,TESTBANK for Davis's Comprehensive Manual of
Laboratory and Diagnostic Tests With Nursing
Implications 10th Edition Anne M. Van Leeuwen
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many
new editions waiting you.
5- If you think you purchased the wrong file
You can contact us at every time, we can
replace it with true one.
Our email:
, 1
Van Leeuwen 10e Test Bank
Van Leeuwen: Davis’s Comprehensive Manual of Laboratory and Diagnostic Tests with Nursing
Implications, 10e
1. A nurse is caring for a patient with a diagnosis of chronic myelogenous leukemia (CML). The
patient was admitted to an acute care unit with a temperature of 100.4°F (38°C) and weight loss
over the past 2 to 3 months. The nurse notes that the patient’s white blood cell (WBC) count is
23 ´ 103/microL (SI = 23 ´ 109/L), and the physical examination shows splenomegaly. Which
intervention is priority for the nurse to initiate?
1. Avoiding falls.
2. Managing pain.
3. Preventing infection.
4. Promoting adequate nutrition.
ANS: 3
Page: 1336
Body System: Circulatory/hematopoietic system, immune system
Feedback
1. This is incorrect. Although avoiding falls is important, it is not the main priority
for a patient presenting with a diagnosis of CML and leukocytosis. Preventing
opportunistic infections should be the priority.
2. This is incorrect. Although managing pain is important, it is not the main priority
for a patient presenting with a diagnosis of CML and leukocytosis. Preventing
opportunistic infections should be the priority.
3. This is correct. The nurse’s priority should be planning interventions to prevent
opportunistic infections for the patient with CML and significant leukocytosis.
Focus on promoting good hygiene and assist with hygiene when needed.
Administer prescribed antibiotics, and monitor vital signs and trend
temperatures.
4. This is incorrect. Although promoting adequate nutrition is important, it is not
the main priority for a patient presenting with a diagnosis of CML and
leukocytosis. Preventing opportunistic infections should be the priority.
2. A patient with diabetes requires assessment of long-term glucose control. Which test would be
most appropriate for this patient?
1. Glycated hemoglobin (Hgb)
2. Glucose
3. Glucose-6-phosphate dehydrogenase (G6PD)
4. Glucose tolerance test
ANS: 1
Page: 735
Body System: Circulatory system, endocrine system
Feedback
1. This is correct. Glycated hemoglobin or hemoglobin A1C is used to indicate
, 2
Van Leeuwen 10e Test Bank
long-term glycemic management.
2. This is incorrect. Glucose levels are used to assist in the diagnosis of
diabetes and to evaluate disorders of carbohydrate metabolism such as
malabsorption syndrome
3. This is incorrect. Glucose-6-phosphate dehydrogenase is used to identify an
enzyme deficiency that can result in hemolytic anemia.
4. This is incorrect. The glucose tolerance test is used to evaluate blood
glucose levels to assist in diagnosing diabetes.
3. A nurse notes that a patient has a urine pH of 7.9. Which information in the patient’s history
may be related to this result?
1. Maintaining a vegetarian diet
2. Training for a marathon
3. Recent febrile illness
4. Use of cranberry supplements daily
ANS: 1
Page: 1292
Body System: Urinary system
Feedback
1. This is correct. Vegetarian diets may result in an elevated urine pH.
2. This is incorrect. Metabolic or respiratory acidosis that may result from intense
physical training results in a lower pH.
3. This is incorrect. Although febrile illness increases urine glucose ketones, it does
not influence pH.
4. This is incorrect. Ingestion of cranberries decreases urine pH and therefore
would not result in an elevated pH.
4. A patient with pernicious anemia has a laboratory order to test for intrinsic factor (IF)
antibodies. Which information should the scheduling nurse instruct the patient about?
1. Begin a bowel prep 24 hours prior to the examination.
2. Eliminate red meat from the diet for 72 hours before the test.
3. Take nothing by mouth for 12 hours before the test is to take place.
4. Withhold vitamin B12 for 2 weeks before the test is to take place.
ANS: 4
Page: 819
Body System: Circulatory/hematopoietic system, digestive system, immune system
Feedback
1. This is incorrect. Bowel prep is not needed prior to this test.
2. This is incorrect. There are no food restrictions for this test unless directed by the
health-care provider.
3. This is incorrect. There are no food or fluid restrictions for this test unless
, 3
Van Leeuwen 10e Test Bank
directed by the health-care provider.
4. This is correct. Administration of vitamin B12, injected, ingested, or administered
otherwise (e.g., absorbed by nasal gel or sublingual tablet), should be withheld 2
weeks before testing.
5. A nurse observes that a patient admitted to the emergency department with decreased level of
consciousness has urine with a very fruity odor. Based on this observation, which diagnosis
should the nurse anticipate?
1. Alcohol withdrawal
2. Diabetic ketoacidosis (DKA)
3. Fibromyalgia
4. Lyme disease
ANS: 2
Page: 829
Body System: Endocrine system
Feedback
1. This is incorrect. Excessive alcohol use may lead to ketoacidosis, but alcohol
withdrawal does not.
2. This is correct. Elevated levels of ketone bodies are evidenced by fruity-smelling
breath, acidosis, ketonuria, and decreased level of consciousness. The nurse
should anticipate this diagnosis and plan interventions to manage it.
Administration of insulin and frequent blood glucose measurement may be
indicated.
3. This is incorrect. Fibromyalgia does not influence the level of ketones in urine.
4. This is incorrect. Lyme disease does not influence the level of ketones in urine.
6. A patient is scheduled to undergo a pulmonary angiography. When reviewing the patient’s
medical record, which finding must the nurse report to the health-care provider before the
procedure? Select all that apply.
1. 10 weeks pregnant
2. History of renal insufficiency
3. Took metformin this AM
4. Allergic to shellfish
5. Body mass index of 20
ANS: 1, 2, 3, 4
Page: 79
Body System: Circulatory system, respiratory system
Feedback
1. This is correct. Being pregnant is a contraindication to this procedure due to the
radiation. This finding must be reported to the health-care provider.
2. This is correct. The iodinated contrast is nephrotoxic and should not be
administered to patients who have a history of renal insufficiency. This finding
, 4
Van Leeuwen 10e Test Bank
must be reported to the health-care provider.
3. This is correct. An angiography places a patient who is taking metformin at risk
for developing drug-induced lactic acidosis, which can be fatal. This finding
must be reported to the health-care provider.
4. This is correct. A shellfish allergy may indicate that the client is allergic to
iodine, which may cause an adverse reaction to the contrast medium. This
finding must be reported to the health-care provider.
5. This is incorrect. A body mass index of 20 is of normal weight and does not need
to be reported to the health-care provider.
7. A patient’s laboratory test results following amniotic fluid analysis indicate elevated α1-
fetoprotein (AFP) levels and presence of acetylcholinesterase. Which condition should the nurse
suspect given these findings?
1. Respiratory distress syndrome
2. Fetal hemolytic disease
3. Neural tube defect
4. Fetal immaturity
ANS: 3
Page: 66
Body System: Reproductive system
Feedback
1. This is incorrect. A lecithin/sphingomyelin ratio of less than 2:1 and absence of
phosphatidylglycerol at term indicates fetal lung immaturity and possible
respiratory distress syndrome.
2. This is incorrect. Elevated bilirubin levels indicate fetal hemolytic disease.
3. This is correct. Elevated AFP levels and the presence of acetylcholinesterase
indicate a neural tube defect.
4. This is incorrect. Creatinine concentration greater than 2 mg/dL (greater than
176.8 micromol/L) indicates fetal maturity (at 36 to 37 weeks) if maternal
creatinine is also within the expected range.
8. A patient has a C-peptide level of 0.6 ng/mL (SI = 0.2 nmol/L). Which medical diagnosis
should the nurse anticipate assessing the patient for? Select all that apply.
1. Type 2 diabetes
2. Chronic kidney disease
3. Islet cell tumor
4. Type 1 diabetes
5. Pancreatectomy
ANS: 4, 5
Page: 460
Body System: Endocrine system
Feedback
, 5
Van Leeuwen 10e Test Bank
1. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with type 2 diabetes will have an elevated C-peptide
level.
2. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with chronic kidney disease will have an elevated
C-peptide level.
3. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with islet cell tumor will have an elevated C-peptide
level.
4. This is correct. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient with type 1 diabetes will have a low C-peptide level.
5. This is correct. C-peptide levels identify how well pancreatic beta cells secrete
insulin. The C-peptide levels will be low in a patient who has had a
pancreatectomy.
9. Which laboratory test should a nurse monitor to determine whether a patient is responding to
the administration of iron for iron-deficiency anemia?
1. Eosinophils
2. Lymphocytes
3. Monocytes
4. Reticulocytes
ANS: 4
Page: 1137
Body System: Circulatory/hematopoietic system
Feedback
1. This is incorrect. Eosinophil count is used to assist in the diagnosis of conditions
related to immune responses, such as asthma, dermatitis, and hay fever. In
addition, the eosinophil count assists in the identification of parasitic infections.
2. This is incorrect. Lymphocytes are white blood cells produced in the bone
marrow and thymus and are used to assess infection.
3. This is incorrect. Monocytes are white blood cells that are used to assess
infection.
4. This is correct. If the patient is responding to the administration of iron for iron-
deficiency anemia, the nurse would expect to see increased reticulocytes,
immature red blood cells produced by the bone marrow.
10. A nurse notes that a patient has an elevated estimated glomerular filtration rate (eGFR).
Which condition is likely the cause of the laboratory result? Select all that apply.
1. Leukemia
2. Paralysis
3. Acromegaly
4. Shock
5. Exercise
6. Carnivorous diet
, 6
Van Leeuwen 10e Test Bank
ANS: 3, 5, 6
Page: 478
Body System: Musculoskeletal system, urinary system
Feedback
1. This is incorrect. Leukemia is a condition that causes the eGFR to decrease.
2. This is incorrect. Paralysis is a condition that causes the eGFR to decrease.
3. This is correct. Acromegaly occurs when the pituitary gland produces too much
growth hormone, which results in increased height and muscle mass. This
condition can cause the eGFR to increase.
4. This is incorrect. Shock results in reduced renal blood flow, which causes the
eGFR to decrease.
5. This is correct. Exercise can elevate the eGFR due to muscle damage and the
increased renal blood flow.
6. This is correct. An intake of a carnivorous diet may elevate the eGFR due to the
increased intake of creatine, which is metabolized to creatinine and excreted by
the kidneys.
11. A nurse is preparing a patient for a lumbar puncture to confirm the diagnosis of bacterial
meningitis. Which position should the nurse ask the patient to assume for this test?
1. Knee-chest
2. Side-lying
3. Prone
4. Standing
ANS: 1
Page: 341
Body System: Immune system, nervous system
Feedback
1. This is correct. To promote maximum spinal flexion and widening of
intervertebral spaces, the knee-chest lateral recumbent (lateral decubitus, Sims,
or side-lying) position is typically required for a lumbar puncture. Pillows may
be placed between the legs to support the spine.
2. This is incorrect. The side-lying position is not appropriate for this test.
3. This is incorrect. The prone position is not appropriate for this test.
4. This is incorrect. The standing position is not appropriate for this test.
12. Which blood test should a nurse monitor to determine whether a patient’s blood level of
warfarin [CA = warfarin sodium] is within the therapeutic range?
1. Activated partial thromboplastin time (aPTT)
2. Bleeding time
3. Platelet count and aPTT
4. Prothrombin time (PT) and international normalized ratio (INR)
, 7
Van Leeuwen 10e Test Bank
ANS: 4
Page: 1088
Body System: Circulatory/hematopoietic system
Feedback
1. This is incorrect. The aPPT time represents the time required for formation of a
firm fibrin clot after tissue thromboplastin reagents and calcium are added to a
plasma specimen.
2. This is incorrect. Bleeding time studies provide measurable responses that
represent the time it might take for platelet closure to occur after a vascular
injury.
3. This is incorrect. Platelet counts are used to assist in diagnosing and evaluating
treatment for blood disorders and to evaluate coagulation status. aPTT is used to
indicate factor deficiencies and assists in assessing coagulation disorders.
4. This is correct. The PT and INR should both be monitored to determine the
therapeutic range for a patient receiving warfarin. The PT is used to evaluate the
tissue factor pathway, formerly called the extrinsic pathway, of the coagulation
sequence in patients receiving oral warfarin anticoagulants.
13. A nurse has just conducted an audiometry test on a 10-year-old patient. The patient’s pure
tone average was 52 dB. Which category of hearing according to the American Speech-
Language-Hearing Association (ASHA) does this result represent?
1. Normal
2. Slight loss
3. Moderate loss
4. Profound loss
ANS: 3
Page: 152
Body System: Nervous system
Feedback
1. This is incorrect. Normal range is −10 to 15 dB.
2. This is incorrect. Slight hearing loss is 16 to 25 dB.
3. This is correct. Moderate hearing loss is 41 to 55 dB.
4. This is incorrect. Profound hearing loss is greater than 91 dB.
14. A patient who is breastfeeding is scheduled for a gallium scan. What should the nurse advise
the patient prior to scheduling the procedure?
1. Recommend complete cessation of breastfeeding after administration of Ga-67
2. Continue breastfeeding 6 hours after administration of Ga-67
3. Encourage pumping and storing milk 24 hours before giving it to the infant
4. Explain that the procedure is not recommended for breastfeeding patients
ANS: 1
, 8
Van Leeuwen 10e Test Bank
Page: 666
Body System: Multisystem
Feedback
1. This is correct. Explain to the patient who is breastfeeding that due to the large
amount of radionuclide that passes into breast milk, complete cessation of
breastfeeding is recommended after administration of Ga-67. The nurse should
discuss alternative strategies for feeding the infant.
2. This is incorrect. Complete cessation of breastfeeding is recommended.
Elimination of the radionuclide from the body occurs between 6 to 24 hours after
administration.
3. This is incorrect. Pumping and storing milk is not safe immediately after
administration of Ga-67.
4. This is incorrect. Breastfeeding patients can safely undergo a gallium scan if
they take the proper precautions and do not breastfeed following administration
of Ga-67.
15. A nurse notes that a patient’s laboratory results show an acetylcholine receptor antibody
(AChR) of 2.46 nmol/L. Based on this information, which clinical manifestation should the nurse
assess this patient for?
1. Malignant hyperpyrexia
2. Myasthenia gravis
3. Multiple myeloma
4. Muscular dystrophy
ANS: 2
Page: 1
Body System: Musculoskeletal system
Feedback
1. This is incorrect. Malignant hyperpyrexia is a complication of general anesthesia
and is not a manifestation of an elevated AChR.
2. This is correct. The nurse should assess the patient with an increased AChR level
for clinical manifestations of myasthenia gravis because the muscle weakness
associated with this disease is related to destruction of acetylcholine receptor
sites.
3. This is incorrect. Multiple myeloma is assessed using albumin levels, and not
AChR.
4. This is incorrect. Muscular dystrophy is assessed using aldolase levels, and not
AChR.
16. A patient is suspected of having an increased risk for stroke. Which type of angiography
should be performed to detect this condition?
1. Abdominal
2. Adrenal
3. Carotid
Laboratory and Diagnostic Tests With Nursing
Implications 10th Edition Anne M. Van Leeuwen
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many
new editions waiting you.
5- If you think you purchased the wrong file
You can contact us at every time, we can
replace it with true one.
Our email:
, 1
Van Leeuwen 10e Test Bank
Van Leeuwen: Davis’s Comprehensive Manual of Laboratory and Diagnostic Tests with Nursing
Implications, 10e
1. A nurse is caring for a patient with a diagnosis of chronic myelogenous leukemia (CML). The
patient was admitted to an acute care unit with a temperature of 100.4°F (38°C) and weight loss
over the past 2 to 3 months. The nurse notes that the patient’s white blood cell (WBC) count is
23 ´ 103/microL (SI = 23 ´ 109/L), and the physical examination shows splenomegaly. Which
intervention is priority for the nurse to initiate?
1. Avoiding falls.
2. Managing pain.
3. Preventing infection.
4. Promoting adequate nutrition.
ANS: 3
Page: 1336
Body System: Circulatory/hematopoietic system, immune system
Feedback
1. This is incorrect. Although avoiding falls is important, it is not the main priority
for a patient presenting with a diagnosis of CML and leukocytosis. Preventing
opportunistic infections should be the priority.
2. This is incorrect. Although managing pain is important, it is not the main priority
for a patient presenting with a diagnosis of CML and leukocytosis. Preventing
opportunistic infections should be the priority.
3. This is correct. The nurse’s priority should be planning interventions to prevent
opportunistic infections for the patient with CML and significant leukocytosis.
Focus on promoting good hygiene and assist with hygiene when needed.
Administer prescribed antibiotics, and monitor vital signs and trend
temperatures.
4. This is incorrect. Although promoting adequate nutrition is important, it is not
the main priority for a patient presenting with a diagnosis of CML and
leukocytosis. Preventing opportunistic infections should be the priority.
2. A patient with diabetes requires assessment of long-term glucose control. Which test would be
most appropriate for this patient?
1. Glycated hemoglobin (Hgb)
2. Glucose
3. Glucose-6-phosphate dehydrogenase (G6PD)
4. Glucose tolerance test
ANS: 1
Page: 735
Body System: Circulatory system, endocrine system
Feedback
1. This is correct. Glycated hemoglobin or hemoglobin A1C is used to indicate
, 2
Van Leeuwen 10e Test Bank
long-term glycemic management.
2. This is incorrect. Glucose levels are used to assist in the diagnosis of
diabetes and to evaluate disorders of carbohydrate metabolism such as
malabsorption syndrome
3. This is incorrect. Glucose-6-phosphate dehydrogenase is used to identify an
enzyme deficiency that can result in hemolytic anemia.
4. This is incorrect. The glucose tolerance test is used to evaluate blood
glucose levels to assist in diagnosing diabetes.
3. A nurse notes that a patient has a urine pH of 7.9. Which information in the patient’s history
may be related to this result?
1. Maintaining a vegetarian diet
2. Training for a marathon
3. Recent febrile illness
4. Use of cranberry supplements daily
ANS: 1
Page: 1292
Body System: Urinary system
Feedback
1. This is correct. Vegetarian diets may result in an elevated urine pH.
2. This is incorrect. Metabolic or respiratory acidosis that may result from intense
physical training results in a lower pH.
3. This is incorrect. Although febrile illness increases urine glucose ketones, it does
not influence pH.
4. This is incorrect. Ingestion of cranberries decreases urine pH and therefore
would not result in an elevated pH.
4. A patient with pernicious anemia has a laboratory order to test for intrinsic factor (IF)
antibodies. Which information should the scheduling nurse instruct the patient about?
1. Begin a bowel prep 24 hours prior to the examination.
2. Eliminate red meat from the diet for 72 hours before the test.
3. Take nothing by mouth for 12 hours before the test is to take place.
4. Withhold vitamin B12 for 2 weeks before the test is to take place.
ANS: 4
Page: 819
Body System: Circulatory/hematopoietic system, digestive system, immune system
Feedback
1. This is incorrect. Bowel prep is not needed prior to this test.
2. This is incorrect. There are no food restrictions for this test unless directed by the
health-care provider.
3. This is incorrect. There are no food or fluid restrictions for this test unless
, 3
Van Leeuwen 10e Test Bank
directed by the health-care provider.
4. This is correct. Administration of vitamin B12, injected, ingested, or administered
otherwise (e.g., absorbed by nasal gel or sublingual tablet), should be withheld 2
weeks before testing.
5. A nurse observes that a patient admitted to the emergency department with decreased level of
consciousness has urine with a very fruity odor. Based on this observation, which diagnosis
should the nurse anticipate?
1. Alcohol withdrawal
2. Diabetic ketoacidosis (DKA)
3. Fibromyalgia
4. Lyme disease
ANS: 2
Page: 829
Body System: Endocrine system
Feedback
1. This is incorrect. Excessive alcohol use may lead to ketoacidosis, but alcohol
withdrawal does not.
2. This is correct. Elevated levels of ketone bodies are evidenced by fruity-smelling
breath, acidosis, ketonuria, and decreased level of consciousness. The nurse
should anticipate this diagnosis and plan interventions to manage it.
Administration of insulin and frequent blood glucose measurement may be
indicated.
3. This is incorrect. Fibromyalgia does not influence the level of ketones in urine.
4. This is incorrect. Lyme disease does not influence the level of ketones in urine.
6. A patient is scheduled to undergo a pulmonary angiography. When reviewing the patient’s
medical record, which finding must the nurse report to the health-care provider before the
procedure? Select all that apply.
1. 10 weeks pregnant
2. History of renal insufficiency
3. Took metformin this AM
4. Allergic to shellfish
5. Body mass index of 20
ANS: 1, 2, 3, 4
Page: 79
Body System: Circulatory system, respiratory system
Feedback
1. This is correct. Being pregnant is a contraindication to this procedure due to the
radiation. This finding must be reported to the health-care provider.
2. This is correct. The iodinated contrast is nephrotoxic and should not be
administered to patients who have a history of renal insufficiency. This finding
, 4
Van Leeuwen 10e Test Bank
must be reported to the health-care provider.
3. This is correct. An angiography places a patient who is taking metformin at risk
for developing drug-induced lactic acidosis, which can be fatal. This finding
must be reported to the health-care provider.
4. This is correct. A shellfish allergy may indicate that the client is allergic to
iodine, which may cause an adverse reaction to the contrast medium. This
finding must be reported to the health-care provider.
5. This is incorrect. A body mass index of 20 is of normal weight and does not need
to be reported to the health-care provider.
7. A patient’s laboratory test results following amniotic fluid analysis indicate elevated α1-
fetoprotein (AFP) levels and presence of acetylcholinesterase. Which condition should the nurse
suspect given these findings?
1. Respiratory distress syndrome
2. Fetal hemolytic disease
3. Neural tube defect
4. Fetal immaturity
ANS: 3
Page: 66
Body System: Reproductive system
Feedback
1. This is incorrect. A lecithin/sphingomyelin ratio of less than 2:1 and absence of
phosphatidylglycerol at term indicates fetal lung immaturity and possible
respiratory distress syndrome.
2. This is incorrect. Elevated bilirubin levels indicate fetal hemolytic disease.
3. This is correct. Elevated AFP levels and the presence of acetylcholinesterase
indicate a neural tube defect.
4. This is incorrect. Creatinine concentration greater than 2 mg/dL (greater than
176.8 micromol/L) indicates fetal maturity (at 36 to 37 weeks) if maternal
creatinine is also within the expected range.
8. A patient has a C-peptide level of 0.6 ng/mL (SI = 0.2 nmol/L). Which medical diagnosis
should the nurse anticipate assessing the patient for? Select all that apply.
1. Type 2 diabetes
2. Chronic kidney disease
3. Islet cell tumor
4. Type 1 diabetes
5. Pancreatectomy
ANS: 4, 5
Page: 460
Body System: Endocrine system
Feedback
, 5
Van Leeuwen 10e Test Bank
1. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with type 2 diabetes will have an elevated C-peptide
level.
2. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with chronic kidney disease will have an elevated
C-peptide level.
3. This is incorrect. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient diagnosed with islet cell tumor will have an elevated C-peptide
level.
4. This is correct. C-peptide levels identify how well pancreatic beta cells secrete
insulin. A patient with type 1 diabetes will have a low C-peptide level.
5. This is correct. C-peptide levels identify how well pancreatic beta cells secrete
insulin. The C-peptide levels will be low in a patient who has had a
pancreatectomy.
9. Which laboratory test should a nurse monitor to determine whether a patient is responding to
the administration of iron for iron-deficiency anemia?
1. Eosinophils
2. Lymphocytes
3. Monocytes
4. Reticulocytes
ANS: 4
Page: 1137
Body System: Circulatory/hematopoietic system
Feedback
1. This is incorrect. Eosinophil count is used to assist in the diagnosis of conditions
related to immune responses, such as asthma, dermatitis, and hay fever. In
addition, the eosinophil count assists in the identification of parasitic infections.
2. This is incorrect. Lymphocytes are white blood cells produced in the bone
marrow and thymus and are used to assess infection.
3. This is incorrect. Monocytes are white blood cells that are used to assess
infection.
4. This is correct. If the patient is responding to the administration of iron for iron-
deficiency anemia, the nurse would expect to see increased reticulocytes,
immature red blood cells produced by the bone marrow.
10. A nurse notes that a patient has an elevated estimated glomerular filtration rate (eGFR).
Which condition is likely the cause of the laboratory result? Select all that apply.
1. Leukemia
2. Paralysis
3. Acromegaly
4. Shock
5. Exercise
6. Carnivorous diet
, 6
Van Leeuwen 10e Test Bank
ANS: 3, 5, 6
Page: 478
Body System: Musculoskeletal system, urinary system
Feedback
1. This is incorrect. Leukemia is a condition that causes the eGFR to decrease.
2. This is incorrect. Paralysis is a condition that causes the eGFR to decrease.
3. This is correct. Acromegaly occurs when the pituitary gland produces too much
growth hormone, which results in increased height and muscle mass. This
condition can cause the eGFR to increase.
4. This is incorrect. Shock results in reduced renal blood flow, which causes the
eGFR to decrease.
5. This is correct. Exercise can elevate the eGFR due to muscle damage and the
increased renal blood flow.
6. This is correct. An intake of a carnivorous diet may elevate the eGFR due to the
increased intake of creatine, which is metabolized to creatinine and excreted by
the kidneys.
11. A nurse is preparing a patient for a lumbar puncture to confirm the diagnosis of bacterial
meningitis. Which position should the nurse ask the patient to assume for this test?
1. Knee-chest
2. Side-lying
3. Prone
4. Standing
ANS: 1
Page: 341
Body System: Immune system, nervous system
Feedback
1. This is correct. To promote maximum spinal flexion and widening of
intervertebral spaces, the knee-chest lateral recumbent (lateral decubitus, Sims,
or side-lying) position is typically required for a lumbar puncture. Pillows may
be placed between the legs to support the spine.
2. This is incorrect. The side-lying position is not appropriate for this test.
3. This is incorrect. The prone position is not appropriate for this test.
4. This is incorrect. The standing position is not appropriate for this test.
12. Which blood test should a nurse monitor to determine whether a patient’s blood level of
warfarin [CA = warfarin sodium] is within the therapeutic range?
1. Activated partial thromboplastin time (aPTT)
2. Bleeding time
3. Platelet count and aPTT
4. Prothrombin time (PT) and international normalized ratio (INR)
, 7
Van Leeuwen 10e Test Bank
ANS: 4
Page: 1088
Body System: Circulatory/hematopoietic system
Feedback
1. This is incorrect. The aPPT time represents the time required for formation of a
firm fibrin clot after tissue thromboplastin reagents and calcium are added to a
plasma specimen.
2. This is incorrect. Bleeding time studies provide measurable responses that
represent the time it might take for platelet closure to occur after a vascular
injury.
3. This is incorrect. Platelet counts are used to assist in diagnosing and evaluating
treatment for blood disorders and to evaluate coagulation status. aPTT is used to
indicate factor deficiencies and assists in assessing coagulation disorders.
4. This is correct. The PT and INR should both be monitored to determine the
therapeutic range for a patient receiving warfarin. The PT is used to evaluate the
tissue factor pathway, formerly called the extrinsic pathway, of the coagulation
sequence in patients receiving oral warfarin anticoagulants.
13. A nurse has just conducted an audiometry test on a 10-year-old patient. The patient’s pure
tone average was 52 dB. Which category of hearing according to the American Speech-
Language-Hearing Association (ASHA) does this result represent?
1. Normal
2. Slight loss
3. Moderate loss
4. Profound loss
ANS: 3
Page: 152
Body System: Nervous system
Feedback
1. This is incorrect. Normal range is −10 to 15 dB.
2. This is incorrect. Slight hearing loss is 16 to 25 dB.
3. This is correct. Moderate hearing loss is 41 to 55 dB.
4. This is incorrect. Profound hearing loss is greater than 91 dB.
14. A patient who is breastfeeding is scheduled for a gallium scan. What should the nurse advise
the patient prior to scheduling the procedure?
1. Recommend complete cessation of breastfeeding after administration of Ga-67
2. Continue breastfeeding 6 hours after administration of Ga-67
3. Encourage pumping and storing milk 24 hours before giving it to the infant
4. Explain that the procedure is not recommended for breastfeeding patients
ANS: 1
, 8
Van Leeuwen 10e Test Bank
Page: 666
Body System: Multisystem
Feedback
1. This is correct. Explain to the patient who is breastfeeding that due to the large
amount of radionuclide that passes into breast milk, complete cessation of
breastfeeding is recommended after administration of Ga-67. The nurse should
discuss alternative strategies for feeding the infant.
2. This is incorrect. Complete cessation of breastfeeding is recommended.
Elimination of the radionuclide from the body occurs between 6 to 24 hours after
administration.
3. This is incorrect. Pumping and storing milk is not safe immediately after
administration of Ga-67.
4. This is incorrect. Breastfeeding patients can safely undergo a gallium scan if
they take the proper precautions and do not breastfeed following administration
of Ga-67.
15. A nurse notes that a patient’s laboratory results show an acetylcholine receptor antibody
(AChR) of 2.46 nmol/L. Based on this information, which clinical manifestation should the nurse
assess this patient for?
1. Malignant hyperpyrexia
2. Myasthenia gravis
3. Multiple myeloma
4. Muscular dystrophy
ANS: 2
Page: 1
Body System: Musculoskeletal system
Feedback
1. This is incorrect. Malignant hyperpyrexia is a complication of general anesthesia
and is not a manifestation of an elevated AChR.
2. This is correct. The nurse should assess the patient with an increased AChR level
for clinical manifestations of myasthenia gravis because the muscle weakness
associated with this disease is related to destruction of acetylcholine receptor
sites.
3. This is incorrect. Multiple myeloma is assessed using albumin levels, and not
AChR.
4. This is incorrect. Muscular dystrophy is assessed using aldolase levels, and not
AChR.
16. A patient is suspected of having an increased risk for stroke. Which type of angiography
should be performed to detect this condition?
1. Abdominal
2. Adrenal
3. Carotid
