Saunders Diagnostic Testing Questions
1. A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the
procedure?
Rationale:
To facilitate removal of fluid from the chest, the client is positioned sitting at the edge of the bed leaning over
the bedside table, with the feet supported on a stool; or lying in bed on the unaffected side with the head of
the bed elevated 30 to 45 degrees. The prone and Sims' positions are inappropriate positions for this procedure.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
1. Lying in bed on the affected side
2. Lying in bed on the unaffected side
3. Sims' position with the head of the bed flat
4. Prone with the head turned to the side and supported by a pillow
2. The nurse is preparing to care for a client who has returned to the nursing unit following cardiac catheterization
performed through the femoral vessel. The nurse checks the health care provider's (HCP's) prescription and plans to
allow which client position or activity following the procedure?
Rationale:
After cardiac catheterization, the extremity into which the catheter was inserted is kept straight for 4 to 6 hours. The
client is maintained on bed rest for 4 to 6 hours (time for bed rest may vary depending on the HCP's preference and
on whether a vascular closure device was used) and the client may turn from side to side. The head is elevated no
more than 30 degrees (although some HCPs prefer a lower position or the flat position) until hemostasis is
adequately achieved.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Perfusion, Safety
1. Bed rest in high Fowler's position
2. Bed rest with bathroom privileges only
3. Bed rest with head elevation at 60 degrees
4. Bed rest with head elevation no greater than 30 degrees
3. A client is about to undergo a lumbar puncture. The nurse describes to the client that which position will be used
during the procedure?
,Rationale:
A client undergoing lumbar puncture is positioned lying on the side, with the legs pulled up to the abdomen and the
head bent down onto the chest. This position helps to open the spaces between the vertebrae and allows for easier
needle insertion by the health care provider. The nurse remains with the client during the procedure to help the client
maintain this position. The other options identify incorrect positions for this procedure.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Intracranial Regulation, Safety
1. Side-lying with a pillow under the hip
2. Prone with a pillow under the abdomen
3. Prone in slight Trendelenburg's position
4. Side-lying with the legs pulled up and the head bent down onto the chest
4. The nurse provides information to a client scheduled for a dual x-ray absorptiometry (DEXA) test. Which
information should the nurse provide to the client? Select all that apply.
Rationale:
The most commonly used screening and diagnostic tool for measuring bone mineral density is the dual x-ray
absorptiometry (DEXA) test. It is a painless test that emits less radiation than a chest x-ray. A height is taken before
the start of the test. The client stays dressed but is asked to remove any metallic objects such as belt buckles, coins,
keys, or jewelry because they may interfere with testing. No special follow-up care for the test is necessary.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Sensory Perception
1. It is a painless test.
2. It emits slightly more radiation than a chest x-ray does.
3. Upper body clothing will need to be removed for testing.
4. Increased fluid intake is necessary following the procedure.
5. Metallic objects such as jewelry or belt buckles may interfere with the test and need to be removed.
5. The nurse working in the outpatient radiology department is giving discharge instructions to a client who has had a
bone scan. Which instruction should the nurse include in the client's teaching plan?
Rationale:
The client should drink large amounts of water for 24 to 48 hours to excrete the radioisotope through the kidneys. No
special diet or activity prescriptions or restrictions are required after a bone scan. Nausea or flushing would
accompany allergic reaction to a dye, which is not used in this procedure.
,Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Client Education, Safety
1. Report any feelings of nausea or flushing.
2. Avoid eating very much for the rest of the day.
3. Drink extra water for a day or so after the procedure.
4. Try to go up and down stairs at least twice before the end of the day.
6. A magnetic resonance imaging (MRI) study is prescribed for a client with a suspected brain tumor. Which priority
action should the nurse include in the client's plan of care to ensure safety?
Rationale:
In MRI, radiofrequency pulses in a magnetic field are converted into pictures. All metal objects, such as rings,
bracelets, hairpins, and watches, should be removed. In addition, a history should be taken to ascertain whether the
client has any internal metallic devices such as orthopedic hardware, pacemakers, or shrapnel. Insertion of a femoral
catheter is not part of the procedure. The client needs to be motionless throughout the procedure for quality of the
scan, but this action is not related to a safety issue and therefore is not the priority. A radioisotope may be prescribed
with positron emission tomography.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Strategic Words, Subject
Priority Concepts: Client Education, Safety
1. Shave the groin for insertion of a femoral catheter.
2. Remove all metal-containing objects from the client.
3. Inform the client to remain motionless throughout the procedure.
4. Instruct the client in inhalation techniques for the administration of the radioisotope.
7. A client is to undergo pleural biopsy at the bedside. When planning for any potential complications of the
procedure, the nurse should have which item(s) available at the bedside?
Rationale:
Complications following pleural biopsy include hemothorax, pneumothorax, and temporary pain from intercostal nerve
injury. The nurse should have a chest tube and drainage system available at the bedside for use if hemothorax or
pneumothorax develops. An intubation tray is not indicated. The client may be premedicated before the procedure, or
a local anesthetic is used. A portable chest x-ray machine would be needed to verify placement of a chest tube if one
was inserted, but it is unnecessary to have at the bedside before the procedure.
Cognitive Ability: Applying
, Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Gas Exchange, Safety
1. Intubation tray
2. Morphine sulfate injection
3. Portable chest x-ray machine
4. Chest tube and drainage system
8. The nurse has a prescription to obtain a 24-hour urine collection in a client with a renal disorder. Which actions
should the nurse take when collecting this specimen? Select all that apply.
Rationale:
The nurse should first explain the procedure to the client and ask the client to void at the beginning of the collection
period and to discard this urine sample. All subsequent voided urine is saved in a container, which is placed on ice or
refrigerated. The client is asked to void at the finish time, and this sample is added to the collection. The container is
labeled, placed on fresh ice, and sent to the laboratory immediately.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Elimination
1. Explain the procedure to the client.
2. Save all subsequent voidings after the first void during the 24-hour period.
3. During the collection period, place the main container on ice or in a refrigerator.
4. Have the client void at the end time, and place this specimen in the main container.
5. Have the client void at the start time, and place this specimen in the main container.
9. How should the nurse position the client for pericardiocentesis to treat cardiac tamponade?
Rationale:
The client undergoing pericardiocentesis is positioned supine with the head of bed raised to a 45- to 60-degree angle.
This places the heart in close proximity to the chest wall for easier insertion of the needle into the pericardial sac.
Options 1, 2, and 3 are incorrect positions.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
