertensives for two days is unsafe and not standard; medication adjustments are individualized (e.g., some agents may be held the morning of the procedure). Therefore, the bowel-cleansing preparation is the best answer among the options provided.

Question 16

You are planning to draw an arterial blood gas from your patient, but you must perform an Allen’s test first. You know that the Allen’s test is used to test what?

Accepted Answer

Answer reason: Allen’s test assesses patency of the ulnar artery (via the palmar arch) to ensure the hand will remain perfused if the radial artery spasms or becomes occluded after an ABG. A normal test shows rapid return of hand color after releasing ulnar compression, indicating sufficient collateral flow. This prevents ischemic complications and is why it is performed prior to radial arterial sampling rather than evaluating leg or carotid circulation.

Question 17

Which of the following should the nurse implement to prepare a client for a KUB (Kidney, Ureter, Bladder) radiograph test?

Accepted Answer

Answer reason: The nursing priority is to remove radiopaque objects (e.g., jewelry, metal snaps) and verify pregnancy status when applicable, rather than implement restrictive prep orders. An enema is more associated with certain GI studies (e.g., barium enema) when bowel clearance is essential for visualization. Diuretics like furosemide are used for specific urinary tract imaging protocols, not for a standard KUB.

Question 18

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: Accurate lipid measurement requires a fasting specimen because recent dietary fat and carbohydrate intake can transiently raise serum triglycerides and affect calculated lipid values. Fasting for about 9–12 hours with water only minimizes postprandial lipemia and improves reliability and comparability of results. Advising a fat-free diet without fasting does not prevent post-meal triglyceride elevations. Drawing the blood shortly after breakfast would increase the chance of falsely elevated triglycerides and an uninterpretable panel.

Question 19

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: Bowel prep (often a laxative the evening before, sometimes with dietary restrictions per protocol) helps reduce stool in the colon and improves diagnostic accuracy. Routine regular diet the day before is not typical because many protocols use light diet/NPO instructions to optimize imaging and safety. Telling the client only one abdominal x-ray is needed is incorrect because IVP involves a series of timed films to track contrast through the urinary system.

Question 20

Which of these observations made by the nurse during an excretory urogram indicate a complication?

Accepted Answer

Answer reason: Generalized flushing/erythema involving the whole body suggests a systemic reaction to iodinated contrast and is not an expected, benign sensation. In contrast, a transient warm feeling and a metallic/salty taste are common, self-limited effects of IV contrast and usually require only reassurance and monitoring. Nausea/gagging can occur with anxiety or contrast effects, but diffuse bright redness is more concerning for a significant reaction and warrants immediate assessment and emergency readiness.

Question 21

The nurse is preparing a client who will undergo a myelogram. Which of the following statements by the client indicates a contraindication for this test?

Accepted Answer

Answer reason: " Myelography uses iodinated contrast introduced into the subarachnoid space, so a significant concern is prior hypersensitivity to iodinated contrast media. A history framed as “shellfish (shrimp) allergy” is commonly tested as a proxy for iodine/contrast allergy risk and should prompt further assessment and potential premedication or alternative imaging rather than proceeding routinely. The other statements describe issues that can be managed as positioning/sedation considerations or expected prior post–lumbar puncture effects, not a direct contraindication to the diagnostic test itself. The safest nursing judgment is to treat a reported contrast-related allergy risk as a red-flag requiring provider notification before the study.

Question 22

A nurse is to collect a sputum specimen for acid-fast bacillus (AFB) from a client. Which action should the nurse take first?

Accepted Answer

Answer reason: Having the sterile, properly labeled container ready at the bedside is the key preparation step before coaching the client to breathe deeply and cough. If the client coughs before the container is available, sputum may be swallowed, spit into an inappropriate receptacle, or contaminate surfaces, requiring recollection. Oral hygiene can be helpful for reducing oral contaminants, but it is not the initial priority over ensuring correct equipment is immediately available for collection.

Question 23

Which of these tests with frequency would the nurse expect to monitor for the evaluation of clients with poor glycemic control in persons aged 18 and older?

Accepted Answer

Answer reason: In adults with poor glycemic control or after treatment adjustments, monitoring at intervals up to every 3 months best matches the biologic window of erythrocyte glycation and allows timely intensification of management. Testing only twice yearly is appropriate for stable, well-controlled clients, not those with poor control. Routine glucose tolerance testing is not used for ongoing monitoring, and adding fasting glucose at fixed intervals is less useful than serial A1c for overall control assessment.

Question 24

A client with colon cancer is having a barium enema. The nurse should instruct the client to take which type of medication after the procedure is completed?

Accepted Answer

Answer reason: A medication that promotes stool passage helps expel retained barium and reduces post-procedure complications. Increased fluids and ambulation are also commonly encouraged, but among the listed medication types, this choice most directly addresses the expected risk. Anticholinergics can further slow GI motility and would worsen constipation rather than prevent it.

Question 25

Sputum sample for AFB should be collected?

Accepted Answer

Answer reason: Collecting before eating or drinking helps avoid contamination with food particles and reduces the chance the patient produces saliva instead of true deep-cough sputum. Timing “after breakfast” can dilute or contaminate the specimen and may reduce cough effectiveness. “Whenever the person cough” is nonspecific and increases the risk of inadequate samples, whereas early-morning collection targets the best-quality specimen for TB evaluation.

Question 26

The client with suspected active pulmonary tuberculosis (TB) has a positive tuberculin skin test (TST). Which prescription from the health care provider does the nurse anticipate will confirm the diagnosis in this client?

Accepted Answer

Answer reason: Early-morning sputum is highest yield because secretions pool overnight, and obtaining specimens on multiple consecutive days increases diagnostic sensitivity. A positive TST and an IGRA (QuantiFERON) support infection/exposure but cannot distinguish latent from active disease and therefore do not confirm active pulmonary TB. Blood cultures and nasal swabs are not the standard confirmatory diagnostic approach for suspected pulmonary TB.

Question 27

You are caring for a 95 year-old female resident with a history of Alzheimer's disease, anemia, and pyelonephritis. The family reports that she seems extremely confused, agitated, and restless. You prepare to call the provider with this information. Which of the following diagnostic tests?

Accepted Answer

Answer reason: A urinalysis with culture directly assesses for bacteriuria/pyuria and identifies the pathogen to guide targeted antibiotics. A CBC helps detect leukocytosis or other hematologic clues of infection/sepsis severity and provides baseline data given her anemia history. A 24-hour urine collection is not useful for acute infectious workup and can delay diagnosis and treatment in a potentially time-sensitive condition.

Question 28

The nurse is aware that a voiding cystourethrogram is performed by which of the following techniques?

Accepted Answer

Answer reason: A voiding cystourethrogram (VCUG) is a fluoroscopic radiographic study used to evaluate the bladder and urethra dynamically during micturition, commonly to assess vesicoureteral reflux and urethral abnormalities. The technique requires contrast instilled into the bladder (typically via catheter) and imaging obtained as the patient voids, because reflux and urethral pathology may only be evident during the voiding phase. Ultrasound does not provide the same contrast-based, real-time visualization of reflux through the ureters. Imaging only after catheter placement without capturing voiding would miss the key “voiding” component of the study.

Question 29

The nurse is aware that the patients who are allergic to intravenous contrast media are usually also allergic to which of the following products?

Accepted Answer

Answer reason: In many nursing exam contexts, shellfish allergy is treated as a proxy for “iodine allergy,” and therefore linked to higher perceived risk with iodinated IV contrast. This makes the shellfish choice the expected test answer when asked what patients “usually” are also allergic to. The other options are common food allergens but are not classically paired with IV contrast reactions in standard nursing test heuristics.

Question 30

A client with a history of dysrhythmias is to wear a Holter monitor for 24 hours on an outpatient basis. What should the nurse teach the client to do while wearing the monitor?

Accepted Answer

Answer reason: Holter monitoring correlates ECG rhythm changes with symptoms and what the client was doing at the time. A detailed activity and symptom diary (e.g., exertion, chest pain, palpitations, dizziness, medication times) allows the provider to match recorded dysrhythmias to triggers and clinical events. Stopping prescribed medications can worsen or unmask arrhythmias and is unsafe unless specifically ordered. Microwaves generally do not interfere with Holter monitors, and routine blood pressure logging is not the key data needed for interpreting ambulatory ECG recordings.

Question 31

Which client statement indicates an understanding of the nurse's instructions concerning a Holter monitor?

Accepted Answer

Answer reason: " A Holter monitor is an ambulatory ECG device used to continuously capture cardiac rhythm during normal daily life to correlate symptoms (e.g., palpitations, dizziness) with rhythm changes. Keeping usual activities helps provoke intermittent dysrhythmias that might not appear during a brief in-clinic ECG. The device is generally worn continuously and is not primarily intended to measure cardiac size/shape (that would be echocardiography or imaging). A common teaching point is also to keep a symptom/activity diary, but the monitor itself does not “record” activities—this makes the statement in option B inaccurate.

Question 32

The nurse determines that a Mantoux tuberculin skin test is positive. To most accurately diagnose tuberculosis (TB), the nurse plans to consult with the physician to follow up the skin test with a?

Accepted Answer

Answer reason: Definitive diagnosis of active pulmonary TB requires identification of the organism, and culture (often alongside smear/NAAT) provides the highest diagnostic accuracy and enables drug-susceptibility testing. Imaging such as a chest x-ray can support suspicion and assess disease extent but cannot confirm TB because findings are not specific. CBC and chest CT may show nonspecific inflammatory changes or detail anatomy but do not establish the microbiologic diagnosis.

Question 33

A client who had several episodes of chest pain is scheduled for an exercise electrocardiogram. Which explanation should the nurse include when teaching the client about this procedure?

Accepted Answer

Answer reason: " An exercise electrocardiogram (treadmill stress test) evaluates cardiac electrical activity and symptoms during progressively increased physical exertion to detect exercise-induced ischemia. It is considered noninvasive because it uses external electrodes and exercise without entering the body. It is not a definitive test for the cause of chest pain; further testing (e.g., imaging stress tests or coronary angiography) may be required depending on risk and results. Calling it “minimally invasive” is inaccurate and can mislead clients about what will happen and what information the test provides.

Question 34

The nurse assesses a client with acute left leg swelling and calf tenderness following a long car ride. The nurse anticipates that the primary healthcare provider (PHCP) will order which diagnostic test?

Accepted Answer

Answer reason: Compression duplex ultrasound is the first-line, noninvasive test that directly visualizes impaired venous compressibility/flow consistent with clot. D-dimer can support ruling out DVT in low-risk patients, but it is nonspecific and can be elevated for many reasons, so it is not the best confirmatory study here. Ankle-brachial index evaluates peripheral arterial disease, and plain X-ray does not diagnose venous thrombosis.

Question 35

Which medication should a nurse withhold from a client 6 hours before a series of pulmonary function tests (PFTs)?

Accepted Answer

Answer reason: Short-acting beta-agonists are commonly held for several hours prior to testing per lab protocol to assess true pre-bronchodilator function. Antibiotics do not directly change immediate airway caliber or lung volumes in a way that would confound same-day PFT measurements. Holding the bronchodilator helps ensure the test reflects the client’s untreated pulmonary status unless the test specifically includes post-bronchodilator measurements.

Question 36

Which test should a nurse expect to be ordered for a client with severe abdominal pain in the midepigastric region, back tenderness, nausea, and vomiting?

Accepted Answer

Answer reason: Serum amylase (and often lipase) rises with pancreatic inflammation, so it is an expected initial diagnostic test. C-peptide is used to evaluate endogenous insulin production (e.g., diabetes workup), not acute epigastric pain. Stool culture and colonoscopy target infectious diarrhea or lower-GI pathology and do not fit the primary presentation.

Question 37

A client has passed a renal calculus. The nurse sends the specimen to the laboratory so it can be analyzed for?

Accepted Answer

Answer reason: Stone analysis is used to identify the chemical makeup (e.g., calcium oxalate/phosphate, uric acid, struvite, cystine) so targeted prevention can be planned. Knowing the composition guides specific interventions such as thiazides for recurrent calcium stones, urine alkalinization for uric acid stones, or infection evaluation and eradication for struvite stones. Antibodies are not measured from a stone specimen, and infection type is determined by urine culture rather than stone chemistry. Stone size and number are assessed with imaging (e.g., CT/ultrasound), not by sending a passed fragment to the lab.

Question 38

Which test should the nurse expect to be ordered for a client suspected of having diverticulosis?

Accepted Answer

Answer reason: A contrast enema can demonstrate diverticular outpouchings along the colon wall and has been classically used to evaluate suspected diverticular disease. An abdominal ultrasound does not reliably visualize colonic diverticula, and a barium swallow evaluates the esophagus/stomach/upper GI tract rather than the colon. Gastroscopy also assesses the upper GI tract and would not be the appropriate test for suspected colonic diverticulosis.

Question 39

For a definitive diagnosis of cirrhosis, the nurse will assist with which diagnostic test?

Accepted Answer

Answer reason: A tissue sample provides the highest specificity compared with indirect blood markers of synthetic function or hepatocellular injury. Albumin and liver enzyme levels can support suspicion and gauge severity but are neither sensitive nor specific enough to confirm cirrhosis. Older functional tests like bromsulphthalein clearance are not the standard confirmatory method and do not establish histologic diagnosis.

Question 40

Which of the following is a noninvasive method of evaluating cardiac status in a child?

Accepted Answer

Answer reason: A transthoracic echocardiogram uses external ultrasound to visualize chambers, valves, and ventricular function, making it a standard noninvasive pediatric assessment. Cardiac catheterization is invasive because it requires intravascular access and instrumentation of the heart. Transesophageal pacing involves placing a device into the esophagus to deliver electrical impulses and is not an evaluation test but a therapeutic/diagnostic intervention with instrumentation, so it is not considered noninvasive.

Question 41

The nurse teaches parents that which test is used to diagnose respiratory syncytial virus (RSV)?

Accepted Answer

Answer reason: Nasopharyngeal washings (or swab/aspirate) provide an appropriate specimen for rapid antigen testing or PCR, which are commonly used to confirm RSV. Blood testing is not a standard diagnostic method for RSV because viremia is not the typical presentation. Throat culture and sputum culture are less reliable/less commonly used in infants and young children and are not the preferred specimen sites for confirming RSV.

Question 42

Two days after undergoing a left thoracotomy, a client’s temperature is 38.9°C. The nurse notifies the physician, who orders two sets of blood cultures. Which amount of blood would the nurse obtain for cultures?

Accepted Answer

Answer reason: Standard adult practice is to draw about 10 mL per culture bottle (commonly 20 mL per set split into aerobic and anaerobic bottles), which maximizes sensitivity and reduces false-negative results. Smaller volumes significantly decrease the chance of recovering the causative organism and can delay appropriate therapy. In a febrile post-thoracotomy patient, correctly collected cultures before antibiotics are key to identifying a bloodstream infection source.

Question 43

A client is scheduled for several tests. Which test should be performed after the thyroid function tests?

Accepted Answer

Answer reason: A head CT with contrast is the only option that involves iodinated contrast and therefore has the greatest potential to confound subsequent thyroid function or uptake evaluations. Non-contrast studies like ultrasound and EEG do not introduce iodine and do not meaningfully affect thyroid testing. Sequencing thyroid tests first helps prevent false or misleading results and avoids unnecessary repeat testing.

Question 44

The nurse is caring for the client with a suspected DVT. For which diagnostic test should the nurse anticipate the client will need to be prepared?

Accepted Answer

Answer reason: This test requires nursing preparation focused on contrast administration considerations (e.g., allergy history, renal function, hydration, IV access) and post-procedure monitoring. A V/Q scan evaluates ventilation–perfusion mismatch and is used for suspected pulmonary embolism rather than locating a leg vein thrombus. An arteriogram assesses arterial flow, and an embolectomy is a therapeutic procedure, not a diagnostic test.

Question 45

A client is scheduled for testing to diagnose an abdominal aortic aneurysm. The most definitive test would be?

Accepted Answer

Answer reason: An aortogram (angiography) provides high-detail vascular imaging that can delineate the aneurysm’s extent and relationship to renal/iliac arteries, which is critical when intervention is considered. Ultrasound is an excellent noninvasive screening tool and can estimate size, but it is less definitive for detailed anatomy compared with angiographic imaging. A plain abdominal X-ray is nonspecific and may only show calcification, and CT is highly useful but is generally considered less “definitive” than direct angiographic visualization in classic NCLEX framing.

Question 46

A nurse is preparing to teach a client with a hiatal hernia. The nurse should provide instruction on which diagnostic test?

Accepted Answer

Answer reason: A contrast esophagram can demonstrate herniation of the stomach through the diaphragm and associated reflux patterns, making it a direct test for this condition. Colonoscopy and a lower GI series assess the large bowel and would not evaluate the esophagogastric anatomy relevant to a hiatal hernia. A plain abdominal X-ray is generally not sensitive or specific for diagnosing this problem compared with contrast swallow studies.

Question 47

A client is seen in the outpatient surgical clinic for a suspected diagnosis of gastric cancer. The nurse anticipates the diagnostic testing of the client will include which test?

Accepted Answer

Answer reason: Upper GI endoscopy (EGD) provides this direct assessment and tissue sampling, making it the key diagnostic test when gastric malignancy is suspected. Barium enema and colonoscopy evaluate the large intestine and do not assess the stomach, so they do not match the suspected site. Serum chemistry tests may reveal nonspecific abnormalities but cannot diagnose or localize gastric cancer.

Question 48

A client is suspected of having cholecystitis. The nurse will prepare the client for which of the following diagnostic tests?

Accepted Answer

Answer reason: It is widely available, noninvasive, and can be performed at the bedside, making it ideal for initial evaluation. CT may help when ultrasound is equivocal or complications are suspected, but it is not typically the initial test. Barium swallow and endoscopy evaluate esophageal/gastric pathology rather than gallbladder inflammation.

Question 49

A client received a purified protein derivative (PPD) test for tuberculosis (TB) on the right forearm. The site is reddened and raised about 3 mm. The nurse interprets this result as?

Accepted Answer

Answer reason: PPD (Mantoux) interpretation is based on the measured induration in millimeters, not the amount of redness. An induration of about 3 mm is below all standard positive thresholds (e.g., 5 mm, 10 mm, or 15 mm depending on risk factors), so it is interpreted as a negative result. Mild erythema can occur from local irritation and does not indicate TB infection without sufficient induration. The test does not need to be repeated solely because the reaction is small unless there is concern for timing/reading error or a need for two-step testing in specific screening situations.

Question 50

A client has received a preliminary diagnosis of tuberculosis. In order to obtain a definitive diagnosis, the nurse anticipates that the physician will order which test?

Accepted Answer

Answer reason: Culture (often alongside smear/NAAT) directly detects the organism and allows drug-susceptibility testing, which guides therapy and infection-control decisions. A chest X-ray can suggest TB patterns but is not specific and cannot confirm etiology. Mantoux/tuberculin skin tests indicate prior exposure/immune sensitization and cannot distinguish latent from active disease.

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