Week 4 Lab Practice Questions
18. A client has been undergoing radiotherapy for the treatment of mandibular cancer. After a few sessions, the client is diagnosed with TumorLysis Syndrome (TLS). Which of the following findings correlates with TLS? A. Phosphorus level of 6 mg/dL. B. Phosphorus level of 3 mg/dL. C. Phosphorus level of 4 mg/dL. D. Phosphorus level of 2 mg/dL.
Answer: A. Phosphorus level of 6 mg/dL. Tumor lysis syndrome (TLS) is a potentially life-threatening metabolic disorder characterized by elevated phosphorus levels. The normal phosphorus is 2.5 to 4.5 mg/dL.
20. A nurse is reviewing the complete blood count (CBC) of a child who has been diagnosed with idiopathic thrombocytopenic purpura. Which of the following laboratory result should the nurse report immediately to the physician? A. Platelet count of 30,000/mm3. B. Hemoglobin level of 7.5 g/dL. C. Reticulocyte count of 6.5%. D. Eosinophil count of 700 cells/mm3.
Answer: B. Hemoglobin level of 7.5 g/dL. The low hemoglobin level indicates that the client has an active bleeding, and immediate actions such as additional diagnostic exam and blood transfusions can be suggested. Options A, C, and D: Decreased platelet count, increased reticulocyte and increased eosinophil count are expected in a child with idiopathic thrombocytopenic purpura.
11. A nurse is caring for a client with diarrhea and dehydration. The nurse determines that the client has received adequate fluid replacement if the blood urea nitrogen decreases to: A. 36 mg/dL. B. 27 mg/dL. C. 18 mg/dL. D. 6 mg/dL.
Answer: C. 18 mg/dL. The normal value of blood urea nitrogen is 8 to 25 mg/dL. Options A and B still indicates dehydration. Option D which has a low BUN occurs with conditions such as fluid volume overload, malnutrition, etc.
16. The nurse caring for a client with a serum calcium of 6.8 mg/dL. What would the nurse expect the change on the electrocardiogram (ECG)? A. None. This is a normal calcium level. B. Prolonged QT interval. C. Shortened ST segment. D. Widened T wave.
Answer: B. Prolonged QT interval. The normal serum calcium level is 8.6 to 10 mg/dL. A serum calcium level lower than 8.6 mg/dL indicates hypocalcemia. Electrocardiographic changes that occur in a client with hypocalcemia include a prolonged ST or QT interval. Options C and D: A shortened ST segment and a widened T wave occur with hypercalcemia.
12. A client with liver cirrhosis has been advised to follow a high-protein diet. The nurse evaluates the effectiveness of the diet if the total protein level is which of the following values? A. 6.9 g/dL. B. 4.9 g/dL. C. 2.9 g/dL. D. 0.9 g/dL.
Answer: A. 6.9 g/dL. The normal value for total serum protein is 6 to 8 g/dL. The client with liver cirrhosis has low total protein levels secondary to inadequate nutrition. Options B, C, and D are abnormal values.
15. The nurse is reviewing the laboratory result of a client receiving digoxin(Lanoxin) and notes that the result is 2.5 ng/mL. The nurse plans to do which of the following? A. Give the next dose. B. Notify the physician. C. Check the client's pulse rate. D. Increase the next dose as ordered.
Answer: B. Notify the physician. The normal value therapeutic range for digoxin is 0.5 to 2 ng/mL. A level of 2.5 ng/mL indicates a toxicity. The nurse should immediately inform the physician, who may give further instructions about holding the next doses of digoxin.
13. The nurse is handling a client with chronic pancreatitis. Upon reviewing the client's record, which of the following serum amylase level is to be expected? A. 50 units/L. B. 150 units/L. C. 350 units/L. D. 650 units/L.
Answer: C. 350 units/L. The normal serum amylase level is 25 to 151 unit/L. Clients with chronic pancreatitis have an increased level of serum amylase which does not exceed three times the normal value. Options A and B are within the normal values. Option D is seen with acute pancreatitis since the value may exceed five times the normal value.
14. A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 10%. Based on the result, the nurse plans to teach the client about the importance of: A. Maintaining the result. B. Preventing hypoglycemia. C. Preventing hyperglycemia. D. Avoiding infection.
Answer: C. Preventing hyperglycemia. Glycosylated hemoglobin A1c level of 8% higher indicates a poor diabetic control. Elevations indicate continued need for a teaching related to the prevention of hyperglycemic episodes.
17. When providing care for a female client with Addison disease, the nurse should be alert for which of the following laboratory value? A. Potassium level of 3.2 mEq/L. B. Calcium level of 3.3 mEq/L. C. Sodium level of 150 mg/dL. D. Hematocrit level of 25%.
Answer: D. Hematocrit level of 25%. A client with Addison's disease is at risk for anemia. The normal hematocrit level of a female adult is 35% to 45%. A client with anemia has a low hematocrit level. Options A and B: Client with Addison's disease have an increased potassium and calcium level. Option C: Client with Addison's disease have a low sodium level.
19. A female client went to the clinic with a creatine clearance of 200 mL/min. Which of the following condition of the client can cause the increased level of this test? A. Renal disease. B. Dehydration. C. Congestive heart failure. D. History of high dietary protein intake.
Answer: D. History of high dietary protein intake. The normal creatine clearance for a female is 88 to 128 ml/min. An increased creatinine clearance is often referred to as hyperfiltration and is most commonly seen during pregnancy or in clients with a large dietary protein intake. Options A, B, and C are seen with a decreased creatinine clearance.
