Diagnostic Testing HESI prep- Adult Care

Cardiac magnetic resonance imaging (MRI) is prescribed for a client. Which finding should the nurse identify as a contraindication for performance of this diagnostic study? a) The client has a pacemaker. b) The client is allergic to iodine. c) The client has diabetes mellitus. d) The client has a biological porcine valve.

a) The client has a pacemaker.

The nurse is preparing to care for a client who has undergone myelography using an oil-based contrast agent. How long and in what position should the nurse plan to position the client on bed rest? a) 2 hours, with the head of bed flat b) 8 hours, with the head of bed flat c) 4 hours, with head of bed elevated 15 to 30 degrees d) 8 hours, with head of bed elevated 15 to 30 degrees

b) 8 hours, with the head of bed flat Rationale: If an oil-based dye is used during myelography, the dye is removed at the end of the procedure. The client is positioned flat in bed for approximately 8 hours after the dye is removed. If a water-based contrast medium is used, the client is positioned with the head of bed elevated 30 degrees for 6 to 8 hours to keep the dye from irritating the cerebral meninges

A client is admitted to the critical care unit with a diagnosis of suspected myocardial infarction. The unit nurse is reviewing the laboratory test results for this client. Which finding would most specifically indicate the presence of a myocardial infarction (MI)? a) Increased troponin I b) Increased myoglobin c) Increased blood urea nitrogen (BUN) d) Decreased white blood cell (WBC) count

a) Increased troponin I

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? a) "No contrast dye is used." b) "Food is restricted for 4 hours before the procedure." c) "Dilating drops will be instilled before the procedure." d) "The study predicts the success of radial keratotomy."

c) "Dilating drops will be instilled before the procedure."

A 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? a) 16% b) 21% c) 30% d) 40%

b) 21% Rationale: Ambient air is the same thing as room air, which contains 21% oxygen

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? a) Right lateral side-lying b) Flat with the head elevated c) Supine with the right hand under the head d) Prone with the hands crossed under the head

c) Supine with the right hand under the head

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? a) Ribs b) Femur c) Scapula d) Iliac crest

d) Iliac crest

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 be able to delete which prescription on the client's care plan? a) Monitor hydration status. b) Assess for nausea and vomiting. c) Monitor for abdominal discomfort. d) Maintain a clear liquid diet for 72 hours.

d) Maintain a clear liquid diet for 72 hours. Rationale: The client should be able to resume the usual diet once the nurse is sure that the client's gastrointestinal (GI) function is normal. It is not necessary to keep the client on clear liquids for 72 hours after the procedure. The nurse would also assess hydration status as part of routine care for the client undergoing a GI diagnostic test. The nurse would monitor the client for complaints of GI discomfort and nausea and vomiting.

A stool smear for culture needs to be obtained from a client. What steps should the nurse plan on implementing when obtaining the specimen? Select all that apply. 1. Wearing sterile gloves 2. Using a sterile container 3. Refrigerating the specimen 4. Sending the specimen directly to the laboratory 5. Positioning the client in a dorsal recumbent position

1. Wearing sterile gloves 2. Using a sterile container 4. Sending the specimen directly to the laboratory

The emergency department nurse is caring for a client with a suspected diagnosis of meningitis. The nurse should prepare the client for which test to confirm the diagnosis? a) Blood culture b) Lumbar puncture c) Serum electrolyte panel d) White blood cell (WBC) count

b) Lumbar puncture

The ambulatory care nurse is preparing a client who is scheduled for a liver biopsy. The nurse reviews the client's record and expects to note which laboratory results documented in the client's chart? a) Uric acid level b) Prothrombin time c) White blood cell count d) Blood urea nitrogen (BUN)

b) Prothrombin time

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? a) Fetal b) Prone c) Supine d) Lateral

a) Fetal Rationale: 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. The nurse also would place a pillow between the client's legs to prevent the upper leg from rolling forward and a small pillow under the client's head to support the spine in a horizontal position.

The nurse is teaching a client about an upcoming colonoscopy procedure. The nurse would include in the instructions the fact that the client will be placed in which position for the procedure? a) Left Sims b) Right Sims c) Knee-chest d) Lithotomy

a) Left Sims

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? a) Schilling test b) Clotting time c) Bone marrow biopsy d) White blood cell differential

a) Schilling test Rationale: The Schilling test is used to determine the cause of vitamin B12 deficiency, which leads to pernicious anemia. This test involves the use of a small oral dose of radioactive B12, followed by a large nonradioactive intramuscular (IM) dose. The IM dose helps flush the oral dose into the urine if it was absorbed. A 24-hour urine collection is performed to measure the amount of radioactivity in the urine. Clotting time and a white blood cell differential count are not significantly related to pernicious anemia and would not be helpful in determining the diagnosis. A bone marrow biopsy is indicated in a client suspected of having leukemia.

A client is scheduled for a Papanicolaou (Pap) smear at the next scheduled clinic visit. The nurse provides instructions to the client regarding preparation for this test. Which statement should the nurse include in the teaching? a) The test is painless. b) Fluids are restricted on the day of the test. c) The test can be performed during menstruation. d) Vaginal douching is required 2 hours before the test.

a) The test is painless.

The nurse is providing instructions to 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? a) Turnips b) Hard cheese c) Milk products d) Cottage cheese

a) Turnips

A magnetic resonance imaging (MRI) study is prescribed for a client with a suspected brain tumor. Which priority action should the nurse include in the client's plan of care to ensure safety? a) Shave the groin for insertion of a femoral catheter. b) Remove all metal-containing objects from the client. c) Inform the client to remain motionless throughout the procedure. d) Instruct the client in inhalation techniques for the administration of the radioisotope.

b) Remove all metal-containing objects from the client.

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? a) "I should elevate my knee while sitting." b) "I can apply heat to the site if it becomes uncomfortable." c) "I should avoid excessive use of the joint for several days." d) "I should return to the health care provider for suture removal in about 7 days."

b) "I can apply heat to the site if it becomes uncomfortable." Rationale: Ice is applied to the affected joint for pain and swelling, and analgesics are administered as prescribed. The application of heat may cause swelling and discomfort. After arthroscopy the client is instructed to avoid excessive use of the joint for several days, elevate the knee while sitting, avoid twisting the knee, and return for suture removal in about 7 days.

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." Rationale: 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 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? a) Ask the client to obtain the specimen after breakfast. b) Use a sterile plastic container for obtaining the specimen. c) Provide tissues for expectoration and obtaining the specimen. d) Ask the client to expectorate a small amount of sputum into the emesis basin.

b) Use a sterile plastic container for obtaining the specimen. Rationale: 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. If the procedure for obtaining the specimen is not sterile, then the specimen would be contaminated and the results of the test would be invalid. A first-morning specimen is preferred because it contains overnight secretions from the tracheobronchial tree.

A health care provider is about to perform a paracentesis for a client with abdominal ascites. The nurse assisting with the procedure should help the client into which position? a) supine b) upright c) right-side lying d) left-side lying

b) upright Rationale: An upright position allows the intestine to float posteriorly and helps prevent intestinal laceration during catheter insertion. The client ideally sits upright in a chair, with the feet flat on the floor and with the bladder emptied before the procedure. Therefore, the remaining positions are incorrect.

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 post-procedure care for this client? a) Monitor vital signs. b) Administer oral analgesics as needed. c) Place the limb in a dependent position for 24 hours. d) Monitor biopsy site for swelling, bleeding, or hematoma.

c) Place the limb in a dependent position for 24 hours. Rationale: The biopsied limb would be elevated for 24 hours to reduce edema, not placed in a dependent position. Other aspects of care include monitoring vital signs; administering analgesics for site discomfort; and monitoring the site for swelling, bleeding, and hematoma formation.

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? a) Lumbar puncture b) Electroencephalogram (EEG) c) Polymerase chain reaction (PCR) d) Computed tomography (CT) scan

c) Polymerase chain reaction (PCR)

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? a) The procedure is noninvasive. b) The client must stand erect during the filming. c) The procedure takes about 30 to 60 minutes to perform. d) The client should remain on bed rest for the remainder of the day after the scan.

c) The procedure takes about 30 to 60 minutes to perform.

How should the nurse position the client for pericardiocentesis to treat cardiac tamponade? a) Supine with slight Trendelenburg's position b) Lying on the right side with a pillow under the head c) Lying on the left side with a pillow under the chest wall d) Supine with the head of bed elevated at a 45- to 60-degree angle

d) Supine with the head of bed elevated at a 45-60 degree angle. Rationale: The client undergoing pericardiocentesis is positioned supine with the head of bed raised to a 45- to 60-degree angle. This places the heart in close proximity to the chest wall for easier insertion of the needle into the pericardial sac.

A client suspected of having an abdominal tumor is scheduled for a computed tomography (CT) scan with dye injection. How should the nurse describe this test to the client? a) The test may be painful. b) The test will take approximately 2 hours. c) Fluids will be restricted following the test. d) The dye injected may cause a warm flushing sensation.

d) The dye injected may cause a warm flushing sensation.

A client recovering from cardiac surgery has a left pleural effusion and is about to undergo a thoracentesis. What is the best position for the nurse to place the client in for the procedure? a) Dorsal recumbent b) Left lateral, with the right arm supported by a pillow c) Right side-lying, with the legs curled up into a fetal position d) Upright and leaning forward with the arms on an over-the-bed table

d) Upright and leaning forward with the arms on an over-the-bed table Rationale: The client undergoing thoracentesis usually sits in an upright position, with the anterior thorax supported by pillows, or leaning over an over-the-bed table. The client must be placed in a position that will enlist the aid of gravity in accessing and draining the effusion. The dorsal recumbent position is an inaccessible position. Any side-lying position will cause fluid to accumulate under that side, which is inaccessible to the health care provider. However, if the client cannot sit upright, the client will be placed in a side-lying position on the unaffected side, with the side to be tapped uppermost.

The clinic nurse has provided instructions to a client who will be reporting to the laboratory the next morning to have blood drawn for a complete blood cell (CBC) count. Which statement, if made by the client, indicates an understanding of the preparation for this laboratory test? a) "There is no special preparation for this test." b) "I cannot eat or drink anything after midnight." c) "I need to avoid any cold cuts and luncheon meats for the rest of the day." d) "I can drink coffee or tea in the morning before the test but cannot eat anything."

a) "There is no special preparation for this test."

The nurse is caring for a client who is going to have arthrography with a contrast medium. Which assessment by the nurse would be of highest priority? a) Allergy to iodine or shellfish b) Whether the client wishes to void before the procedure c) Ability of the client to remain still during the procedure d) Whether the client has any remaining questions about the procedure

a) Allergy to iodine or shellfish

The nurse is providing instructions to a client who is scheduled for an oral cholecystogram. What should the nurse instruct the client to do? a) Eat a high-fat meal on the evening before the procedure. b) Eat a high-fat meal for breakfast on the day of the procedure. c) Avoid oral intake except for water on the day of the procedure. d) Maintain strict nothing-by-mouth status on the day of the procedure.

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

An ultrasound examination of the gallbladder is scheduled for a client with a suspected diagnosis of cholecystitis. Correct instructions about the procedure should include which statement? a) "This procedure may cause discomfort." b) "This test requires that you lie still for short intervals." c) "This procedure is preceded by the administration of oral tablets." d) "This procedure requires that you not eat or drink anything for 24 hours before the test."

b) "This test requires that you lie still for short intervals."

A fasting blood glucose screening test is performed on a pregnant client. The results indicate that the blood glucose level is 140 mg/dL. The nurse should anticipate that which treatment measure would be prescribed next for the mother? a) An oral hypoglycemic agent b) A 3-hour glucose tolerance test c) A sliding-scale regular insulin dose. d) Humulin N insulin on a daily basis

b) A 3-hour glucose tolerance test

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 is most appropriate in urine collection in an infant? a) Catheterizing the infant using a Foley catheter b) Attaching a urine collection device to the infant's perineum c) Obtaining the specimen from the diaper, using a syringe, after the infant voids d) Monitoring the urinary patterns and preparing to collect the specimen into a cup when the infant voids

b) Attaching a urine collection device to the infant's perineum

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.

The nurse is giving client instructions over the telephone about preparing for a mammography. The nurse should make which statement to the client? a) "Wear metal jewelry as desired." b) "Consume clear liquids only on the day of the test." c) "Avoid using underarm deodorant on the day of the test." d) "Use only lanolin-based skin lotions on the day of the test."

c) "Avoid using underarm deodorant on the day of the test."

A nurse is developing a plan of care for a client who has undergone an esophagogastroduodenoscopy (EGD) procedure. The nurse should include which intervention in the nursing care plan? a) Monitor the client's vital signs every hour for 4 hours. b) Place the client in a prone position to provide comfort. c) Check the gag reflex by using a tongue depressor to stroke the back of the client's throat. d) Provide saline gargles immediately on the client's return to the nursing unit to aid in comfort.

c) Check the gag reflex by using a tongue depressor to stroke the back of the client's throat.

The nurse notes that the health care provider (HCP) 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? a) Patch test b) Skin biopsy c) Culture of the lesion d) Wood's lamp examination

c) Culture of the lesion

The nurse provides instructions to a client who is scheduled for an electroencephalogram (EEG). Which statement by the client indicates a need for further instruction? a) "The test will take between 45 minutes and 2 hours." b) "My hair should be washed the evening before the test." c) "Cola, tea, and coffee are restricted on the day of the test." d) "All medications need to be withheld on the day of the test."

d) "All medications need to be withheld on the day of the test." Rationale: The client is informed that the test will take 45 minutes to 2 hours and that medications usually are not withheld before the test unless specifically prescribed. Preprocedural instructions include informing the client that the procedure is painless. Cola, tea, and coffee are stimulants and need to be restricted on the morning of the test. The hair should be washed the evening before the test, and gels, hairsprays, and lotion should be avoided.

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? a) "My jewelry will need to be removed." b) "An informed consent form will need to be signed." c) "My procedure will take approximately 45 minutes." d) "I need to be sure to eat a full meal before the procedure."

d) "I need to be sure to eat a full meal before the procedure." Rationale: 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 client is told that the procedure takes about 45 minutes. An informed consent is required, and the client will need to remove jewelry and any metal objects. The client also is told that pretest medications may be administered for relaxation.

The nurse is giving post-procedure instructions to a client returning home after arthroscopy of the shoulder. What is the priority instruction for this client? a) "Do not eat or drink anything until tomorrow morning." b) "Keep the shoulder completely immobilized for the rest of the day." c) "You need to refrain from strenuous activity for the next few weeks." d) "Report any fever or redness and heat at the site to your health care provider (HCP)."

d) "Report any fever or redness and heat at the site to your health care provider (HCP)." Rationale: After arthroscopy, signs and symptoms of infection such as fever or redness and heat at the site should be reported to the HCP. The client may resume the usual diet immediately. The arm does not have to be completely immobilized once sensation has returned, but the client usually is encouraged to refrain from strenuous activity for at least a few days.

A client is scheduled for a digital subtraction angiography study. In providing information and instructions to the client regarding the test, which statement by the client indicates the teaching has been effective? a) "The purpose of the test is to detect lesions in the brain." b) "The purpose of the test is to inject medication into the bone." c) "The purpose of the test is to examine the cerebrospinal column." d) "The purpose of the test is to provide information about the blood vessels."

d) "The purpose of the test is to provide information about the blood vessels."

The nurse is caring for a client with possible cholelithiasis who is being prepared for intravenous cholangiography and is teaching the client about the procedure. Which statement indicates that the client understands the purpose of this test? a) "My gallbladder will be irrigated." b) "This procedure will drain my gallbladder." c) "They will put medication in my gallbladder." d) "They are going to look at my gallbladder and ducts."

d) "They are going to look at my gallbladder and ducts."

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? a) Eat a normal breakfast on the day of the test. b) Take insulin as scheduled on the day of the test c) Eat a low-carbohydrate diet for at least 3 days before the test. d) Avoid alcohol, coffee, and tea for 36 hours before and during the test.

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

The nurse is admitting a client to the short-stay unit after a myelogram. A water-based contrast agent was used. Which activity restrictions should the nurse should plan for the client? a) Bed rest for 2 to 4 hours, with the head of bed flat b) Bed rest for 6 to 8 hours, with the head of bed flat c) Bed rest for 2 to 4 hours, with the head of bed elevated 30 degrees d) Bed rest for 6 to 8 hours, with the head of bed elevated 30 degrees

d) Bed rest for 6 to 8 hours, with the head of bed elevated 30 degrees

A 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? a) Encourage fluid and food intake. b) Allow the client bathroom privileges only. c) Allow the client to sit in a chair for meals. d) Place a sandbag or other approved device over the insertion site.

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

The nurse is caring for a client who has been diagnosed as having a kidney mass and is scheduled for a renal biopsy. The client asks the nurse the reason for this procedure when other tests such as an ultrasound exam are available. In formulating a response, which knowledge about renal biopsy should the nurse incorporate? a) Provides an outline of the renal vascular system b) Determines if the mass is growing rapidly or slowly c) Helps differentiate between a solid mass and a fluid-filled cyst d) Provides a tissue specimen to examine for specific cytological information about the lesion

d) Provides a tissue specimen to examine for specific cytological information about the lesion

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. 1) Explain the procedure to the client. 2) Save all subsequent voidings after the first void during the 24-hour period. 3) During the collection period, place the main container on ice or in a refrigerator. 4) Have the client void at the end time, and place this specimen in the main container. 5) Have the client void at the start time, and place this specimen in the main container.

1) Explain the procedure to the client. 2) Save all subsequent voidings after the first void during the 24-hour period. 3) During the collection period, place the main container on ice or in a refrigerator. 4) Have the client void at the end time, and place this specimen in the main container.

A health care provider (HCP) is planning to perform a lumbar puncture on a client. The nurse knows that this procedure will allow access to which anatomical area for diagnostic testing? a) Vertebrae b) Spinal cord c) Epidural space d) Subarachnoid space

d) Subarachnoid space

A clinic nurse is providing instructions to a female client regarding the procedure for collecting a midstream (clean-catch) urine specimen. What should the nurse instruct the client to do? a) Begin the flow of urine and then collect the specimen. b) Cleanse the perineum from back to front before collecting the specimen. c) Collect the specimen in the evening before going to bed and deliver it to the laboratory immediately the next morning. d) Scrub the perineum with povidone-iodine solution in the evening and again in the morning before collecting the specimen.

a) Begin the flow of urine and then collect the specimen.

A client with diabetes mellitus is scheduled for a fasting blood glucose level determination in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information about fluid and food intake, the nurse clarifies by stating that which would be acceptable to consume before the test? a) Water b) Tea without any sugar c) Coffee without any milk d) Clear liquids such as apple juice

a) Water

The nurse is providing information to a client who is scheduled for an electromyogram (EMG). Which statement by the client indicates the teaching has been effective? a) "An informed consent form is not required." b) "Needles will be inserted into the skeletal muscles." c) "Medication is injected into the nerve for stimulation." d) "Nothing by mouth status must be maintained for 12 hours before the test."

b) "Needles will be inserted into the skeletal muscles." Rationale: For an EMG, needle electrodes are inserted into selected skeletal muscles to evaluate changes and electrical potential of the muscles and the nerves that lead to them. The test is useful in evaluating suspected lumbar or cervical disk disease, myasthenia gravis, muscular dystrophy, and other motor neuron diseases. The client should be reassured that the needle will not electrocute him or her and that he or she will experience sensations similar to those for an injection as the needles are inserted. An informed consent form is required. No other special preparation is required for this test.

The ambulatory care nurse is providing instructions to a client who is scheduled for a colonoscopy to remove a polyp. Which instructions are appropriate for client preparation for this procedure? a) Clear liquids may be consumed starting 24 hours after the procedure. b) A bowel preparation will be required in preparation for the procedure. c) Clear liquids only are allowed on the day of the scheduled procedure. d) If blood-tinged stools are noted after the procedure, the health care provider (HCP) should be notified

b) A bowel preparation will be required in preparation for the procedure.

A client with urolithiasis is scheduled for extracorporeal shock wave lithotripsy. The nurse should tell the client that which will be necessary before the procedure is performed? a) Insertion of a Foley catheter b) A signed informed consent form c) Clear liquids only on the day of the procedure d) Administration of antihypertensive medication

b) A signed informed consent form Rationale: Extracorporeal shock wave lithotripsy is done with the client under epidural or general anesthesia. The client must sign a consent form for the procedure and must have no oral intake beginning the night before the procedure. The client needs an intravenous line for the procedure as well. Insertion of a Foley catheter is not normally performed, and there is no reason to administer antihypertensive medication for this procedure.

The nurse is scheduling diagnostic tests for a client. Which of the diagnostic tests prescribed should be performed last? a) Barium enema b) Barium swallow c) Gallbladder series d) Oral cholecystogram

b) Barium swallow Rationale: A barium swallow should be done after a barium enema or gallbladder series to prevent the contrast used in the barium swallow from obstructing the view of other organs. It takes several days for swallowed barium to pass completely out of the gastrointestinal tract.

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? a) Use a wax container for the collection. b) Consume a high-fat diet for 3 days before the test. c) Avoid refrigeration of the specimen during the collection. d) Take laxatives starting 2 days before the test for collection of an adequate specimen.

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

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? a) Hypothermia b) Decreased blood pressure c) Hematoma in the left groin d) Discomfort in the left groin

b) Decreased blood pressure Rationale: Signs of allergic reaction to the contrast dye include early signs such as localized itching and edema, which are followed by more severe symptoms such as respiratory distress, stridor, and decreased blood pressure. Hypothermia, discomfort in the left groin, and hematoma in the left groin are abnormal assessment findings but are not related to allergic reaction to the contrast medium.

The nurse working in a same-day procedure unit is admitting a client scheduled for an arthrogram using a contrast medium. Which is the priority nursing assessment for this client? a) Determine if the client understands the procedure. b) Determine if the client has an allergy to iodine or shellfish. c) Determine if the client wishes to void before the procedure. d) Determine if the client is able to remain still during the procedure.

b) Determine if the client has an allergy to iodine or shellfish.

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? a) Liquid b) Low-fat c) Low-protein d) High-carbohydrate

b) Low-fat Rationale: Normal dietary intake of fat should be maintained during the days preceding an oral cholecystogram to empty bile from the gallbladder, and a low-fat diet is prescribed on the evening before the test. The low-fat diet prevents contraction of the gallbladder and allows accumulation of the contrast substance needed for radiographic visualization.

The nurse is providing information to a client about a computerized tomography (CT) scan of the head. Which statement should the nurse include when reviewing the CT with the client? a) "You will need to stand up straight for the entire procedure." b) "All scans require the injection of dye before the procedure." c) "Each set of head scans takes less than 5 minutes to perform." d) "You will need to remain on bedrest for 12 hours after the scan."

c) "Each set of head scans takes less than 5 minutes to perform." Rationale: For a CT scan of the head, the client lies on a movable table in a head-holding device. Each set of head scans takes less than 5 minutes to perform. An iodinated contrast medium may or may not be used. No special aftercare is indicated, so the client may resume the usual diet and activity afterward.

The nurse is providing information to a client scheduled for a lumbar puncture. Which information should the nurse provide to the client? a) The test will probably take about 2 hours. b) Food and fluids will be restricted after the test. c) A signed informed consent form will be required. d) Maintaining bed rest after the test will not be necessary.

c) A signed informed consent form will be required.

The nurse is preparing to collect a 24-hour urine specimen from the client. Which is an inaccurate action in collecting the specimen? . a) Placing the specimen on ice or refrigerating it b) Discarding the urine specimen at the start time c) Asking the client to void, saving the specimen, and noting the start time d) Asking the client to void at the end of the collection and adding this specimen to the collection

c) Asking the client to void, saving the specimen, and noting the start time Rationale: Because the 24-hour urine is a timed, quantitative determination, it is essential to start the test with an empty bladder. The collected urine should be refrigerated or placed on ice to prevent changes in the urine. Fifteen minutes before the end of the collection time, the client should be asked to void, and this specimen is added to the collection.

A client is scheduled for an intravenous pyelogram. Before the test, which is the priority nursing action? a) Restrict fluids. b) Administer a sedative. c) Determine a history of iodine or seafood allergies. d) Administer an oral preparation of radiopaque dye.

c) Determine a history of iodine or seafood allergies.

The nurse working in the outpatient radiology department is giving discharge instructions to a client who has had a bone scan. Which instruction should the nurse include in the client's teaching plan? a) Report any feelings of nausea or flushing. b) Avoid eating very much for the rest of the day. c) Drink extra water for a day or so after the procedure. d) Try to go up and down stairs at least twice before the end of the day.

c) Drink extra water for a day or so after the procedure. Rationale: The client should drink large amounts of water for 24 to 48 hours to excrete the radioisotope through the kidneys. No special diet or activity prescriptions or restrictions are required after a bone scan. Nausea or flushing would accompany allergic reaction to a dye, which is not used in this procedure

The nurse is providing instructions to a client who has had a bone scan. The nurse should instruct the client to take which measure? a) Avoid eating or drinking for 24 hours. b) Take a liquid laxative daily for the next 3 days. c) Increase fluid intake for the next 24 to 48 hours. d) Ambulate vigorously several times for the next 2 days.

c) Increase fluid intake for the next 24 to 48 hours. Rationale: The client should be encouraged to drink large amounts of water for 24 to 48 hours to facilitate urinary excretion of the radioisotope. No special restrictions are necessary after a bone scan. Options 1, 2, and 4 are incorrect instructions.

The nurse is providing instructions to the client scheduled for magnetic resonance imaging (MRI). Which instruction should the nurse provide to the client? a) Injection of a dye is necessary. b) Food and fluids are restricted for 12 to 24 hours before the test. c) Lying still in a flat position for 45 to 60 minutes may be necessary. d) The test may cause some pain, and pain medication will be prescribed if pain occurs.

c) Lying still in a flat position for 45 to 60 minutes may be necessary. Rationale: The client will need to lie in a flat position for 45 to 60 minutes. The client is informed that MRI is a painless test and a contrast dye may or may not be used. Additionally, no dietary restrictions are necessary with MRI. The nurse informs the client that the MRI may damage items such as credit cards and watches and that jewelry and hair clips cause artifacts. These objects should be removed from the client before the test.

A nurse is caring for a client who has undergone renal angiography using the left femoral artery for access. The nurse determines that the client is experiencing a complication of the procedure if which finding is observed? a) Urine output, 50 mL/hr b) Blood pressure, 110/74 mm Hg c) Pallor and coolness of the left leg d) Absence of hematoma in the left groin

c) Pallor and coolness of the left leg

A client is scheduled for a fiberoptic gastrointestinal (GI) procedure. The nurse instructs the client to remain on clear liquids the day before the test because a clear liquid diet supports which action? a) Stimulating peristalsis b) Promoting a laxative action c) Providing little or no residue d) Providing minimal calories and nutrients

c) Providing little or no residue

A client with acquired immunodeficiency syndrome is suspected of having cutaneous Kaposi's sarcoma. The nurse should prepare the client for which test to confirm the presence of this type of sarcoma? a) Liver biopsy b) Sputum culture c) White blood cell count d) Punch biopsy of the cutaneous lesions

d) Punch biopsy of the cutaneous lesions

A client is about to undergo a lumbar puncture (LP). The nurse should tell the client that which position will be used during the procedure? a) Prone in slight Trendelenburg b) Side-lying with a pillow under the hip c) Prone with a pillow under the abdomen d) Side-lying with the legs pulled up and the head bent down onto the chest

d) Side-lying with the legs pulled up and the head bent down onto the chest

The nurse instructs a female client to obtain a clean-catch urine specimen for culture and sensitivity testing. Which statement by the client indicates that she understands the procedure for collecting the specimen? a) "A urine specimen will be obtained from a catheter." b) "I need to clean the labia with toilet paper and void into the sterile specimen container." c) "I should empty my bladder into a container so that the full amount of urine can be determined." d) "I need to cleanse the labia using cleansing towels, void into the toilet, and then void into the sterile specimen container."

d) "I need to cleanse the labia using cleansing towels, void into the toilet, and then void into the sterile specimen container." Rationale: Urine specimens for culture and sensitivity need to be obtained with the use of proper cleansing and voiding techniques to avoid contamination from external sources. The use of toilet paper will contaminate the specimen. The procedure described in option 3 would not provide a clean specimen. It is not necessary to obtain the specimen via a catheter.

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? a) 1 week b) 6 hours c) 8 hours d) 1 to 2 days

d) 1 to 2 days Rationale: It takes at least 12 to 24 hours for a substance to pass through the colon. One week is too long a period, and 6 to 8 hours is too short a period because of residual barium and decreased peristalsis.

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) Liquids are restricted for 24 hours after the test. b) A clear liquid diet is required for 4 days before the test. c) Laxatives should not be taken for at least 1 week before the test. d) A low-fiber diet needs to be maintained for 1 to 3 days before the test.

d) A low-fiber diet needs to be maintained for 1 to 3 days before the test.

The nurse assists a health care provider in performing a liver biopsy. After the biopsy, the nurse should place the client in which position? a) Prone b) Supine c) A left side-lying position with a small pillow or folded towel under the puncture site d) A right side-lying position with a small pillow or folded towel under the puncture site

d) A right side-lying position with a small pillow or folded towel under the puncture site Rationale: After a liver biopsy, the client is assisted to assume a right side-lying position with a small pillow or folded towel under the puncture site for 3 hours. This position compresses the liver against the chest wall at the biopsy site. Therefore all other options are incorrect.

The nurse is preparing a client who is scheduled to undergo cerebral angiography. The nurse should assess the client for which finding? a) Claustrophobia b) Excessive weight c) Allergy to salmon d) Allergy to iodine or shellfish

d) Allergy to iodine or shellfish Rationale: The client undergoing cerebral angiography is assessed for possible allergy to the contrast dye, which can be determined by questioning the client about allergies to iodine or shellfish. Claustrophobia and excessive weight are areas of concern with magnetic resonance imaging. Salmon is irrelevant to the question and is not associated with the contrast dye used for this procedure.

The nurse is preparing to care for a client who has returned to the nursing unit following cardiac catheterization performed through the femoral artery. The nurse checks the health care provider's (HCP's) prescription and plans to allow which client position or activity following the procedure? a) Bed rest in high Fowler's position b) Bed rest with bathroom privileges only c) Bed rest with head elevation at 60 degrees d) Bed rest with head elevation no greater than 30 degrees

d) Bed rest with head elevation no greater than 30 degrees Rationale: After cardiac catheterization, the extremity into which the catheter was inserted is kept straight for 4 to 6 hours. The client is maintained on bed rest for 4 to 6 hours (time for bed rest may vary depending on the HCP's preference and on whether a vascular closure device was used) and the client may turn from side to side. The head is elevated no more than 30 degrees (although some HCPs prefer the flat position) until hemostasis is adequately achieved.

A client is scheduled for an excretory urogram. Which should the nurse expect to be prescribed as a component of preparation for this test? a) NPO status after midnight b) Administration of intravenous fluids c) Administration of a sedative before the test d) Bowel preparation to remove fecal contents

d) Bowel preparation to remove fecal contents Rationale: An excretory urogram is an invasive test that uses contrast radiopaque dye to assess the ability of the kidneys to excrete dye in the urine. Bowel preparation is necessary to permit adequate visualization of the kidneys, ureters, and bladder. Options 1, 2, and 3 usually are not components of preparation for this test.

A nurse is preparing to care for a client following a gastroscopy procedure. Which priority component should the nurse include in the nursing care plan? a) Monitor the client's vital signs every hour for 4 hours. b) Place the client in a supine position to provide comfort. c) Provide saline gargles immediately on return to the unit to aid in comfort. d) Check the gag reflex by using a tongue depressor to stroke the back of the client's throat.

d) Check the gag reflex by using a tongue depressor to stroke the back of the client's throat.

A client is to undergo pleural biopsy at the bedside. When planning for any potential complications of the procedure, the nurse should have which item(s) available at the bedside? a) Intubation tray b) Morphine sulfate injection c) Portable chest x-ray machine d) Chest tube and drainage system

d) Chest tube and drainage system Rationale: Complications following pleural biopsy include hemothorax, pneumothorax, and temporary pain from intercostal nerve injury. The nurse should have a chest tube and drainage system available at the bedside for use if hemothorax or pneumothorax develops.

A pulmonary angiography is scheduled to be performed in a client suspected of having a pulmonary embolism. In planning the preprocedure care for this client, which nursing action is unnecessary? a) Shave the anticipated entry site. b) Obtain a signed informed consent. c) Ask the client about allergies to shellfish or contrast media. d) Contact the operating room regarding the need for the procedure

d) Contact the operating room regarding the need for the procedure Rationale: it is not performed in the operating room

The nurse is developing a plan of care for a client who is scheduled to return to the nursing unit after a liver biopsy. What is the most appropriate position for the client? a) Prone b) Supine c) On the left side d) On the right side

d) On the right side