NCLEX Practice- Diagnostic Testing & Lab Values

The nurse is providing instructions to a client who is scheduled for a gallium scan. Which statement, if made by the client, indicates an understanding of the instructions? A. "The procedure will take all day." B. "I need to have an injection 2 to 3 hours before the procedure." C. "I will need to avoid food and fluids and remain on bed rest for 2 days after the procedure." D. "I need to get a good night's rest because I will have to stand for several hours for this test."

B. "I need to have an injection 2 to 3 hours before the procedure." *A gallium scan is similar to a bone scan, but with injection of gallium isotope instead of radioisotope. Gallium is injected 2 to 3 hours before the procedure. The procedure takes 30 to 60 minutes to perform. The client needs to lie still during the procedure. There is no special aftercare.

A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the procedure? A. Lying in bed on the affected side B. Lying in bed on the unaffected side C. Sims position with the head of the bed flat D. Prone with the head turned to the side and supported by a pillow

B. Lying in bed on the unaffected side Rationale: To facilitate removal of fluid from the chest, the client is positioned sitting at the edge of the bed leaning over the bedside table, with the feet supported on a stool; or lying in bed on the unaffected side with the head of the bed elevated 30 to 45 degrees. The prone and Sims positions are inappropriate positions for this procedure.

A client is being scheduled for a positron emission tomography (PET) scan of the brain. The nurse should provide which explanation to the client? A. "The test uses magnetic fields to produce images." B. "The test provides cross-sectional views of the brain." C. "The test detects abnormal glucose metabolism in the brain." D. "The test views bones of the skull, nasal sinuses, and vertebrae."

C. "The test detects abnormal glucose metabolism in the brain." *The PET scan can detect abnormal brain tissue metabolism. A radionuclide is attached to a glucose component and is injected as an intravenous bolus. The computer records the chemical activity in the brain following injection. Options 1, 2, and 4 describe magnetic resonance imaging (MRI), computed tomography (CT) scanning, and radiography, respectively.

The clinic nurse is caring for an infant who has been diagnosed with primary hypothyroidism. The nurse is reviewing the results of the laboratory tests for a T4 and thyroid-stimulating (TSH) hormone. Which laboratory finding indicates a diagnosis of primary hypothyroidism? A. A normal T4 level B. An elevated T4 level C. An elevated TSH level D. A decreased TSH level

C. An elevated TSH level *Diagnostic findings in primary hypothyroidism include a low T4 level and a high TSH level. Options 1, 2, and 4 are not diagnostic findings in this condition.

A 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? A. Iodine B. Colchicine C. Ascorbic acid D. Acetylsalicylic acid

C. Ascorbic Acid *Ascorbic acid can interfere with results of occult blood testing, yielding a false-negative result. Colchicine and iodine can cause false-positive results. Acetylsalicylic acid would have no effect or could cause a positive result by inducing bleeding from the gastrointestinal (GI) tract.

A client's laboratory test results reveal an increased transferrin level and a decreased iron-binding capacity. The nurse interprets that these laboratory results are compatible with anemia because of which problem? A. Infection B. Malnutrition C. Iron deficiency D. Sickle cell disease

C. Iron Deficience *Iron deficiency anemia usually is characterized by decreased iron-binding capacity and increased transferrin saturation. Infection is not associated with these laboratory values. Malnutrition can cause reductions in both iron-binding capacity and transferrin saturation. Sickle cell anemia is diagnosed by determining that the client has hemoglobin S.

A nurse is monitoring for agranulocytosis in a client who is taking clozapine (Clozaril). The nurse should check which serum laboratory result to determine the presence of agranulocytosis? A. Basophil count lower than normal B. Creatinine level greater than normal C. White blood cell (WBC) count lower than normal D. Blood urea nitrogen (BUN) level greater than normal

C. White blood cell (WBC) count lower than normal *In agranulocytosis, the WBC count decreases as a result of bone marrow suppression, and the deficiency causes the affected client to become susceptible to infection. Because some antipsychotic medications, such as clozapine, can produce this adverse effect, a baseline WBC count is obtained and is evaluated periodically during therapy with this medication. Although a basophil count is a component of the WBC differential count, it does not provide adequate data to determine the presence of agranulocytosis. Levels of BUN and creatinine that are higher than normal may indicate renal disease.