Lab values & electrolytes worksheet with answers

Serum creatinine comes mainly from:

1. AThe normal breakdown of creatine in muscle
2. BThe breakdown of old red cells in the spleen
3. CThe digestion of protein by gut bacteria
4. DThe breakdown of dietary fat in the liver

A urine dipstick is positive for leukocyte esterase. What does this show?

1. AWhite blood cells are present in the urine
2. BProtein is leaking through the glomeruli
3. CBilirubin is being passed in the urine
4. DRed blood cells are present in the urine

What does a positive direct antiglobulin test (direct Coombs test) show?

1. AThe patient's red cells are too small and contain little hemoglobin
2. BAntibodies or complement are attached to the patient's red cells
3. CThe patient's plasma is missing the clotting factor VIII
4. DThe patient's platelets are clumping together in the blood sample

A patient taking furosemide has a potassium of 2.9 mEq/L. Which finding would the nurse expect?

1. AMuscle weakness and leg cramps
2. BTingling around the mouth with a positive Chvostek’s sign
3. CTall, peaked T waves on the ECG
4. DDiarrhea and abdominal cramping from overactive bowels

A patient has burning on urination and frequency. The dipstick is positive for nitrites and leukocyte esterase, and a urine culture is ordered. When should the sample be taken?

1. AAfter 3 days of antibiotic treatment
2. BAt any time, as antibiotics do not matter
3. CAfter the symptoms have fully settled
4. DBefore the first dose of antibiotic

Which instruction is correct for a patient starting oral iron tablets?

1. ATake the tablet with an antacid to improve absorption
2. BYour urine will turn bright orange while you take it
3. CYour stools may turn dark green or black
4. DTake each tablet with milk to protect the stomach

A patient on an IV insulin infusion has a blood glucose of 65 mg/dL (3.6 mmol/L). What is the best action?

1. AStop the infusion and leave the glucose recheck until the morning
2. BContinue at the same rate and recheck in four hours
3. CFollow the protocol for low glucose and inform the provider
4. DGive oral potassium to protect the heart

A patient with a serum albumin of 1.9 g/dL (19 g/L) has signs of phenytoin toxicity, although the total phenytoin level is in the usual range. What is the most likely explanation?

1. ALow albumin makes the total level falsely high in all cases
2. BLow albumin stops phenytoin from crossing into the brain
3. CLow albumin makes the liver clear phenytoin much faster
4. DLow albumin raises the free (active) fraction of phenytoin