Laboratory Studies

The nurse is caring for a 48-year-old male patient who is receiving 20 mg of furosemide (Lasix) OD. Which information is most important to tell the oncoming nurse?

Which test is most helpful to diagnose kidney failure?

The patient presents with diffuse maculopapular rash, fever, myalgia, arthralgia and headache. The patient reports several tick bites after hiking two weeks ago, which prompts the provider to suspect Rocky Mountain spotted fever (RMSF). Which test confirms the diagnosis?

The nurse asks a patient to provide a urine sample for a urine culture. When the nurse returns 3 hours later, the patient says the urine sample has been sitting by the bed for the last 2 hours. Which action by the nurse is appropriate?

The patient is found to have 4 g/dL protein in the 24-hour urine collection. This result indicates which condition? 

The nurse is providing dietary education to a patient with nephrotic syndrome. Which dietary change does the nurse counsel the patient to make?

The patient who resides in a long term care facility is admitted to the hospital for an acute decrease in level of consciousness, confusion, and dehydration due to anorexia. The patient’s arterial blood gas, temperature, heart rate, respiratory rate, breath sounds, and bowel sounds are all within normal limits. The nurse anticipates which diagnosis?

The patient with signs of sepsis was started on a broad spectrum antibiotic. The patient's blood culture has grown gram-positive cocci in clusters resistant to penicillin but susceptible to methicillin. Which antibiotic is appropriate?

The nurse is preparing to draw blood from a patient who requires multiple laboratory tests. Which lab does the nurse draw first?

The patient receiving thyroid supplementation for hypothyroidism reports insomnia, fatigue, tachycardia, and headache. Which statement by the nurse is appropriate?

The patient receiving levothyroxine for hypothyroidism reports treatment failure after the third dose increase. The nurse anticipates the provider to order which test for this patient?

Which lab value is consistent with acute disseminated intravascular coagulopathy (DIC)?

The patient with von Willebrand disease has a fibrinogen level of 68 mg/dL. The nurse anticipates administering which blood product?

The premature neonate with severe intrauterine growth restriction is being evaluated for possible in utero TORCH organism exposure. The nurse obtains lab specimens to test for which organisms? Select all that apply.

Which is the most appropriate patient assignment to assign to an unlicensed assistive personnel (UAP)?

The nurse is supervising the care of a diabetic patient with stomach cancer. After surgery, the patient is placed on total parenteral nutrition (TPN). Which information does the nurse provide the nursing student about the TPN?

The patient with chronic malnourishment is started on total parenteral nutrition (TPN). The nurse is vigilant for signs of which complication?

A patient comes into the ER with HR 122 bpm, BP 110/72 mm Hg, Temp 99.4 F, and RR 22. They report a racing feeling in their heart and have also been experiencing diarrhea for the last several months. Which lab result does the nurse anticipate?

Which lab value is most concerning for a patient who is being treated for hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?

The patient with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine (AZT). The nurse requests an order for which lab test to monitor adverse effects of the drug?

The nurse is collecting a urine specimen from a 44-year-old woman with dysuria. Which instructions does the nurse provide to the patient? Select all that apply.

The nurse is assigned to care for a patient who presents with fever, chills, lethargy, and sore throat. Past medical history is significant for schizophrenia diagnosed three months ago for which clozapine was prescribed. Which additional laboratory finding does the nurse expect to see in this patient?

The nurse is taking care of a patient who is prescribed chloramphenicol. After three days, the patient develops fatigue and dyspnea on exertion. Physical assessment reveals tachycardia, pallor and multiple petechiae on the trunk and extremities. The nurse anticipates which laboratory result(s)?

The nurse is assigned to a 38-year-old patient who presents with polydipsia and polyuria. Past medical history is significant for bipolar disorder diagnosed two months ago, for which the patient was prescribed lithium. The nurse anticipates further testing will reveal which condition? 

The 17-year-old pregnant female patient presents for her first prenatal visit. The nurse plans care based on which understanding of recommended screening?

The 23-year-old G1P0 patient who is 14 weeks pregnant presents to the emergency department with weakness and lethargy due to intractable nausea and vomiting. The patient has lost approximately 7% of pre-pregnancy weight. The nurse is aware the patient's symptoms are due to excess production of which hormone(s)? Select all that apply.

A 23-year-old pregnant woman presents to the clinic stating, “I am a teacher and have heard there is a measles outbreak in my community. I want to get the measles vaccine to protect my baby and myself. Which response by the nurse is most appropriate?

The patient complains of heart palpitations. The nurse understands which lab result is responsible for the patient's symptoms?

The 31-week-gestation woman is brought to the emergency department after being struck in the abdomen when the airbags deployed during a motor vehicle accident. Initial screening labs reveal the mother is blood type A-. The nurse advocates for which additional lab to assess the status of the pregnancy?

The nurse is performing an assessment of an infant born 8 hours ago. The infant’s POC blood glucose level is 25 mg/dL. Which action does the nurse take first?

The nurse is caring for the patient with intestinal obstruction who is receiving total parenteral nutrition (TPN). The nurse reviews which lab results to ensure the patient is tolerating the infusion? Select all that apply. 

The patient with angina is experiencing crushing chest pain but the ECG shows no abnormalities. Which lab result indicates the patient is experiencing a non-ST segment elevation myocardial infarction (NSTEMI)? 

The nurse reviews the woman’s complete blood count (CBC) and finds the red blood cell count is 3.9 million cells per microliter. The nurse suspects the patient will be diagnosed with which condition?

The patient with diabetes is brought to the emergency department with severe confusion and is unable to follow commands. A point-of-care (POC) glucose measurement reveals a blood sugar of 44 g/dL. The nurse begins a 50 mL infusion of D50W. Which action does the nurse take next?

The 34-week-gestation neonate is born weighing 1.7 kg to a mother who is hepatitis B surface antigen (HBsAg) positive; all other infectious disease serologies are negative. Which orders are appropriate for this patient? Select all that apply.

The 1.9 kg neonate is born precipitously via vaginal delivery to a 32-year-old mother who received no prenatal care or infectious disease serology testing before delivery. The mother has a history of intravenous drug use. Which intervention does the nurse perform first?

The 19-year-old patient tells the nurse, “I was reviewing my vaccination records for school and noted I never received the varicella vaccination.” Which response by the nurse is most appropriate?

The 10-year-old female patient’s mother brings her to the clinic for a check-up and immunizations and requests that she receives the human papillomavirus (HPV) vaccination. Which question does the nurse ask first?

The 18-year-old healthy female presents to the clinic requesting to receive the vaccinations her mother refused for her when she was a child. Reviewing the chart, the nurse notes the patient never received the measles, mumps, rubella (MMR) vaccine. Prior to administering the vaccination, which test is most important?

The 7-year-old child with pica is brought to the emergency room (ER) with decreased level of consciousness after ingesting lead paint. His blood lead level (BLL) is determined to be 72 mcg/dL. The nurse prepares to administer which medication?

Which urinalysis findings support the diagnosis of shock in the hypotensive patient? Select all that apply.

Which information does the nurse include in patient teaching about cholesterol testing? Select all that apply.

Hemolytic anemia can have which etiologies? Select all that apply.

The patient with a lung mass that was discovered on imaging is scheduled for a flexible bronchoscopy. Which nursing action is appropriate to prepare the patient for the procedure?

Which lab result is expected in the patient with acute disseminated intravascular coagulation (DIC)?

The patient intubated in the intensive care unit has the following arterial blood gas results: pH 7.21 PCO2 51 PaO2 38 HCO3 16 Base Excess -7 Which action does the nurse take first?

Which arterial blood gas result is most indicative that the intubated and mechanically ventilated patient is ready to have the ventilator rate weaned?

The patient’s arterial blood gas and serum electrolyte results are as follows: pH 7.28, PCO2 = 32, PaO2 = 59, HCO3- = 16, SaO2 = 88%, Sodium = 149, Potassium 3.9, Chloride 112. Calculate this patient’s anion gap. Enter your answer using a whole number.

The patient with metabolic acidosis is determined to have an anion gap of 11 mmol/L. The nurse advocates for which additional lab test?

The 56-year-old intubated and sedated patient’s arterial blood gas results are as follows: pH = 7.25, PCO2 = 36, PaO2 = 50, HCO3- = 15, SaO2 = 86%. Other lab values are notable for a hemoglobin of 7.9 mg/dL, albumin of 2.5 g/dL, sodium of 152 mEq/L, potassium of 2.1 mEq/L, chloride of 118 mEq/L. Vital signs are notable for a heart rate of 118 bpm, blood pressure of 86/38 mmHg, temperature of 102°F, and pulse oximetry of 85% on room air. The nurse advocates for which order?