Diagnostic Tests (20 Questions)

1. You are working on a medical-surgical unit. You are caring for Mr. Tremblay, a 58-year-old patient with a history of cirrhosis. He has just returned to his room following a percutaneous liver biopsy performed under local anesthesia. His vital signs are stable: BP 124/76, HR 82, RR 18. He reports mild discomfort at the insertion site but denies severe pain.

Question:
Ensure patient safety immediately following this procedure, which positioning intervention is the priority? *
2. Mrs. Gauthier, 34, visits the outpatient clinic for an employment health screening. You administer a Mantoux (Tuberculin Skin Test – PPD) on her left forearm to screen for tuberculosis. You provide her with teaching regarding the care of the injection site and the necessary follow-up.

Question:
Which instruction regarding the timeframe for reading the result is correct? *
3. You are working on a gastroenterology unit. Mr. Roy, 67, is admitted for a colonoscopy scheduled for tomorrow morning at 08:00 to investigate a change in bowel habits. He has been prescribed a polyethylene glycol (PEG) electrolyte solution for bowel preparation. He began drinking the solution 4 hours ago.

Question:
You assess Mr. Roy to determine the effectiveness of the bowel preparation. Which clinical finding indicates that the patient is ready for the procedure? *
4. Mrs. Lefebvre, a 72-year-old woman with heart failure, is admitted with a large right-sided pleural effusion causing significant dyspnea. The physician arrives at the bedside to perform a thoracentesis. Mrs. Lefebvre is anxious and asks how she needs to sit for the procedure.

Question:
To ensure proper access to the pleural space and minimize the risk of injury, how should you position the patient? *
5. You are caring for Mr. Cote, 55, who has just undergone a bronchoscopy with sedation to investigate a persistent cough and a lung mass. He returns to the unit drowsy but arousable. An hour later, he tells the nursing assistant that he is very thirsty and requests a glass of water.

Question:
What is your priority nursing action before allowing Mr. Cote to drink? *
6. You are preparing Mrs. Dubé, a 45-year-old patient, for a Magnetic Resonance Imaging (MRI) scan of the brain with contrast. She has a history of claustrophobia, hypertension, and a previous cholecystectomy. You are completing the pre-procedure safety checklist.

Question:
Which of the following findings in her history requires immediate notification of the radiologist and may contraindicate the procedure? *
7. You are working in the recovery area. A 19-year-old male patient has just undergone a lumbar puncture (spinal tap) to rule out meningitis. The procedure was uncomplicated, and the cerebrospinal fluid was clear. He is anxious to get up and use the washroom.

Question:
To prevent the most common post-procedure complication (post-dural puncture headache), what instructions should you give? *
8. Mrs. Gagnon, 62, returns to the telemetry unit following a cardiac catheterization via the right femoral artery. The insertion site is covered with a pressure dressing. She is alert and oriented.

Question:
In addition to monitoring vital signs and the insertion site for bleeding, what is the priority assessment for this patient? *
9. You are instructing Mr. Lavoie, an ambulatory patient, on how to perform a 24-hour urine collection to measure creatinine clearance. He asks when he should start the collection.

Question:
Which instruction describes the correct procedure to ensure accurate results? *
10. You are discharging Mrs. Fortin following an upper GI series (Barium Swallow). She is concerned about the side effects of the barium contrast.

Question:
Which discharge teaching is essential to prevent complications related to the retained barium? *
11. You are working on a medical unit. Mr. Lapointe, a 67-year-old patient with a history of alcohol-induced cirrhosis and worsening ascites, is scheduled for an abdominal paracentesis at the bedside to relieve severe abdominal pressure and dyspnea. His current vital signs are BP 138/84, HR 88, RR 24, and Temp 36.8°C. The physician is preparing the sterile field.

Question:
What is the priority nursing intervention before the procedure begins? *
12. Mrs. St-Pierre, a 55-year-old woman with Type 2 diabetes controlled by metformin (Glucophage) and glyburide, is admitted to the emergency department with severe right lower quadrant pain. A Computed Tomography (CT) scan of the abdomen with intravenous (IV) iodine contrast is ordered to rule out diverticulitis. Her creatinine levels are within normal limits.

Question:
Following the completion of the CT scan with contrast, what specific discharge instruction regarding her medication management is essential to prevent renal complications? *
13. You are working in a cardiology clinic. Mr. Vachon, 45, presents with complaints of intermittent heart palpitations and lightheadedness that have not been captured on a standard resting ECG. The cardiologist orders a 24-hour Holter monitor. You are applying the electrodes and connecting the device.

Question:
To ensure the diagnostic data collected is clinically useful, what represents the most important element of patient teaching? *
14. Mrs. Giroux, a 28-year-old patient being investigated for leukemia, has just undergone a bone marrow aspiration and biopsy from the posterior iliac crest. The procedure was performed under local anesthesia and conscious sedation. She is now resting in the recovery area.

Question:
Which nursing intervention is appropriate in the immediate post-procedure period to prevent bleeding and hematoma formation? *
15. Mr. Tessier, a 60-year-old smoker with a history of chronic obstructive pulmonary disease (COPD), is admitted with suspected pneumonia. The physician orders a sputum culture and sensitivity (C&S) to identify the causative organism. Mr. Tessier is coughing but states he "can't get anything up right now."

Question:
To obtain the most accurate specimen and minimize contamination, when and how should you attempt to collect the sputum? *
16. You are caring for Mrs. Bernier, a 50-year-old woman scheduled for an Electroencephalogram (EEG) tomorrow morning to investigate new-onset seizure activity. She is asking how she should prepare for the test.

Question:
Which instruction is correct regarding preparation for an EEG? *
17. Mr. Ouellet, a 70-year-old male with a history of benign prostatic hyperplasia (BPH) and hematuria, returns to the day surgery unit following a cystoscopy performed under local anesthesia. He calls you to the bedside 45 minutes later complaining of urgency and mild burning upon urination. He produced urine that is pink-tinged.

Question:
What is your interpretation of these findings and the appropriate nursing action? *
18. Mrs. Landry, a 58-year-old patient with a history of angina, is scheduled for an exercise stress test (treadmill ECG) to evaluate the patency of her coronary arteries. She calls the clinic the day before to confirm her instructions.

Question:
Which statement by the patient indicates a need for further teaching regarding pre-procedure preparation? *
19. You are the nurse in a prenatal clinic. Mrs. Cloutier, a 36-year-old multigravida who is 16 weeks pregnant, has just undergone an amniocentesis for genetic testing. Her blood type is A Negative. The fetal heart rate is stable post-procedure.

Question:
Because Mrs. Cloutier is Rh-negative, what specific intervention is required following this invasive procedure? *
20. Mr. Rioux, 42, is admitted with jaundice and right upper quadrant pain. He undergoes an Endoscopic Retrograde Cholangiopancreatography (ERCP) to remove a common bile duct stone. Two hours after returning to the unit, he complains of severe, worsening abdominal pain, and his abdomen feels rigid and board-like upon palpation. His pulse has increased to 110 bpm.

Question:
Based on these assessment findings, what complication do you suspect, and what is the immediate action? *