Nokea
A patient is scheduled for a growth hormone stimulation test. Which of the following items should the nurse obtain in preparation for the test?
- A. Basin of ice
- B. Cardiac monitor
- C. Vial of glargine insulin
- D. Intravenous dextrose solution
Correct Answer: D
Rationale: Hypoglycemia is induced during the growth hormone stimulation test, and the nurse should be prepared to administer glucose IV immediately or have a sweet snack available for the patient immediately following the test. Regular insulin is used to induce hypoglycemia (glargine is never given intravenously). The patient does not require cardiac monitoring during the test. Although blood samples for some tests must be kept on ice, this is not true for the growth hormone stimulation test.
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The nurse is teaching a patient how to prepare for an oral glucose tolerance test (OGTT). Which of the following patient response indicates that the teaching has been effective?
- A. Fast 12 hours before the procedure
- B. Clear fluid diet 12 hours prior to the test
- C. Drink only full fluids 6 hours before the test
- D. No fluid or food restrictions prior to the test
Correct Answer: A
Rationale: Fasting for 12 hours before the procedure demonstrates that teaching has been effective. The patient is to be NPO 12 hours prior to the test. A clear fluid diet 12 hours pretest is not indicated. A full fluid diet 6 hours pretest is not indicated.
The nurse is caring for a patient in the outpatient clinic who has a prescription for blood cortisol testing. Which of the following instructions should the nurse provide for the patient?
- A. Avoid adding any salt to your foods for 24 hours before the test.
- B. You will need to lie down for 30 minutes before the blood is drawn.
- C. Come to the laboratory to have the blood drawn early in the morning.
- D. Do not have anything to eat or drink before the blood test is obtained.
Correct Answer: C
Rationale: Cortisol levels are usually drawn in the morning when levels are highest. The other instructions would be given to patients who were having other endocrine testing.
The nurse is evaluating the laboratory results for a patient who has increased secretion of the anterior pituitary hormones. Which of the following findings should the nurse anticipate when reviewing the laboratory findings?
- A. Decreased serum thyroxine levels
- B. Elevated serum aldosterone levels
- C. An increase in urinary free cortisol
- D. Low urinary excretion of catecholamines
Correct Answer: C
Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.
The nurse is caring for a patient who is scheduled for a 24-hour urine collection for 17-ketosteroids. Which of the following actions should the nurse implement?
- A. Keep the specimen on ice.
- B. Insert a retention catheter.
- C. Have the patient void and save that specimen to start the collection.
- D. Encourage the patient to drink 2-3 L of fluid during the 24 hours.
Correct Answer: A
Rationale: The specimen must be kept on ice or refrigerated until the collection is finished. Voided or catheterized specimens are acceptable for the test. The initial voided specimen is discarded. There is no fluid intake requirement for the 24-hour collection.
When reviewing the laboratory results for a patient's total calcium level, which of the following information should the nurse consider?
- A. The blood glucose is elevated.
- B. The phosphate level is normal.
- C. The serum albumin level is low.
- D. The magnesium level is normal.
Correct Answer: C
Rationale: Part of the total calcium is bound to albumin, so hypoalbuminemia can lead to misinterpretation of calcium levels. Ionized calcium is unaffected by albumin levels. The other laboratory values will not affect total calcium interpretation.