LPN Interpreting Lab Values and Nursing Actions 3 — Questions and Answers
Question 1: A patient's BUN is 35 mg/dL and creatinine is 3.2 mg/dL. These values together suggest which condition?
- Impaired renal function (Correct answer)
- Dehydration alone
- Liver failure
- Normal findings in an elderly patient
Correct answer: Impaired renal function
Both elevated BUN and creatinine together indicate impaired glomerular filtration and reduced renal function.
Question 2: A patient's platelet count is 45,000/mm³. Which nursing intervention is the highest priority?
- Implement bleeding precautions and use soft-bristle toothbrush (Correct answer)
- Encourage vigorous ambulation to promote circulation
- Apply firm pressure with a hard object to IV sites
- Administer aspirin for any pain complaints
Correct answer: Implement bleeding precautions and use soft-bristle toothbrush
Thrombocytopenia (<50,000/mm³) places the patient at severe bleeding risk, requiring strict bleeding precautions.
Question 3: A patient's fasting blood glucose is 58 mg/dL and they are diaphoretic and trembling. What should the LPN do first?
- Give 15-20 g of fast-acting carbohydrates and recheck glucose in 15 minutes (Correct answer)
- Administer insulin per sliding scale
- Notify the provider before taking any action
- Offer a full meal immediately
Correct answer: Give 15-20 g of fast-acting carbohydrates and recheck glucose in 15 minutes
Symptomatic hypoglycemia requires immediate treatment with 15-20 g of rapid-acting carbohydrates followed by recheck using the 15-15 rule.
Question 4: A patient's magnesium level is 1.0 mEq/L. Which clinical manifestation should the LPN monitor for?
- Neuromuscular irritability and positive Trousseau's sign (Correct answer)
- Lethargy, hyporeflexia, and bradycardia
- Hypertension and flushing
- Constipation and polyuria
Correct answer: Neuromuscular irritability and positive Trousseau's sign
Hypomagnesemia (<1.5 mEq/L) causes neuromuscular irritability; because it often co-exists with hypocalcemia, Trousseau's sign may be positive.
Question 5: A post-operative patient's hemoglobin drops from 11 g/dL to 7.2 g/dL within 4 hours. What is the priority assessment?
- Assess surgical site for active bleeding and vital signs (Correct answer)
- Recheck the lab in 2 hours to confirm the result
- Encourage oral iron-rich foods
- Administer erythropoietin as a first response
Correct answer: Assess surgical site for active bleeding and vital signs
A rapid significant hemoglobin drop post-operatively suggests active hemorrhage; immediate assessment of the wound and hemodynamic status is critical.
Question 6: A patient's serum calcium is 11.8 mg/dL. Which symptom is consistent with this lab result?
- Muscle weakness, constipation, and confusion (Correct answer)
- Carpopedal spasm and laryngospasm
- Peaked T waves and muscle cramps
- Tetany and positive Chvostek's sign
Correct answer: Muscle weakness, constipation, and confusion
Hypercalcemia (>10.5 mg/dL) causes the classic 'bones, groans, moans, and psychic overtones': muscle weakness, constipation, and altered mentation.
Question 7: A patient's WBC is 1,800/mm³. What is the most important nursing action?
- Implement neutropenic precautions and restrict visitors with illness (Correct answer)
- Encourage the patient to increase vitamin C intake
- Place the patient in airborne isolation
- Prepare to administer antibiotics immediately
Correct answer: Implement neutropenic precautions and restrict visitors with illness
Severe leukopenia (<2,000/mm³) indicates high infection risk, requiring protective (neutropenic) precautions to prevent exposure to pathogens.
LPN Interpreting Lab Values and Nursing Actions 3
A patient's BUN is 35 mg/dL and creatinine is 3.2 mg/dL.
These values together suggest which condition?