1.Easy
Why is serum creatinine a better marker of kidney function than BUN?
- AIt is less affected by diet, hydration and bleeding in the gut
- BIt is not filtered by the kidneys, so its level stays very stable
- CIt is made by the liver, so it rises in every kind of illness
- DIt is affected mainly by protein intake, which is easy to control
2.Easy
Which tube additive is used for a complete blood count (CBC)?
- ANo additive, clot activator (red top)
- BSodium fluoride (usually a gray top)
- CEDTA (usually a lavender or purple top)
- DSodium citrate (usually a light blue top)
3.Easy
Which type of white blood cell is normally the most numerous in an adult's blood?
- AEosinophils
- BNeutrophils
- CLymphocytes
- DMonocytes
4.Medium
A patient receiving chemotherapy has an ANC of 300/µL and a new temperature of 38.3 °C (100.9 °F). What should the nurse do first?
- AEncourage oral fluids and record the fever in the chart
- BGive acetaminophen (paracetamol) and recheck the temperature in 4 hours
- CReport it at once so cultures and antibiotics start quickly
- DRemove extra blankets and offer a tepid sponge bath
5.Medium
A patient with a low clinical probability of deep vein thrombosis has a normal (negative) D-dimer. What is the best interpretation?
- AA DVT is unlikely and can usually be ruled out
- BThe test is useless and should always be ignored
- CA DVT is confirmed and anticoagulation is needed
- DA pulmonary embolism is now certain to be present
6.Medium
Which treatment lowers serum potassium by moving it into the cells?
- AIV 0.45% sodium chloride infusion
- BIV regular insulin given with glucose
- COral potassium chloride supplements
- DIV calcium gluconate given over 10 minutes
7.Hard
The nurse teaches a patient starting lithium. Which statement shows a need for further teaching?
- A"I will check with the pharmacist before taking ibuprofen"
- B"I will drink plenty of fluids, especially in hot weather"
- C"I will cut out salt from my diet completely to stay healthy"
- D"I will tell my doctor if I have vomiting or diarrhea"
8.Hard
A 68-year-old man has fatigue, a hemoglobin of 9.8 g/dL (98 g/L), an MCV of 72 fL and a low ferritin. He eats a normal diet. What is the most important next step?
- AStart vitamin B12 injections
- BGive iron and do no further tests at all
- CLook for a source of blood loss in the gut
- DRepeat the blood count in one year
Answer key
- 1. A · It is less affected by diet, hydration and bleeding in the gut
- 2. C · EDTA (usually a lavender or purple top)
- 3. B · Neutrophils
- 4. C · Report it at once so cultures and antibiotics start quickly
- 5. A · A DVT is unlikely and can usually be ruled out
- 6. B · IV regular insulin given with glucose
- 7. C · "I will cut out salt from my diet completely to stay healthy"
- 8. C · Look for a source of blood loss in the gut
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