Basic Questions Part 3
- 1.
Which of the following is a good indicator of the glomerular filtration rate (GFR)?
- A.
BUN
- B.
Bence-Jones
- C.
Creatinine
- D.
Urine cytology
Correct Answer
C. CreatinineExplanation
Creatinine is formed and excreted at a constant rate and is the ideal substance for measuring renal clearance. Incorrect answers: BUN reflects the balance between production and excretion of urea; Bence-Jones proteins are
positive for multiple myeloma; urine cytology detects urinary inflammatory diseases.Rate this question:
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- 2.
Which of the following is a measurement of the kidney’s ability to concentrate urine?
- A.
Urine osmolality
- B.
Creatinine clearance
- C.
Specific gravity
- D.
Urine cytology
Correct Answer
C. Specific gravityExplanation
Incorrect answers: a, b, and d—urine osmolality identifies the osmotic concentration; creatinine clearance determines the glomerular filtration rate; urine cytology detects urinary inflammatory diseases.Rate this question:
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- 3.
Which of the following examinations requires a serum sample and 24-hour urine sample?
- A.
Urine cytology
- B.
Creatinine clearance
- C.
Bicarbonate
- D.
BUN
Correct Answer
B. Creatinine clearanceExplanation
Midway through the 24-hour urine collection, a serum creatinine level is collected to help calculate the rate at which kidneys are clearing creatinine from the blood.
Incorrect answers: a, c, and d—urine cytology requires a urine sample only; bicarbonate levels can be done on either serum or urine samples; BUN requires a serum sample.Rate this question:
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- 4.
A 69-year-old client with diabetes mellitus type 2 is to undergo a CT scan using contrast media. Which laboratory test(s) should be performed prior to the CT scan?
- A.
Liver function tests
- B.
Electrolytes
- C.
BUN and creatinine
- D.
Fasting blood sugar
Correct Answer
C. BUN and creatinineExplanation
Clients undergoing CT scans using contrast media need adequate renal function to process the media. Elderly clients and clients with diabetes mellitus are at risk due to decreased renal function. Incorrect answers: a, b, and d—Abnormal liver function, electrolyte, or blood sugar tests do not typically prevent a
client from having a CT scan.Rate this question:
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- 5.
Which test can a pregnant woman undergo without concern for causing harm to the fetus?
- A.
CT scan of the brain
- B.
Chest X-ray
- C.
CT scan of the abdomen
- D.
Ultrasound of the gallbladder
Correct Answer
D. Ultrasound of the gallbladderExplanation
An ultrasound of the gallbladder involves only sound waves, not radiation.
Incorrect answers: a, b, and c—CT scans and X-rays involve exposure of the fetus to radiationRate this question:
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- 6.
Immediate postprocedure care of the client who has undergone a bronchoscopy includes all of the following except:
- A.
Monitoring vital signs
- B.
Ensuring siderails are up
- C.
Pushing fluids
- D.
Assessing breath sounds
Correct Answer
C. Pushing fluidsExplanation
The client is not to have fluids until the nurse is certain the gag reflex is intact.
Incorrect answers: a, b, and d—After a bronchoscopy thenurse is to periodically monitor the vital signs and breath sounds to assess for development of complications such as pneumothorax. Due to receipt of sedation during the
procedure, the client is to remain in bed with the siderails up until fully conscious.Rate this question:
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- 7.
You are monitoring a client who is receiving conscious sedation while undergoing a colonoscopy. Medications used are midazolam and fentanyl. You notice that the client is experiencing respiratory depression. You should:
- A.
Increase the intravenous infusion rate.
- B.
Administer naloxone
- C.
Administer CPR.
- D.
Recheck the vital signs in 15 minutes.
Correct Answer
B. Administer naloxoneExplanation
The client is most likely experiencing respiratory depression from the narcotic fentanyl. The antidote for fentanyl overdose is naloxone.
Incorrect answers: a, c, and d—Increasing the IV rate will not affect the respiratory depression. CPR is not neededsince the client is still breathing. Vital signs are to be monitored every 5 minutes during conscious sedation.Rate this question:
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- 8.
A PPD test is administered to a healthy 23-year-old nurse who is starting employment at a local hospital. Which of the following measurements would be considered a positive” reading for this individual?
- A.
10 mm of erythema
- B.
5 mm of induration
- C.
10 mm of induration
- D.
15 mm of induration
Correct Answer
C. 10 mm of indurationExplanation
For health care workers, 10 mm and above of induration is considered positive.
Incorrect answers: a—Erythema is not considered as positive; b—5 mm of induration is positive if the person is immunocompromised; d—15 mm of induration is positive for persons with no known risk factors.Rate this question:
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- 9.
Which of the following procedures would be contraindicated in a client with a bleeding disorder?
- A.
Intravenous pyelogram
- B.
Liver biopsy
- C.
Renal scan
- D.
CT scan of the brain
Correct Answer
B. Liver biopsyExplanation
Liver biopsy is contraindicated in clients with bleeding disorders due to the risk of bleeding from the biopsy site. Incorrect answers: a, c, and d—A client with a bleeding disorder can safely undergo an intravenous pyelogram,
renal scan, or CT scan of the brain since, other than a venipuncture for administration of contrast dye or radioisotope, they are noninvasive.Rate this question:
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- 10.
A client with diabetes mellitus self monitors blood sugar at home. His primary care provider wants to assess the client’s average blood sugar over a 3 month period. The best test for this would be:
- A.
Fasting plasma glucose
- B.
Urine dipstick for glucose
- C.
Glucose tolerance test
- D.
Hemoglobin A1C
Correct Answer
D. Hemoglobin A1CExplanation
Hemoglobin A1C absorbs glucose and holds it for the lifespan of the red blood cell (up to 120 days). Incorrect answers: a, b, and d—The fasting plasma glucose, urine dipstick for glucose, and glucose tolerance test provide information on glucose levels at one point in time.Rate this question:
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- 11.
A pregnant client is undergoing a nonstress test. Which of the following would be considered a “nonreactive” test?
- A.
There is fetal movement only after she rubs her abdomen.
- B.
There is no fetal movement in 20 minutes.
- C.
There is fetal movement at 30 minutes only after a loud noise is placed near the abdomen.
- D.
There is no fetal movement in 40 minutes.
Correct Answer
D. There is no fetal movement in 40 minutes.Explanation
The NST is considered nonreactive if there is no fetal movement in 40 minutes. A contraction stress test is then scheduled.
Incorrect answers: a, b, c—Any fetal movement in less than 40 minutes is considered normal, even if external stimulation, such as rubbing the abdomen or a loud noise, is needed to stimulate the fetus.Rate this question:
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- 12.
A client has a severe bacterial infection. Which of the following would be expected on the client’s complete blood count (CBC) with differential?
- A.
WBC 8,500, lymphocytes 45%
- B.
WBC 15,000, segmented neutrophils 50%
- C.
WBC 25,000, band neutrophils 20%
- D.
WBC 20,000, segmented neutrophils 58%
Correct Answer
C. WBC 25,000, band neutrophils 20%Explanation
With a severe bacterial infection, the total white blood cell count would be above normal. Band neutrophils would be elevated because the body is trying to quickly fight the infection; so quickly, that the neutrophils are being released into the circulation before they are mature cells. Incorrect answer: a—WBC count is normal with elevated lymphocytes, indicating viral infection; b—WBC count is
above normal but segs are normal, thus indicating the infection is not severe; d—although the WBC count is elevated, the segs are still within normal limits, again
indicating the infection is not severe.Rate this question:
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- 13.
A client with atrial fibrillation is receiving warfarin (Coumadin) 5 mg each day. His INR today is 2.4. What is the expected change in medication dosage?
- A.
His INR is too low. His warfarin dose needs to be increased.
- B.
His INR is too high. His warfarin dose needs to be decreased.
- C.
His INR is too high. His warfarin dose needs to be increased.
- D.
His INR is within desired range. No change in warfarin dose is needed.
Correct Answer
D. His INR is within desired range. No change in warfarin dose is needed.Explanation
Target INR for clients with afib is 2.0–3.0. This client’s INR is within this range.Rate this question:
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- 14.
A client is experiencing cardiac dysrhythmias, confusion, and weakness. An abnormal level of which of the following would most likely be the cause?
- A.
Phosphorus
- B.
Calcium
- C.
Potassium
- D.
Sodium
Correct Answer
C. PotassiumExplanation
Low potassium levels (hypokalemia) cause confusion, anorexia, muscle weakness, paresthesias, hypotension, cardiac dysrhythmias, and decreased reflexes. Incorrect answers: a, b, and d—Abnormal levels of phosphorus, calcium, and sodium do not result in the triad of dysrhythmias, confusion, and weakness.Rate this question:
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- 15.
For which of the following medications should a client undergo therapeutic drug monitoring?
- A.
Penicillin (antibiotic)
- B.
Propranolol (beta-blocker)
- C.
Furosemide (diuretic)
- D.
Digoxin (cardiac glycoside)
Correct Answer
D. Digoxin (cardiac glycoside)Explanation
There is a narrow margin of safety between therapeutic drug effect and drug toxicity with digoxin.Rate this question:
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- 16.
A client has acute hepatitis. Which of the following would most likely be elevated?
- A.
Serum protein electrophoresis
- B.
Alanine aminotransferase (ALT)
- C.
Ammonia
- D.
Troponin
Correct Answer
B. Alanine aminotransferase (ALT)Explanation
ALT, an enzyme found primarily in the liver, is elevated in clients with hepatitis.Rate this question:
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- 17.
You note that your client with chronic renal failure has a urine specific gravity (SG) of 1.035. You explain to the client that:
- A.
This specific gravity is normal.
- B.
This specific gravity indicates very concentrated urine and you recommend increased fluid intake.
- C.
This specific gravity is high and indicates the presence of a urinary tract infection.
- D.
This specific gravity indicates dilute urine due to the kidneys’ lack of ability to concentrate urine.
Correct Answer
D. This specific gravity indicates dilute urine due to the kidneys’ lack of ability to concentrate urine.Explanation
Clients with renal disease lose the ability to concentrate urine. Incorrect answers: a—normal specific gravity is 1.005–1.030, this client’s SG is above normal; b—an increased SG indicates dilute, not concentrated urine; c—
urinary tract infection does not typically cause this increase in SG.Rate this question:
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- 18.
Which of the following findings from a urinalysis would most likely indicate renal dysfunction?
- A.
Positive leukocyte esterase
- B.
Positive urobilinogen
- C.
Positive protein
- D.
Positive nitrites
Correct Answer
C. Positive proteinExplanation
With renal dysfunction, the glomerular filtrate membrane “leaks”, allowing large protein molecules to pass through
into the urine. Incorrect answers: a, b, and d—positive leukocyte esterase and nitrites are indicative of urinary tract infection. Positive urobilinogen occurs with liver dysfunction.Rate this question:
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- 19.
Which of the following is a normal finding for the client with a chest tube?
- A.
New pockets of air are palpated under the skin
- B.
Bubbling is present in the water seal chamber
- C.
Drainage from the chest tube increases each day
- D.
The water level in the water seal chamber oscillates with the client’s respirations
Correct Answer
D. The water level in the water seal chamber oscillates with the client’s respirationsExplanation
If there is no air leak, the water level in the water seal chamber will oscillate with the client’s respirations. Incorrect answers: a—pockets of air represent subcutaneous emphysema, the physician should be notified if it increases; b—bubbling in the water seal chamber indicates the presence of an air leak; c—increased drainage suggests new or increased bleeding and needs to be reported.Rate this question:
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- 20.
Which of the following is the most accurate method of determining proper placement of a nasogastric tube?
- A.
Using a 50-ml syringe to aspirate gastric contents
- B.
Instilling air into the tube and auscultating for aswooshing sound
- C.
Obtaining a chest X-ray
- D.
Placing the end of the tube in water to check for bubbling
Correct Answer
C. Obtaining a chest X-rayExplanation
A chest X-ray is the most accurate method. Incorrect answers: a, and b—both of these methods are less reliable options; d—this option is not acceptable practice.Rate this question:
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- 21.
A client is to undergo three tests: upper GI series, lower GI series (barium enema), and renal ultrasound. In what order should these tests be performed?
- A.
Lower GI series, then upper GI series, then renal ultrasound
- B.
Upper GI series, then renal ultrasound, then lower GI series
- C.
. Renal ultrasound, then lower GI series, then upper GI series
- D.
It does not matter in what order these tests are performed
Correct Answer
C. . Renal ultrasound, then lower GI series, then upper GI seriesExplanation
The renal ultrasound is done before any studies involving barium. Then the lower GI series is done so that barium from the upper GI series does not obscure the lower GI images. Incorrect answers: a, b, and d—lower GI series is done
before the upper GI series; renal ultrasound cannot be done within 2 days of barium studies, so it is best to complete this first.Rate this question:
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- 22.
Colonoscopy is contraindicated for clients with which of the following disorders?
- A.
Polyps
- B.
Hemorrhoids
- C.
Diarrhea
- D.
Acute diverticulitis
Correct Answer
D. Acute diverticulitisExplanation
Performing a colonoscopy in the presence of acute diverticulitis increases the risk of perforation of the colon wall during the procedure.
Incorrect answers: a, b, and c—none of these problems would prevent the client from having a colonoscopy.Rate this question:
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- 23.
Your client is a 32-year-old healthy female whose maternal grandmother had breast cancer at age 45. Your client is asking your guidance as to when she should have a mammogram. According to the American Cancer Society, she should begin screening at age:
- A.
32
- B.
35
- C.
40
- D.
50
Correct Answer
B. 35Explanation
Screening for women who are high-risk is to begin 10 years before the age of the diagnosis of breast cancer in a family member.Rate this question:
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- 24.
Your client is to undergo an amniocentesis. Which of the following should be included in your care of this client?
- A.
The client should have a full bladder for the procedure.
- B.
The client should be reassured that the procedure is risk-free.
- C.
The client should be instructed to report abdominal pain, cramping, chills, fever, vaginal bleeding, fetal hyperactivity, or lethargy.
- D.
Explanation that the procedure involves obtaining a sample of amniotic fluid through the cervical os.
Correct Answer
C. The client should be instructed to report abdominal pain, cramping, chills, fever, vaginal bleeding, fetal hyperactivity, or lethargy.Explanation
These signs are all indicators of possible complications and need to be reported immediately. Incorrect answers: a—the client should empty her bladder prior to the procedure to avoid accidental puncture during the amniocentesis; b—there are numerous possible complications of the procedure, including hemorrhage, infection, premature labor, and spontaneous abortion; d—the procedure involves transabdominal needle aspiration of amniotic fluid.Rate this question:
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- 25.
A client is diagnosed with a wound infection which is quite painful. Which of the following is true?
- A.
An antibiotic should be started immediately. The client can return for a wound culture when the wound is less painful.
- B.
Antibiotic therapy will be withheld until the culture and sensitivity report is available.
- C.
A wound culture is obtained first, after which a broad spectrum antibiotic is started.
- D.
The culture report will identify the correct antibiotic to use to treat the infection.
Correct Answer
C. A wound culture is obtained first, after which a broad spectrum antibiotic is started.Explanation
Specimen collection should occur prior to beginning antibiotic therapy.
Incorrect answers: a—treatment with antibiotics before obtaining the culture may produce false-negative results; b—the client is started on a broad spectrum antibiotic while awaiting the culture and sensitivity report. If the bacteria are found to be resistant to the prescribed antibiotic, the medication will be changed; d—the sensitivity report identifies the antibiotics to which the bacteria are susceptible.Rate this question:
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Mar 21, 2023Quiz Edited by
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Oct 31, 2011Quiz Created by
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