FISCHBACH'S A MANUAL OF
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
1)
Reference
Ch. 1 — Diagnostic Testing
Stem
A 62-year-old male is scheduled for routine metabolic blood
work. He reports he ate breakfast 45 minutes ago. The nurse
reviews the order and sees "fasting basic metabolic panel
(BMP)." The most appropriate immediate nursing action is to:
A. Proceed with blood draw immediately; fasting is not required
for BMP.
B. Document the patient is not fasting, proceed, and note
,nonfasting on the lab form.
C. Cancel the order and reschedule the BMP for another day
without notifying the provider.
D. Obtain the blood sample and request the lab to adjust
reference ranges for nonfasting samples.
Correct answer
B
Rationales
Correct (B): Many chemistry tests (including components of the
BMP) require fasting for accurate interpretation. If the patient is
not fasting, the correct nursing action is to proceed if clinically
necessary but document nonfasting status so the provider and
laboratory can correctly interpret results or reorder if needed.
This aligns with pretest responsibilities described in Ch. 1.
Incorrect (A): Fasting can affect glucose and lipid-related values;
assuming fasting is unnecessary is erroneous.
Incorrect (C): Canceling without provider notification could
delay care; rescheduling requires provider input and patient
agreement.
Incorrect (D): Laboratories do not “adjust” reference ranges on
a per-sample basis; documentation of nonfasting is the correct
step for interpretation.
Teaching point
Always document patient fasting status; nonfasting samples
must be clearly noted.
,Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
2)
Reference
Ch. 1 — Diagnostic Testing
Stem
A 4-year-old child requires a capillary fingerstick glucose
measurement. The child was crying vigorously for 10 minutes
just before the sample was obtained; the result is 210 mg/dL
(11.7 mmol/L). Which interpretation or action is most
appropriate?
A. Report the result as hyperglycemia and call the provider
immediately for insulin.
B. Recognize stress and sample technique may falsely elevate
capillary glucose; repeat after calming.
C. Discard the result because capillary glucose is never reliable
in children.
D. Treat for hypoglycemia because crying can cause lower
glucose in fingerstick samples.
Correct answer
B
Rationales
Correct (B): Stress, poor technique, and increased local blood
, flow can affect capillary glucose results. Repeating the
measurement after the child is calm or obtaining a confirmatory
venous sample is appropriate before urgent treatment.
Incorrect (A): Immediate treatment for hyperglycemia (e.g.,
insulin) based on a single stressed capillary value is
inappropriate without confirmation.
Incorrect (C): Capillary glucose testing is useful in children but
requires correct technique and consideration of confounders.
Incorrect (D): Crying typically does not produce falsely low
capillary glucose; if anything, stress can transiently raise
glucose.
Teaching point
Capillary glucose can be affected by stress and technique—
confirm unexpected values.
Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
3)
Reference
Ch. 1 — Diagnostic Testing
Stem
A patient’s blood sample for potassium returns hemolyzed with
a reported value of 6.2 mEq/L. The patient is asymptomatic and
has no ECG changes. Which is the best nursing action?
LABORATORY AND DIAGNOSTIC TESTS.
11TH EDITION
• AUTHOR(S)FRANCES FISCHBACH;
MARGARET FISCHBACH; KATE STOUT
TESTBANKS
1)
Reference
Ch. 1 — Diagnostic Testing
Stem
A 62-year-old male is scheduled for routine metabolic blood
work. He reports he ate breakfast 45 minutes ago. The nurse
reviews the order and sees "fasting basic metabolic panel
(BMP)." The most appropriate immediate nursing action is to:
A. Proceed with blood draw immediately; fasting is not required
for BMP.
B. Document the patient is not fasting, proceed, and note
,nonfasting on the lab form.
C. Cancel the order and reschedule the BMP for another day
without notifying the provider.
D. Obtain the blood sample and request the lab to adjust
reference ranges for nonfasting samples.
Correct answer
B
Rationales
Correct (B): Many chemistry tests (including components of the
BMP) require fasting for accurate interpretation. If the patient is
not fasting, the correct nursing action is to proceed if clinically
necessary but document nonfasting status so the provider and
laboratory can correctly interpret results or reorder if needed.
This aligns with pretest responsibilities described in Ch. 1.
Incorrect (A): Fasting can affect glucose and lipid-related values;
assuming fasting is unnecessary is erroneous.
Incorrect (C): Canceling without provider notification could
delay care; rescheduling requires provider input and patient
agreement.
Incorrect (D): Laboratories do not “adjust” reference ranges on
a per-sample basis; documentation of nonfasting is the correct
step for interpretation.
Teaching point
Always document patient fasting status; nonfasting samples
must be clearly noted.
,Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
2)
Reference
Ch. 1 — Diagnostic Testing
Stem
A 4-year-old child requires a capillary fingerstick glucose
measurement. The child was crying vigorously for 10 minutes
just before the sample was obtained; the result is 210 mg/dL
(11.7 mmol/L). Which interpretation or action is most
appropriate?
A. Report the result as hyperglycemia and call the provider
immediately for insulin.
B. Recognize stress and sample technique may falsely elevate
capillary glucose; repeat after calming.
C. Discard the result because capillary glucose is never reliable
in children.
D. Treat for hypoglycemia because crying can cause lower
glucose in fingerstick samples.
Correct answer
B
Rationales
Correct (B): Stress, poor technique, and increased local blood
, flow can affect capillary glucose results. Repeating the
measurement after the child is calm or obtaining a confirmatory
venous sample is appropriate before urgent treatment.
Incorrect (A): Immediate treatment for hyperglycemia (e.g.,
insulin) based on a single stressed capillary value is
inappropriate without confirmation.
Incorrect (C): Capillary glucose testing is useful in children but
requires correct technique and consideration of confounders.
Incorrect (D): Crying typically does not produce falsely low
capillary glucose; if anything, stress can transiently raise
glucose.
Teaching point
Capillary glucose can be affected by stress and technique—
confirm unexpected values.
Citation
Fischbach, F., Fischbach, M., & Stout, K. (2021). A Manual of
Laboratory and Diagnostic Tests (11th ed.). Ch. 1.
3)
Reference
Ch. 1 — Diagnostic Testing
Stem
A patient’s blood sample for potassium returns hemolyzed with
a reported value of 6.2 mEq/L. The patient is asymptomatic and
has no ECG changes. Which is the best nursing action?
