diagnostic procedures

The nurse is told to draw an arterial blood gas sample with the client on ambient air. The nurse documents in the record that the client was receiving how much oxygen for this procedure?

21% Ambient air is the same thing as room air, which contains 21% oxygen

The nurse is providing directions to a client about how to test a stool for occult blood. The nurse cautions the client that which could cause a false-negative result?

Ascorbic acid Ascorbic acid can interfere with results of occult blood testing, yielding a false-negative result.

The nurse is caring for a client admitted with a diagnosis of systemic lupus erythematosus (SLE). A highly sensitive C-reactive protein (hsCRP) blood test is prescribed. What other blood test is often used along with the hsCRP?

Erythrocyte sedimentation rate (ESR) Both tests are very useful for detecting inflammation anywhere in the body.

How should the nurse position the client for pericardiocentesis to treat cardiac tamponade?

Supine with the head of the bed elevated at a 45- to 60-degree angle

The nurse is providing instructions for a client who will collect a stool specimen for an occult blood test. The nurse instructs the client that it is best to avoid which food for 3 days before collection of the stool specimen?

Turnips

A client is scheduled for a test to detect kidney tumors or cysts. What test is considered safest for the client?

Ultrasonography An ultrasound is the safest test to have done because it is noninvasive, affording minimal risk to the client

A client recovering from cardiac surgery has a left pleural effusion and is about to undergo a thoracentesis. What position should the nurse place the client in for the procedure?

Upright and leaning forward with the arms on an over-the-bed table

cholangiography

X-ray examination of the bile ducts, used to locate and identify an obstruction.

The nurse is giving client instructions over the telephone about preparing for a mammography. The nurse should make which statement to the client?

"Avoid using underarm deodorant on the day of the test." The client should avoid the use of lotions or underarm deodorant on the day of mammography because this can affect breast and axilla positioning and obtaining clear mammography pictures.

A client asks the nurse to explain what is involved in an intravenous fluorescein angiography study of the eye. The nurse should incorporate which statement in the reply?

"Dilating drops will be instilled before the procedure."

The nurse is providing information to a client about a computed tomography (CT) scan of the head. Which statement should the nurse include when reviewing preparation for the CT with the client?

"Each set of head scans takes less than 5 minutes to perform."

The nurse is caring for an 8-month-old infant. A urinalysis has been prescribed, and the nurse plans to collect the specimen. Which method should be used for urine collection in an infant?

Attaching a urine collection device to the infant's perineum

Pulmonary angiography

is an X-ray of the blood vessels that supply the lungs. It is used to find a blood clot, also called a pulmonary embolism

The ambulatory care nurse is providing home care instructions to the client after an arthroscopy of the knee. Which statement by the client indicates a need for further instruction?

"I can apply heat to the site if it becomes uncomfortable." Ice is applied to the affected joint for pain and swelling, and analgesics are administered as prescribed

A client is scheduled for a digital subtraction angiography study. After being provided information and instructions regarding the test, which statement by the client indicates that the teaching has been effective?

"The purpose of the test is to provide information about the blood vessels." Digital subtraction angiography is a radiographic method to study the blood vessels.

A client is being scheduled for a positron emission tomography (PET) scan of the brain. The nurse should provide which explanation to the client?

"The test detects abnormal glucose metabolism in the brain."

The nurse is admitting a client with suspected ascites. What radiology films would initially be prescribed to diagnose ascites? Select all that apply.

-Plain film - Scout film - Flat plate of the abdomen - Kidney ureters bladder (KUB)

The clinic nurse is providing instructions to a client who is scheduled for a barium enema. What should the nurse instruct the client to do in preparation for this procedure?

A low-fiber diet needs to be maintained for 1 to 3 days before the test. Preparation for a barium enema includes maintaining a low-fiber diet for 1 to 3 days before the test. Clear liquids or water may be allowed 12 to 24 hours before the test. Laxatives and enemas may be prescribed before the test to cleanse the bowel. The client is encouraged to drink liquids after the procedure to facilitate the passage of barium.

The nurse is preparing a client who is scheduled to undergo cerebral angiography. The nurse should assess the client for which finding?

Allergy to iodine or shellfish

A quantitative 72-hour fecal fat collection is prescribed by the health care provider. How should the nurse instruct the client to prepare for the specimen collection?

Consume a high-fat diet for 3 days before the test.

The nurse is caring for a client with suspected kidney failure. A 24-hour urine specimen is prescribed. What value measures overall kidney function?

Creatinine clearance levels Creatinine clearance is a calculated measure of glomerular filtration rate and is the best indication of overall kidney function

The nurse is providing instructions to a client who has had a bone scan. The nurse should instruct the client to take which measure?

Increase fluid intake for the next 24 to 48 hours. The client should be encouraged to drink large amounts of water for 24 to 48 hours to facilitate urinary excretion of the radioisotope.

A client is scheduled for an oral cholecystogram. The nurse should plan to prescribe which type of diet for the evening meal before the test?

Low-fat a low-fat diet is prescribed on the evening before the test.

A clinic nurse is reviewing the record of a client with a suspected diagnosis of pernicious anemia. The nurse anticipates that which diagnostic test will be prescribed by the client's health care provider?

Schilling test The Schilling test is used to determine the cause of vitamin B12 deficiency, which leads to pernicious anemia

electromyogram

electromyogram, needle electrodes are inserted into selected skeletal muscles to evaluate electrical activity in response to a nerve's stimulation of the muscle.

The high-sensitivity C-reactive protein (hs-CRP) test

is a blood test that finds lower levels of C-reactive protein (CRP). This protein measures general levels of inflammation in your body. The hsCRP is a test to measure inflammation in clients with an autoimmune disease such as SLE

Pheochromocytoma

is a rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure.

Extracorporeal shock wave lithotripsy

is a technique for treating stones in the kidney and ureter that does not require surgery. Instead, high energy shock waves are passed through the body and used to break stones into pieces as small as grains of sand

oral cholecystography

is an X-ray examination of your gallbladder. A low-fat or fat-free diet is prescribed on the evening before the test. prior to the test and contrast tablets are also swallowed to help visualize the gallbladder on x-ray.

The nurse is caring for a client who is scheduled to have a lumbar puncture (LP). What are some contraindications for a client to have an LP? Select all that apply.

- Clients with infection near the LP site - Clients with increased intracranial pressure - Clients receiving anticoagulation medications - Clients who have severe degenerative vertebral joint disease

The nurse provides instructions to a client who is scheduled for an electroencephalogram. Which statement by the client indicates a need for further instruction?

"All medications need to be withheld on the day of the test." medications usually are not withheld before the test unless specifically prescribed.

A client with type 2 diabetes mellitus presents to the health care provider's office with a glycosylated hemoglobin (HgbA1C) level of 10.5%. Which statement by the client indicates an understanding of this test and its results?

"Well, I have 3 months to really work on watching my diet and lowering my blood sugar. My next glycosylated hemoglobin test should be better then."

The nurse is caring for a client just admitted to the critical care unit with a diagnosis of myocardial infarction (MI). In the early period after an MI, why are nutrition interventions and education so important? Select all that apply.

- To reduce angina - To cut down on cardiac workload - To decrease the risk of dysrhythmias

The nurse is scheduling diagnostic tests for a client. Which of the diagnostic tests prescribed should be performed last?

Barium swallow

Knee arthroscopy

Knee arthroscopy is a surgical procedure that allows doctors to view the knee joint without making a large incision (cut) through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of knee problems. During knee arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your knee joint. The camera displays pictures on a video monitor, and your surgeon uses these images to guide miniature surgical instruments.

The nurse is assisting the health care provider during a colonoscopy procedure. The nurse helps the client to assume which position for the procedure?

Left Sims'

The nurse is collecting a sputum specimen for culture and sensitivity testing from a client who has a productive cough. The nurse plans to implement which intervention to obtain the specimen?

Use a sterile plastic container for obtaining the specimen. Sputum specimens for culture and sensitivity testing need to be obtained using sterile technique because the test is done to determine the presence of organisms.

Pericardiocentesis

a procedure done to remove fluid that has built up in the sac around the heart (pericardium). It's done using a needle and small catheter to drain excess fluid. A fibrous sac known as the pericardium surrounds the heart.

HIDA scan

also called hepatobiliary scintigraphy, is an imaging test used to view the liver, gallbladder, bile ducts, and small intestine. The scaninvolves injecting a radioactive tracer into a person's vein

renal angiography

an imaging test to look at the blood vessels in your kidneys. You may need a renal angiogram to help your healthcare provider find problems in the blood vessels of your kidneys. These problems may include: Bulging of a blood vessel (aneurysm) Narrowing of a blood vessel (stenosis) An abnormal connection between arteries and veins (arteriovenous malformation) Blood clot (thrombosis) Blockage (occlusion)

intravenous Pyelogram (IVP)

an x-ray exam that uses a contrast dye to show images of the kidneys, ureters and bladder

Myelography

diagnostic test using x-ray and contrast dye to check for any problems with the spinal cord

electroencephalogram (EEG)

is a test that detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp. An EEG is noninvasive

gallium scan

is a test to look for swelling (inflammation), infection, or cancer in the body. It uses a radioactive material called gallium and is a type of nuclear medicine exam. Nuclear medicine uses radioactive materials to create images of the body.

A client requires a myelogram, and the ambulatory care nurse is providing instructions to the client regarding preparation for the procedure. Which statement by the client indicates a need for further instruction?

"I need to be sure to eat a full meal before the procedure." Client preparation for a myelogram includes instructing the client to withhold food and fluids for 4 to 8 hours before the procedure as prescribed. Some health care providers may allow fluids or a light diet (but not a full meal).

The health care provider (HCP) tells a client that a blood transfusion is needed and that a blood sample must be drawn first for blood typing and crossmatching. The nurse explains to the client what a typing and crossmatch test is for and why it is done. What response by the client about blood typing implies to the nurse that further teaching is needed?

"It is an antibody found on the surface of the red blood cell." The blood type indicates an antigen, not an antibody, found on the surface of the red blood cell.

The nurse has a prescription to obtain a 24-hour urine collection in a client with a renal disorder. Which actions should the nurse take when collecting this specimen? Select all that apply.

- Explain the procedure to the client. - Save all subsequent voidings after the first void during the 24-hour period. - During the collection period, place the main container on ice or in a refrigerator. - Have the client void at the end time, and place this specimen in the main container.

The nurse is explaining an upper gastrointestinal series to a client and provides the client with the preprocedure and postprocedure instructions. The nurse informs the client that after this procedure, the stools can be expected to remain white for what time period?

1 to 2 days

A clinic nurse is providing instructions to a client who is scheduled for a glucose tolerance test. Which instruction should the nurse provide to the client in preparation for the test?

Avoid alcohol, coffee, and tea for 36 hours before and during the test.

The nurse is providing instructions to a client who is scheduled for a hepatobiliary scintigraphy (HIDA) scan. What should the nurse instruct the client to do?

Avoid oral intake except for water on the day of the procedure.

The nurse is providing instructions to a client who is scheduled for a gallium scan. Which statement made by the client indicates an understanding of the instructions?

"I need to have an injection 2 to 3 hours before the procedure."

The nurse is caring for a client who had intracranial surgery and is now suspected of having developed diabetes insipidus (DI). What initial prescription should the nurse expect from the health care provider (HCP)?

24-hour fluid intake and output without restricting food or fluid intake

The nurse is caring for a client after pulmonary angiography with catheter insertion via the left groin. Which assessment finding is related to an allergic reaction to the contrast medium?

Decreased blood pressure

The nurse is assisting the health care provider in performing a lumbar puncture on a client. The nurse prepares the client for the procedure by placing the client in which position?

Fetal The client is assisted into a fetal position at the edge of the bed with the knees drawn up to the chest. This position allows full flexion of the spine and wider spaces between the vertebrae.

A nursing student is assigned to an adult client who is scheduled for bone marrow aspiration. The coassigned nurse asks the nursing student about the possible sites that could be used for obtaining the bone marrow. The student demonstrates understanding of the procedure by identifying what as the correct aspiration site?

Iliac crest The most common sites for bone marrow aspiration in the adult are the iliac crest and the sternum

The nurse is developing a plan of care for a client who will be returning to the nursing unit after a percutaneous transhepatic cholangiogram. The nurse should include which intervention in the postprocedure plan of care?

Place a sandbag or other approved device over the insertion site.

A client is about to undergo a lumbar puncture (LP). Which position should the nurse tell the client will be used during the procedure?

Side-lying position, with legs pulled up and head bent down onto the chest (fetal position)

The nurse explaining the procedure of indium imaging to a client with a bone infection should include which information?

Some of the client's white blood cells are tagged with indium, which will later accumulate in infected bone.

The nurse collects a 24-hour urine specimen for catecholamine testing from a client with suspected pheochromocytoma. The results of the catecholamine test are reported as epinephrine 20 mcg (109 nmol) and norepinephrine 100 mcg (590 nmol). The nurse should make which interpretation about this result?

Higher than normal, indicating pheochromocytoma The normal range of urinary catecholamines is epinephrine <20 mcg/day and norepinephrine <100 mcg/day, with higher levels occurring in pheochromocytoma.

A client is scheduled to have a needle liver biopsy. During the procedure, the nurse should instruct the client to take which action?

Lie supine with the right arm over the head. For the health care provider to have optimal access to the liver during a liver biopsy, the client should be instructed to lie in a supine position with the right arm over the head.

The nurse is planning care for a client who has just returned to the nursing unit after an oral cholecystogram. The nurse should expect to delete which prescription on the client's care plan?

Maintain a clear liquid diet for 72 hours. It is not necessary to keep the client on clear liquids for 72 hours after the procedure

The clinic nurse reads the results of a tuberculin skin test performed on a 5-year-old child who is at low risk for contracting tuberculosis. The results indicate an area of induration measuring 10 mm. How would the nurse interpret these results?

Negative Induration measuring 15 mm or greater is considered a positive result in a child 4 years of age

The nurse is planning care for a client returning to the nursing unit after a bone biopsy. Which nursing action would be contraindicated in the postprocedure care for this client?

Place the limb in a dependent position for 24 hours. The biopsied limb would be elevated for 24 hours to reduce edema, not placed in a dependent position (hanging down to ground)

The nurse is preparing for the admission of a client with a suspected diagnosis of herpes simplex encephalitis. The nurse anticipates that which diagnostic test will be prescribed to confirm this diagnosis?

Polymerase chain reaction

A client is scheduled for a fiberoptic gastrointestinal procedure. The nurse instructs the client to remain on clear liquids the day before the test because a clear liquid diet supports which action?

Providing little or no residue Because clear liquid diets have little or no residue, the GI tract will have an opportunity to empty itself of solid contents. This will enable the HCP to view the GI tract clearly.

The nurse is caring for a client who has been diagnosed as having an acute kidney injury. What diagnostic test is most effective in confirming this diagnosis?

Renal biopsy A renal biopsy is considered the best method for confirming intrarenal causes of acute kidney injury (AKI). Magnetic resonance imaging (MRI) and computed tomography (CT) scans contain contrast mediums that can be harmful to clients. An ultrasound study is not definitive and may not provide enough information.

The nurse reviews the health care provider's (HCP's) prescriptions for a child with a streptococcal infection. The HCP prescribes an antistreptolysin O titer. Based on this prescription, which diagnosis should the nurse suspect in the child?

Rheumatic fever (RF) Rheumatic fever can occur after a strep throat infection from a bacteria called group A streptococcus

The nurse is caring for a client with a peptic ulcer who has just had an esophagogastroduodenoscopy (EGD). Which client problem should be the priority?

Risk for choking and aspiration related to a poor gag reflex postprocedure before the procedure of a local anesthetic is administered to the throat to stop the gag reflex so the to endoscope can go down easily

myelography concerns

Since dye is injected and spinal fluid leakage is a concern, the client should avoid bending over, avoid strenuous exercise, and rest with the head elevated. Clear drainage from the dressing site indicates cerebrospinal fluid leakage, requiring health care provider notification.

A sweat test is performed on an infant with a suspected diagnosis of cystic fibrosis (CF). The nurse reviews the results of the test and notes that the chloride level is 40 mEq/L. How should the nurse interpret this finding?

Suggestive of CF A chloride level higher than 60 mEq/L is considered to be a positive test result. A sweat chloride level lower than 40 mEq/L is considered normal. A sweat chloride level higher than or equal to 40 mEq/L is suggestive of CF and requires a repeat test.

The ambulatory care nurse is preparing to assist the health care provider in performing a liver biopsy on a client. The client is receiving a local anesthetic for the procedure. The nurse should assist the client into which position for this test to be performed?

Supine with the right hand under the head A client undergoing liver biopsy with the use of a local anesthetic will be positioned supine with the client's right hand placed under the head. An alternative position is the left lateral side-lying position

A client has just returned from the cardiac catheterization laboratory. The left-sided femoral vessel was used as the access site. How should the nurse position the client?

Supine, with the head of the bed elevated about 15 degrees. Following cardiac catheterization, the extremity used for catheter insertion is kept straight for 4 to 6 hours. The head of the bed is not elevated more than 15 degrees The client may be positioned sitting on the edge of the bed, leaning over the bedside table, with the feet supported on a stool. The other position is lying in bed on the unaffected side, with the head of the bed elevated 45 degrees (Fowler's position)

The nurse is teaching a client about what to expect during a gallium scan. The nurse should include which item as part of the instructions?

The procedure takes about 30 to 60 minutes to perform. A gallium scan requires the injection of gallium isotope 2 to 3 hours before the procedure; therefore, the procedure is invasive. The procedure takes 30 to 60 minutes to perform. The client will lie down during the procedure and must lie still. There is no special aftercare.

The nurse is explaining to an older client about a creatinine clearance test that has been prescribed. What response by the client indicates that there is a need for further teaching?

This test measures the levels of all of the medications that I take."

indium imaging

a sample of the client's blood is collected, and the leukocytes (white blood cells) are tagged with indium. The leukocytes are then reinjected into the client. They accumulate in infected areas of bone and can be detected with scanning. No special preparation or aftercare is necessary.

percutaneous transhepatic cholangiogram

is an x-ray of the biliary duct system that is taken with the use of an iodinated dye instilled via a percutaneous needle inserted through the liver into the intrahepatic ducts. After this procedure, the nurse monitors the client's vital signs closely for indications of hemorrhage and observes the needle insertion site for bleeding and bile leakage. A sandbag or other pressure device is placed over the insertion site to prevent bleeding.

cerebral angiography

uses a catheter, x-ray imaging guidance and an injection of contrast material to examine blood vessels in the brain for abnormalities such as aneurysms and disease such as atherosclerosis (plaque) or blockages in the blood vessels

The nurse notes that the health care provider has documented a suspected diagnosis of herpes zoster in the client's chart. The nurse should prepare the client for which diagnostic test to confirm this diagnosis?

Culture of the lesion