Fundamental Skills - Laboratory Values.txt

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Fundamental Skills - Laboratory Values.txt
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  1. A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium (Coumadin) has a prothrombin time (PT) of 35 seconds. On the basis of the prothrombin time, the nurse anticipates which prescription
    1. Adding a dose of heparin sodium
    2. Holding the next dose of warfarin
    3. Increasing the next dose of warfarin
    4. Administering the next dose of warfarin
    2. Holding the next dose of warfarin
  2. The nurse checks the laboratory result for a serum digoxin level that was prescribed for a client earlier in the day and notes that the result is 2.4 ng/mL. The nurse should take which immediate action?
    1. Check the client's last pulse rate.
    2. Notify the health care provider (HCP).
    3. Record the normal value on the client's flow sheet.
    4. Administer the next dose of the medication as scheduled.
    2. Notify the health care provider (HCP).
  3. A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen level drops to which value?
    1. 3 mg/dL
    2. 15 mg/dL
    3. 29 mg/dL
    4. 35 mg/dL
    2. 15 mg/dL
  4. A client arrives in the emergency department complaining of chest pain that began 4 hours ago. A troponin T blood specimen is obtained, and the results indicate a level of 0.6 ng/mL. The nurse determines that this result indicates which finding?
    1. A normal level
    2. A low value that indicates possible gastritis
    3. A level that indicates a myocardial infarction
    4. A level that indicates the presence of possible angina
    3. A level that indicates a myocardial infarction
  5. A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin (aPTT) time is 65 seconds. The nurse anticipates that which action is needed?
    1. Discontinuing the heparin infusion
    2. Increasing the rate of the heparin infusion
    3. Decreasing the rate of the heparin infusion
    4. Leaving the rate of the heparin infusion as is
    4. Leaving the rate of the heparin infusion as is
  6. A client with a history of cardiac disease is due for a morning dose of furosemide (Lasix). Which serum potassium level, if noted in the client's laboratory report, should be reported before administering the dose of furosemide?
    1. 3.2 mEq/L
    2. 3.8 mEq/L
    3. 4.2 mEq/L
    4 .4.8 mEq/L
    1. 3.2 mEq/L
  7. Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which abnormal laboratory test results should the nurse report? Select all that apply.
    1. Calcium, 7 mg/dL
    2. Magnesium, 1 mg/dL
    3. Phosphorus, 3.6 mg/dL
    4. Neutrophils, 1000 cells/mm3
    5. Serum creatinine, 1 mg/dL
    6. White blood cells, 3000 cells/mm3
    • 1. Calcium, 7 mg/dL
    • 2. Magnesium, 1 mg/dL
    • 4. Neutrophils, 1000 cells/mm3
    • 6. White blood cells, 3000 cells/mm3
  8. An adult client with cirrhosis has been prescribed a diet with optimal amounts of protein. The nurse evaluates the client's status as being most satisfactory if the total protein is which value?
    1. 0.4 g/dL
    2. 3.7 g/dL
    3. 6.4 g/dL
    4. 9.8 g/dL
    3. 6.4 g/dL
  9. A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 9%. On the basis of this test result, the nurse plans to teach the client about the need for which measure?
    1. Avoiding infection
    2. Taking in adequate fluids
    3. Preventing and recognizing hypoglycemia
    4. Preventing and recognizing hyperglycemia
    4. Preventing and recognizing hyperglycemia
  10. The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which value?
    1. 2000 cells/mm3
    2. 5800 cells/mm3
    3. 8400 cells/mm3
    4. 11,500 cells/mm3
    1. 2000 cells/mm3
  11. A client brought to the emergency department states that he has accidentally been taking two times his prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to take which action?
    1. Prepare to administer an antidote.
    2. Draw a sample for type and crossmatch and transfuse the client.
    3. Draw a sample for an activated partial thromboplastin time (aPTT) level.
    4. Draw a sample for prothrombin time (PT) and international normalized ratio (INR).
    4. Draw a sample for prothrombin time (PT) and international normalized ratio (INR).
  12. The nurse is assigned to a 40-year-old client who has a diagnosis of chronic pancreatitis. The nurse anticipates the client's serum amylase level to be which value?
    1. 45 units/L
    2. 100 units/L
    3. 300 units/L
    4. 500 units/L
    3. 300 units/L
  13. An adult female client has a hemoglobin level of 10.8 g/dL. The nurse interprets that this result is most likely caused by which condition noted in the client's history?
    1. Dehydration
    2. Heart failure
    3. Iron deficiency anemia
    4. Chronic obstructive pulmonary disease
    3. Iron deficiency anemia
  14. A client with a history of gastrointestinal bleeding has a platelet count of 300,000 cells/mm3. The nurse should take which action after seeing the laboratory results?
    1. Report the abnormally low count.
    2. Report the abnormally high count.
    3. Place the client on bleeding precautions.
    4. Place the normal report in the client's medical record.
    4. Place the normal report in the client's medical record.
  15. A client is undergoing diagnostic tests to rule out a diagnosis of renal disease. The laboratory results indicate a ratio of blood urea nitrogen (BUN) to creatinine of 15:1. The nurse plans care, knowing that this result indicates which condition?
    1. Liver failure
    2. A normal ratio
    3. A fluid volume deficit
    4. A fluid volume excess
    2. A normal ratio
  16. An unlicensed assistive personnel (UAP) collects a urine specimen from a client and is planning to deliver the specimen to the laboratory after completing morning care for other assigned clients. The registered nurse (RN) instructs the UAP to place the collected specimen in the unit laboratory refrigerator because which condition results if urine is allowed to stand unrefrigerated?
    1. The pH decreases.
    2. The urine clumps.
    3. The urine becomes more acidic.
    4. Bacteria and white blood cells (WBCs) decompose.
    4. Bacteria and white blood cells (WBCs) decompose.
  17. A client is undergoing diagnostic testing because of suspected renal disease. Which laboratory test best evaluates the kidneys' ability to regulate fluid balance?
    1. Creatinine
    2. Urinary protein
    3. Urine specific gravity
    4. Blood urea nitrogen (BUN)
    3. Urine specific gravity
  18. A client with acute glomerulonephritis has had a urinalysis sample sent to the laboratory. The report reveals the presence of hematuria and proteinuria. The nurse interprets these results as which condition?
    1. Consistent with glomerulonephritis
    2. Inconsistent with glomerulonephritis
    3. Unclear, and no conclusion can be drawn
    4. Indicative of impending acute kidney injury
    1. Consistent with glomerulonephritis
  19. The clinic nurse has obtained a throat culture specimen from a client in whom a throat infection is suspected. The nurse calls the laboratory to have the specimen picked up and is told that the laboratory is short-staffed and that the laboratory assistant will pick up the specimen in 2 hours. Which is the most appropriate nursing action?
    1. Refrigerate the specimen.
    2. Tell the client to return in 1 hour for a repeat throat culture.
    3. Contact the health care provider (HCP) who prescribed the specimen.
    4. Tell the laboratory that someone needs to pick up the specimen immediately.
    1. Refrigerate the specimen.
  20. Ferrous sulfate (iron) has been prescribed for the pregnant client with anemia. Before initiating the therapy, the nurse reviews which laboratory value that reflects the need for this dietary supplement?
    1. Clotting time
    2. Bleeding time
    3. Prothrombin time
    4. Hemoglobin level
    4. Hemoglobin level
  21. To detect the development of a chronic carrier state in a client with hepatitis, which laboratory test should the nurse assess?
    1. Hepatitis B virus DNA
    2. Prolonged prothrombin time
    3. Hepatitis B surface antigen (HBsAg)
    4. Antibody to surface antigen (anti-HBs)
    3. Hepatitis B surface antigen (HBsAg)
  22. Which outcome should the nurse expect to observe in the client who is recovering from viral hepatitis without complications?
    1. Presence of asterixis
    2. Increasing prothrombin time values
    3. Decrease in aspartate aminotransferase (AST)
    4. Decreased absorption of vitamin K in the intestine
    3. Decrease in aspartate aminotransferase (AST)
  23. The nurse is caring for a client who is receiving immunosuppressant therapy, including corticosteroids, after renal transplantation. The nurse should plan to carefully monitor results of which laboratory test for this client?
    1. Blood glucose level
    2. Serum calcium level
    3. Serum magnesium level
    4. Serum albumin concentration
    1. Blood glucose level
  24. A client with trigeminal neuralgia who is receiving carbamazepine (Tegretol) 400 mg orally daily has a white blood cell (WBC) count of 2800 cells/mm3, blood urea nitrogen (BUN) of 17 mg/dL, sodium of 141 mEq/L, and uric acid of 5 mg/dL. On the basis of these laboratory values, the nurse should make which interpretation?
    1. The WBC is low, indicating a blood dyscrasia.
    2. The BUN is elevated, indicating nephrotoxicity.
    3. The sodium level is low, indicating an electrolyte imbalance.
    4. The uric acid level is elevated, indicating the risk for renal calculi.
    1. The WBC is low, indicating a blood dyscrasia.
  25. A client has a prescription to have blood drawn to measure peak and trough vancomycin (Vancocin) levels to determine the effectiveness of therapy with this medication. The nurse arranges with the laboratory to have the peak level specimen drawn at which time?
    1. 1 hour before administration of the scheduled dose
    2. 1.5 hours after completion of the scheduled infusion
    3. Immediately after administration of the scheduled dose
    4. 30 minutes before administration of the scheduled dose
    2. 1.5 hours after completion of the scheduled infusion
  26. After completing an assessment and reviewing the laboratory test results of an adult client admitted to the hospital with acute abdominal pain, the nurse should take action for which serum amylase level noted?
    1. 54 units/dL
    2. 100 units/dL
    3. 120 units/dL
    4. 200 units/dL
    4. 200 units/dL
  27. After completing an assessment and reviewing the laboratory test results for a client seen in the clinic, the nurse determines that the serum ammonia level is normal if which value is noted?
    1. 5 mcg/dL
    2. 9 mcg/dL
    3. 40 mcg/dL
    4. 100 mcg/dL
    3. 40 mcg/dL
  28. The client is suspected of having a skeletal muscle disorder. Which isoenzyme value reported with the creatine kinase (CK) level should the nurse assess for elevation?
    1. MM
    2. MB
    3. BB
    4. MS
    1. MM
  29. The nurse is reviewing the serum creatinine laboratory test results for an adult male. The nurse determines that which is a normal serum creatinine level?
    1. 0.6 mg/dL
    2. 1.9 mg/dL
    3. 2.4 mg/dL
    4. 3.5 mg/dL
    1. 0.6 mg/dL
  30. The nurse is reviewing the laboratory results of a serum drug level assay for a client seen in the health care clinic who has been taking phenytoin (Dilantin) for the control of seizures. The nurse determines that a nontherapeutic level of phenytoin is present and that additional medication is required if which level is found?
    1. 3 mcg/mL
    2. 16 mcg/mL
    3. 18 mcg/mL
    4. 24 mcg/mL
    1. 3 mcg/mL
  31. The nurse in the respiratory care unit completes a lung assessment and reviews the laboratory results of a serum drug level assay for a client receiving theophylline. The nurse determines that a therapeutic medication level has been achieved by indication of which value?
    1. 8 mcg/mL
    2. 9 mcg/mL
    3. 18 mcg/mL
    4. 26 mcg/mL
    3. 18 mcg/mL
  32. The nurse checks the laboratory results of a serum drug level assay for a newly admitted client taking digoxin (Lanoxin) 0.125 mg orally daily. Which value would indicate a therapeutic level?
    1. 0.1 ng/mL
    2. 0.3 ng/mL
    3. 1.8 ng/mL
    4. 2.4 ng/mL
    3. 1.8 ng/mL
  33. The nurse is reviewing the results of the electrolyte panel for a client seen in the clinic. The nurse determines that the client's sodium level is normal if which value is noted?
    1. 120 mEq/L
    2. 142 mEq/L
    3. 148 mEq/L
    4. 152 mEq/L
    2. 142 mEq/L
  34. The nurse is reviewing the results of the electrolyte panel for a client seen in the health care clinic. The nurse determines that the client's potassium level is normal if which value is noted?
    1. 2.0 mEq/L
    2. 4.0 mEq/L
    3. 5.3 mEq/L
    4. 6.0 mEq/L
    2. 4.0 mEq/L
  35. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the client's fasting serum glucose level is normal if which value is noted?
    1. 110 mg/dL
    2. 120 mg/dL
    3. 130 mg/dL
    4. 140 mg/dL
    1. 110 mg/dL
  36. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the client's platelet level is normal if which value is noted?
    1. 70,000 cells/mm3
    2. 110,000 cells/mm3
    3. 160,000 cells/mm3
    4. 500,000 cells/mm3
    3. 160,000 cells/mm3
  37. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the serum protein level is normal if which value is noted on the laboratory report?
    1. 0.9 g/dL
    2. 2.7 g/dL
    3. 7.0 g/dL
    4. 9.2 g/dL
    3. 7.0 g/dL
  38. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the serum lipase level is normal if which value is noted on the laboratory report?
    1. 4 units/L
    2. 100 units/L
    3. 210 units/L
    4. 360 units/L
    2. 100 units/L
  39. The nurse just completed an assessment and reviewed the laboratory test results for an adult female client seen in the clinic. The client complains of being tired. The nurse determines the hemoglobin level is normal if which value is noted on the laboratory report?
    1. 8 g/dL
    2. 14 g/dL
    3. 22 g/dL
    4. 32 g/dL
    2. 14 g/dL
  40. The nurse is reviewing the laboratory test results for an adult male client seen in the health care clinic. The nurse determines that the hematocrit level is normal if which value is noted on the laboratory report?
    1. 58%
    2. 50%
    3. 40%
    4. 32%
    2. 50%
  41. A client with diabetes mellitus reports to the clinic for determination of the glycosylated hemoglobin A1c level. Which value on this laboratory test indicates client compliance with the prescribed diabetic regimen?
    1. 5%
    2. 8%
    3. 10%
    4. 15%
    1. 5%
  42. The nurse is reviewing the laboratory test results for a client seen in the clinic. The nurse determines that the urine specific gravity is normal if which value is noted on the laboratory results
    1. 1.004
    2. 1.012
    3. 1.019
    4. 1.036
    3. 1.019
  43. The nurse is reviewing the laboratory test results for a client seen in the clinic. The nurse determines that the white blood cell (WBC) count is normal if which value is noted on the laboratory report?
    1. 2000 cells/mm3
    2. 3600 cells/mm3
    3. 8600 cells/mm3
    4. 13,500 cells/mm3
    3. 8600 cells/mm3
  44. The nurse is reviewing the laboratory test results for a client seen in the clinic. The nurse reports to the client that the total cholesterol level is within the recommended guidelines if which value is noted on the laboratory report?
    1. 146 mg/dL
    2. 224 mg/dL
    3. 256 mg/dL
    4. 301 mg/dL
    1. 146 mg/dL
  45. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the blood urea nitrogen (BUN) level is normal if which value is noted on the laboratory report?
    1. 6 mg/dL
    2. 20 mg/dL
    3. 30 mg/dL
    4. 39 mg/dL
    2. 20 mg/dL
  46. A female client is at risk for developing disseminated intravascular coagulopathy (DIC). The nurse determines that which fibrinogen level is normal?
    1. 170 mg/dL
    2. 400 mg/dL
    3. 480 mg/dL
    4. 500 mg/dL
    2. 400 mg/dL
  47. The nurse is reviewing the laboratory blood test results for a client and notes that the hemoglobin S (Hgb S) value is elevated. The nurse determines that this laboratory finding is associated with which condition?
    1. Aplastic anemia
    2. Sickle cell anemia
    3. Infectious mononucleosis
    4. Acute lymphocytic leukemia
    2. Sickle cell anemia
  48. A client is donating blood for a family member who is having surgery. The nurse tells the client that an indirect Coombs' test will be performed on the blood. The client asks the nurse about the purpose of the test. Which response should the nurse provide to the client?
    1. "The test detects the presence of hepatitis B virus."
    2. "The test detects the amount of hemoglobin in the blood."
    3. "The test detects the presence of human immunodeficiency virus."
    4. "The test detects circulating antibodies against red blood cells (RBCs)."
    4. "The test detects circulating antibodies against red blood cells (RBCs)."
  49. A client's laboratory test results reveal an increased transferrin level and a decreased iron-binding capacity. The nurse interprets that these laboratory results are compatible with anemia because of which problem?
    1. Infection
    2. Malnutrition
    3. Iron deficiency
    4. Sickle cell disease
    3. Iron deficiency
  50. The nurse is reviewing the laboratory test results for a client and notes that the differential white blood cell count indicates a shift to the right. The nurse suspects that the client's diagnosis is most likely to be which one?
    1. Sepsis
    2. Pneumonia
    3. Pernicious anemia
    4. Coronary artery disease
    3. Pernicious anemia
  51. The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia. The nurse notes that the granulocyte count is decreased. The nurse interprets that the client is at risk for which condition?
    1. Anemia
    2. Infection
    3. Bleeding
    4. Dehydration
    2. Infection
  52. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse notes that the red blood cell (RBC) count is increased. The nurse interprets that this finding may be related to which condition or treatment?
    1. Iron deficiency
    2. Vitamin deficiency
    3. Corticosteroid therapy
    4. Bone marrow depression
    3. Corticosteroid therapy
  53. The nurse is reviewing the laboratory test results for a client seen in the health care clinic and notes that the red blood cell (RBC) count is decreased. The nurse determines that this finding occurs in which condition?
    1. Dehydration
    2. Iron deficiency
    3. Severe diarrhea
    4. Polycythemia vera
    2. Iron deficiency
  54. The nurse preceptor and the orientee note that the reticulocyte count for a client is increased. The preceptor determines that the orientee understands the significance of reticulocytes if the orientee makes which statement with regard to red blood cells (RBC)?
    1. "A reticulocyte is a mature RBC."
    2. "A reticulocyte is an immature RBC."
    3. "A reticulocyte is decreased whenever there is accelerated production of RBCs."
    4. "A reticulocyte is increased when the bone marrow has slowed production of RBCs."
    2. "A reticulocyte is an immature RBC."
  55. The ambulatory care nurse is reviewing an adult client's laboratory test results and notes that the hematocrit level is 60%. The nurse recognizes that this level is most likely to be found in clients with which diagnosis?
    1. Leukemia
    2. Hemolytic anemia
    3. Pernicious anemia
    4. Iron deficiency anemia
    3. Pernicious anemia
  56. The nurse is reviewing the laboratory test results for a client seen in the health care clinic and notes that the hematocrit value is 30%. The nurse determines that this hematocrit value is most likely to be associated with which condition?
    1. Dehydration
    2. Pernicious anemia
    3. Polycythemia vera
    4. Iron deficiency anemia
    4. Iron deficiency anemia
  57. The nurse is reviewing the laboratory test results for a client with a diagnosis of severe dehydration. The nurse should expect the hematocrit level for this client to be noted at which level?
    1. 60%
    2. 47%
    3. 45%
    4. 32%
    1. 60%
  58. The nurse is caring for a client with a diagnosis of fluid volume overload. The nurse reviews the laboratory test results and would expect to note which finding about the hematocrit level?
    1. Normal
    2. Increased
    3. Decreased
    4. Insignificant related to the condition
    3. Decreased
  59. The nurse is reviewing the laboratory results of a client admitted to the hospital with a diagnosis of venous thrombosis. The nurse expects the platelet aggregation to be reported as which level in this client?
    1. Normal
    2. Increased
    3. Decreased
    4. Insignificant
    2. Increased
  60. The nurse is reviewing the laboratory test results for a client with a diagnosis of thrombocytopenia purpura. The nurse should expect the results for platelet aggregation to be at which level?
    1. Normal
    2. Increased
    3. Decreased
    4. Insignificant
    3. Decreased
  61. The nurse is reviewing the electrolyte panel results for an assigned client who is taking a potassium supplement. The nurse should determine that a therapeutic effect is present if which value is noted?
    1. 2.8 mEq/L
    2. 3.0 mEq/L
    3. 3.3 mEq/L
    4. 4.0 mEq/L
    4. 4.0 mEq/L
  62. The nurse is reviewing the medication list for a client seen in the health care clinic. The nurse determines that which medications will most likely increase the sodium level? Select all that apply.
    1. Laxatives
    2. Stool softeners
    3. Anabolic steroids
    4. Oral contraceptives
    5. Nonsteroidal anti-inflammatory drugs
    • 3. Anabolic steroids
    • 4. Oral contraceptives
    • 5. Nonsteroidal anti-inflammatory drugs
  63. The nurse is reviewing the results of a urinalysis for a client with chronic kidney disease. The nurse understands that the specific gravity of the urine is expected to be at what level?
    1. 1.001
    2. 1.016
    3. 1.035
    4. 1.040
    1. 1.001
  64. The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that which level indicates the need for follow-up andimmediate notification of the health care provider (HCP)?
    1. Calcium 4.0 mg/dL
    2. Sodium 140 mEq/L
    3. Potassium 4.0 mEq/L
    4. Magnesium 2.0 mg/dL
    1. Calcium 4.0 mg/dL
  65. The nurse is reviewing the laboratory results from a lumbar puncture performed in a client with a diagnosis of meningitis. Which laboratory findings are expected to be noted with bacterial meningitis? Select all that apply.
    1. Increased glucose level
    2. Protein level of 20 mg/dL
    3. Increased white blood cells
    4. Clear appearance of the cerebrospinal fluid
    5. Cerebrospinal fluid (CSF) pressure of 250 mm H2O
    • 2. Protein level of 20 mg/dL
    • 3. Increased white blood cells
    • 5. Cerebrospinal fluid (CSF) pressure of 250 mm H2O
  66. A child is receiving edetate calcium disodium (calcium ethylene diamine tetra-acetic acid [EDTA]) by intravenous infusion for the treatment of lead poisoning. The health care provider prescribes a blood level concentration measurement. Which action should the nurse take to obtain the blood specimen?
    1. Stop the IV infusion for 1 hour before obtaining the blood.
    2. Irrigate the IV line with normal saline before drawing the blood.
    3. Obtain the blood specimen on the extremity that is not receiving the IV infusion.
    4. Maintain the client on NPO status 12 hours before obtaining the blood specimen.
    1. Stop the IV infusion for 1 hour before obtaining the blood.
  67. A test to measure the fluorescent antinuclear antibody (FANA) titer is performed in a client with suspected rheumatoid arthritis (RA). The nurse reviews the laboratory results and determines that the test result is positive if which value is noted?
    1. 0.5
    2. 0.8
    3. 1.5
    4. 2.0
    4. 2.0
  68. Determination of an erythrocyte sedimentation rate (ESR) is prescribed for a client with a connective tissue disorder. What should the nurse tell the client is the purpose of this test?
    1. Determines the presence of antigens
    2. Identifies what additional tests need to be performed
    3. Confirms the diagnosis of connective tissue disorders
    4. Confirms the presence of inflammation or infection in the body
    4. Confirms the presence of inflammation or infection in the body
  69. The nurse is reviewing the diagnostic tests performed on a client with a connective tissue disorder. The erythrocyte sedimentation rate (ESR) is reported as 100 mm/hr. How should the nurse interpret this finding?
    1. A normal result
    2. Mild inflammation
    3. Severe inflammation
    4. Moderate inflammation
    3. Severe inflammation
  70. A client with a diagnosis of rheumatoid arthritis reports to the health care clinic to have a blood specimen drawn for determination of the salicylate level in the serum. A nurse reviews the results of the test and determines that the client's level is within the therapeutic range if which result is noted?
    1. 5 mg/dL
    2. 8 mg/dL
    3. 15 mg/dL
    4. 25 mg/dL
    3. 15 mg/dL
  71. A nurse is reviewing the laboratory results of a urine culture for a client with suspected cystitis. Which colony counts would indicate a positive culture result?
    1. 10,000 bacterial units/mL of urine
    2. 20,000 bacterial units/mL of urine
    3. 50,000 bacterial units/mL of urine
    4. 100,000 bacterial units/mL of urine
    4. 100,000 bacterial units/mL of urine
  72. A nurse is reviewing the laboratory results for a client with a diagnosis of leukemia and notes that the absolute neutrophil count is decreased. The nurse interprets this to mean that the client is at risk for which problem?
    1. Anemia
    2. Bleeding
    3. Infection
    4. Dehydration
    3. Infection
  73. A nurse reviews the fasting blood glucose level of a client with diabetes mellitus who is scheduled for surgery and plans to contact the health care provider (HCP) if the level is abnormal. Which level is abnormal?
    1. 70 mg/dL
    2. 90 mg/dL
    3. 100 mg/dL
    4. 190 mg/dL
    4. 190 mg/dL
  74. A client with cirrhosis is being treated for hypernatremia. On reviewing the laboratory values for the client, the nurse determines that treatment is effective if which laboratory result is noted?
    1. Urine specific gravity of 1.040
    2. Serum sodium value of 150 mEq/L
    3. Serum sodium value of 145 mEq/L
    4. Serum osmolality of 300 mOsm/kg
    3. Serum sodium value of 145 mEq/L
  75. A client with a diagnosis of hyperphosphatemia has been treated with dietary management and phosphate binding gels. The client reports to the clinic, and the nurse is reviewing the laboratory results. Which reported serum phosphate level would indicate improvement in the client's condition?
    1. 4.0 mg/dL
    2. 5.2 mg/dL
    3. 6.0 mg/dL
    4. 6.5 mg/dL
    1. 4.0 mg/dL
  76. A nurse is reviewing the laboratory test results for an adult client who is taking furosemide (Lasix).The nurse determines that the client's serum sodium level is normal if which value is noted?
    1. 120 mEq/L
    2. 130 mEq/L
    3. 140 mEq/L
    4. 150 mEq/L
    3. 140 mEq/L
  77. A nurse is reviewing the laboratory test results for a client and notes that the serum sodium level is 150 mEq/L. The nurse understands that this value would be most likely noted in which conditions?
    1. Heart failure
    2. Addison's disease
    3. A severe burn injury
    4. Adrenal insufficiency
    1. Heart failure
  78. A nurse is reviewing the laboratory test results for an adult client who is being treated for metabolic acidosis. The nurse determines that the serum potassium level is normal if which value is noted?
    1. 3.0 mEq/L
    2. 4.1 mEq/L
    3. 5.5 mEq/L
    4. 6.0 mEq/L
    2. 4.1 mEq/L
  79. A nurse is reviewing the laboratory test results for a client and notes that the serum potassium level is 5.5 mEq/L. The nurse understands that this value would be most likely noted in which condition?
    1. Diarrhea
    2. Addison's disease
    3. Diabetes insipidus
    4. Dumping syndrome
    2. Addison's disease
  80. A nurse is reviewing the laboratory test results for a woman who takes 325 mg of acetylsalicylic acid, or aspirin, daily and has been having frequent nosebleed episodes. The nurse determines that the prothrombin time (PT) is normal if which value is noted?
    1. 7.8 seconds
    2. 8.2 seconds
    3. 9.3 seconds
    4. 11.0 seconds
    4. 11.0 seconds
  81. A nurse is reviewing the laboratory test results and notes that the prothrombin time (PT) is 7.0 seconds. The nurse understands that this PT value would be most likely noted in which conditions?
    1. Hepatic disease
    2. Cirrhosis of the liver
    3. Factor VII deficiency
    4. Deep vein thrombosis
    4. Deep vein thrombosis
  82. A nurse is reviewing the laboratory test results for a client who is receiving chemotherapy. The nurse determines that the platelet count is normal if which value is noted?
    1. 90,000 cells/mm3
    2. 120,000 cells/mm3
    3. 300,000 cells/mm3
    4. 500,000 cells/mm3
    3. 300,000 cells/mm3
  83. A nurse is reviewing the laboratory test results for an adult with ascites. The nurse determines that the albumin level is normal if which result is noted?
    1. 1.0 g/dL
    2. 3.0 g/dL
    3. 4.0 g/dL
    4. 6.0 g/dL
    3. 4.0 g/dL
  84. A nurse is reviewing the laboratory test results for a client and notes that the albumin level is 3.0 g/dL. The nurse understands that this laboratory value would be noted in which condition?
    1. Diarrhea
    2. Dehydration
    3. Multiple myeloma
    4. Cirrhosis of the liver
    4. Cirrhosis of the liver
  85. A client who has a serum potassium (K+) level of 2.9 mEq/L tells the nurse that he does not feel like eating lunch. The nurse checks his serum digoxin level from that morning and notes that it is 2.1 ng/mL. What should the nurse determine about this digoxin level?
    1. Low
    2. Extremely toxic
    3. Within the therapeutic range
    4. Just above the high end of the therapeutic range
    4. Just above the high end of the therapeutic range
  86. A nurse is monitoring for agranulocytosis in a client who is taking clozapine (Clozaril). The nurse should check which serum laboratory result to determine the presence of agranulocytosis?
    1. Basophil count lower than normal
    2. Creatinine level greater than normal
    3. White blood cell (WBC) count lower than normal
    4. Blood urea nitrogen (BUN) level greater than normal
    3. White blood cell (WBC) count lower than normal
  87. A client is undergoing an oral glucose tolerance test. The nurse interprets that the test results are not indicative of diabetes mellitus if, after 2 hours, the glucose level is less than which threshold value?
    1. 80 mg/dL
    2. 110 mg/dL
    3. 140 mg/dL
    4. 160 mg/dL
    3. 140 mg/dL
  88. A nurse is assessing the status of a client with diabetes mellitus. The nurse interprets that the client is exhibiting adequate diabetic control if the serum level of glycosylated hemoglobin A1c is less than what percentage?
    1. 7%
    2. 9%
    3. 10%
    4. 15%
    1. 7%
  89. A client with diabetes mellitus is scheduled for a fasting blood glucose level determination in the morning. The nurse tells the client not to eat or drink after midnight. When the client asks for further information about fluid and food intake, the nurse clarifies by stating that which would be acceptable to consume before the test?
    1. Water
    2. Tea without any sugar
    3. Coffee without any milk
    4. Clear liquids such as apple juice
    1. Water
  90. The nurse notes that a client's lithium level is 3.9 mEq/L. What is the nurse's priority action in response to this finding?
    1. Determining visual acuity
    2. Assisting with ambulation
    3. Monitoring intake and output
    4. Instituting seizure precautions
    4. Instituting seizure precautions
  91. The nurse is reviewing the differential white blood cell count on a client and notes that the results indicate a left shift. What are the possible indications for this finding? Select all that apply.
    1. An increased number of bands
    2. The total number of white blood cells
    3. The presence of an acute infectious process
    4. An increased number of mature neutrophils
    5. An increased number of immature neutrophils
    • 1. An increased number of bands
    • 2. The total number of white blood cells
    • 3. The presence of an acute infectious process
    • 5. An increased number of immature neutrophils
  92. An older client is admitted to the hospital with a diagnosis of malnutrition. Which laboratory datum indicates that the client is experiencing a protein deficiency?
    1. Calcium, 10 mg/dL
    2. Sodium, 138 mEq/L
    3. Creatinine, 0.6 mg/dL
    4. Transferrin, 90 mg/dL
    4. Transferrin, 90 mg/dL
  93. An adult male client admitted to the hospital with shock has received fluid volume replacement. The nurse should determine that the client has had adequate fluid resuscitation if the client's repeat hematocrit level has decreased to which value in the normal range?
    1. 56%
    2. 48%
    3. 39%
    4. 34%
    2. 48%
  94. A nurse instructs a client with diabetes mellitus who takes insulin about blood glucose monitoring and monitoring for signs of hypoglycemia. The nurse should inform the client that a blood glucose level lower than which value is hypoglycemia?
    1. 60 mg/dL
    2. 90 mg/dL
    3. 110 mg/dL
    4. 120 mg/dL
    1. 60 mg/dL
  95. A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium (Coumadin). The client's prothrombin time is 20 seconds, with a control of 11 seconds. How should the nurse interpret these results?
    1. The client needs to have the test repeated.
    2. Client results are within the therapeutic range.
    3. Client results are higher than the therapeutic range.
    4. Client results are lower than the needed therapeutic level.
    2. Client results are within the therapeutic range.
  96. The nurse is caring for a client with suspected hepatitis. Which diagnostic test result will assist in confirming this client's diagnosis?
    1. Elevated hemoglobin level
    2. Elevated serum bilirubin level
    3. Elevated blood urea nitrogen level
    4. Decreased erythrocyte sedimentation rate
    2. Elevated serum bilirubin level
  97. The health care provider tells a client that a blood transfusion is needed and that a blood sample must be drawn first for blood typing and cross-matching. After the health care provider leaves, the client asks the nurse, "What exactly is a blood type, anyway?" The nurse bases her response on the understanding that blood type represents which?
    1. An antigen found on the surface of the red blood cell
    2. An antibody found on the surface of the red blood cell
    3. An antigen that normally circulates in the blood plasma
    4. An antibody that normally circulates in the blood plasma
    1. An antigen found on the surface of the red blood cell
  98. A nurse is preparing to test a client's blood glucose level with a glucometer. Which steps would facilitate obtaining an accurate result?Select all that apply.
    1. Hold the finger in a dependent position during the test.
    2. Use gentle pressure to obtain an adequate amount of blood.
    3. Obtain the blood specimen by puncturing the central tip of the finger.
    4. Obtain the blood specimen by puncturing the lateral side of the finger.
    5. Allow the drop of blood to form without squeezing near the puncture site.
    6.Clean the site with an antiseptic swab and then puncture the site immediately.
    • 1. Hold the finger in a dependent position during the test.
    • 2. Use gentle pressure to obtain an adequate amount of blood.
    • 4. Obtain the blood specimen by puncturing the lateral side of the finger.
  99. A nurse caring for a 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?
    1. Report the abnormally low level.
    2. Report the abnormally high level.
    3. Inform the client that the laboratory result is normal.
    4. Place the normal report in the client's medical record.
    1. Report the abnormally low level.
  100. The clinic nurse is caring for an infant who has been diagnosed with primary hypothyroidism. The nurse is reviewing the results of the laboratory tests for a T4 and thyroid-stimulating (TSH) hormone. Which laboratory finding indicates a diagnosis of primary hypothyroidism?
    1. A normal T4 level
    2. An elevated T4 level
    3. An elevated TSH level
    4. A decreased TSH level
    3. An elevated TSH level
  101. The nurse provides instructions to the parent of a newborn to bring the infant to the well-baby clinic for a phenylketonuria (PKU) rescreening blood test. The parent brings the infant to the clinic, and the blood test is drawn. The results of the test indicate a serum phenylalanine level of 1.0 mg/dL. How should the nurse interpret this result?
    1. Positive
    2. Negative
    3. Inconclusive
    4. Requires rescreening
    2. Negative
  102. The nurse is reviewing the client's results of preadmission testing laboratory studies for a complete blood count, electrolytes, coagulation studies, and creatinine laboratory studies before a surgical procedure. Which laboratory result should the nurse report immediately to the surgeon?
    1. Platelet count, 210,000 cells/mm3
    2. Serum creatinine level, 0.8 mg/dL
    3. Hemoglobin (Hgb) level, 8.9 g/dL
    4. Serum sodium (Na) level, 141 mEq/L
    3. Hemoglobin (Hgb) level, 8.9 g/dL
  103. A nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse should check to see that which medication is available in the stock medication supply for possible use to reverse this elevation?
    1. Calcitonin
    2. Vitamin D
    3. Calcium chloride
    4. Calcium gluconate
    1. Calcitonin
  104. A nurse is reading a computer printout of the results of a cerebrospinal fluid (CSF) analysis performed on an adult client who has undergone lumbar puncture. The nurse determines that which is an abnormal finding?
    1. Red blood cells, 0
    2. Glucose, 52 mg/dL
    3. Protein, 100 mg/dL
    4. White blood cells, 3 cells/mm3
    3. Protein, 100 mg/dL
  105. 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 therapeutic range if which value is reported?
    1. 6 mcg/mL
    2. 15 mcg/mL
    3. 28 mcg/mL
    4. 35 mcg/mL
    2. 15 mcg/mL
  106. A client with chronic obstructive pulmonary disease (COPD) has had a sample for a serum theophylline level drawn as part of routine follow-up care. Which result should lead the nurse to conclude that the client has most likely been compliant with medication therapy?
    1. 3 mcg/mL
    2. 7 mcg/mL
    3. 14 mcg/mL
    4. 24 mcg/mL
    3. 14 mcg/mL
  107. A long-term care nurse about to give a daily dose of digoxin (Lanoxin) is told that a serum digoxin level drawn earlier in the day measured 2.7 ng/mL. Which action should the nurse take first?
    1. Administer the daily dose of the medication.
    2. Report the finding to the health care provider (HCP).
    3. Record the normal value on the intershift report sheet.
    4. Gather data from the client related to signs of toxicity.
    4. Gather data from the client related to signs of toxicity.
  108. A client is receiving oral anticoagulant therapy with warfarin (Coumadin). The result of a newly drawn prothrombin time (PT) is 40 seconds. The nurse should anticipate which prescription to be prescribed for this client?
    1. Hold the next dose of warfarin.
    2. Increase the next dose of warfarin.
    3. Administer the next dose of warfarin.
    4. Stop the warfarin, and administer heparin.
    1. Hold the next dose of warfarin.
  109. An adult client has had serum electrolyte levels drawn. The nurse receiving the results by telephone from the laboratory should be moAn adult client has had serum electrolyte levels drawn. The nurse receiving the results by telephone from the laboratory should bemost concerned with which finding? 
    1. Sodium level, 142 mEq/L
    2. Chloride level, 103 mEq/L
    3. Potassium level, 5.4 mEq/L
    4. Bicarbonate level, 24 mEq/L
    3. Potassium level, 5.4 mEq/L
  110. A client with heart disease is scheduled to receive a daily morning dose of furosemide (Lasix). The nurse should report which serum potassium level to the health care provider (HCP) before administering the daily dose?
    1 .5.0 mEq/L
    2. 4.2 mEq/L
    3. 3.8 mEq/L
    4. 3.0 mEq/L
    4. 3.0 mEq/L
  111. A nurse receives a telephone laboratory report indicating that a diabetic client has a glycosylated hemoglobin A1c level of 7.6%. In which priority area should the nurse plan to provide diabetic teaching?
    1. Avoidance of infection
    2. Rotation of insulin injection sites
    3. Measures to prevent hyperglycemia
    4. Avoidance of hypoglycemic episodes
    3. Measures to prevent hyperglycemia
  112. A nurse is monitoring the client for hypocalcemia. Which are indicative of this imbalance? Select all that apply.
    1. Irritability
    2. Muscle cramps
    3. Tingling sensations
    4. Hyperactive reflexes
    5. Memory impairment
    6. Severe muscle weakness
    • 1. Irritability
    • 2. Muscle cramps
    • 3. Tingling sensations
    • 4. Hyperactive reflexes
    • 5. Memory impairment

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