Chapter 09: Diagnostic Procedures

Chapter 09: Diagnostic Procedures

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The patient asks the nurse why an x-ray film with contrast medium is needed. How should the nurse respond?

ANS:  B

The radiologist uses contrast medium to visualize internal structures not seen with regular x-ray films. The dye saturates the affected area for the x-ray film, and the image stands out against the tissue without dye. Because the healthcare provider and radiologist know the normal contour and appearance of internal structures, they can spot abnormalities such as filling defects, tumors, fistulas, and fractures. The nurse needs to be direct and answer the patient’s question.

DIF:    Cognitive Level: Apply                   REF:   Page 218

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning

2. A contrast medium study is being scheduled. Which statement by the patient during the assessment warrants further investigation by the nurse?

ANS:  A

The nurse needs to establish whether the patient is truly allergic to shellfish, indicating sensitivity to iodine. The antiseptic used for the test has an iodine base and might cause a reaction; if so, the nurse or provider uses chlorhexidine or another agent for the skin preparation before the study. In addition, because many contrast mediums have an iodine base, the provider needs to choose an alternative dye. Establishing the nature of the reaction is important because the information provides valuable data for the radiologist to aid in choosing the proper contrast medium. It also establishes baseline data necessary when preparing for postprocedure nursing care. Small veins and urinary patterns do not pose potential problems for this type of test. Although the nurse should provide the patient with information to ease anxiety about the test, the allergy information is key to patient safety during this procedure.

DIF:    Cognitive Level: Analyze                REF:   Page 218-219

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Planning

3. A patient is being monitored in the left femoral artery 2 hours after an angiogram. What assessment by the nurse is of greatest priority?

ANS:  B

The radiologist inserts the angiographic catheter in the groin for a femoral angiogram. Because a major vessel is accessed for the procedure, the patient has a high risk for postprocedure bleeding and thromboembolic events. For early detection of postangiographic bleeding, the nurse monitors the patient for subcutaneous discoloration, a change in the pulses distal to the insertion site, and bright red bleeding. The peripheral pulses detect a thromboembolic event early, which helps to prevent tissue damage or loss. It would not be unusual for a patient to be sleepy and amnesic after this procedure. If both feet are cool, it is probably because of room temperature since nothing invasive was done on the patient’s right side.

DIF:    Cognitive Level: Apply                   REF:   Page 219-220

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Implementation

4. The patient is being monitored by the nurse during a gastroscopy. Which patient data need to be communicated to the healthcare provider doing the procedure?

ANS:  C

Inserting the endoscope can stimulate the vagus nerve, potentially leading to a slower heart rate and hypotension. Left lateral Sims’ position is suitable for gastroscopy. The patient should be drowsy with the medication used but able to follow basic directions. The nurse and healthcare provider use the gastric erosion identified during the gastroscopy to plan nursing care and patient therapy.

DIF:    Cognitive Level: Apply                   REF:   Page 223| Page 234

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Evaluation

5. The nurse provides patient teaching before a lumbar puncture. Which information does the nurse include about patient activity during the procedure?

ANS:  C

The nurse instructs the patient to maintain the lateral position and lie without moving during the procedure, especially while the provider inserts the needle, because the goal is to put the needle in the subarachnoid space. Unexpected patient movement potentially leads to needle misplacement, patient injury, and increased risk of postprocedural headache and infection from leaking cerebrospinal fluid. The local anesthetic injection stings, and insertion of the needle potentially elicits a sharp, stabbing, or shooting pain that causes patients to flinch. The nurse assists the patient to maintain the position and offers reassurance and information. The nurse instructs the patient to indicate verbally that pain is present during the procedure but not to move. Unless fluids are contraindicated, providers typically prescribe flat positioning and normal fluid intake following the procedure.

DIF:    Cognitive Level: Apply                   REF:   Page 227

OBJ:   NCLEX: Physiological Integrity      TOP:   Nursing Process: Implementation