Saunders Diagnostic Testing Questions
1. A client is being prepared for a thoracentesis. The nurse should assist the client to which position for the
procedure?
1. Lying in bed on the affected side
2. Lying in bed on the unaffected side
3. Sims' position with the head of the bed flat
4. Prone with the head turned to the side and supported by a pillow
Correct answer: 2
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.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
2. The nurse is preparing to care for a client who has returned to the nursing unit following cardiac catheterization
performed through the femoral vessel. The nurse checks the health care provider's (HCP's) prescription and plans to
allow which client position or activity following the procedure?
1. Bed rest in high Fowler's position
2. Bed rest with bathroom privileges only
3. Bed rest with head elevation at 60 degrees
4. Bed rest with head elevation no greater than 30 degrees
Correct answer: 4
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 a lower position or the flat position) until
hemostasis is adequately achieved.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Perfusion, Safety
3. A client is about to undergo a lumbar puncture. The nurse describes to the client that which position will be used
during the procedure?
1. Side-lying with a pillow under the hip
2. Prone with a pillow under the abdomen
3. Prone in slight Trendelenburg's position
,4. Side-lying with the legs pulled up and the head bent down onto the chest
Correct answer: 4
Rationale: A client undergoing lumbar puncture is positioned lying on the side, with the legs pulled up to the
abdomen and the head bent down onto the chest. This position helps to open the spaces between the vertebrae and
allows for easier needle insertion by the health care provider. The nurse remains with the client during the procedure
to help the client maintain this position. The other options identify incorrect positions for this procedure.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Intracranial Regulation, Safety
4. The nurse provides information to a client scheduled for a dual x-ray absorptiometry (DEXA) test. Which
information should the nurse provide to the client? Select all that apply.
1. It is a painless test.
2. It emits slightly more radiation than a chest x-ray does.
3. Upper body clothing will need to be removed for testing.
4. Increased fluid intake is necessary following the procedure.
5. Metallic objects such as jewelry or belt buckles may interfere with the test and need to be removed.
Correct answer: 1, 5
Rationale: The most commonly used screening and diagnostic tool for measuring bone mineral density is the dual x-
ray absorptiometry (DEXA) test. It is a painless test that emits less radiation than a chest x-ray. A height is taken
before the start of the test. The client stays dressed but is asked to remove any metallic objects such as belt buckles,
coins, keys, or jewelry because they may interfere with testing. No special follow-up care for the test is necessary.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Sensory Perception
5. 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?
1. Report any feelings of nausea or flushing.
2. Avoid eating very much for the rest of the day.
3. Drink extra water for a day or so after the procedure.
4. Try to go up and down stairs at least twice before the end of the day.
Correct answer: 3
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.
Cognitive Ability: Applying
,Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Client Education, Safety
6. 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?
1. Shave the groin for insertion of a femoral catheter.
2. Remove all metal-containing objects from the client.
3. Inform the client to remain motionless throughout the procedure.
4. Instruct the client in inhalation techniques for the administration of the radioisotope.
Correct answer: 2
Rationale: In MRI, radiofrequency pulses in a magnetic field are converted into pictures. All metal objects, such as
rings, bracelets, hairpins, and watches, should be removed. In addition, a history should be taken to ascertain
whether the client has any internal metallic devices such as orthopedic hardware, pacemakers, or shrapnel. Insertion
of a femoral catheter is not part of the procedure. The client needs to be motionless throughout the procedure for
quality of the scan, but this action is not related to a safety issue and therefore is not the priority. A radioisotope may
be prescribed with positron emission tomography.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Strategic Words, Subject
Priority Concepts: Client Education, Safety
7. 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?
1. Intubation tray
2. Morphine sulfate injection
3. Portable chest x-ray machine
4. Chest tube and drainage system
Correct answer: 4
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. An intubation tray is not indicated. The client may be premedicated before
the procedure, or a local anesthetic is used. A portable chest x-ray machine would be needed to verify placement of a
chest tube if one was inserted, but it is unnecessary to have at the bedside before the procedure.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Planning
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Gas Exchange, Safety
8. 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.
Correct answer: 1, 2, 3, 4
Rationale: The nurse should first explain the procedure to the client and ask the client to void at the beginning of the
collection period and to discard this urine sample. All subsequent voided urine is saved in a container, which is
placed on ice or refrigerated. The client is asked to void at the finish time, and this sample is added to the collection.
The container is labeled, placed on fresh ice, and sent to the laboratory immediately.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Elimination
9. How should the nurse position the client for pericardiocentesis to treat cardiac tamponade?
1. Supine with slight Trendelenburg's position
2. Lying on the right side with a pillow under the head
3. Lying on the left side with a pillow under the chest wall
4. Supine with the head of the bed elevated at a 45- to 60-degree angle
Correct answer: 4
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. Options 1, 2, and 3 are incorrect positions.
Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals of Care: Diagnostic Tests
Strategy(ies): Subject
Priority Concepts: Clinical Judgment, Safety
10. A stool smear for culture needs to be obtained from a client. What steps should the nurse plan to implement 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
Correct answer: 1, 2, 4
