NR 155 EXAM 2 (CHAPTER 34) STUDY GUIDE
The nurse is caring for a patient who has diabetes. The patient reports compliance with
the medical regime. Which test result indicates to the nurse that the patient has not
been compliant with the treatment plan?
a. Hemoglobin A1c 16%
b. Random blood sugar (RBS) 112 mg/dL
c. Lactate dehydrogenase (LDH) 55 units/L
d. Erythrocyte sedimentation rate (ESR) 14 mm/hr - ANSWER ANS: A
Hemoglobin A1c (Hgb A1c), or glycosylated hemoglobin, testing evaluates blood sugar
levels over a period of 2 to 3 months This blood test is performed to provide the primary
care provider (PCP) with information about long-term blood sugar control. The normal
value of Hgb A1c in patients without diabetes is 4% to 5.9%. The American Diabetes
Association (2016) states that diabetes is diagnosed for Hgb A1c levels greater than
6.5%. A higher level indicates that the patient has had poor blood glucose control during
the past few weeks, and increases the patient's risk of long-term complications from
hyperglycemia. The other tests are not related to long-term diabetes control.
The nurse is caring for an elderly patient with dementia. Which laboratory finding
indicates to the nurse that that patient is often forgetting to eat meals?
a. Serum bilirubin 0.4 mg/dL
b. PLT (platelet count) 425,000/mm3
c. Serum cholesterol 175 mg/dL
d. Albumin 1.4 g/dL - ANSWER ANS: D
Albumin level is an indicator of the patient's protein intake and nutritional status. Normal
albumin level is 3.3 to 5 g/dL. It is an essential component of fluid balance, responsible
for maintaining colloidal oncotic pressure in the vascular and extravascular spaces.
Low levels of albumin may indicate malnutrition.
The nurse is caring for a patient who has a deep leg wound that is badly infected. Which
laboratory test results will the nurse expect to find in the patient's chart?
a. Elevated C-reactive protein (CRP) 6.5 mg/dL b. Decreased serum creatinine 0.8
mg/dL
c. Elevated serum bilirubin 0.5 mg/dL
d. Prothrombin time (PT) 11.5 sec - ANSWER ANS: A
, C-reactive protein (CRP) is produced by the liver in response to inflammation, tissue
damage, and infection. Blood levels of CRP have been used as a marker for
inflammatory and autoimmune disorders. The nurse would expect to see an elevated
CRP in a patient with an infected wound. Creatinine is an indicator of kidney function,
and bilirubin is an indicator of liver function. Prothrombin time indicates clotting ability
of the blood, particularly when the patient is taking warfarin (Coumadin).
The nurse is caring for a patient who has a bleeding gastric ulcer. How will the nurse
expect the patient's stool to appear?
a. Soft and formed with bright red streaks
b. Watery with particles of undigested food
c. Sticky and black
d. Hard lumps that are difficult to pass - ANSWER ANS: C
Bleeding anywhere along the GI tract results in blood in the stool. Bleeding that occurs
in the upper GI tract produces stools that are black and tarry in appearance. Bleeding
within the lower GI tract presents with soft stools that have bright red streaks. Watery
stool with particles of food is indicative of gastroenteritis. Hard lumps that are difficult
to pass indicate constipation, often from medications or lack of fiber in the diet.
The nurse is caring for a patient who is to have a noncontrast MRI scan performed.
Which assessment finding leads the nurse to report that the patient may not be able to
have the test?
a. The patient has an implanted insulin pump. b. The patient is breastfeeding her
newborn infant.
c. The patient is severely allergic to iodine and latex.
d. The patient has profound hearing loss. - ANSWER ANS: A
Any metal implants are a contraindication for an MRI scan because the scan uses
powerful magnets. Insulin pumps often contain metal that can react with the strong
magnets in the MRI machine. Breastfeeding is not a contraindication to MRI because
there is no radiation exposure. No latex or iodine is used during MRI testing. Profound
hearing loss will not be a problem, although MRI scanning is very loud.
The nurse is caring for a patient who has had severe acid reflux. Which test will allow
the physician to directly check for damage to the esophagus?
a. Esophagogastroduodenoscopy (EGD)
b. MRIscan with contrast
c. Abdominal ultrasound
The nurse is caring for a patient who has diabetes. The patient reports compliance with
the medical regime. Which test result indicates to the nurse that the patient has not
been compliant with the treatment plan?
a. Hemoglobin A1c 16%
b. Random blood sugar (RBS) 112 mg/dL
c. Lactate dehydrogenase (LDH) 55 units/L
d. Erythrocyte sedimentation rate (ESR) 14 mm/hr - ANSWER ANS: A
Hemoglobin A1c (Hgb A1c), or glycosylated hemoglobin, testing evaluates blood sugar
levels over a period of 2 to 3 months This blood test is performed to provide the primary
care provider (PCP) with information about long-term blood sugar control. The normal
value of Hgb A1c in patients without diabetes is 4% to 5.9%. The American Diabetes
Association (2016) states that diabetes is diagnosed for Hgb A1c levels greater than
6.5%. A higher level indicates that the patient has had poor blood glucose control during
the past few weeks, and increases the patient's risk of long-term complications from
hyperglycemia. The other tests are not related to long-term diabetes control.
The nurse is caring for an elderly patient with dementia. Which laboratory finding
indicates to the nurse that that patient is often forgetting to eat meals?
a. Serum bilirubin 0.4 mg/dL
b. PLT (platelet count) 425,000/mm3
c. Serum cholesterol 175 mg/dL
d. Albumin 1.4 g/dL - ANSWER ANS: D
Albumin level is an indicator of the patient's protein intake and nutritional status. Normal
albumin level is 3.3 to 5 g/dL. It is an essential component of fluid balance, responsible
for maintaining colloidal oncotic pressure in the vascular and extravascular spaces.
Low levels of albumin may indicate malnutrition.
The nurse is caring for a patient who has a deep leg wound that is badly infected. Which
laboratory test results will the nurse expect to find in the patient's chart?
a. Elevated C-reactive protein (CRP) 6.5 mg/dL b. Decreased serum creatinine 0.8
mg/dL
c. Elevated serum bilirubin 0.5 mg/dL
d. Prothrombin time (PT) 11.5 sec - ANSWER ANS: A
, C-reactive protein (CRP) is produced by the liver in response to inflammation, tissue
damage, and infection. Blood levels of CRP have been used as a marker for
inflammatory and autoimmune disorders. The nurse would expect to see an elevated
CRP in a patient with an infected wound. Creatinine is an indicator of kidney function,
and bilirubin is an indicator of liver function. Prothrombin time indicates clotting ability
of the blood, particularly when the patient is taking warfarin (Coumadin).
The nurse is caring for a patient who has a bleeding gastric ulcer. How will the nurse
expect the patient's stool to appear?
a. Soft and formed with bright red streaks
b. Watery with particles of undigested food
c. Sticky and black
d. Hard lumps that are difficult to pass - ANSWER ANS: C
Bleeding anywhere along the GI tract results in blood in the stool. Bleeding that occurs
in the upper GI tract produces stools that are black and tarry in appearance. Bleeding
within the lower GI tract presents with soft stools that have bright red streaks. Watery
stool with particles of food is indicative of gastroenteritis. Hard lumps that are difficult
to pass indicate constipation, often from medications or lack of fiber in the diet.
The nurse is caring for a patient who is to have a noncontrast MRI scan performed.
Which assessment finding leads the nurse to report that the patient may not be able to
have the test?
a. The patient has an implanted insulin pump. b. The patient is breastfeeding her
newborn infant.
c. The patient is severely allergic to iodine and latex.
d. The patient has profound hearing loss. - ANSWER ANS: A
Any metal implants are a contraindication for an MRI scan because the scan uses
powerful magnets. Insulin pumps often contain metal that can react with the strong
magnets in the MRI machine. Breastfeeding is not a contraindication to MRI because
there is no radiation exposure. No latex or iodine is used during MRI testing. Profound
hearing loss will not be a problem, although MRI scanning is very loud.
The nurse is caring for a patient who has had severe acid reflux. Which test will allow
the physician to directly check for damage to the esophagus?
a. Esophagogastroduodenoscopy (EGD)
b. MRIscan with contrast
c. Abdominal ultrasound
