Lab values NCLEX

The nurse is monitoring the laboratory results of a client preparing to receive chemotherapy. The nurse determines that the white blood cell count (WBC) is normal if which result is present?

5000 mm3 (5 × 109/L)

A client who takes theophylline for chronic obstructive pulmonary disease (COPD) is seen in the urgent care center for respiratory distress. Just before initiating treatment for the respiratory distress, a sample for a theophylline level is drawn. The nurse notes the therapeutic range for the serum theophylline level is 10 to 20 mcg/mL and determines that the client may not be taking the medication as prescribed if which result is obtained?

6 mcg/mL

A client has been treated for dehydration and pneumonia. The nurse evaluates that the client has been successfully treated if the blood urea nitrogen (BUN) level is which value?

19 mg/dL

An adult client has had serum electrolytes drawn. The nurse receiving the results by telephone from the laboratory should be most concerned with which result?

Potassium 5.4 mEq/L

Which laboratory results indicate a therapeutic drug level? Refer to chart. Select all that apply.

1, 3, 5

A client has been diagnosed as having syndrome of inappropriate antidiuretic hormone (SIADH) secretion following cranial surgery. The nurse interprets that this complication is not resolving if which urine specific gravity measurement is obtained?

1.030

A client with a history of seizure disorder is having a routine serum phenytoin level drawn. The nurse who receives a telephone report of the results notes that the client's blood level of the medication is within the normal range if which value is reported?

15 mcg/mL

A client has been admitted for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value?

15 mg/dL

The nurse is assigned to a hospitalized client with chronic pancreatitis. The nurse reviews the client's record and expects to note a serum amylase level that is most like which value?

300 units/L

The nurse is caring for a client recovering from hepatitis. The nurse recognizes the need to report which laboratory test result to the primary health care provider?

Alanine aminotransferase (ALT) that is significantly elevated

A client is admitted to the hospital with a diagnosis of malnutrition. The nurse is told that blood will be drawn to determine whether the client has a protein deficiency. Which laboratory data indicate that the client is experiencing a protein deficiency? Select all that apply.

Albumin 2.2 g/dL, Transferrin, 90 mg/dL, Prealbumin 10 mg/dL

The nurse is reviewing the results of a client's serum laboratory studies. Which result indicates a deficiency of protein intake?

Albumin, 2.6 mg/dL

A child is receiving edetate calcium disodium (calcium EDTA) for the treatment of lead poisoning. Which laboratory result would be important to monitor during treatment?

Blood urea nitrogen (BUN) level

The nurse reviews the client's laboratory results. Which abnormal findings should the nurse report? Select all that apply.

Calcium 8.2 mg/dL Potassium 6 mEq/L Magnesium 2.9 mg/dL Phosphorus 5.2 mg/dL

The nurse reviews the client's laboratory data. Which data warrant notification of the registered nurse and an immediate call to the primary health care provider? Refer to chart.

Calcium level

Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which laboratory results warrant a call to the primary health care provider (PHCP)? Select all that apply.

Calcium, 7 mg/dL, Magnesium, 1 mg/dL, White blood cells (WBC), 3000 mm3

Which laboratory result would verify the diagnosis of bacterial meningitis?

Cloudy cerebrospinal fluid with high protein and low glucose levels

A client is suspected of having a myocardial infarction. The nurse should expect elevations in which laboratory values to support the diagnosis? Select all that apply.

Creatinine phosphokinase MB (CPK-MB) Troponin I

A primary health care provider is caring for a client who is human immunodeficiency virus (HIV) positive and has delivered a newborn baby. The nurse anticipates which interventions should be employed for the newborn to decrease the risk of HIV. Select all that apply.

HIV testing of the newborn within 48 hours Antiretroviral prophylaxis for newborns testing HIV positive. Periodic testing for HIV at set intervals until the age of 6 months.

A client is receiving standard oral anticoagulant therapy with warfarin. The result of a newly drawn international normalized ratio is 3.8 seconds. The client needs to have an invasive procedure done on the next day. Which medication will likely be ordered to reverse the anticoagulant effect?

Phytonadione

The nurse working the 3:00 to 11:00 pm shift notes that a client with coronary artery disease (CAD) has a prescription for serum lipid levels to be drawn in the morning. The nurse places the client on which dietary preparation to ensure accurate test results?

Fasting for 12 hours

The nurse is reviewing the complete blood count (CBC) laboratory results of a female adult client suspected of having iron deficiency anemia. The nurse reviews the results and determines that which results are consistent with this diagnosis? Select all that apply.

Hemoglobin (Hgb) 8.8 g/dL, Hematocrit (Hct) 30%, Decreased mean corpuscular volume (MCV) 66 fL

The nurse is reviewing the laboratory results of a client scheduled for surgery. Which laboratory result should indicate to the nurse that the surgery might be postponed?

Hemoglobin, 8.4 g/dL

Which cardiovascular sign should the nurse expect to note in a client with a diagnosis of hypocalcemia?

Hypotension

A client is admitted to the hospital with a diagnosis of suspected myocardial infarction (MI). The nurse is reviewing the laboratory results performed on the client. Which documented laboratory result specifically indicates the presence of an MI?

Increased creatine kinase (CK-MB)

The nurse is reading a client's urinalysis report. The nurse interprets which item found on the report to be considered abnormal? Select all that apply.

Positive protein Leukocyte esterase positive White blood cells, 10 per high power screen

A hospitalized client with heart disease who is taking digoxin has a digoxin level prescribed. The level is elevated above normal. Based on this finding the nurse plans to notify the registered nurse and primary health care provider (PHCP) and anticipates which additional interventions will be prescribed? Select all that apply.

Monitor the potassium level, Place the client on cardiac monitor, Monitor the blood urea nitrogen (BUN) and creatinine.

A licensed practical nurse (LPN) is assisting in the care of a client receiving a continuous intravenous (IV) infusion of heparin sodium for deep vein thrombosis (DVT). The LPN notes that the result of a newly drawn activated partial thromboplastin time (aPTT) level is 90 seconds. The client's baseline before the initiation of therapy was 30 seconds. The LPN should take which action?

Notify the RN about the value immediately.

A client with a history of seizure disorder is receiving phenytoin in the hospital. The client has a seizure and the nurse reviews the laboratory results of the phenytoin level of 18 mcg/mL. The therapeutic level is 10 to 20 mcg/mL. The nurse understands from reviewing the medication level that which is the correct situation?

Phenytoin alone is not effectively controlling seizures.

The nurse is monitoring a client who is attached to a cardiac monitor and notes the presence of U waves. The nurse checks the client and then reviews the results of the client's recent electrolyte results. The nurse expects to note which electrolyte value?

Potassium 3.0 mEq/L

A client with diabetes mellitus has a glycosylated hemoglobin A (HbA1c) level of 8%. Which instruction does the nurse plan to reinforce to the client based on this test result?

Prevent hyperglycemia.

The nurse is reviewing the laboratory results from the lumbar puncture performed on a client with a diagnosis of meningitis. Which findings are indicative of a bacterial infection? Select all that apply.

Protein level of 20 mg/dL, Increased white blood cells, A cerebrospinal fluid (CSF) pressure of 250 mm H2O

The nurse caring for a male client with a diagnosis of gastrointestinal (GI) bleeding reviews the client's laboratory results and notes a hematocrit level of 30%. Which action should the nurse take?

Report the abnormally low level.

A nurse about to give a daily dose of digoxin and notes that a serum digoxin level drawn earlier in the day measured 2.7 ng/mL. The nurse should take which actions? Select all that apply.

Report the finding to the registered nurse. Gather data from the client related to signs of toxicity.

The nurse is assisting in monitoring a client who may be started on parenteral nutrition (PN). The nurse reviews the client's laboratory results and determines that the client is at risk of severe malnutrition if the report indicates which critical level?

Serum albumin 2.8 g/dL

A CD4+ count has been prescribed for a child with human immunodeficiency virus (HIV) infection. The mother asks the nurse about the purpose of the test and why the test needs to be done if it is already known that the child has HIV. The nurse should reinforce which information to the mother? Select all that apply.

The CD4+ count is used to determine the child's immune status. The CD4+ count is used to identify the risk for disease progression. The CD4+ count identifies the need for Pneumocystis jiroveci pneumonia prophylaxis after 1 year of age. The CD4+ count is measured at ages 1 and 3 months, every 3 months until the age of 2 years, and at least every 6 months thereafter. More frequent monitoring of CD4+ counts is indicated when pneumonia prophylaxis and antiretroviral therapy are administered.

A client with diabetes mellitus calls the clinic nurse to report that the blood glucose level is 150 mg/dL. After obtaining further data from the client, the nurse determines that the client ate lunch approximately 2 hours ago. How should the nurse interpret the data?

The blood glucose level is slightly higher than the normal value.

The nurse is explaining to a client the reason a peak and trough has been prescribed because the client is receiving an antibiotic. Which reason for the blood levels should be included in the teaching plan?

To determine if the dose of the antibiotic is effective against the organism causing the infection

A client is seen in the urgent care center for complaints of chest pain 2 days ago. Since that time, the client has not been feeling well and fatigues easily. The nurse reviews the results of the laboratory tests. An elevation of which laboratory test indicates a myocardial infarction occurred at the time of chest pain 2 days ago?

Troponin I

The nurse is reviewing the laboratory studies of a client receiving epoetin alfa. When should the nurse expect to note a therapeutic effect of this medication on the hemoglobin and hematocrit?

Two months after therapy

The nurse is caring for a client with a diagnosis of gout. Which laboratory value should the nurse expect to note in the client?

Uric acid level of 8.4 mg/dL

The nurse is reviewing laboratory results and notes that the client's international normalized ratio (INR) is 2.2. The nurse should realize this test is performed to monitor the effectiveness of which medication?

Warfarin

A client is admitted to the hospital with a fever and extreme weakness. Which laboratory studies are likely to be elevated if the client is experiencing an infection? Select all that apply.

White blood cell count (WBC), Erythrocyte sedimentation rate (ESR)

The nurse volunteering at the health screening clinic reinforces instructions to a 22-year-old client that diet and exercise should be used as tools to keep the total cholesterol level under at least which level?

200 mg/dL

The nurse is providing directions to a client about how to test a stool for occult blood. The nurse cautions that which could cause a false-negative result?

Ascorbic acid