Question 1

A nurse is reviewing lab results for a patient with acute kidney injury (AKI). Which of the following findings should the nurse expect?

Accepted Answer

Answer reason: With AKI, renal excretion of nitrogenous wastes falls due to decreased filtration, so BUN typically rises along with serum creatinine. A decreased creatinine would be unexpected because impaired clearance causes it to accumulate. GFR decreases in AKI rather than increasing. Electrolyte abnormalities are common, but magnesium is more often elevated (hypermagnesemia) from reduced excretion, making hypomagnesemia less likely as a general expected finding.
Category reason: This question asks the nurse to anticipate a characteristic laboratory abnormality seen in acute kidney injury, which is primarily an interpretation of abnormal lab values relevant to monitoring for complications.

Question 2

A nurse is reviewing a patient's chart and notices a trend of increasing blood glucose levels. Which step of the NCSBN model does this represent?

Accepted Answer

Answer reason: This step involves noticing and interpreting relevant patient data, including trends in assessment findings and laboratory values. Identifying a rising blood glucose pattern is the collection and recognition of significant information that may indicate worsening glycemic control. The nurse has not yet selected interventions or judged the effects of interventions, so it is not taking action or evaluating outcomes.
Category reason: This question focuses on nursing clinical judgment by identifying which step of the NCSBN Clinical Judgment Measurement Model applies to recognizing a significant trend in patient lab data, aligning with Abnormal Laboratory Values.

Question 3

A patient is prescribed furosemide for heart failure. What should the nurse monitor?

Accepted Answer

Answer reason: Furosemide is a loop diuretic that can cause significant losses of potassium, sodium, magnesium, and chloride, increasing risk for dysrhythmias, weakness, and hypotension. In heart failure, diuresis can also contribute to volume depletion and prerenal azotemia, so electrolyte trends help guide safe dosing and replacement. Monitoring electrolytes supports early detection and prevention of complications related to diuretic therapy.
Category reason: This question tests nursing monitoring for adverse effects and lab abnormalities associated with a medication used in patient care, which aligns with NCLEX Reduction of Risk Potential focused on abnormal laboratory values.

Question 4

A client is prescribed digoxin for heart failure. What should the nurse monitor?

Accepted Answer

Answer reason: Hypokalemia increases myocardial sensitivity to digoxin by reducing competition at the Na+/K+-ATPase pump, which raises the risk of digoxin toxicity and dysrhythmias. Clients with heart failure are commonly on loop or thiazide diuretics that can further lower potassium, making monitoring especially important. Detecting and correcting potassium abnormalities helps prevent life-threatening arrhythmias and other toxicity manifestations (e.g., nausea, visual changes).
Category reason: This is a nursing safety question focused on monitoring labs to prevent medication-related complications, which aligns with identifying and responding to abnormal laboratory values.

Question 5

A homeless person who is in the manic phase of bipolar disorder is admitted to the mental health unit. Which laboratory findings obtained on admission is most important for the nurse to report to the healthcare provider?

Accepted Answer

Answer reason: A low TSH suggests possible hyperthyroidism, which can mimic or worsen manic symptoms and requires prompt medical evaluation and management. Identifying a reversible medical contributor is critical for safe psychiatric treatment planning, including medication selection and monitoring. Untreated thyroid dysfunction can increase risk of cardiovascular complications (e.g., tachyarrhythmias) and can destabilize mood, making it a higher-priority abnormality to report than nonspecific or less immediately explanatory results.
Category reason: This asks the nurse to identify which admission lab value requires priority reporting to the provider, emphasizing nursing judgment around abnormal labs and potential complications, which fits Abnormal Laboratory Values.

Question 6

Jannah is admitted to the labor and delivery unit. The critical laboratory result for this client would be?

Accepted Answer

Answer reason: d. Serum Calcium Hypocalcemia can trigger neuromuscular irritability and uterine irritability, increasing risk for complications such as tetany, seizures, or dysrhythmias—findings that require prompt evaluation and intervention in the peripartum setting. In contrast, blood typing is important but not inherently “critical” unless there is an emergency hemorrhage/transfusion situation. “Ion binding capacity” is not a standard critical obstetric lab in routine admission panels, and oxygen saturation is a vital sign/assessment rather than a laboratory result.
Category reason: This question tests recognition of a critical abnormal lab value that could signal imminent physiologic risk in a laboring client, aligning with monitoring for complications under Abnormal Laboratory Values.

Question 7

When caring for a postsurgical client who has undergone multiple blood transfusions, which serum laboratory finding is of most concern to the nurse?

Accepted Answer

Answer reason: This value reflects hyperkalemia, which can occur with multiple transfusions due to potassium leakage from stored red blood cells and is particularly dangerous after surgery. Elevated potassium increases the risk of life-threatening cardiac dysrhythmias and requires prompt assessment and intervention (e.g., ECG monitoring and provider notification). The other values are within expected normal ranges and are less immediately threatening.
Category reason: This question asks the nurse to identify the most concerning lab value in a postoperative transfusion scenario, emphasizing clinical judgment about abnormal labs and risk of complications, which aligns with Abnormal Laboratory Values under Reduction of Risk Potential.

Question 8

Nurse Ronald is aware that the best tool for data gathering is?

Accepted Answer

Answer reason: Objective, standardized measurements are the most reliable foundation for accurate assessment because they are less affected by patient recall, interviewer bias, or observer interpretation. Lab results provide quantifiable physiologic evidence that can confirm or refute suspected problems and help trend changes over time. While interviews and questionnaires are valuable for subjective data, they are inherently influenced by communication barriers and perception. Observation is important but can miss internal physiologic abnormalities that lab testing detects earlier and more precisely.

Question 9

Which laboratory result would require immediate intervention by the nurse for the client scheduled for surgery?

Accepted Answer

Answer reason:  Severe hypokalemia significantly increases the risk of perioperative dysrhythmias and can potentiate the effects of anesthetics and neuromuscular blockers, making it an immediate safety threat before surgery. A value this low commonly warrants prompt replacement and re-evaluation (often delaying elective surgery) to reduce risk of ventricular arrhythmias and respiratory muscle weakness. The other values are within expected ranges for most adults: calcium 9.2 mg/dL is normal, bleeding time 2 minutes is not prolonged, and hemoglobin 15 g/dL indicates adequate oxygen-carrying capacity. Therefore, correcting the critically low potassium is the priority intervention.

Question 10

The nurse draws blood from a patient with acute chest pain and nausea. Which of the following troponin-I levels would indicate the presence of a myocardial infarction?

Accepted Answer

Answer reason: 0.05 ng/mL Myocardial injury causes release of cardiac troponins into the bloodstream, and values above the assay’s upper reference limit are considered abnormal and supportive of acute MI when paired with ischemic symptoms. Many nursing exam references use a troponin I cutoff around 0.04 ng/mL as the threshold for positivity, so a value exceeding that is the best indicator among the choices. The lower values listed fall at or below common decision limits and are less consistent with infarction in typical NCLEX-style lab interpretation. While exact cutoffs vary by laboratory and assay, selecting the clearly elevated option is the safest test-taking approach in this format.

Question 11

Which serum potassium level requires no immediate nursing intervention for an adult?

Accepted Answer

Answer reason: 5–5.0 mEq/L, and values within this range generally do not require urgent action. A potassium of 4 mEq/L is mid-normal, so the nurse would continue routine monitoring rather than initiate immediate corrective interventions. In contrast, 3.2 mEq/L indicates hypokalemia with potential for dysrhythmias and muscle weakness, typically prompting assessment and replacement planning. Levels like 5.7 or 6 mEq/L reflect hyperkalemia, which raises concern for life-threatening cardiac conduction changes and usually warrants prompt evaluation and interventions based on severity and ECG findings.

Question 12

Which serum potassium level requires no immediate nursing intervention for an adult?

Accepted Answer

Answer reason: 5–5.0 mEq/L, and values within this range generally do not require urgent action beyond routine monitoring. A level of 4 mEq/L is squarely normal and is not expected to cause cardiac conduction changes or neuromuscular symptoms. In contrast, 3.2 mEq/L indicates hypokalemia, which increases risk for dysrhythmias and muscle weakness and warrants assessment of causes and replacement planning. Levels such as 5.7–6 mEq/L represent hyperkalemia with potential for life-threatening ECG changes and require prompt evaluation and interventions.

Question 13

The best test to access the fluid status in a burn patient is?

Accepted Answer

Answer reason: Hematocrit rises as plasma volume drops, so trending it provides a sensitive indirect indicator of fluid status during early burn resuscitation. Hemoglobin can also concentrate, but hematocrit is typically used and trended alongside urine output and vital signs to judge adequacy of resuscitation. Electrolytes and creatinine help detect metabolic and renal complications but are less direct for estimating intravascular volume changes from third spacing.

Question 14

A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse?

Accepted Answer

Answer reason: Preoperative nursing responsibility prioritizes identifying and reducing immediate perioperative risk through verification of required diagnostics and readiness criteria. Reviewing laboratory results can reveal contraindications or correctable abnormalities (e.g., anemia, electrolyte imbalance, coagulation issues, pregnancy testing when indicated) that directly affect anesthesia and surgical safety. Vital signs are important but are a routine task and do not replace confirming medical readiness or catching high-risk abnormalities before transport to the OR. Obtaining the permit and explaining the procedure are primarily the provider’s responsibilities; the nurse’s role is to verify consent is present/valid and reinforce teaching, not to provide primary procedural disclosure.

Question 15

A rheumatology nurse provide care to a client diagnosed with systemic lupus. Which of the following is a priority?

Accepted Answer

Answer reason: Creatinine 2.0 An elevated creatinine indicates impaired renal function, which in systemic lupus can reflect lupus nephritis and can rapidly progress to serious complications if not addressed. A creatinine of 2.0 is a clinically significant abnormal lab suggesting reduced kidney clearance and need for prompt assessment, trend review, urine protein/hematuria evaluation, and provider notification. This finding also affects medication selection and dosing (e.g., NSAIDs, ACE inhibitors, immunosuppressants) and signals higher risk for fluid/electrolyte and blood pressure complications. Moderate knee pain is important for comfort but is not as immediately threatening as potential organ involvement. Rheumatoid factor levels are not a priority marker in SLE and do not indicate acute organ compromise.

Question 16

Today's prothrombin time for a client receiving Coumadin is 20 (normal range listed by the lab is 10-14). What is the appropriate nursing action?

Accepted Answer

Answer reason: A PT of 20 seconds, when the lab normal is 10–14 seconds, is consistent with expected anticoagulation rather than an emergency value by itself. Immediate provider notification is generally reserved for supratherapeutic anticoagulation (e.g., markedly elevated INR/PT) or any active/serious bleeding. While monitoring for bleeding is prudent, the best action from the choices is to interpret the value as within therapeutic expectations for a client on warfarin.

Question 17

A nurse is assessing a newborn with jaundice. Which finding should the nurse report immediately?

Accepted Answer

Answer reason: A value of 15 mg/dL at 48 hours is concerning for significant hyperbilirubinemia and typically warrants prompt provider notification for risk stratification and possible phototherapy based on age in hours and risk factors. In contrast, mild cephalocaudal jaundice limited to the face/chest can be consistent with early physiologic jaundice and requires monitoring rather than emergent escalation. Adequate breastfeeding every 2–3 hours is a supportive finding that helps increase stooling and bilirubin excretion, not an urgent abnormality.

Question 18

A client who is on lithium presents with fine hand tremors. What is the appropriate nursing intervention?

Accepted Answer

Answer reason: Fine tremor is a common early sign of lithium adverse effects and can also be an early indicator of rising serum concentration. The safest nursing action is to assess for potential toxicity by checking the drug level, because management depends on whether the level is therapeutic, elevated, or frankly toxic. Holding or stopping the medication independently is typically not within nursing scope without an order unless severe toxicity is suspected; instead, objective data should be obtained promptly. Simply monitoring without evaluating a potential toxic level delays recognition of worsening neurologic effects that can progress to coarse tremor, ataxia, confusion, and seizures.

Question 19

The nurse, who is working on a respiratory unit, is caring for a patient admitted with an exacerbation of chronic obstructive pulmonary disease (COPD). Which type of acid/base problem would the nurse most likely expect to find once results are available for the patient’s arterial blood gases (ABG’s)?

Accepted Answer

Answer reason: Increased PaCO2 shifts the carbonic acid-bicarbonate buffer toward greater hydrogen ion concentration, lowering pH and producing a primary respiratory acidosis on ABG. While chronic COPD may show partial renal compensation with elevated HCO3−, the primary disturbance remains respiratory. Respiratory alkalosis would be more consistent with acute hyperventilation states (e.g., anxiety or early hypoxemia without CO2 retention), not typical CO2-retaining COPD exacerbation.

Question 20

The nurse is caring for a client who is scheduled for a CT angiogram scan with IV contrast. Which of the following would be a priority for the nurse to include in the plan of care?

Accepted Answer

Answer reason: IV iodinated contrast can precipitate contrast-associated acute kidney injury, so assessing baseline renal function is the key safety priority before administration. BUN and creatinine provide the most direct, actionable screen for impaired clearance and help identify clients who may need hydration protocols or alternative imaging. Hydration and maintaining urine output are important supportive measures, but they are guided by and secondary to confirming kidney function and overall clinical status. Teaching about transient flushing supports comfort and anxiety reduction but does not address the primary physiologic risk of nephrotoxicity.

Question 21

A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide (Lasix) in the amount of 40 mg IV push. Knowing that the client also will be started on digoxin a nurse checks the client’s most recent ?

Accepted Answer

Answer reason: Low potassium increases myocardial sensitivity to digoxin and significantly raises the risk of digoxin toxicity and dysrhythmias, so potassium status must be verified/corrected before and during therapy. In this setting, checking digoxin level is not useful because the client is just being started, and sodium does not directly predict digoxin toxicity risk. Creatinine is important for dosing/clearance but is less immediately tied to the acute toxicity trigger created by concurrent diuretic-induced electrolyte loss.

Question 22

The nurse has been made aware of laboratory test results for assigned clients. Which of the following test results would require immediate follow-up?

Accepted Answer

Answer reason: Adalimumab (a TNF-α inhibitor) increases susceptibility to bacterial, opportunistic, and reactivated infections; a WBC of 14,000/mm³ is abnormal and may signal an acute infectious process needing immediate evaluation and provider notification. By contrast, mild hyperglycemia is an expected steroid effect, BNP 300 pg/mL in a known heart-failure client is not an acute critical value by itself, and potassium 3.5 mEq/L is low-normal and not emergent. Immediate follow-up focuses on infection screening (vitals, cultures as ordered) and holding/clarifying immunosuppressant therapy per protocol.

Question 23

The nurse draws blood from a patient with acute chest pain and nausea. Which of the following troponin-I levels would indicate the presence of a myocardial infarction?

Accepted Answer

Answer reason: 0.05 Myocardial injury releases cardiac troponin into the bloodstream, and values above the assay’s reference range are interpreted as abnormal in the setting of ischemic symptoms. Many contemporary troponin-I assays use a cutoff around the 99th percentile that is commonly near 0.04 ng/mL, so a value above this threshold supports myocardial infarction when paired with the clinical picture. Among the choices, only one value is clearly above a typical decision limit used in exam questions. Lower values can be within normal range or represent non-diagnostic early/low-level results without meeting the usual threshold for MI.

Question 24

A client receives parenteral nutrition and develops hypomagnesemia. The nurse monitors for which complication?

Accepted Answer

Answer reason: When magnesium is low, cardiac excitability increases and conduction becomes unstable, predisposing the patient to dysrhythmias (including ventricular ectopy and torsades-like patterns). Clients on parenteral nutrition are at risk for electrolyte shifts and refeeding-related deficits, so continuous assessment for cardiac rhythm changes is a priority. Circumoral paresthesia is more characteristic of hypocalcemia, while polyuria and respiratory arrest are not the most expected primary complications of isolated hypomagnesemia.

Question 25

A nurse is caring for a client who is taking furosemide for heart failure. The client's serum potassium level is 3.1 mEq/L. Which of the following actions should the nurse take?

Accepted Answer

Answer reason: 1 mEq/L indicates hypokalemia, which increases risk for dysrhythmias and can be worsened by loop diuretics. Furosemide promotes renal potassium loss, so continuing it without addressing the electrolyte abnormality is unsafe. The nurse should hold the medication and promptly notify the provider for orders such as potassium replacement and/or medication adjustment while monitoring cardiac status. Adding a potassium-sparing diuretic is a provider-level change and not an independent nursing action, and increasing the loop diuretic dose would further lower potassium and heighten risk.

Question 26

A male patient has the following lab values: Arterial HCO3 of 25, Hemoglobin of 15.5, Phosphate of 1.5, Calcium of 8.0, TSH of 2.9. Which of the above is a critical result and must be reported to the physician immediately?

Accepted Answer

Answer reason: A phosphate of 1.5 mg/dL indicates severe hypophosphatemia, which can impair ATP production leading to muscle weakness (including diaphragmatic weakness), hemolysis, and cardiac/neurologic instability, making it time-sensitive. The other listed values are not critical in this context: arterial HCO3 of 25 is normal, hemoglobin of 15.5 is normal for an adult male, and calcium of 8.0 is only mildly low and typically less immediately dangerous than severe hypophosphatemia. Therefore this abnormality warrants prompt provider notification and evaluation for causes (e.g., refeeding, DKA treatment, alcoholism) and replacement.

Question 27

A nurse is caring for a client with heart failure who is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor most closely?

Accepted Answer

Answer reason: In heart failure, hypokalemia can precipitate dangerous dysrhythmias and worsen cardiac stability, making this the most time-sensitive electrolyte to trend. Monitoring potassium also guides the need for supplementation or adjustment of diuretic/other cardiac medications. While sodium may also decrease, potassium abnormalities more directly and acutely impact cardiac conduction and patient safety.

Question 28

The nurse is assessing a client receiving mechanical ventilation. Which clinical data is most important to review before weaning the client off the ventilator?

Accepted Answer

Answer reason: ABG values directly measure PaO2/oxygenation, PaCO2/ventilation, and pH, which are the most critical physiologic targets during liberation from mechanical support. Abnormal results signal ongoing respiratory failure or inadequate respiratory drive/muscle strength and predict weaning failure. Chest x-ray and sputum culture help evaluate etiology (e.g., pneumonia) but do not confirm effective gas exchange at the time of weaning, and lung sounds are important but more subjective and less definitive than ABG trends.

Question 29

When admitting a client to the hospital with suspected acute pancreatitis, which electrolyte disorder would be expected?

Accepted Answer

Answer reason: This hypocalcemia is a classic expected electrolyte abnormality and may correlate with more severe disease. In contrast, glucose abnormalities in pancreatitis are more commonly hyperglycemia from impaired insulin secretion rather than low glucose. Sodium and potassium changes are not the characteristic hallmark electrolyte disturbance for acute pancreatitis on admission.

Question 30

A client has been diagnosed with multiple myeloma. The nurse should assess the client for?

Accepted Answer

Answer reason: Multiple myeloma causes malignant plasma cells to stimulate osteoclast activity, leading to bone destruction and release of calcium into the bloodstream. This makes elevated serum calcium a common and clinically important abnormality to monitor because it can cause dehydration, constipation, confusion, and cardiac dysrhythmias. The other listed electrolyte elevations are not characteristic primary findings of multiple myeloma; potassium and magnesium abnormalities are more typically secondary to renal failure or treatment effects rather than a hallmark presentation. Therefore, assessing for calcium elevation best matches the expected disease-related lab complication.

Question 31

A client is admitted to the hospital with hypercalcemia. The nurse is aware that the client is at risk for what?

Accepted Answer

Answer reason: This is a classic clinical manifestation of elevated calcium and is an important safety concern due to fall risk. In contrast, tremors are more consistent with hypocalcemia, which increases neuromuscular irritability (e.g., tetany). Confusion can occur with significant hypercalcemia, but weakness is a more characteristic and commonly tested neuromuscular finding tied directly to the electrolyte abnormality.

Question 32

Which sign or symptom should a nurse most likely assess in a client with a magnesium level of 2.9 mEq/L?

Accepted Answer

Answer reason: Hypermagnesemia depresses neuromuscular transmission, so increasing magnesium levels blunt reflex activity and can progress to flaccidity and respiratory depression. A value of 2.9 mEq/L is above the typical reference range, making diminished or absent deep tendon reflexes an expected early assessment finding. Findings like tetany and muscle twitching are more consistent with neuromuscular irritability seen in low calcium or low magnesium states. A positive Homan’s sign relates to possible venous thrombosis and is not a hallmark of magnesium imbalance.

Question 33

The nurse instructs a client with newly diagnosed diabetes mellitus that hypoglycemia occurs when the blood sugar level is less than?

Accepted Answer

Answer reason: Hypoglycemia is identified when blood glucose falls below a clinically dangerous threshold where neuroglycopenic and adrenergic symptoms can occur and prompt treatment is required. A commonly taught cutoff is

Question 34

A client is diagnosed with malnutrition secondary to cirrhosis. Which laboratory study supports a diagnosis of malnutrition?

Accepted Answer

Answer reason: Malnutrition reduces hepatic protein synthesis and leads to low circulating transport proteins used as nutritional markers. Transferrin is a negative acute-phase reactant and commonly decreases with protein-calorie malnutrition, which can be exacerbated by cirrhosis-related impaired liver synthetic function. An increased albumin level would not support malnutrition; albumin is typically low (and is also influenced by inflammation and fluid status). Normal cholesterol and elevated BUN are nonspecific for malnutrition and more suggest normal lipid status or altered renal function/protein catabolism rather than confirming undernutrition.

Question 35

A nurse cares for a client with hyperthyroidism whose serum calcium level is 11.7 mg/dL. Which medication should the nurse anticipate being ordered for this client?

Accepted Answer

Answer reason: Hyperthyroidism can contribute to hypercalcemia via increased bone turnover, and a calcium level of 11.7 mg/dL indicates mild hypercalcemia that warrants treatment aimed at lowering serum calcium. Calcitonin decreases serum calcium by inhibiting osteoclast-mediated bone resorption and promoting renal calcium excretion, making it an appropriate medication to anticipate. Calcium chloride and calcium gluconate are used to treat hypocalcemia and would worsen the current abnormal value. Vitamin D increases intestinal calcium absorption and would also be inappropriate in the setting of hypercalcemia.

Question 36

A nurse cares for a client with an intracranial pressure reading of 10 mm Hg. The nurse knows that this reading?

Accepted Answer

Answer reason: Normal adult intracranial pressure is typically about 5–15 mm Hg, and values above this range suggest intracranial hypertension with risk to cerebral perfusion. A value of 10 mm Hg falls squarely within the expected physiologic range, so it does not indicate deterioration by itself. Without additional concerning trends or neurologic changes, there is no immediate need for emergent treatment or provider notification. A common distractor is assuming any measured ICP is dangerous, but clinical action is driven by abnormal elevation (often >20–22 mm Hg) and the overall assessment.

Question 37

Which laboratory value for a newly diagnosed client with diabetes should the nurse report to the physician?

Accepted Answer

Answer reason: A sodium level of 118 mEq/L is markedly below normal and warrants immediate provider notification regardless of diabetes status. The other values listed are within expected ranges (pH 7.45 high-normal, glucose 120 mg/dl near-normal, potassium 3.9 mEq/L normal) and are not as acutely dangerous. Because patient safety hinges on early recognition of critical labs, this finding should be escalated promptly.

Question 38

A client is being treated for adrenal crisis (addisonian crisis). Which laboratory values are most important for the nurse to monitor?

Accepted Answer

Answer reason: These abnormalities drive hypotension, dehydration, and potentially lethal dysrhythmias, making sodium and potassium the most safety-critical labs to trend during treatment. Monitoring them guides urgent therapy (IV fluids, glucocorticoids, and management of hyperkalemia) and helps evaluate response. Glucose can be low in adrenal crisis, but ketones are more central to diabetic ketoacidosis than primary adrenal insufficiency, so that pairing is less targeted for this diagnosis.

Question 39

The nurse determined that the client's fluid volume deficit from HHNS has resolved. Which serum laboratory finding led to the nurse’s conclusion?

Accepted Answer

Answer reason: As intravascular volume is restored with fluids and hyperglycemia is corrected, serum osmolality should trend down toward normal, reflecting improved hydration status and reduced solute concentration. Glucose can decrease with insulin even before volume is fully corrected, so it is less specific for resolution of the fluid deficit. Sodium and potassium shifts in HHNS are heavily influenced by water movement and insulin therapy, making isolated decreases unreliable markers of resolved dehydration.

Question 40

A client with new onset of atrial fibrillation is receiving warfarin (Coumadin) to help prevent thromboemboli. The warfarin dosage will reach therapeutic levels when the international normalized ratio (INR) falls within which range?

Accepted Answer

Answer reason: 0–3.0 to reduce cardioembolic stroke risk while limiting bleeding. Values below this range indicate insufficient anticoagulation and higher thromboembolism risk. Higher ranges (such as 2.5–3.5) are typically reserved for certain mechanical heart valves, which require more intense anticoagulation. Therefore, the appropriate therapeutic range for this client’s indication is the standard 2–3 window.

Question 41

The nurse reviews lab results of a second-day postoperative client and notes a hemoglobin level of 10 g/dl. During assessment of the client, the nurse would expect to see which of the following?

Accepted Answer

Answer reason: Clinically significant hypoxia symptoms are more expected with lower values or with increased oxygen demand (e.g., exertion) or limited cardiopulmonary reserve. Compensatory signs like dyspnea and palpitations typically appear when oxygen-carrying capacity is reduced enough to trigger tachycardia and increased work of breathing. Pallor can occur with anemia but is not reliably expected at a mild level and is less specific than correlating symptoms with severity and trends.

Question 42

The nurse is reviewing a 52-year-old client’s laboratory values. The platelet count is 75,000/μl. How would the nurse interpret this value?

Accepted Answer

Answer reason: A reduced platelet count increases bleeding risk, especially with trauma or invasive procedures, and warrants closer assessment for bruising, petechiae, and mucosal bleeding. This finding reflects a quantitative platelet problem rather than a qualitative dysfunction. Thrombocytosis would require an elevated count, and thrombocytopathy refers to impaired platelet function with a count that may be normal.

Question 43

The nurse is monitoring the lab values of a client diagnosed with multiple myeloma early in the disease course. The nurse would anticipate the lab values to identify abnormal?

Accepted Answer

Answer reason: Multiple myeloma is a plasma cell malignancy characterized by early overproduction of a monoclonal immunoglobulin (M-protein) and/or free light chains. Therefore, abnormal serum immunoglobulin patterns (e.g., elevated total protein, M-spike on electrophoresis, abnormal light chains) are expected early. Cytopenias such as anemia, thrombocytopenia, or leukopenia more often develop as marrow infiltration progresses, so they may be normal initially. Monitoring immunoglobulin-related studies best reflects the underlying disease activity at this stage.

Question 44

When reviewing a client’s morning laboratory results, the nurse knows that potassium is important because it can alter?

Accepted Answer

Answer reason: Potassium is the primary intracellular cation and is critical for establishing the resting membrane potential and normal depolarization/repolarization in excitable tissue. Abnormal potassium levels (hypokalemia or hyperkalemia) can directly disrupt cardiac conduction and contractility, creating dangerous dysrhythmias and ECG changes. This makes potassium monitoring a key safety priority when interpreting labs, especially in clients receiving diuretics, ACE inhibitors/ARBs, or with renal dysfunction. The pulmonary artery and pulmonary smooth muscle are not the primary clinical systems emphasized for potassium-related life-threatening effects compared with the myocardium.

Question 45

The nurse checks the results of a urinalysis performed on a client with dehydration. Which results should the nurse expect to find?

Accepted Answer

Answer reason: Dehydration leads to reduced circulating volume, prompting the kidneys to conserve water via increased tubular reabsorption. This concentrates the urine, raising urine osmolality and specific gravity on urinalysis. In contrast, increased white blood cells suggests urinary tract infection/inflammation rather than isolated fluid deficit. Protein or ketones can occur in specific disease states (e.g., renal disease, uncontrolled diabetes/starvation) but are not the expected hallmark finding of uncomplicated dehydration.

Question 46

The nurse is caring for a client with Addison’s disease. Which of the following serum laboratory values indicates that the treatment being given is effective?

Accepted Answer

Answer reason: Untreated adrenal insufficiency commonly causes hyponatremia and hyperkalemia due to renal sodium wasting and impaired potassium excretion. A sodium level of 142 mEq/L reflects normalization into the expected physiologic range, consistent with adequate replacement therapy. By contrast, potassium of 6.0 mEq/L suggests persistent mineralocorticoid deficiency and ongoing risk for dysrhythmias, while potassium of 2.9 mEq/L would indicate overcorrection or another cause of hypokalemia.

Question 47

The 6-year-old with fever and painful urination is brought to the clinic by the parent. Which finding on UA completed that morning is most important for the nurse to report to the health care provider?

Accepted Answer

Answer reason: Blood in the urine can reflect significant inflammation, renal involvement (e.g., pyelonephritis), stones, or other causes of urinary tract bleeding that may require prompt evaluation and treatment. In contrast, urine pH 6.5 is within typical range and specific gravity 1.010 can be normal depending on hydration status. Trace ketones can occur with decreased intake/fasting during illness and is generally less urgent than evidence of bleeding in the urinary tract in this presentation.

Question 48

Which laboratory result would the nurse anticipate in a client with peritonitis?

Accepted Answer

Answer reason: An elevated WBC count (often >15,000/µl) is a common expected lab finding and supports the presence of significant infection or inflammation. Markedly prolonged PTT would instead suggest a coagulation disorder or anticoagulant effect rather than peritonitis. Hyperkalemia and anemia are not expected primary indicators of peritoneal infection and would depend on separate conditions (e.g., renal failure, bleeding) rather than the core pathology.

Question 49

The nurse is reviewing the serum laboratory report for the hospitalized client who has adrenocortical insufficiency. The nurse should immediately notify the HCP about which value?

Accepted Answer

Answer reason: Potassium 6.2 mEq/L Adrenocortical insufficiency (low aldosterone) reduces renal potassium excretion, predisposing the patient to hyperkalemia. A potassium level of 6.2 mEq/L is a critical value associated with dangerous cardiac dysrhythmias and requires urgent provider notification and likely immediate interventions (e.g., ECG, potassium-lowering therapy). The other values are not immediately life-threatening in this context: WBC 11,000/mm3 is only mildly elevated, glucose 138 mg/dL is a modest elevation, and sodium 148 mEq/L is mild hypernatremia (Addison’s more typically causes hyponatremia). Prioritization is driven by the highest near-term risk to airway/breathing/circulation, which here is potassium-related cardiotoxicity.

Question 50

Prior to administering digoxin to the 6-year-old child with HF, the nurse reviews the child’s serum laboratory report. Which value should concern the nurse and be reported to the HCP?

Accepted Answer

Answer reason: Potassium 3.2 mEq/L Hypokalemia increases myocardial sensitivity to digoxin by reducing competition at the Na+/K+-ATPase pump, markedly raising the risk for digoxin toxicity and dangerous dysrhythmias. A potassium of 3.2 mEq/L is below normal and should be corrected and communicated before giving the dose. The listed digoxin concentration is within/near the typical therapeutic range used clinically, so it is less immediately concerning than low potassium in this context. The other values are not as directly linked to acute digoxin toxicity risk as a low potassium level.

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Abnormal Laboratory Values NCLEX Practice Test

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A nurse is reviewing lab results for a patient with acute kidney injury (AKI). Which of the following findings should the nurse expect?

A nurse is reviewing a patient's chart and notices a trend of increasing blood glucose levels. Which step of the NCSBN model does this represent?

A patient is prescribed furosemide for heart failure. What should the nurse monitor?

A client is prescribed digoxin for heart failure. What should the nurse monitor?

A homeless person who is in the manic phase of bipolar disorder is admitted to the mental health unit. Which laboratory findings obtained on admission is most important for the nurse to report to the healthcare provider?

Jannah is admitted to the labor and delivery unit. The critical laboratory result for this client would be?

When caring for a postsurgical client who has undergone multiple blood transfusions, which serum laboratory finding is of most concern to the nurse?

Nurse Ronald is aware that the best tool for data gathering is?

Which laboratory result would require immediate intervention by the nurse for the client scheduled for surgery?

The nurse draws blood from a patient with acute chest pain and nausea. Which of the following troponin-I levels would indicate the presence of a myocardial infarction?

Which serum potassium level requires no immediate nursing intervention for an adult?

Which serum potassium level requires no immediate nursing intervention for an adult?

The best test to access the fluid status in a burn patient is?

A 24 year-old female client is scheduled for surgery in the morning. Which of the following is the primary responsibility of the nurse?

A rheumatology nurse provide care to a client diagnosed with systemic lupus. Which of the following is a priority?

Today's prothrombin time for a client receiving Coumadin is 20 (normal range listed by the lab is 10-14). What is the appropriate nursing action?

A nurse is assessing a newborn with jaundice. Which finding should the nurse report immediately?

A client who is on lithium presents with fine hand tremors. What is the appropriate nursing intervention?

The nurse is caring for a client who is scheduled for a CT angiogram scan with IV contrast. Which of the following would be a priority for the nurse to include in the plan of care?

A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide (Lasix) in the amount of 40 mg IV push. Knowing that the client also will be started on digoxin a nurse checks the client’s most recent ?

The nurse has been made aware of laboratory test results for assigned clients. Which of the following test results would require immediate follow-up?

The nurse draws blood from a patient with acute chest pain and nausea. Which of the following troponin-I levels would indicate the presence of a myocardial infarction?

A client receives parenteral nutrition and develops hypomagnesemia. The nurse monitors for which complication?

A nurse is caring for a client who is taking furosemide for heart failure. The client's serum potassium level is 3.1 mEq/L. Which of the following actions should the nurse take?

A male patient has the following lab values: Arterial HCO3 of 25, Hemoglobin of 15.5, Phosphate of 1.5, Calcium of 8.0, TSH of 2.9. Which of the above is a critical result and must be reported to the physician immediately?

A nurse is caring for a client with heart failure who is prescribed furosemide (Lasix). Which laboratory value should the nurse monitor most closely?

The nurse is assessing a client receiving mechanical ventilation. Which clinical data is most important to review before weaning the client off the ventilator?

When admitting a client to the hospital with suspected acute pancreatitis, which electrolyte disorder would be expected?

A client has been diagnosed with multiple myeloma. The nurse should assess the client for?

A client is admitted to the hospital with hypercalcemia. The nurse is aware that the client is at risk for what?

Which sign or symptom should a nurse most likely assess in a client with a magnesium level of 2.9 mEq/L?

The nurse instructs a client with newly diagnosed diabetes mellitus that hypoglycemia occurs when the blood sugar level is less than?

A client is diagnosed with malnutrition secondary to cirrhosis. Which laboratory study supports a diagnosis of malnutrition?

A nurse cares for a client with hyperthyroidism whose serum calcium level is 11.7 mg/dL. Which medication should the nurse anticipate being ordered for this client?

A nurse cares for a client with an intracranial pressure reading of 10 mm Hg. The nurse knows that this reading?

Which laboratory value for a newly diagnosed client with diabetes should the nurse report to the physician?

A client is being treated for adrenal crisis (addisonian crisis). Which laboratory values are most important for the nurse to monitor?

The nurse determined that the client's fluid volume deficit from HHNS has resolved. Which serum laboratory finding led to the nurse’s conclusion?

A client with new onset of atrial fibrillation is receiving warfarin (Coumadin) to help prevent thromboemboli. The warfarin dosage will reach therapeutic levels when the international normalized ratio (INR) falls within which range?

The nurse reviews lab results of a second-day postoperative client and notes a hemoglobin level of 10 g/dl. During assessment of the client, the nurse would expect to see which of the following?

The nurse is reviewing a 52-year-old client’s laboratory values. The platelet count is 75,000/μl. How would the nurse interpret this value?

The nurse is monitoring the lab values of a client diagnosed with multiple myeloma early in the disease course. The nurse would anticipate the lab values to identify abnormal?

When reviewing a client’s morning laboratory results, the nurse knows that potassium is important because it can alter?

The nurse checks the results of a urinalysis performed on a client with dehydration. Which results should the nurse expect to find?

The nurse is caring for a client with Addison’s disease. Which of the following serum laboratory values indicates that the treatment being given is effective?

The 6-year-old with fever and painful urination is brought to the clinic by the parent. Which finding on UA completed that morning is most important for the nurse to report to the health care provider?

Which laboratory result would the nurse anticipate in a client with peritonitis?

The nurse is reviewing the serum laboratory report for the hospitalized client who has adrenocortical insufficiency. The nurse should immediately notify the HCP about which value?

Prior to administering digoxin to the 6-year-old child with HF, the nurse reviews the child’s serum laboratory report. Which value should concern the nurse and be reported to the HCP?

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