Green or Gold top
A nurse reviews the laboratory results of four patients. Which result should the nurse recognize as abnormal?
A. Sodium 140 mEq/L
B. Potassium 4.2 mEq/L
C. Calcium 7.8 mg/dL
D. Chloride 102 mEq/L
Answer: C
Rationale: Normal calcium is 8.5–10.2 mg/dL. A calcium of 7.8 mg/dL indicates hypocalcemia.
Mild hypocalcemia often causes no symptoms, but severe or acute low blood calcium leads to tingling, muscle spasms, and abnormal heart rhythms
Which laboratory value is most directly associated with the patient's ability to maintain adequate oxygen-carrying capacity?
A. Platelets
B. Hemoglobin
C. WBC count
D. Hematocrit
Answer: B
Rationale: Hemoglobin carries oxygen from the lungs to body tissues.
A patient receiving warfarin has an INR of 2.5. How should the nurse interpret this result?
A. The INR is dangerously elevated
B. The INR is below the therapeutic range
C. The INR is within the expected therapeutic range
D. The patient has impaired liver function.
Answer: C
Rationale: The provided reference identifies an INR of approximately 2–3 as the therapeutic range for anticoagulated patients. A patient with an elevated INR without anticoagulation may have impaired liver function.
19. A patient reports severe epigastric pain radiating to the back. Which laboratory results would the nurse anticipate being evaluated?
A. Troponin and BNP
B. Amylase and lipase
C. TSH and free T4
D. PT and INR
Answer: B
Rationale: Amylase and lipase are pancreatic enzymes and may be elevated with pancreatitis.
ABG Questions
11. The nurse reviews the following ABG results:
How should the nurse interpret these results?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
Rationale: The pH is low, indicating acidosis. The PaCO₂ is elevated, indicating a respiratory cause. HCO₃⁻ is within the expected range.
A patient has a potassium level of 6.2 mEq/L. Which assessment finding is the nurse most concerned about? Is this a critical result that needs to be reported to the provider and documented immeadiately?
A. Muscle weakness and cardiac dysrhythmias
B. Increased thirst and dry mucous membranes
C. Constipation and abdominal distention
D. Decreased urine output
Answer: A
Rationale: Hyperkalemia can cause muscle weakness and potentially life-threatening cardiac dysrhythmias. Hyperkalemia may be a result of kidney injury and you may or may not see decrease urinary output. Call and report the critical right away.
Treatments:Stabilize the heart: Intravenous (IV) calcium gluconate or calcium chloride protects the heart muscle right away, though it does not lower blood potassium. Lower K: Regular insulin (usually given with IV dextrose/glucose, Inhaled or nebulized albuterol, Loop diuretics like furosemide, dialysis, Potassium binders:oral medicines like patiromer or sodium zirconium cyclosilicate
4. A patient's hemoglobin is 8.2 g/dL. Which condition would the nurse suspect?
A. Acute GI bleeding
B. Anemia
C. Dehydration
D. Thrombocytopenia
Answer: B
Rationale: A hemoglobin of 8.2 g/dL is below the expected range and is consistent with anemia. There is not enough information to identify the type of bleed or where if any active bleed is present.
A patient receiving a heparin infusion has an aPTT of 78 seconds. Which statement best explains why the nurse is monitoring this laboratory value?
A. It evaluates bleeding risk.
B. It evaluates the intrinsic clotting pathway and helps monitor heparin therapy.
C. It measures the patient's risk for a DVT.
D. It evaluates liver function..
Answer: B
Rationale: aPTT evaluates the intrinsic coagulation pathway and is commonly monitored when patients receive unfractionated heparin. N = 25 to 35 seconds
20. A patient has the following results:
Which condition should the nurse suspect?
A. Myocardial infarction
B. Pancreatitis
C. Renal failure
D. Hypothyroidism
Answer: B
Rationale: Both amylase and lipase are elevated above the ranges provided and can indicate pancreatic inflammation/injury.
12. Which ABG result is within the expected range?
A. pH 7.28
B. PaCO₂ 52 mmHg
C. HCO₃⁻ 24 mEq/L
D. PaO₂ 65 mmHg
Answer: C
Rationale: Normal HCO₃⁻ is approximately 22–26 mEq/L.
A patient has the following laboratory results:
Which interpretation is most appropriate?
A. The results indicate normal renal function.
B. The results suggest impaired kidney function.
C. The results indicate the need for emergent dialysis.
D. The results indicate dehydration only.
Answer: B
Rationale: Elevated BUN and creatinine with a GFR below 60 mL/min suggest impaired renal function. There is not enough information given to decipher if emergent dialysis or just dehydration is the issue.
5. The nurse is caring for a patient with a platelet count of 75,000/µL. Which intervention is most appropriate?
A. Prepare to transfuse a unit of platelets
B. Use bleeding precautions
C. Encourage foods high in potassium
D. Administer aspirin as prescribed
Answer: B
Rationale: A platelet count below 150,000/µL indicates thrombocytopenia and increases bleeding risk. We typically do not transfuse until 10,000-20,000/µL.
A patient may still get their prescribed aspirin depending on their condition. Contact the provider to confirm.
A patient presents to the emergency department with sudden shortness of breath and pleuritic chest pain. The provider orders a D-dimer. The patient's result is 1.2 µg/mL. How should the nurse interpret this result?
A. The result is within the expected range.
B. The result indicates adequate clotting function.
C. The result is elevated and may indicate clot formation.
D. The result confirms the presence of a pulmonary embolism.
Answer: C. The result is elevated and may indicate clot formation.
Rationale: The provided normal D-dimer is <0.5 µg/mL. An elevated D-dimer can occur with clot formation, but it is not specific enough to confirm a pulmonary embolism by itself.
27. A nurse is reviewing the following laboratory results for a patient admitted with weakness and confusion:
Which laboratory abnormality is the nurse's priority?
A. Sodium
B. Potassium
C. Calcium
D. Creatinine
Answer: A
Rationale: A sodium of 122 mEq/L represents significant hyponatremia. Severe hyponatremia can cause neurologic manifestations, including confusion and seizures.
13. A patient has an ABG showing:
Which condition does the nurse identify?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: B
Rationale: The pH is elevated (alkalosis) and the PaCO₂ is decreased, indicating a respiratory cause.
Which laboratory findings could indicate impaired renal function? Select all that apply.
A. BUN 35 mg/dL
B. Creatinine 2.1 mg/dL
C. GFR 40 mL/min
D. Creatinine 0.8 mg/dL
E. BUN 12 mg/dL
Answers: A, B, C
Blood Urea Nitrogen (BUN) (7-20 mg/dL): Creatinine (0.6-1.3 mg/dL): Glomerular Filtration Rate (GFR) (>60 mL/min)
14. The nurse is reviewing a patient's CBC. Which laboratory values are components of a CBC? Select all that apply.
A. Hemoglobin
B. Platelets
C. WBC count
D. PT
E. Hematocrit
F. INR
Answers: A, B, C, E
Rationale: A CBC evaluates blood cells and includes WBCs, RBCs, hemoglobin, hematocrit, and platelets.
PT and INR are coag labs and would be in a blue citrate top.
A patient has a PT of 19 seconds and an INR of 4.2. Which nursing action is the priority?
A. Encourage the patient to increase consumption of green leafy foods.
B. Assess the patient for signs of bleeding.
C. This is a normal finding on warfarin.
D. Administer the next dose of SQ heparin as scheduled to prevent a DVT.
Answer: B. Assess the patient for signs of bleeding.
Rationale: The PT and INR are significantly elevated compared with the provided normal ranges. An elevated INR increases the patient's risk for bleeding. The nurse should assess for bleeding and follow facility/provider protocols regarding anticoagulant therapy.
18. The nurse receives laboratory results for four patients. Which patient should the nurse assess first?
A. Patient with a sodium of 132 mEq/L
B. Patient with a hemoglobin of 10.5 g/dL
C. Patient with a potassium of 6.4 mEq/L
D. Patient with a platelet count of 135,000/µL
Answer: C
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias and requires immediate attention.
24. A patient has a urine specific gravity of 1.035. What does this result suggest?
A. Very dilute urine
B. Urine concentration above the expected range
C. Normal urine concentration
D. Complete inability of the kidneys to concentrate urine
Answer: B
Rationale: The provided expected range is 1.010–1.030. A value of 1.035 is elevated and may be associated with concentrated urine/dehydration.
Which laboratory values are associated with liver function? And what lab panel would be ordered? Select all that apply.
A. AST
B. ALT
C. Bilirubin
D. Albumin
E. Troponin
Answers: A, B, C, D
Liver function panel needs to be ordered.
17. Which findings would the nurse associate with increased bleeding risk? Select all that apply.
A. Platelets 80,000/µL
B. INR 4.5
C. Platelets 250,000/µL
D. Prolonged PT
E. Hemoglobin 8 g/dL
Answers: A, B, D
Hemoglobin may be low but it does not indicate that they are necessarily at an increase risk for bleeding.
30. The nurse is prioritizing assessment of patients based on laboratory results. Which patient requires the most immediate follow-up?
A. Patient with BNP 150 pg/mL and mild peripheral edema
B. Patient with WBC 13,000/µL and a temperature of 38.2°C
C. Patient with potassium 6.8 mEq/L and new cardiac palpitations
D. Patient with triglycerides 220 mg/dL and no symptoms
Answer: C
Rationale: Severe hyperkalemia combined with cardiac symptoms creates an immediate risk for life-threatening dysrhythmias.
Lipid Panel
25. Which laboratory result would the nurse identify as desirable?
A. LDL 165 mg/dL
B. Triglycerides 210 mg/dL
C. Total cholesterol 185 mg/dL
D. HDL 32 mg/dL
Answer: C