FISCHBACH'S A MANUAL OF
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
Ch. 1 — Diagnostic Testing
Stem: A 62-year-old male scheduled for a fasting lipid panel at
0800 reports that he took his morning lisinopril and had a small
black coffee (no milk). The phlebotomist documents “fasting”
and sends the specimen to the laboratory. Which action best
reflects appropriate nursing/clinical judgment?
A. Accept the specimen and document as fasting; small coffee
does not affect lipid results.
B. Note the deviation, communicate with provider, and consider
rescheduling fasting test.
C. Reject the specimen because any oral intake invalidates all
lipid testing.
,D. Proceed but draw an additional nonfasting sample for
comparison.
Correct Answer: B
Rationale — Correct: The chapter emphasizes accurate
documentation of pretest preparation and that coffee and
medications can affect some tests; notify the provider and
consider rescheduling to ensure clinically meaningful fasting
results. This preserves test validity and informs clinical decision-
making.
Rationale — A (incorrect): Small coffee can alter some lipid
values (especially triglycerides) and taking an antihypertensive
may not invalidate results but the pretest preparation was not
met; passive acceptance risks misinterpretation.
Rationale — C (incorrect): Not all oral intake invalidates lipid
testing categorically; rejection without provider consultation is
excessive.
Rationale — D (incorrect): Drawing an extra nonfasting sample
might be informative, but the immediate priority is
documenting deviation and discussing rescheduling; arbitrarily
obtaining extra samples wastes resources without provider
order.
Teaching point: Always document pretest deviations and notify
the provider before accepting fasting-dependent results.
Citation: Fischbach, F., Fischbach, M., & Stout, K. (2021). A
Manual of Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
,Ch. 1 — Diagnostic Testing
Stem: A nurse preparing a patient for an arterial blood gas
(ABG) notes the provider ordered “ABG at 0900.” The patient is
receiving supplemental oxygen by nasal cannula at 2 L/min. The
nurse suspects the ABG should reflect baseline respiratory
status. What is the most appropriate nursing step before
collection?
A. Remove supplemental oxygen for 5 minutes to obtain a true
baseline ABG.
B. Leave the oxygen as ordered and document the flow rate on
the requisition.
C. Increase oxygen to 4 L/min for 10 minutes prior to ABG to
ensure oxygenation.
D. Cancel the test because oxygen therapy invalidates ABG
interpretation.
Correct Answer: B
Rationale — Correct: Chapter 1 stresses documenting clinical
context and therapies (including oxygen flow) because results
must be interpreted relative to current treatment; altering
therapy without an order risks patient harm.
Rationale — A (incorrect): Withdrawing oxygen without an
order may cause hypoxia and is not an appropriate independent
nursing action.
Rationale — C (incorrect): Increasing oxygen will change ABG
values and should only be done with a provider order for
, clinical reasons.
Rationale — D (incorrect): Oxygen therapy does not invalidate
ABG; rather, it must be documented so providers interpret
results correctly.
Teaching point: Document therapeutic interventions (e.g.,
oxygen flow) so lab results are interpreted in clinical context.
Citation: Fischbach, F., Fischbach, M., & Stout, K. (2021). A
Manual of Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
Ch. 1 — Diagnostic Testing
Stem: A newly hired RN is reviewing the facility’s diagnostic
testing policy. She asks whether point-of-care (POC) glucose
testing requires the same documentation and quality controls
as central lab tests. According to best-practice testing standards
in the chapter, which statement is correct?
A. POC testing is informal and requires only the result to be
recorded in the chart.
B. POC testing must follow manufacturer instructions and
documented quality control like other testing.
C. POC testing never requires calibration because strip
technology is self-validating.
D. Only the laboratory staff are responsible for POC quality
control, not bedside nurses.
Correct Answer: B
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
Ch. 1 — Diagnostic Testing
Stem: A 62-year-old male scheduled for a fasting lipid panel at
0800 reports that he took his morning lisinopril and had a small
black coffee (no milk). The phlebotomist documents “fasting”
and sends the specimen to the laboratory. Which action best
reflects appropriate nursing/clinical judgment?
A. Accept the specimen and document as fasting; small coffee
does not affect lipid results.
B. Note the deviation, communicate with provider, and consider
rescheduling fasting test.
C. Reject the specimen because any oral intake invalidates all
lipid testing.
,D. Proceed but draw an additional nonfasting sample for
comparison.
Correct Answer: B
Rationale — Correct: The chapter emphasizes accurate
documentation of pretest preparation and that coffee and
medications can affect some tests; notify the provider and
consider rescheduling to ensure clinically meaningful fasting
results. This preserves test validity and informs clinical decision-
making.
Rationale — A (incorrect): Small coffee can alter some lipid
values (especially triglycerides) and taking an antihypertensive
may not invalidate results but the pretest preparation was not
met; passive acceptance risks misinterpretation.
Rationale — C (incorrect): Not all oral intake invalidates lipid
testing categorically; rejection without provider consultation is
excessive.
Rationale — D (incorrect): Drawing an extra nonfasting sample
might be informative, but the immediate priority is
documenting deviation and discussing rescheduling; arbitrarily
obtaining extra samples wastes resources without provider
order.
Teaching point: Always document pretest deviations and notify
the provider before accepting fasting-dependent results.
Citation: Fischbach, F., Fischbach, M., & Stout, K. (2021). A
Manual of Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
,Ch. 1 — Diagnostic Testing
Stem: A nurse preparing a patient for an arterial blood gas
(ABG) notes the provider ordered “ABG at 0900.” The patient is
receiving supplemental oxygen by nasal cannula at 2 L/min. The
nurse suspects the ABG should reflect baseline respiratory
status. What is the most appropriate nursing step before
collection?
A. Remove supplemental oxygen for 5 minutes to obtain a true
baseline ABG.
B. Leave the oxygen as ordered and document the flow rate on
the requisition.
C. Increase oxygen to 4 L/min for 10 minutes prior to ABG to
ensure oxygenation.
D. Cancel the test because oxygen therapy invalidates ABG
interpretation.
Correct Answer: B
Rationale — Correct: Chapter 1 stresses documenting clinical
context and therapies (including oxygen flow) because results
must be interpreted relative to current treatment; altering
therapy without an order risks patient harm.
Rationale — A (incorrect): Withdrawing oxygen without an
order may cause hypoxia and is not an appropriate independent
nursing action.
Rationale — C (incorrect): Increasing oxygen will change ABG
values and should only be done with a provider order for
, clinical reasons.
Rationale — D (incorrect): Oxygen therapy does not invalidate
ABG; rather, it must be documented so providers interpret
results correctly.
Teaching point: Document therapeutic interventions (e.g.,
oxygen flow) so lab results are interpreted in clinical context.
Citation: Fischbach, F., Fischbach, M., & Stout, K. (2021). A
Manual of Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
Ch. 1 — Diagnostic Testing
Stem: A newly hired RN is reviewing the facility’s diagnostic
testing policy. She asks whether point-of-care (POC) glucose
testing requires the same documentation and quality controls
as central lab tests. According to best-practice testing standards
in the chapter, which statement is correct?
A. POC testing is informal and requires only the result to be
recorded in the chart.
B. POC testing must follow manufacturer instructions and
documented quality control like other testing.
C. POC testing never requires calibration because strip
technology is self-validating.
D. Only the laboratory staff are responsible for POC quality
control, not bedside nurses.
Correct Answer: B
