Chapter 24: Diagnostic Tests and Specimen Collection

Chapter 24: Diagnostic Tests and Specimen Collection

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who is on an anticoagulant (Coumadin) asks, “What did the primary care provider mean when he said I was to have my blood tested every 2 weeks?” The nurse explains, “It is important to monitor the effects of the drug to see how long it takes your blood to clot. The blood test the primary care provider was talking about is the:

a.	complete blood count (CBC).”
b.	activated partial thromboplastin time (APTT).”
c.	international normalized ratio (INR).”
d.	erythrocyte sedimentation rate (ESR).”

 

 

ANS:  C

The INR is a method for reporting the prothrombin time, which is prolonged with warfarin (Coumadin) therapy.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 410             OBJ:   Theory #2

TOP:   Blood Tests    KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

2. A patient is scheduled to have a blood chemistry profile drawn at 8 AM tomorrow. The note should be added on the care plan and report provided to the oncoming shift to withhold food and drink after:

a.	6 AM.
b.	12 midnight tonight.
c.	4 AM today.
d.	noon today.

 

 

ANS:  B

Food and drink are usually withheld for 8 to 12 hours before blood chemistry tests are performed.

 

DIF:    Cognitive Level: Application           REF:   p. 411             OBJ:   Theory #3

TOP:   Blood Tests    KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Safe, Effective Care Environment: Coordinated Care

 

3. A patient wants to know what was meant when the doctor said that his white blood cell (WBC) count had a shift to the left. The nurse explains that a shift to the left indicates:

a.	an improvement in an infectious process.
b.	the relative effectiveness of the antibiotic therapy.
c.	an increase in the number of immature WBCs.
d.	that the infection is viral in nature.

 

 

ANS:  C

In reporting a differential WBC, the less mature WBCs are reported on the left side of the page. An increase in immature WBCs causes the left side of the report to show large numbers and indicates an infection.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 410             OBJ:   Clinical Practice #1

TOP:   Differential     KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The nurse instructing in the collection of a midstream urine catch would tell the patient to first cleanse the external genitalia and then to:

a.	begin voiding into the specimen cup.
b.	let a few drops of urine dribble into the specimen cup.
c.	void until the bladder is almost empty and then collect the end portion of the voiding in the cup.
d.	pass a small amount of urine into the toilet and then collect the specimen.

 

 

ANS:  D

To collect a midstream specimen, the external genitalia are cleansed, a small amount of urine is passed, and then a midportion of the voiding is collected in a sterile container and used for a culture.

 

DIF:    Cognitive Level: Application           REF:   p. 411             OBJ:   Clinical Practice #1

TOP:   Urinalysis       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort

 

5. The nurse instructs an outpatient female patient preparing for an abdominal ultrasonography that prior to the procedure, she should:

a.	eat or drink nothing after midnight.
b.	drink a liter of water.
c.	empty the bladder fully.
d.	use enemas at home to clear the bowel fully.

 

 

ANS:  B

For abdominal ultrasonography, the patient is asked to drink a liter of water before the procedure. This helps change the echo reflection pattern from the bladder, helping to better distinguish the bladder from the female reproductive organs that lie nearby.

 

DIF:    Cognitive Level: Application           REF:   p. 416             OBJ:   Clinical Practice #1

TOP:   Abdominal Ultrasonography            KEY:  Nursing Process Step: Implementation

MSC:   NCLEX: Physiological Integrity: Basic Care and Comfort