Exam (elaborations)
Chapter 34 Diagnostic Testing
- Course
- Fundamentals of Nursing
- Institution
- Oxford College Of Emory University
Chapter 34 Diagnostic Testing
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DAWITChapter 34: Diagnostic Testing
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative
Practice, 3RD Edition
MULTIPLE CHOICE
1. The nurse is caring for a patient who has diabetes. The patient reports compliance with the
medical regime. Which test result indicates to the nurse that the patient has not been
compliant with the treatment plan?
a. Hemoglobin A1c 16%
b. Random blood sugar (RBS) 112 mg/dL
c. Lactate dehydrogenase (LDH) 55 units/L
d. Erythrocyte sedimentation rate (ESR) 14 mm/hr
ANS: A
Hemoglobin A1c (Hgb A1c), or glycosylated hemoglobin, testing evaluates blood sugar levels
over a period of 2 to 3 months This blood test is performed to provide the primary care
provider (PCP) with information about long-term blood sugar control. The normal value of
Hgb A1c in patients without diabetes is 4% to 5.9%. The American Diabetes Association
(2016) states that diabetes is diagnosed for Hgb A1c levels greater than 6.5%. A higher level
indicates that the patient has had poor blood glucose control during the past few weeks, and
increases the patient‘s risk of long-term complications from hyperglycemia. The other tests
are not related to long-term diabetes control.
DIF: Applying OBJ: 34.2 TOP: Assessment
MSC: NCLEX Client Needs CN ategR
ory:I
PhyG
siolB
og.
icC
al AM
daptation
NOT: Concepts: Glucose RegulaU
tionS N T O
2. The nurse is caring for an elderly patient with dementia. Which laboratory finding indicates to
the nurse that that patient is often forgetting to eat meals?
a. Serum bilirubin 0.4 mg/dL
b. PLT (platelet count) 425,000/mm3
c. Serum cholesterol 175 mg/dL
d. Albumin 1.4 g/dL
ANS: D
Albumin level is an indicator of the patient‘s protein intake and nutritional status. Normal
albumin level is 3.3 to 5 g/dL. It is an essential component of fluid balance, responsible for
maintaining colloidal oncotic pressure in the vascular and extravascular spaces. Low levels of
albumin may indicate malnutrition.
DIF: Applying OBJ: 34.2 TOP: Assessment
MSC: NCLEX Client Needs Category: Management of Care NOT: Concepts: Nutrition
3. The nurse is caring for a patient who has a deep leg wound that is badly infected. Which
laboratory test results will the nurse expect to find in the patient‘s chart?
a. Elevated C-reactive protein (CRP) 6.5 mg/dL
b. Decreased serum creatinine 0.8 mg/dL
c. Elevated serum bilirubin 0.5 mg/dL
d. Prothrombin time (PT) 11.5 sec
, DAWIT
ANS: A
C-reactive protein (CRP) is produced by the liver in response to inflammation, tissue damage,
and infection. Blood levels of CRP have been used as a marker for inflammatory and
autoimmune disorders. The nurse would expect to see an elevated CRP in a patient with an
infected wound. Creatinine is an indicator of kidney function, and bilirubin is an indicator of
liver function. Prothrombin time indicates clotting ability of the blood, particularly when the
patient is taking warfarin (Coumadin).
DIF: Applying OBJ: 34.2 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Adaptation
NOT: Concepts: Infection
4. The nurse is caring for a patient who has a bleeding gastric ulcer. How will the nurse expect
the patient‘s stool to appear?
a. Soft and formed with bright red streaks
b. Watery with particles of undigested food
c. Sticky and black
d. Hard lumps that are difficult to pass
ANS: C
Bleeding anywhere along the GI tract results in blood in the stool. Bleeding that occurs in the
upper GI tract produces stools that are black and tarry in appearance. Bleeding within the
lower GI tract presents with soft stools that have bright red streaks. Watery stool with
particles of food is indicative of gastroenteritis. Hard lumps that are difficult to pass indicate
constipation, often from medications or lack of fiber in the diet.
DIF: Applying OBJ: 34N
.3 R I GTOB P:.
ACssessment
U S Physiological
MSC: NCLEX Client Needs Category: N Adaptation
NOT: Concepts: Elimination
5. The nurse is caring for a patient who is to have a noncontrast MRI scan performed. Which
assessment finding leads the nurse to report that the patient may not be able to have the test?
a. The patient has an implanted insulin pump.
b. The patient is breastfeeding her newborn infant.
c. The patient is severely allergic to iodine and latex.
d. The patient has profound hearing loss.
ANS: A
Any metal implants are a contraindication for an MRI scan because the scan uses powerful
magnets. Insulin pumps often contain metal that can react with the strong magnets in the MRI
machine. Breastfeeding is not a contraindication to MRI because there is no radiation
exposure. No latex or iodine is used during MRI testing. Profound hearing loss will not be a
problem, although MRI scanning is very loud.
DIF: Understanding OBJ: 34.5 TOP: Assessment
MSC: NCLEX Client Needs Category: Reduction of Risk Potential
NOT: Concepts: Safety
6. The nurse is caring for a patient who has had severe acid reflux. Which test will allow the
physician to directly check for damage to the esophagus?
a. Esophagogastroduodenoscopy (EGD)
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