Diagnostic Evaluation

Every question here, with the answer

1. A nurse is teaching a patient who will have an imaging study with contrast to evaluate bowel functioning. Which statements should the nurse include? Select all that apply.

   1. If contrast is used, you may need to remain NPO for four to six hours before the test.
   2. Oral contrast may have a chalky taste and will pass out of the body through the stools.
   3. After receiving contrast, increasing fluid intake may help eliminate it from the body, as appropriate.
   4. IV contrast may cause a slight burning sensation, metallic taste, or warm flushing that resolves in a few seconds.
   5. IV contrast should cause severe symptoms that last for several hours.

   Answer: If contrast is used, you may need to remain NPO for four to six hours before the test., Oral contrast may have a chalky taste and will pass out of the body through the stools., After receiving contrast, increasing fluid intake may help eliminate it from the body, as appropriate., IV contrast may cause a slight burning sensation, metallic taste, or warm flushing that resolves in a few seconds.

   The section states that contrast may require NPO status for four to six hours, oral contrast can taste chalky and pass through stool, and IV contrast can cause brief burning, metallic taste, or warmth. After the procedure, patients who received contrast should be encouraged to increase fluid intake as appropriate; prolonged severe symptoms are not described as expected.

2. A patient receives a positive Cologuard result after completing a home stool sample. Which follow-up should the nurse anticipate?

   1. Teach the patient that the result confirms an intestinal parasitic infection.
   2. Repeat the same Cologuard test every week until the result is negative.
   3. Prepare the patient for follow-up with a colonoscopy to investigate and confirm findings.
   4. Request a hydrogen breath test to measure carbohydrate malabsorption.

   Answer: Prepare the patient for follow-up with a colonoscopy to investigate and confirm findings.

   A positive Cologuard result indicates abnormal DNA and/or blood in the stool and requires follow-up colonoscopy. The result does not confirm parasites, and breath testing evaluates bacterial overgrowth or carbohydrate malabsorption rather than Cologuard findings.

3. A patient is being evaluated for suspected lactose intolerance and possible bacterial overgrowth. Which finding from a hydrogen breath test would suggest improper bowel functioning?

   1. A decrease in hydrogen levels after drinking water only
   2. A significant increase in hydrogen levels compared to baseline after ingesting the substrate
   3. Elevated alkaline phosphatase and bilirubin levels
   4. The presence of parasite ova in a stool sample

   Answer: A significant increase in hydrogen levels compared to baseline after ingesting the substrate

   The hydrogen breath test measures hydrogen after ingestion of a fermentable carbohydrate such as lactose or glucose. A significant increase from baseline suggests bacterial overgrowth or malabsorption; stool ova and parasite testing and liver function tests assess different concerns.

4. A nurse reviews the complete blood count of a patient being evaluated for inflammatory bowel disease. Which CBC-related abnormalities are associated with IBD? Select all that apply.

   1. High red blood cell count
   2. Low hemoglobin and hematocrit
   3. Increased platelet count
   4. Low white blood cell count as the expected inflammatory response
   5. Elevated white blood cell count

   Answer: Low hemoglobin and hematocrit, Increased platelet count, Elevated white blood cell count

   The section links IBD with elevated WBC and platelet count and low hemoglobin and hematocrit. High RBC count and low WBC count are not described as the associated CBC pattern for IBD in this section.

5. A nurse is explaining stool tests used to evaluate bowel functioning. Which explanations are accurate? Select all that apply.

   1. A fecal occult blood test detects occult blood in stool samples that may indicate GI bleeding.
   2. A fecal immunochemical test detects occult blood using immunochemical methods for human hemoglobin.
   3. A stool culture can identify pathogenic bacteria, viruses, or parasites responsible for GI infections.
   4. A stool culture is used primarily to assess thyroid-stimulating hormone levels.
   5. An ova and parasite examination looks microscopically for parasite ova, larvae, or cysts.

   Answer: A fecal occult blood test detects occult blood in stool samples that may indicate GI bleeding., A fecal immunochemical test detects occult blood using immunochemical methods for human hemoglobin., A stool culture can identify pathogenic bacteria, viruses, or parasites responsible for GI infections., An ova and parasite examination looks microscopically for parasite ova, larvae, or cysts.

   FOBT and FIT are used to detect occult blood, stool culture identifies pathogens responsible for GI infections, and ova and parasite examination detects parasite forms in stool. Thyroid-stimulating hormone is assessed with thyroid function tests, not stool culture.

6. A patient is scheduled for a barium enema/lower GI series. Which explanation by the nurse is most appropriate?

   1. You will swallow barium so the esophagus, stomach, and duodenum can be evaluated.
   2. A blood sample will be analyzed for thyroid-stimulating hormone to assess bowel motility.
   3. You will ingest lactulose, and breath samples will be collected to measure hydrogen and methane.
   4. Barium contrast will be introduced into the colon through an enema, followed by x-rays to view the colon and rectum.

   Answer: Barium contrast will be introduced into the colon through an enema, followed by x-rays to view the colon and rectum.

   A barium enema/lower GI series examines the lower GI tract, including the colon and rectum, by introducing barium through an enema and taking x-rays. Swallowed barium describes an upper GI series, lactulose describes a breath test, and TSH is measured with thyroid function testing.