Chapter 34 Diagnostic Testing

Chapter 34  Diagnostic Testing

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse is caring for a patient who states that he has been taking his medications and following his diabetic diet carefully. 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 levels indicate the patient’s average blood sugar levels for the past few weeks. A normal value is 3% to 6%; in well-controlled diabetics, the value is 7% to 11%. A level of 16% indicates that the patient’s blood sugar has been elevated for the last few weeks and he has not been compliant with the prescribed treatment plan.

DIF: Applying REF: p. 776 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological Adaptation
NOT: Concepts: Glucose Regulation

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 5.5 g/dL. A very low albumin level of 1.4 g/dL indicates to the nurse that the patient has not been eating well and missing meals.

DIF: Applying REF: p. 772 | p. 778 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.
C-reactive protein (CRP) 6.5 mg/dL
b.
Serum creatinine 0.8 mg/dL
c.
Serum bilirubin 0.5 mg/dL
d.
Prothrombin time (PT) 11.5 sec

ANS: A
C-reactive protein is an indicator of inflammation, tissue damage, and infection within the body. 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 REF: pp. 775-777 | p. 779 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 with strong foul odor
d.
Hard lumps that are difficult to pass

ANS: C
Bleeding within the upper GI tract will cause stools to appear black and tarry with a foul odor as the blood is digested by the lower GI tract. 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 REF: p. 780 TOP: Assessment
MSC: NCLEX Client Needs Category: Physiological 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
Insulin pumps often contain metal that can react with the strong magnets in the MRI machine. The technician, radiologist, and ordering physician should be notified that the patient may not be able to have the test. 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 REF: p. 782 TOP: Assessment
MSC: NCLEX Client Needs Category: Reduction of Risk Potential
NOT: Concepts: Safety