Chapter 44: Diagnostic Procedures

Chapter 44: Diagnostic Procedures

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse should contact the physician to postpone intravenous moderate sedation if the patient:

a.	has been NPO for 1 hour.
b.	has a history of substance abuse.
c.	has no history of latex allergy.
d.	has demonstrated an understanding of the procedure.

 

 

ANS:  A

Verify that the patient has not ingested food or fluids, except for oral medications, for at least 4 hours. Verify specific agency requirements. Because a risk of moderate sedation is loss of airway protection, an empty stomach reduces the risk for aspiration. A history of substance abuse is not a contraindication to the procedure, although it usually requires dose adjustment of the sedative. With no history of latex allergy, allergic reactions are not a concern. An understanding of the procedure implies that consent was informed.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 1100

OBJ:   Demonstrate understanding of nursing responsibilities related to the use of intravenous sedation during diagnostic procedures.          TOP:              Moderate Sedation

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Physiological Integrity

 

2. Which action should the nurse take after a procedure requiring intravenous moderate sedation?

a.	Report to the physician a Ramsay sedation score that is less than 3.
b.	Monitor airway patency and vital signs every 5 minutes for 30 minutes.
c.	Take vital signs every 15 minutes for the next 2 hours.
d.	Take vital signs every 30 minutes until stable.

 

 

ANS:  B

After the procedure, monitor airway patency, vital signs, SpO₂, pain score, and level of consciousness every 5 minutes for at least 30 minutes, then every 15 minutes for an hour, and then every 30 minutes until the patient meets the discharge criteria on the agency’s designated scoring system. Report to the physician only a Ramsay sedation score higher than 3.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 1102

OBJ:   Demonstrate understanding of nursing responsibilities related to the use of intravenous sedation during diagnostic procedures.          TOP:              Moderate Sedation

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Physiological Integrity

 

3. Under which circumstances should a nurse contact the physician to postpone an angiography?

a.	If a patient has been NPO for only 1 hour
b.	If a patient’s femoral site has been shaved and cleansed with an antiseptic
c.	If the patient received Benadryl as a pre-procedure medication
d.	When test results reveal a BUN level of 15 mg/100 mL and a creatinine level of 0.8 mg/mL

 

 

ANS:  A

A patient needs to be NPO for 6 to 8 hours before the procedure to prevent possible aspiration because the patient is sedated. The site of catheter insertion needs to be shaved and prepped with antiseptic just before the procedure. Benadryl is used prophylactically to block histamine and decrease allergic responses. Elevated BUN or creatinine levels would place patients at risk for renal failure induced by contrast media.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 1105

OBJ:   Effectively assist health care providers with angiogram, cardiac catheterization, intravenous (IV) pyelogram, bone marrow aspiration/biopsy, lumbar puncture, paracentesis, bronchoscopy, and endoscopy.     TOP:    Postponing Angiography

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Physiological Integrity

 

4. What action should the nurse take after an angiography?

a.	Limit the patient’s fluid intake.
b.	Have the patient ambulate as soon as possible.
c.	Apply a pressure dressing to the vascular site.
d.	Maintain the patient in a sitting position while he or she is in bed.

 

 

ANS:  C

Five to 15 minutes of manual pressure is often enough to stop active site bleeding. However, a certain amount of bed rest is needed to achieve reliable hemostasis. Check agency policy for post-procedure bed rest requirements. This is often up to 6 hours when no vascular closure device is used. Encourage patient to drink 1 to 2 L of fluid after the procedure. Emphasize the need to lie flat for 6 to 12 hours.

 

DIF:    Cognitive Level: Application           REF:   Text reference: p. 1107

OBJ:   Perform appropriate physical and psychosocial assessments before, during, and after diagnostic procedures.           TOP:              Post-Angiography Procedure

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Physiological Integrity