NCLEX LAB questions-Laboratory Values Exam with || || || || || ||
verified detailed solutions || ||
A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium
|| || || || || || || || || || || || ||
(Coumadin) has a prothrombin time (PT) of 35 seconds. On the basis of the PT, the nurse|| || || || || || || || || || || || || || || || ||
anticipates which prescription? || ||
1. Adding a dose of heparin sodium
|| || || || || ||
2. Holding the next dose of warfarin
|| || || || || ||
3. Increasing the next dose of warfarin
|| || || || || ||
4. Administering the next dose of warfarin - ✔✔2. Rationale- The normal PT is 9.6 to 11.8
|| || || || || || || || || || || || || || || || ||
seconds (male adult) or 9.5 to 11.3 seconds (female adult). A therapeutic PT level is 1.5 to 2 times
|| || || || || || || || || || || || || || || || || || ||
higher than the normal level. Because the value of 35 seconds is high ( and perhaps near the
|| || || || || || || || || || || || || || || || || ||
critical range), the nurse should anticipate that the client would not receive further doses at this
|| || || || || || || || || || || || || || || ||
time. Therefore the prescription noted in the remaining options are incorrect.
|| || || || || || || || || ||
The nurse checks the laboratory result for a serum digoxin level that was prescribed for a client
|| || || || || || || || || || || || || || || || ||
earlier in the day and notes that the result is 2.4 ng/mL. The nurse should take which immediate
|| || || || || || || || || || || || || || || || || ||
action?
1. Check the client's last pulse rate
|| || || || || ||
2. Notify the health care provider
|| || || || ||
3. Record the normal value on the client's flow sheet
|| || || || || || || || ||
4. Administer the next dose of the medication as scheduled - ✔✔2.Rationale- The normal
|| || || || || || || || || || || || || ||
therapeutic range for digoxin is 0.5 to 2 ng/mL. A level of 2.4 ng/mL exceeds the therapeutic
|| || || || || || || || || || || || || || || || ||
range and indicates toxicity. The nurse should notify the HCP, who may give further prescriptions
|| || || || || || || || || || || || || || ||
about holding further doses of digoxin. The option that indicates to record the normal value on the
|| || || || || || || || || || || || || || || ||
client's flow sheet is incorrect because the level is not normal. The next dose should not be
|| || || || || || || || || || || || || || || || || ||
administered because the serum digoxin level exceeds the therapeutic range. Checking the client's || || || || || || || || || || || || ||
last pulse rate may have limited value in this situation. Depending on the time that has elapsed
|| || || || || || || || || || || || || || || || ||
since the last assessment, a current assessment of the client's status may be more useful.
|| || || || || || || || || || || || || ||
, A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse
|| || || || || || || || || || || || || || || ||
determines that the client has received adequate volume replacement if the blood urea nitrogen
|| || || || || || || || || || || || || ||
level drops to which value?|| || || ||
1. 3 mg/dL
|| ||
2. 15 mg/dL
|| ||
3. 29 mg/dL
|| ||
4. 35 mg/dL - ✔✔2. Rationale-The normal blood urea nitrogen level is 8 to 25 mg/dL. Values of
|| || || || || || || || || || || || || || || || || ||
29 mg/dL and 35 mg/dL reflect continued dehydration. A value of 3 mg/dL reflects a lower than
|| || || || || || || || || || || || || || || || ||
normal value, which may occur with fluid volume overload, among other conditions.
|| || || || || || || || || || ||
A client arrives in the emergency department complaining of chest pain that began 4 hours ago. A
|| || || || || || || || || || || || || || || || ||
troponin T blood specimen is obtained and the results indicate a level of 0.6 ng/mL. The nurse
|| || || || || || || || || || || || || || || || ||
determines that this result indicates which finding? || || || || || ||
1. A normal level
|| || || ||
2. A low value that indicates possible gastritis
|| || || || || || ||
3. A level that indicates a myocardial infarction
|| || || || || || ||
4. A level that indicates the presence of possible angina - ✔✔3. Rationale- Troponin is a
|| || || || || || || || || || || || || || || ||
regulatory protein found in striated muscle. The troponins function together in the contractile
|| || || || || || || || || || || || ||
apparatus for muscle in skeletal muscle and in the myocardium. Increased amounts of troponins
|| || || || || || || || || || || || || ||
are released into the bloodstream when an infarction causes damage to the myocardium. A
|| || || || || || || || || || || || || ||
troponin T value that is higher than 0.1 to 0.2 ng/mL is consistent with a myocardial infarction. A
|| || || || || || || || || || || || || || || || || ||
normal troponin I level is lower than 0.6 ng/mL.
|| || || || || || || ||
A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein
|| || || || || || || || || || || || || || ||
thrombosis. The client's activated partial thromboplasm (aPTT) time is 65 seconds. The nurse
|| || || || || || || || || || || || ||
anticipates that which action is needed? || || || || ||
1. Discontinuing the heparin infusion
|| || || || ||
2. Increasing the rate of the heparin infusion
|| || || || || || ||
3. Decreasing the rate of the heparin infusion
|| || || || || || ||
4. Leaving the rate of the heparin infusion as is - ✔✔4. Rationale- The normal aPTT varies
|| || || || || || || || || || || || || || || || ||
between 20 and 36 seconds, depending on the type of activator used in testing therapeutic dose of
|| || || || || || || || || || || || || || || || ||
heparin for treatment of deep vein thrombosis is to the keep the aPTT between 1.5 and 2.5 times
|| || || || || || || || || || || || || || || || || ||
verified detailed solutions || ||
A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium
|| || || || || || || || || || || || ||
(Coumadin) has a prothrombin time (PT) of 35 seconds. On the basis of the PT, the nurse|| || || || || || || || || || || || || || || || ||
anticipates which prescription? || ||
1. Adding a dose of heparin sodium
|| || || || || ||
2. Holding the next dose of warfarin
|| || || || || ||
3. Increasing the next dose of warfarin
|| || || || || ||
4. Administering the next dose of warfarin - ✔✔2. Rationale- The normal PT is 9.6 to 11.8
|| || || || || || || || || || || || || || || || ||
seconds (male adult) or 9.5 to 11.3 seconds (female adult). A therapeutic PT level is 1.5 to 2 times
|| || || || || || || || || || || || || || || || || || ||
higher than the normal level. Because the value of 35 seconds is high ( and perhaps near the
|| || || || || || || || || || || || || || || || || ||
critical range), the nurse should anticipate that the client would not receive further doses at this
|| || || || || || || || || || || || || || || ||
time. Therefore the prescription noted in the remaining options are incorrect.
|| || || || || || || || || ||
The nurse checks the laboratory result for a serum digoxin level that was prescribed for a client
|| || || || || || || || || || || || || || || || ||
earlier in the day and notes that the result is 2.4 ng/mL. The nurse should take which immediate
|| || || || || || || || || || || || || || || || || ||
action?
1. Check the client's last pulse rate
|| || || || || ||
2. Notify the health care provider
|| || || || ||
3. Record the normal value on the client's flow sheet
|| || || || || || || || ||
4. Administer the next dose of the medication as scheduled - ✔✔2.Rationale- The normal
|| || || || || || || || || || || || || ||
therapeutic range for digoxin is 0.5 to 2 ng/mL. A level of 2.4 ng/mL exceeds the therapeutic
|| || || || || || || || || || || || || || || || ||
range and indicates toxicity. The nurse should notify the HCP, who may give further prescriptions
|| || || || || || || || || || || || || || ||
about holding further doses of digoxin. The option that indicates to record the normal value on the
|| || || || || || || || || || || || || || || ||
client's flow sheet is incorrect because the level is not normal. The next dose should not be
|| || || || || || || || || || || || || || || || || ||
administered because the serum digoxin level exceeds the therapeutic range. Checking the client's || || || || || || || || || || || || ||
last pulse rate may have limited value in this situation. Depending on the time that has elapsed
|| || || || || || || || || || || || || || || || ||
since the last assessment, a current assessment of the client's status may be more useful.
|| || || || || || || || || || || || || ||
, A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse
|| || || || || || || || || || || || || || || ||
determines that the client has received adequate volume replacement if the blood urea nitrogen
|| || || || || || || || || || || || || ||
level drops to which value?|| || || ||
1. 3 mg/dL
|| ||
2. 15 mg/dL
|| ||
3. 29 mg/dL
|| ||
4. 35 mg/dL - ✔✔2. Rationale-The normal blood urea nitrogen level is 8 to 25 mg/dL. Values of
|| || || || || || || || || || || || || || || || || ||
29 mg/dL and 35 mg/dL reflect continued dehydration. A value of 3 mg/dL reflects a lower than
|| || || || || || || || || || || || || || || || ||
normal value, which may occur with fluid volume overload, among other conditions.
|| || || || || || || || || || ||
A client arrives in the emergency department complaining of chest pain that began 4 hours ago. A
|| || || || || || || || || || || || || || || || ||
troponin T blood specimen is obtained and the results indicate a level of 0.6 ng/mL. The nurse
|| || || || || || || || || || || || || || || || ||
determines that this result indicates which finding? || || || || || ||
1. A normal level
|| || || ||
2. A low value that indicates possible gastritis
|| || || || || || ||
3. A level that indicates a myocardial infarction
|| || || || || || ||
4. A level that indicates the presence of possible angina - ✔✔3. Rationale- Troponin is a
|| || || || || || || || || || || || || || || ||
regulatory protein found in striated muscle. The troponins function together in the contractile
|| || || || || || || || || || || || ||
apparatus for muscle in skeletal muscle and in the myocardium. Increased amounts of troponins
|| || || || || || || || || || || || || ||
are released into the bloodstream when an infarction causes damage to the myocardium. A
|| || || || || || || || || || || || || ||
troponin T value that is higher than 0.1 to 0.2 ng/mL is consistent with a myocardial infarction. A
|| || || || || || || || || || || || || || || || || ||
normal troponin I level is lower than 0.6 ng/mL.
|| || || || || || || ||
A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein
|| || || || || || || || || || || || || || ||
thrombosis. The client's activated partial thromboplasm (aPTT) time is 65 seconds. The nurse
|| || || || || || || || || || || || ||
anticipates that which action is needed? || || || || ||
1. Discontinuing the heparin infusion
|| || || || ||
2. Increasing the rate of the heparin infusion
|| || || || || || ||
3. Decreasing the rate of the heparin infusion
|| || || || || || ||
4. Leaving the rate of the heparin infusion as is - ✔✔4. Rationale- The normal aPTT varies
|| || || || || || || || || || || || || || || || ||
between 20 and 36 seconds, depending on the type of activator used in testing therapeutic dose of
|| || || || || || || || || || || || || || || || ||
heparin for treatment of deep vein thrombosis is to the keep the aPTT between 1.5 and 2.5 times
|| || || || || || || || || || || || || || || || || ||
