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Copyright © 2013 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. Pagana: Mosby's Canadian Manual of Diagnostic and Laboratory Tests, 1st Canadian Edition 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 often are 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: 1073 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 Answer: b Rationale: Patients with destructive bone diseases commonly have elevated ALP levels as a result of bone cell destruction and regeneration. Reference page: 58 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: 1025 NURSINGTB.COMMosby's Canadian Manual of Diagnostic and Laboratory Tests 2nd Edition Pagana Test BankWWW.NURSYLAB.COM NURSINGTB.COMPractice Test Answer Key 2 Copyright © 2013 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 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 Answer: a Rationale: CT is accurate for identifying an abdominal abscess. Colonoscopy and barium enema are contraindicated in patients with suspected perforated viscus. Reference page: 1073 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 Answer: d Rationale: BUN levels can decrease normally in patients who are well hydrated. Because liver function must be adequate to make urea, severe liver dysfunction is associated with decreased BUN levels. Because BUN also is a measure of protein nutrition, this level can be diminished in starving patients. Reference page: 578 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 Answer: a Rationale: An elevated serum creatinine level indicates renal disease. No other diseased organ causes elevation of the serum creatinine level. Reference page: 218 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 Answer: c Rationale: EGD is the most accurate diagnostic test. Furthermore, transendoscopic coagulation of active bleeding can be performed with EGD. Reference page: 689 NURSINGTB.COMMosby's Canadian Manual of Diagnostic and Laboratory Tests 2nd Edition Pagana Test BankWWW.NURSYLAB.COM NURSINGTB.COMPractice Test Answer Key 3 Copyright © 2013 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 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 Answer: b Rationale: Ultrasonography should be performed first because intraabdominal barium will distort the sound waves and thus decrease the accuracy. Also, if the ultrasonography of the abdomen includes water distension of the stomach, the patient will need to void before proceeding to CT to prevent discomfort. Likewise, barium within the bowel will distort the CT image. Therefore ultrasonography should be done first, CT second, and barium enema last. Reference page: 971 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. Answer: d Rationale: The patient’ s peripheral vascular disease will cause calf pain during exercise. This pain probably will precede exercise-induced chest pain and cause the test to be terminated prematurely. Reference page: 607 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 Answer: d Rationale: The extremity in which the catheter was placed must be kept straight and immobilized for several hours after catheterization to prevent bleeding. Ice packs may minimize any swelling or hematoma at the catheter insertion site. Reference page: 1141 NURSINGTB.COMMosby's Canadian Manual of Diagnostic and Laboratory Tests 2nd Edition Pagana Test BankWWW.NURSYLAB.COM
