LPN Interpreting Lab Values and Nursing Actions 4 — Questions and Answers
Question 1: A patient's urinalysis shows glucose 3+ and ketones 2+. What condition does the LPN suspect?
- Diabetic ketoacidosis (DKA) (Correct answer)
- Urinary tract infection
- Renal failure
- Cushing's syndrome
Correct answer: Diabetic ketoacidosis (DKA)
Glucosuria and ketonuria together are hallmark findings of diabetic ketoacidosis due to insulin deficiency and fat catabolism.
Question 2: A patient's serum albumin is 2.1 g/dL. Which complication is the patient most at risk for?
- Edema and impaired wound healing (Correct answer)
- Hypercalcemia
- Polycythemia
- Hypernatremia
Correct answer: Edema and impaired wound healing
Low albumin (<3.5 g/dL) reduces plasma oncotic pressure, causing third-spacing and edema, and impairs tissue repair.
Question 3: A patient's ABG shows pH 7.50, PaCO2 50 mmHg, HCO3 38 mEq/L. What does this indicate?
- Metabolic alkalosis with respiratory compensation (Correct answer)
- Respiratory alkalosis
- Metabolic acidosis
- Combined respiratory and metabolic acidosis
Correct answer: Metabolic alkalosis with respiratory compensation
High pH and high HCO3 indicate metabolic alkalosis; the elevated PaCO2 reflects hypoventilation as respiratory compensation.
Question 4: A patient has an LDH (lactate dehydrogenase) of 850 U/L. Which condition is this finding most associated with?
- Tissue damage such as MI, hemolysis, or liver injury (Correct answer)
- Normal physiologic aging
- Urinary tract infection
- Dehydration
Correct answer: Tissue damage such as MI, hemolysis, or liver injury
Elevated LDH indicates widespread tissue damage and is non-specifically elevated in MI, hemolytic anemia, and hepatic injury.
Question 5: A patient receiving a blood transfusion develops flank pain and dark urine. Which lab change would confirm a hemolytic transfusion reaction?
- Elevated plasma free hemoglobin and hemoglobinuria (Correct answer)
- Elevated WBC count only
- Decreased BUN and creatinine
- Low serum LDH
Correct answer: Elevated plasma free hemoglobin and hemoglobinuria
Hemolysis releases free hemoglobin into the plasma and urine, producing hemoglobinemia and hemoglobinuria as definitive markers of a hemolytic reaction.
Question 6: A patient's serum TSH is 0.05 mIU/L and free T4 is elevated. Which clinical findings would the LPN expect?
- Tachycardia, heat intolerance, and weight loss (Correct answer)
- Bradycardia, cold intolerance, and weight gain
- Hyponatremia and lethargy
- Hyperglycemia and polyuria
Correct answer: Tachycardia, heat intolerance, and weight loss
Low TSH with high free T4 indicates hyperthyroidism, causing increased metabolic rate with tachycardia, heat intolerance, and unintentional weight loss.
Question 7: A patient's urine specific gravity is 1.030. How should the LPN interpret this finding?
- Concentrated urine, likely indicating dehydration (Correct answer)
- Dilute urine suggesting overhydration
- Normal, well-hydrated status
- Indicates renal failure with inability to concentrate
Correct answer: Concentrated urine, likely indicating dehydration
Urine specific gravity >1.025 indicates highly concentrated urine, most commonly due to dehydration or inadequate fluid intake.
LPN Interpreting Lab Values and Nursing Actions 4
A patient's urinalysis shows glucose 3+ and ketones 2+.
What condition does the LPN suspect?