CHAPTER 34: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 34: Diagnostic Testing Multiple Choice Questions 1. Which test result indicates noncompliance with diabetes treatment when a patient reports adherence to their medical regimen? 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 Answer: A Explanation: Hemoglobin A1c reflects average blood glucose levels over 2-3 months; a value of 16% indicates prolonged poor glycemic control despite reported compliance. Why Other Options Are Wrong: B shows normal RBS; C and D are unrelated to diabetes monitoring. 2. Which laboratory finding suggests an elderly dementia patient frequently misses meals? A. Serum bilirubin 0.4 mg/dL B. Platelet count 425,000/mm³ C. Serum cholesterol 175 mg/dL D. Albumin 1.4 g/dL Answer: D Explanation: Albumin levels below 3.3 g/dL indicate protein malnutrition, likely due to inadequate intake. Why Other Options Are Wrong: A, B, and C are within normal ranges and unrelated to nutritional status. 3. Which test result would the nurse expect in a patient with a severe leg wound infection? 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 Answer: A Explanation: CRP is a marker of inflammation/infection; elevated levels correlate with active infection. Why Other Options Are Wrong: B reflects kidney function; C indicates liver function; D assesses clotting, none of which are primary infection markers. 4. How would stool appear in a patient with a bleeding gastric ulcer? A. Soft with bright red streaks B. Watery with undigested food C. Sticky and black D. Hard lumps Answer: C Explanation: Upper GI bleeding produces melena (black, tarry stools) due to digested blood. Why Other Options Are Wrong: A suggests lower GI bleeding; B indicates gastroenteritis; D reflects constipation. 5. Which finding contraindicates a noncontrast MRI for a patient? A. Implanted insulin pump B. Breastfeeding a newborn C. Iodine/latex allergy D. Profound hearing loss Answer: A Explanation: MRI magnets can interfere with metal devices like insulin pumps, posing safety risks. Why Other Options Are Wrong: B is safe (no radiation); C is irrelevant (no contrast); D requires ear protection but isn’t a contraindication. 6. Which test allows direct visualization of esophageal damage from acid reflux? A. Esophagogastroduodenoscopy (EGD) B. MRI with contrast C. Abdominal ultrasound D. PET scan Answer: A Explanation: EGD uses a lighted scope to examine the esophagus, stomach, and duodenum directly. Why Other Options Are Wrong: B, C, and D provide indirect imaging, not direct visualization. 7. Which test confirms whether a breast cyst is malignant? A. Needle aspiration with biopsy B. Paracentesis C. Thoracentesis D. Fiberoptic endoscopy Answer: A Explanation: Biopsy provides tissue samples for pathological analysis to detect cancer cells. Why Other Options Are Wrong: B and C drain fluid from abdomen/pleura; D visualizes GI tract, none of which diagnose breast cysts. 8. Which nursing diagnosis is most relevant for a patient awaiting biopsy results to rule out cancer? A. Anxiety related to potential cancer diagnosis B. Impaired health maintenance due to insurance delays C. Powerlessness related to diagnostic wait D. Ineffective coping due to nervousness Answer: A Explanation: Fear of a cancer diagnosis is a priority concern during biopsy result waiting periods. Why Other Options Are Wrong: B, C, and D are less directly related to the immediate emotional impact of potential cancer. 9. What is an appropriate goal for a patient preparing for flexible sigmoidoscopy? A. Verbalize understanding of preprocedure prep B. Express comfort with the test C. List medication side effects D. Acknowledge test importance Answer: A Explanation: Patient education about bowel preparation is measurable and ensures test accuracy. Why Other Options Are Wrong: B, C, and D are subjective and non-measurable. 10. Which allergy must be reported before iodine-based contrast CT scans? A. Gluten and lactose B. Strawberries and blueberries C. Peanuts and cashews D. Shrimp and scallops Answer: D Explanation: Shellfish allergies indicate potential iodine sensitivity, risking contrast reactions. Why Other Options Are Wrong: A, B, and C are unrelated to iodine contrast. 11. What action should the nurse take when a post-bronchoscopy patient requests water? A. Provide ice chips B. Check gag reflex C. Offer ice water with a straw D. Keep NPO Answer: B Explanation: Gag reflex assessment prevents aspiration risk due to throat numbness from the procedure. Why Other Options Are Wrong: A, C, and D are unsafe without confirming gag reflex return. 12. Which statement by a patient undergoing bone marrow biopsy indicates need for further teaching? A. "I will count ceiling tiles during numbing." B. "I will take acetaminophen for discomfort." C. "I will squeeze your hand for comfort." D. "I will keep the site clean for 24 hours." Answer: A Explanation: Prone/lateral positioning during biopsy makes ceiling-tile counting impossible. Why Other Options Are Wrong: B, C, and D are appropriate post-procedure actions. 13. What is the priority nursing action for a sedated post-colonoscopy patient? A. Provide a quiet, dark environment B. Monitor pulse oximetry and respirations C. Inform the procedure is complete D. Assess bowel sounds/flatus Answer: B Explanation: Sedation can suppress respirations; continuous monitoring ensures airway safety. Why Other Options Are Wrong: A, C, and D are secondary to respiratory stability. 14. Who must receive liver biopsy results per HIPAA guidelines? A. The patient B. The health care provider C. The insurance company D. The patient’s spouse Answer: B Explanation: Providers require results to plan treatment; others need written patient consent. Why Other Options Are Wrong: A, C, and D are not mandatory recipients under HIPAA. 15. Which statement about 24-hour urine collection indicates teaching is needed? A. "I will chill the specimen." B. "I will restart if I urinate in the toilet." C. "I will start after my first morning void." D. "I will drink extra fluids for a large sample." Answer: D Explanation: Excess fluid dilutes urine, skewing test results; normal intake is required. Why Other Options Are Wrong: A, B, and C are correct collection steps. 16. Which result reflects rapid RBC destruction in a patient with immune-mediated hemolysis? A. Bilirubin 4 mg/dL B. Platelets 450,000/mm³ C. Uric acid 1.7 mg/dL D. PTT 45 seconds Answer: A Explanation: Elevated bilirubin occurs when RBC breakdown exceeds liver processing capacity. Why Other Options Are Wrong: B, C, and D are unrelated to hemolysis. 17. Which test identifies effective antibiotics for a urinary tract infection? A. Complete blood count (CBC) B. Culture and sensitivity (C&S) C. Renal scan D. HCG assay Answer: B Explanation: C&S identifies causative bacteria and their antibiotic susceptibilities. Why Other Options Are Wrong: A, C, and D do not guide antibiotic selection. 18. What complication should the nurse monitor for post-paracentesis? A. Lung collapse B. Fecal impaction C. CSF leak D. Bowel perforation Answer: D Explanation: Bowel perforation risks peritonitis due to needle proximity to intestines. Why Other Options Are Wrong: A, B, and C are unrelated to abdominal fluid drainage. 19. What is the most critical step for nurse/patient safety during venipuncture? A. Limit tourniquet time B. Use the smallest needle C. Proper sharps disposal D. Fill tubes completely Answer: C Explanation: Safe needle disposal prevents needlestick injuries and bloodborne pathogen exposure. Why Other Options Are Wrong: A, B, and D are important but less critical for safety. 20. How can a nurse best confirm a diabetic patient’s ability to perform fingerstick glucose testing? A. Quiz the steps B. Observe a return demonstration C. Ask about questions D. Use simple terminology Answer: B Explanation: Direct observation ensures competency in technique and accuracy. Why Other Options Are Wrong: A, C, and D are insufficient to verify procedural skill. MULTIPLE RESPONSE QUESTIONS 1. Which CBC results indicate resolving anemia? (Select all that apply.) A. RBC 5.8 million/mm³ B. HCT 25% C. HGB 14 g/dL D. WBC 4,500/mm³ E. PLT 255,000/mm³ Answer: A, C Explanation: Normal RBC and HGB levels confirm improved oxygen-carrying capacity. Why Other Options Are Wrong: B indicates ongoing anemia; D and E are unrelated to anemia. 2. Which tests diagnose an abdominal aortic aneurysm? (Select all that apply.) A. MRI B. Needle biopsy C. Endoscopy D. CT scan E. Sigmoidoscopy F. Thoracentesis Answer: A, D Explanation: MRI and CT provide detailed vascular imaging to detect aneurysms. Why Other Options Are Wrong: B, C, E, and F do not visualize aortic structures. 3. Which interventions reduce infection risk post-liver biopsy? (Select all that apply.) A. Monitor for redness/fever B. Maintain sterile technique C. Teach site care D. Provide emotional support E. Explain liver cancer treatments F. Use healing touch Answer: A, B, C Explanation: Infection prevention requires monitoring, sterility, and patient education. Why Other Options Are Wrong: D, E, and F address psychosocial needs, not infection risk. 4. Which 24-hour urine collection tasks can be delegated? (Select all that apply.) A. Label containers B. Assess patient ability C. Explain the procedure D. Obtain collection supplies E. Transport specimens F. Verify test orders Answer: A, D, E Explanation: Non-clinical tasks like labeling, supply retrieval, and transport are delegable. Why Other Options Are Wrong: B, C, and F require nursing judgment/education. 5. Which tests monitor liver toxicity from medications? (Select all that apply.) A. ALT B. ALP C. BUN D. ANA E. ESR F. FDP Answer: A, B Explanation: ALT and ALP are liver enzymes that rise with hepatotoxicity. Why Other Options Are Wrong: C assesses kidneys; D, E, and F are unrelated to liver function.