Chapter 34- Diagnostic Testing

A client is scheduled for a bronchoscopy. What should the nurse instruct the client about this procedure? Standard Text: Select all that apply. 1. Tissue samples may be taken for biopsy. 2. Eating will not be permitted for 12 hours. 3. A local anesthetic is sprayed on the throat. 4. Bed rest for 8 hours is necessary after the test. 5. Informed consent is required for this procedure.

Rationale 1: A bronchoscopy is a sterile procedure. Tissue samples may also be taken for biopsy. Rationale 3: A local anesthetic is sprayed on the clients pharynx to prevent gagging. Rationale 5: Informed consent is required for this procedure.

A client is to have an echocardiogram. Which statement by the client indicates the teaching about the test has been effective? 1. Im told this test causes no discomfort. 2. I will have to walk on a treadmill. 3. I will need to remain NPO. 4. I will need to take my pulse prior to the test.

Rationale 1: An echocardiogram causes no discomfort, although conductive gel is used and it may be cold.

An older client is having difficulty handling the specimen cup for a clean catch urine specimen. What can the nurse do to help this client? 1. Provide a clean funnel to pour the urine into the specimen cup. 2. Document that the specimen could not be obtained. 3. Catheterize the client for the specimen. 4. Ask the physician to obtain the specimen.

Rationale 1: If an older client is having difficulty with a specimen cup for a clean catch urine specimen, the nurse should provide a clean funnel to pour the urine into the container.

A client is having a lumbar puncture. In which position should the nurse place the client? 1. Lateral with head bent toward the chest and knees flexed onto the abdomen 2. Lying prone, with the knees drawn up toward the abdomen 3. Sitting bent over from the waist with legs extended 4. Supine with knees pulled toward the chest

Rationale 1: Lying in the lateral position with the head bent toward the chest and knees flexed onto the abdomen is the correct position for a lumbar puncture. In this position the back is arched, increasing the spaces between the vertebrae so that the spinal needle can be readily inserted.

The nurse is preparing to collect a throat culture from a client. What client response indicates to the nurse that teaching about this test has not been effective? 1. I need to hyperextend my neck. 2. I need to say ah.' 3. I will need to sit up. 4. The nurse will use a light.

Rationale 1: The client should extend the tongue when a throat culture is to be taken, not hyperextend the neck.

A client is prescribed a diagnostic test requiring a 24-hour stool specimen. What should this test indicate to the nurse? 1. Analyze the stool for dietary products and digestive secretions. 2. Detect the presence of bacteria or viruses. 3. Detect the presence of ova and parasites. 4. Determine the presence of occult blood.

Rationale 1: The nurse needs to collect and send the total quantity of stool expelled at one time instead of a small sample so that the specimen can be analyzed for dietary products and digestive secretions.

A client has just completed a bone marrow biopsy. What should the nurse document about the client at this time? Standard Text: Select all that apply. 1. Clients tolerance of the procedure 2. Bowel sounds 3. The site for bleeding 4. Status of deep tendon reflexes 5. Presence of pain and any pain medication received

Rationale 1: The nurse should document how well the client tolerated the procedure, as it can cause considerable discomfort. Rationale 3: The nurse should document the bone marrow biopsy site for bleeding, as this can occur. Rationale 5: The nurse should document whether the client is experiencing any pain, and whether any pain medication was provided.

The nurse is teaching a client with heart failure about diagnostic tests. Which test should the nurse emphasize in this teaching? 1. BNP 2. CBC 3. LDH 4. PKU

Rationale 1: The specific blood test to detect and guide treatment for heart failure is the BNP test. B-type natriuretic peptide is secreted primarily by the left ventricle in response to increased ventricular volume and pressure.

The nurse needs to obtain a urine specimen from a client with an indwelling urinary catheter. What should the nurse do when collecting this specimen? Standard Text: Select all that apply. 1. Withdraw 30 mL of urine for a routine urinalysis. 2. Perform catheter care before obtaining the specimen. 3. Apply sterile gloves before retrieving the urine specimen. 4. Send the specimen immediately or refrigerate it for later pickup. 5. Clamp the drainage tubing for 30 minutes if there is no urine in the catheter.

Rationale 1: When collecting a urine specimen from a client with an indwelling urinary catheter, the nurse should withdraw 30 mL of urine for a routine urinalysis. Rationale 4: When collecting a urine specimen from a client with an indwelling urinary catheter, the nurse should send the specimen immediately or refrigerate it for later pickup. Rationale 5: When collecting a urine specimen from a client with an indwelling urinary catheter, the nurse should clamp the drainage tubing for 30 minutes if there is no urine in the catheter.

The nurse is caring for a client who has just had a lumbar puncture. What should the nurse document about this clients procedure? Standard Text: Select all that apply. 1. Date and time performed 2. The physicians name 3. The clients ability to void after the procedure 4. The color, character, and amount of cerebrospinal fluid withdrawn 5. The clients status after the procedure

Rationale 1: When documenting after a lumbar procedure, the nurse should include the date and time the procedure was performed. Rationale 2: When documenting after a lumbar procedure, the nurse should include the physicians name. Rationale 4: When documenting after a lumbar procedure, the nurse should include the color, character, and amount of cerebrospinal fluid withdrawn. Rationale 5: When documenting after a lumbar procedure, the nurse should include the clients status after the procedure.

he nurse is assisting a client with a diagnostic test. Which role should the nurse expect to perform in the intratest phase? 1. Assess the data. 2. Collect the specimen. 3. Observe the client. 4. Prepare the client.

Rationale 2: Collecting the specimen comes during the intratest phase.

he nurse is providing care to a client during the posttest phase of diagnostic testing. What will the nurse do during this phase? Standard Text: Select all that apply. 1. Provide emotional and physical support to the client. 2. Compare the previous and current test results. 3. Prepare the client for the test. 4. Modify nursing interventions as necessary. 5. Report the results to appropriate health team members.

Rationale 2: During the posttest phase of diagnostic testing, the nurse will compare the previous and current test results. Rationale 4: During the posttest phase of diagnostic testing, the nurse will modify nursing interventions as necessary. Rationale 5: During the posttest phase of diagnostic testing, the nurse will report the results to appropriate health team members.

A client is scheduled for a nuclear imaging test. What should the nurse instruct the client about this test? 1. It is the use of a magnetic field to produce an image of a body part or organ. 2. A radioisotope will be injected to determine organ functioning as being either hot or cold. 3. It produces a three-dimensional image of an organ. 4. It is more sensitive than an x-ray image.

Rationale 2: In nuclear imaging studies, a radioisotope is injected, and the body organ is determined as functioning as either hot or cold.

The nurse is collecting a sputum specimen from a client. Which action should the nurse take during the collection of this specimen? 1. Collect at least 30 mL of sputum. 2. Offer mouth care. 3. Take shallow breaths. 4. Wear a mask.

Rationale 2: Offer mouth care so that the specimen will not be contaminated with microorganisms from the mouth.

What should the nurse instruct a client for obtaining a clean voided urine specimen? 1. Collect at least 5 mL of urine. 2. Collect the first voided specimen in the morning. 3. Keep the specimen on ice. 4. Void in a sterile cup.

Rationale 2: Routine urine examination is usually performed on the first voided specimen in the morning because it tends to have a higher, more uniform concentration and a more acidic pH than specimens later in the day.

What is the responsibility of the nurse when collecting a specimen from a client? 1. Always accompany the client to collect a specimen. 2. Handle the specimen discreetly. 3. Clean technique should be used with all specimen collection. 4. Use day-old specimens.

Rationale 2: The nurse should handle the specimen discreetly to avoid embarrassing the client.

A client is being treated for tuberculosis, and the doctor writes an order to collect a sputum specimen. What is the rationale behind this order? 1. To test for acid-fast bacillus 2. To assess the effectiveness of therapy 3. To identify origin, structure, function, and pathology of cells 4. To identify the specific organism

Rationale 2: The reason for this doctors order is to assess if the therapy ordered is effective for this client.

The nurse is instructing a female client on how to cleanse the perineum before collecting a clean catch urine specimen for culture and sensitivity. What should the nurse instruct this client to do? Standard Text: Select all that apply. 1. Clean the perineal area using a circular motion. 2. Use all towelettes provided. 3. Use each towelette once, and discard. 4. Clean the perineal area from back to front. 5. Clean the perineal area from front to back.

Rationale 2: To cleanse the perineum before collecting a clean catch urine specimen for culture and sensitivity for a female client, the client should be instructed to use all towelettes provided. Rationale 3: To cleanse the perineum before collecting a clean catch urine specimen for culture and sensitivity for a female client, the client should be instructed to use each towelette once and discard. Rationale 5: To cleanse the perineum before collecting a clean catch urine specimen for culture and sensitivity for a female client, the client should be instructed to clean the perineal area from front to back.

The nurse needs to collect a specimen from a client; however, the nurse has never collected this type of specimen in the past. What should the nurse do? 1. Notify the physician. 2. Ask another nurse to collect the specimen. 3. Consult the nursing procedure manual. 4. Delegate the collection of the specimen to unlicensed assistive personnel.

Rationale 3: A nursing procedure or laboratory manual is often available if the nurse is unfamiliar with the procedure. If there is any question about the procedure, the nurse should call the laboratory for directions before collecting the specimen.

A client is scheduled to have abdominal ascites fluid removed. What should the nurse instruct the client about this procedure? 1. A catheter will be inserted into the bladder. 2. A liver biopsy will be done. 3. An abdominal paracentesis will be done. 4. A thoracentesis will be done.

Rationale 3: An abdominal paracentesis is performed to remove ascites, which relieves pressure on the abdominal organs.

A client asks the nurse, Why do I have to monitor my blood glucose levels? What is an appropriate response from the nurse? 1. Because your doctor ordered it. 2. If I were you, I would monitor the blood glucose when I didnt feel good. 3. Monitoring your blood glucose better enables you to manage your diabetes. 4. You can eat anything you want.

Rationale 3: Blood glucose monitoring improves diabetes management. By testing ones blood, one can change the insulin regimen to maintain a normal glycemic range.

The nurse needs to obtain a sputum specimen from a client. What should the nurse have the client do? 1. Apply sterile gloves. 2. Clear the throat. 3. Cough to bring up secretions. 4. Rinse the mouth with mouthwash prior to the collection.

Rationale 3: Clients need to cough to bring sputum up from the lungs, bronchi, and trachea into the mouth in order to expectorate the specimen into a collecting container.

A client is scheduled for a barium enema. What is the nursing priority for this client? 1. Assess bowel sounds. 2. Assess for allergies. 3. Cleanse the bowel. 4. Keep the client NPO.

Rationale 3: For visualization of the colon, the bowel has to be cleansed; otherwise the test cannot be performed. Therefore, that is the first priority the nurse must keep in mind.

The nurse is reviewing laboratory results for a client. Which diagnostic study determines how well blood glucose levels have been controlled in the client? 1. Blood chemistry 2. Capillary blood glucose 3. Hemoglobin A1c 4. Serum electrolytes

Rationale 3: The glycosylated hemoglobin or hemoglobin A1c (HbA1c) is a measurement of blood glucose that is bound to hemoglobin. Hemoglobin A1c is a reflection of how well blood glucose levels have been controlled.

A client is having a timed urine collection done. The unlicensed assistive personnel does not save one specimen. What should the nurse do? 1. Continue with the test, and document that one specimen is missing. 2. End the test immediately, and send what is collected to the laboratory. 3. Document that the test cannot be completed. 4. Start the test over.

Rationale 4: If the client or staff forgets and discards the clients urine during a timed collection, the procedure must be restarted from the beginning.

Which return demonstration by a client indicates that teaching about performing a blood glucose monitoring test has been effective? 1. The client punctures the fingertip. 2. The client puts on gloves. 3. The client smears the blood on the reagent strip. 4. The client washes the hands.

Rationale 4: One of the first steps the client would perform is hand washing for infection control.

A client with tattooed eyeliner is scheduled for an MRI. What should the nurse instruct the client about this diagnostic test? 1. Earplugs will be provided. 2. Lie very still. 3. Report any burning sensation. 4. Wear goggles.

Rationale 4: Recent reports have shown that, in very few instances, people with tattoos or permanent cosmetics experience edema or burning in the tattoo during an MRI. Any potential problems can be avoided by wearing goggles to cover permanent cosmetics around the eyes.

The nurse is reviewing instructions provided to a client about an upcoming cystoscopy. Which client response indicates that no further teaching is required? 1. During the procedure the physician will take x-rays. 2. I will be awake for this procedure. 3. The doctor will be able to see my kidneys. 4. The scope is a lighted instrument inserted through the urethra.

Rationale 4: The cystoscope is a lighted instrument inserted through the urethra.

Unlicensed assistive personnel (UAP) will be conducting a test on a clients urine. What should the nurse instruct the UAP about the test? Standard Text: Select all that apply. 1. Nothing, because the UAP can perform urine testing. 2. Remind the UAP to tell the client the results of the test. 3. Notify the physician with the results of the test. 4. Report the results of the test to the nurse. 5. Save the urine, in case the nurse wants to repeat the test.

Rationale 4: The nurse should instruct the UAP to report the results of the test to the nurse. Rationale 5: The nurse should instruct the UAP to save the urine in case the nurse wants to repeat the test.

Which instruction should the nurse give to the client when a stool specimen is to be collected? 1. Defecate in the toilet. 2. Follow sterile technique. 3. Send at least 60 mL of specimen. 4. Void before the specimen is collected.

Rationale 4: To avoid contaminating the specimen, the client should void before the specimen is collected.