Chapter 19 Laboratory and Diagnostic Tests

Chapter 19  Laboratory and Diagnostic Tests

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The leukocyte count of an older adult patient is elevated. The nurse shows the best understanding of the effect of aging on body function when:
a.
checking the patient for drug allergies before requesting an antibiotic prescription.
b.
asking that the patient’s temperature be taken before notifying the physician.
c.
encouraging the patient to drink several glasses of water and then repeat the laboratory tests.
d.
having the patient produce a urine sample and requesting a stat urinalysis.

ANS: B
When interpreting laboratory values and deciding the best course of treatment, the older adult should be viewed holistically: signs, symptoms, and test results, such as the patient’s temperature, should all be taken into account.

DIF: Application (Applying) REF: N/A OBJ: 19-10
TOP: Nursing Process: Assessment MSC: Physiologic Integrity

2. The nurse helps minimize an older adult patient’s risk of developing pernicious anemia by:
a.
suggesting supplementing vitamin A.
b.
encouraging regular intake of citrus.
c.
identifying iron-rich foods.
d.
suggesting supplementing vitamin B12.

ANS: D
Malabsorption of B12 can be caused by the effect of antibodies on gastric parietal cells and a decrease in intrinsic factor, the underlying cause of pernicious anemia. The prevalence of pernicious anemia increases significantly with aging. Pernicious anemia is not associated with vitamin A, citrus, or iron.

DIF: Applying (Application) REF: N/A OBJ: 19-10
TOP: Teaching-Learning MSC: Physiologic Integrity

3. The nurse suspects that an acute postoperative infectious process may be developing in your older adult patient. What abnormal finding best supports this suspicion?
a.
A thrombocyte count of 40,000/mm3
b.
Decreasing erythrocyte sedimentation rate of 10 to 20 mm/hr
c.
Increasing C-reactive protein level
d.
Increased partial prothrombin time

ANS: C
C-reactive protein is a marker present in the acute phase of an inflammatory response. The other lab values do not indicate infection.

DIF: Remembering (Knowledge) REF: Page 348 OBJ: 19-10
TOP: Nursing Process: Assessment MSC: Physiologic Integrity

4. On assessing the laboratory data of an older adult patient, the nurse notes the serum potassium level is 5.3 mEq/L. Based on this information, the nurse:
a.
asks if the patient has been using a nonsteroidal antiinflammatory drug (NSAID).
b.
determines if the patient is receiving a diuretic that promotes potassium loss.
c.
suggests several potassium-rich foods to supplement dietary potassium intake.
d.
monitors the patient’s urinary output for possible fluid retention.

ANS: A
A potassium level of 5.3 mEq/L is high. NSAIDs such as ibuprofen interfere with potassium excretion. The other answers are not related to hyperkalemia.

DIF: Application (Applying) REF: N/A OBJ: 19-3
TOP: Nursing Process: Assessment MSC: Physiologic Integrity

5. An older adult patient is experiencing symptoms commonly associated with hyperglycemia. Which laboratory test is most reliable for detecting hyperglycemia in older adults?
a.
A random serum glucose
b.
An oral glucose tolerance test
c.
An early morning urine test for glucose
d.
A 24-hour urine glucose test

ANS: B
Appropriate glucose testing includes a fasting blood glucose, an oral glucose tolerance test, and the hemoglobin A1C. The other options are not appropriate.

DIF: Remembering (Knowledge) REF: Page 352 OBJ: 19-1
TOP: Nursing Process: Assessment MSC: Physiologic Integrity