Exam 1- NSG 535 Questions With Complete Solutions
2 hour plasma glucose Correct Answers -75g oral glucose
tolerance test
-greater than or equal to 200 = diabetes
A1C targets for pts w/ DM Correct Answers -individualized
-goal to avoid hypoglycemic episodes w/ too stringent of control
-health adult <7.5%
-older adults w/ comorbid conditions 8-8.5%
-children <7%
-children who are nonverbal <7.5%
-pregnancy <6%
Abnormal TT Correct Answers >Prolonged:
-afibrinogenmeia (too little fibrin) / fibrinogen deficiency
-heparin
-dysfirbinogenemia- abnormal fibrinogen
-presence of FDPs
>Shortened:
-Valproate- seizure meds
-anabolic steroid
Acute blood loss CBC findings Correct Answers >RBC = dec
>Hgb = dec
>Hct = normla or dec or inc
>MCV = eventually dec but normal at first
>MCH = eventually dec but normal at first
>MCHC= eventually dec but normal at first
>reticulocytes = increased
,Aldosterone deficiency Correct Answers -aldosterone is
released form the adrenal gland to increases resorption of Na &
H20
-renal Na exchange is decreased resulting in decreased serum
Na, inc Serum L & urine w/ more Na In it than normal
-urine osmolarity is increased as well
-Addison's disease
ALT & AST levels Correct Answers -levels >1000 -->
extensive hepatocellular injury (viral hepatitis, ischemic liver
disease, drug or toxin induced)
>ACUTE hepatocellular damage: ALT > AST
>Alcoholic liver disease: AST:ALT >2:1 (suggestive); >3:1
(highly suggestive)
Amylase Correct Answers -digestive enzyme
-aids in hydrolysis of starch into sugars
-main sources are the pancreas and salivary glands
Anemia Correct Answers -reduced RBC, dec Hgb, reduced Hct
-results in reduction in the O2 carrying capacity of the blood
resulting in hypoxia
-Males Hgb <13.5 or Hct <41%; females Hgb <12 or Hct <36%
-is not always primary disease
-general causes: poor or inadequate cell production (d/t
deficiency of cofactors), poor cell survival (hemolysis), blood
loss
Anemia of chronic disease Correct Answers -usually
normocytic (can be microcytic)
,>Mechanisms
-dysregulation of Fe homeostasis; low serum Fe in face of
normal Fe stores or down regulation of Fe release form storage
-Hepcidin- acute phase reactant that blocks Fe update from gut
& release from storage; can be increased in stressed states
-inhibited erythropoiesis by inflammatory substances
Anemia of chronic disease CBC findings Correct Answers
>RBC = dec
>Hgb = dec
>Hct = dec
>MCV = normal or dec
>MCH = normal or dec
>MCHC= normal or dec
>reticulocytes = normal or dec
>serum Fe = dec
>TIBC = dec
>ferritin = normal
Anemia studies Correct Answers -ordered for specific sx,
routine screens
-help tell: if anemia is present, what type & likely causes
-CBC w/ diff
--then other studies depending on anemia
Anemias d/t membrane defects Correct Answers -
microangiopathic anemias & hemolysis caused by RBC trauma
-damaged & fragmented red cells: DIC, prosthetic heart valve
replacement, long distance runners, extensive burns
, Anion Gap Correct Answers -difference between measured &
unmeasured ions
-an increased gap indicates the presence of an abundance of
unmeasured ions
-helps determine if an acidosis is d/t an abundance of acids we
don't routinely have (lactic acid)
-Na, K, Cl, & HCO3 all play a role in ionic balance
-acidosis is either high or normal anion gap
-low anion gap is rare & can occur from presence of excess
positively charged proteins like MM
Anion Gap Acidosis Correct Answers -ketones are unmeasured
anions
Anion Gap level Correct Answers -normal 12-18 mEq/L w/out
K in equation
AG = (Na + K) - (Cl+CO2)
-increased when there are increased unmeasured anions
Antifactor Xa assay Correct Answers -used in patients on low
molecular weight heparin w/ risk factors: obese, renal failure,
young children, pregnant women, or those w/ bleeding or clot
risk labs
-LMWH has very short half life
-measure this lab 3-5 hr after administration
Antithyroid Antibodies (TgAb) Correct Answers -antithyroid
antibodies: TSH receptor antibodies; immunoglobulins that bind
to TSH receptors & cause stimulation or inhibition
2 hour plasma glucose Correct Answers -75g oral glucose
tolerance test
-greater than or equal to 200 = diabetes
A1C targets for pts w/ DM Correct Answers -individualized
-goal to avoid hypoglycemic episodes w/ too stringent of control
-health adult <7.5%
-older adults w/ comorbid conditions 8-8.5%
-children <7%
-children who are nonverbal <7.5%
-pregnancy <6%
Abnormal TT Correct Answers >Prolonged:
-afibrinogenmeia (too little fibrin) / fibrinogen deficiency
-heparin
-dysfirbinogenemia- abnormal fibrinogen
-presence of FDPs
>Shortened:
-Valproate- seizure meds
-anabolic steroid
Acute blood loss CBC findings Correct Answers >RBC = dec
>Hgb = dec
>Hct = normla or dec or inc
>MCV = eventually dec but normal at first
>MCH = eventually dec but normal at first
>MCHC= eventually dec but normal at first
>reticulocytes = increased
,Aldosterone deficiency Correct Answers -aldosterone is
released form the adrenal gland to increases resorption of Na &
H20
-renal Na exchange is decreased resulting in decreased serum
Na, inc Serum L & urine w/ more Na In it than normal
-urine osmolarity is increased as well
-Addison's disease
ALT & AST levels Correct Answers -levels >1000 -->
extensive hepatocellular injury (viral hepatitis, ischemic liver
disease, drug or toxin induced)
>ACUTE hepatocellular damage: ALT > AST
>Alcoholic liver disease: AST:ALT >2:1 (suggestive); >3:1
(highly suggestive)
Amylase Correct Answers -digestive enzyme
-aids in hydrolysis of starch into sugars
-main sources are the pancreas and salivary glands
Anemia Correct Answers -reduced RBC, dec Hgb, reduced Hct
-results in reduction in the O2 carrying capacity of the blood
resulting in hypoxia
-Males Hgb <13.5 or Hct <41%; females Hgb <12 or Hct <36%
-is not always primary disease
-general causes: poor or inadequate cell production (d/t
deficiency of cofactors), poor cell survival (hemolysis), blood
loss
Anemia of chronic disease Correct Answers -usually
normocytic (can be microcytic)
,>Mechanisms
-dysregulation of Fe homeostasis; low serum Fe in face of
normal Fe stores or down regulation of Fe release form storage
-Hepcidin- acute phase reactant that blocks Fe update from gut
& release from storage; can be increased in stressed states
-inhibited erythropoiesis by inflammatory substances
Anemia of chronic disease CBC findings Correct Answers
>RBC = dec
>Hgb = dec
>Hct = dec
>MCV = normal or dec
>MCH = normal or dec
>MCHC= normal or dec
>reticulocytes = normal or dec
>serum Fe = dec
>TIBC = dec
>ferritin = normal
Anemia studies Correct Answers -ordered for specific sx,
routine screens
-help tell: if anemia is present, what type & likely causes
-CBC w/ diff
--then other studies depending on anemia
Anemias d/t membrane defects Correct Answers -
microangiopathic anemias & hemolysis caused by RBC trauma
-damaged & fragmented red cells: DIC, prosthetic heart valve
replacement, long distance runners, extensive burns
, Anion Gap Correct Answers -difference between measured &
unmeasured ions
-an increased gap indicates the presence of an abundance of
unmeasured ions
-helps determine if an acidosis is d/t an abundance of acids we
don't routinely have (lactic acid)
-Na, K, Cl, & HCO3 all play a role in ionic balance
-acidosis is either high or normal anion gap
-low anion gap is rare & can occur from presence of excess
positively charged proteins like MM
Anion Gap Acidosis Correct Answers -ketones are unmeasured
anions
Anion Gap level Correct Answers -normal 12-18 mEq/L w/out
K in equation
AG = (Na + K) - (Cl+CO2)
-increased when there are increased unmeasured anions
Antifactor Xa assay Correct Answers -used in patients on low
molecular weight heparin w/ risk factors: obese, renal failure,
young children, pregnant women, or those w/ bleeding or clot
risk labs
-LMWH has very short half life
-measure this lab 3-5 hr after administration
Antithyroid Antibodies (TgAb) Correct Answers -antithyroid
antibodies: TSH receptor antibodies; immunoglobulins that bind
to TSH receptors & cause stimulation or inhibition
