Chapter 34 Diagnostic Testing
Answers for Review Questions
1. The nurse who recognizes and analyzes clues among laboratory results should immediately
report which of the following to the primary care provider (PCP)? (Selectallthatapply.)
a. Hemoglobin: 15.6 g/dL
b. Hematocrit: 31%
c. Red blood cells: 5.3 × 106/μL
d. White blood cells: 2,000 cells/mm3
e. Platelets 230,000 cells /mm3
Answer: b, d
Normal hematocrit levels range from 42% to 52% for males and 37% to 47% for females.
White blood cells should be between 5,000 and 10,000 cells/mm3 for adults. The results for the
hemoglobin, red blood cells, and platelets are within normal ranges.
LO: 34.2
Bloom’s: Understanding
NCLEX Client Needs: Physiological Integrity: Laboratory Values
2. The patient is taking an oral anticoagulant (warfarin). Which of the following laboratory
results should the nurse recognize as being the most clinically significant for this patient?
a. Platelets: 400,000 cells/mm3
b. INR: 5.9
c. Activated partial thromboplastin time: 30 seconds
d. Fibrinogen: 350 mg/dL
Answer: b
An increased international normalized ratio (INR) indicates prolonged bleeding times. The
normal INR is between 0.8 and 1.1 for a patient not taking an anticoagulant. Warfarin increases
prothrombin times—the INR should be between 2 and 3 or 3 and 4 depending on the patient’s
risk level. An INR level of 5.9 is dangerously high and puts the client at risk for bleeding. T
other levels are within normal limits.
Copyright © 2023 by Elsevier, Inc. All rights reserved.
, LO 34.2
Bloom’s: Understanding
NCLEX Client Needs: Physiological Integrity: Laboratory Values
3. Put the following steps in the correct sequence for obtaining a capillary blood glucose.
a. Cleanse the site with alcohol and allow to dry.
b. Ensure that hands are washed.
c. Select the site and put on gloves.
d. Quickly puncture the skin with the lancet.
e. Cover the test strip with full blood sample.
f. Wipe away the first drop of blood with gauze.
Answer: b, c, a, d, f, e
First, wash hands. Then, select the site and put on gloves. Cleanse the finger with alcohol a
allow to dry. Puncture the site with the lancet, then obtain the blood sample. The first drop
should be wiped away and the second drop of blood should be collected on the test strip. Cov
the entire test strip with blood to obtain the glucose result on the meter.
LO 34.8
Bloom’s: Applying
NCLEX Client Needs: Physiological Integrity: Laboratory Values
4. A male patient with heart disease asks the nurse what his ideal numbers should be for
cholesterol and triglycerides. Which of the following is the recommended level for lipids?
a. Total cholesterol: >200 mg/dL
b. LDL: >100 mg/dL
c. HDL: >45 mg/dL
d. Triglycerides: >160 mg/dL
Answer: c
Recommended levels for high-density lipoprotein (HDL) cholesterol are >45 mg/dL for males
and >55 mg/dL for females. The total cholesterol level should be < 200 mg/dL, the low-density
Copyright © 2023 by Elsevier, Inc. All rights reserved.
, lipoprotein (LDL) cholesterol level should be < 130 mg/dL, and the triglyceride levels should be
<160 mg/dL for males and <135 mg/dL for females.
LO: 34.2
Bloom’s: Remembering
NCLEX Client Needs: Physiological Integrity: Laboratory Values
5. The nurse is preparing a patient for a barium swallow test. Which statement(s) by the patien
indicate that the patient has understood the nurse's teaching? (Selectallthatapply.)
a. “The doctor will be able to view my stomach and intestines during the test.”
b. “I should increase fluids after the test.”
c. “I will have to drink a contrast agent.”
d. “Barium can cause constipation and I may need a mild laxative.”
e. “I will be NPO for 8 hours after the test.”
f. “My stools may turn black for a few days afterward.”
Answer: a, b, c, d
The doctor will be able to view the esophagus, stomach, duodenum, and upper portion of the
jejunum during a barium swallow (upper GI series). Ulcers, hiatal hernias, and carcinomas can
be visualized during the test. The patient will receive an oral contrast agent (barium sulfate),
which outlines the organs on X-ray. Patients should be instructed to increase fluid intake after t
test to help excrete the barium, which can cause constipation. Some patients may need a mild
laxative. Patients can usually eat and drink immediately after the test. Stools may turn white for
few days as the barium is expelled.
LO: 34.4
Bloom’s: Applying
NCLEX Client Needs: Physiological Integrity: Diagnostic Tests
6. A patient has a 24-hour urine specimen ordered for creatinine clearance. Which education
should be provided by the nurse?
a. “Collect all urine from the time the collection begins until it ends.”
b. “Save only a sample from each voiding.”
c. “Clean the perineal area three times before beginning to urinate.”
Copyright © 2023 by Elsevier, Inc. All rights reserved.
Answers for Review Questions
1. The nurse who recognizes and analyzes clues among laboratory results should immediately
report which of the following to the primary care provider (PCP)? (Selectallthatapply.)
a. Hemoglobin: 15.6 g/dL
b. Hematocrit: 31%
c. Red blood cells: 5.3 × 106/μL
d. White blood cells: 2,000 cells/mm3
e. Platelets 230,000 cells /mm3
Answer: b, d
Normal hematocrit levels range from 42% to 52% for males and 37% to 47% for females.
White blood cells should be between 5,000 and 10,000 cells/mm3 for adults. The results for the
hemoglobin, red blood cells, and platelets are within normal ranges.
LO: 34.2
Bloom’s: Understanding
NCLEX Client Needs: Physiological Integrity: Laboratory Values
2. The patient is taking an oral anticoagulant (warfarin). Which of the following laboratory
results should the nurse recognize as being the most clinically significant for this patient?
a. Platelets: 400,000 cells/mm3
b. INR: 5.9
c. Activated partial thromboplastin time: 30 seconds
d. Fibrinogen: 350 mg/dL
Answer: b
An increased international normalized ratio (INR) indicates prolonged bleeding times. The
normal INR is between 0.8 and 1.1 for a patient not taking an anticoagulant. Warfarin increases
prothrombin times—the INR should be between 2 and 3 or 3 and 4 depending on the patient’s
risk level. An INR level of 5.9 is dangerously high and puts the client at risk for bleeding. T
other levels are within normal limits.
Copyright © 2023 by Elsevier, Inc. All rights reserved.
, LO 34.2
Bloom’s: Understanding
NCLEX Client Needs: Physiological Integrity: Laboratory Values
3. Put the following steps in the correct sequence for obtaining a capillary blood glucose.
a. Cleanse the site with alcohol and allow to dry.
b. Ensure that hands are washed.
c. Select the site and put on gloves.
d. Quickly puncture the skin with the lancet.
e. Cover the test strip with full blood sample.
f. Wipe away the first drop of blood with gauze.
Answer: b, c, a, d, f, e
First, wash hands. Then, select the site and put on gloves. Cleanse the finger with alcohol a
allow to dry. Puncture the site with the lancet, then obtain the blood sample. The first drop
should be wiped away and the second drop of blood should be collected on the test strip. Cov
the entire test strip with blood to obtain the glucose result on the meter.
LO 34.8
Bloom’s: Applying
NCLEX Client Needs: Physiological Integrity: Laboratory Values
4. A male patient with heart disease asks the nurse what his ideal numbers should be for
cholesterol and triglycerides. Which of the following is the recommended level for lipids?
a. Total cholesterol: >200 mg/dL
b. LDL: >100 mg/dL
c. HDL: >45 mg/dL
d. Triglycerides: >160 mg/dL
Answer: c
Recommended levels for high-density lipoprotein (HDL) cholesterol are >45 mg/dL for males
and >55 mg/dL for females. The total cholesterol level should be < 200 mg/dL, the low-density
Copyright © 2023 by Elsevier, Inc. All rights reserved.
, lipoprotein (LDL) cholesterol level should be < 130 mg/dL, and the triglyceride levels should be
<160 mg/dL for males and <135 mg/dL for females.
LO: 34.2
Bloom’s: Remembering
NCLEX Client Needs: Physiological Integrity: Laboratory Values
5. The nurse is preparing a patient for a barium swallow test. Which statement(s) by the patien
indicate that the patient has understood the nurse's teaching? (Selectallthatapply.)
a. “The doctor will be able to view my stomach and intestines during the test.”
b. “I should increase fluids after the test.”
c. “I will have to drink a contrast agent.”
d. “Barium can cause constipation and I may need a mild laxative.”
e. “I will be NPO for 8 hours after the test.”
f. “My stools may turn black for a few days afterward.”
Answer: a, b, c, d
The doctor will be able to view the esophagus, stomach, duodenum, and upper portion of the
jejunum during a barium swallow (upper GI series). Ulcers, hiatal hernias, and carcinomas can
be visualized during the test. The patient will receive an oral contrast agent (barium sulfate),
which outlines the organs on X-ray. Patients should be instructed to increase fluid intake after t
test to help excrete the barium, which can cause constipation. Some patients may need a mild
laxative. Patients can usually eat and drink immediately after the test. Stools may turn white for
few days as the barium is expelled.
LO: 34.4
Bloom’s: Applying
NCLEX Client Needs: Physiological Integrity: Diagnostic Tests
6. A patient has a 24-hour urine specimen ordered for creatinine clearance. Which education
should be provided by the nurse?
a. “Collect all urine from the time the collection begins until it ends.”
b. “Save only a sample from each voiding.”
c. “Clean the perineal area three times before beginning to urinate.”
Copyright © 2023 by Elsevier, Inc. All rights reserved.
