Question 1

A patient has heart failure and takes spironolactone (aldactone).What diet selection from the menu shows that the patient needs more education?

Accepted Answer

A)  A low-fat chicken salad sandwich
B)  Salt-free vegetable soup
C)  Broiled fish with lemon
D)  Salt substitute and pepper D

Question 2

A 66-year-old patient has a decreased calcium level.The nurse anticipates a(n):

Accepted Answer

A)  elevated sodium level.
B)  elevated phosphorus level.
C)  decreased magnesium level.
D)  decreased serum glucose level. B

Question 3

A 71-year-old patient has a cholesterol level of 182 mg/dL.The nurse evaluates this as:

Accepted Answer

A)  high.
B)  low.
C)  normal.
D)  unknown;no norms have been established for this age group. A

Question 4

An older adult has been admitted for dehydration.Which laboratory value correlates with this condition?

Accepted Answer

A)  Na+: 160 mEq/L
B)  Na+: 128 mEq/L
C)  K+: 3.5 mEq/L
D)  K+: 5.2 mEq/L

Question 5

An older patient's BUN is 28 mg/dL and creatinine is 0.6 mg/dL.How does the nurse interpret these findings?

Accepted Answer

A)  Normal for all age groups
B)  Normal for older adults
C)  High for all age groups
D)  Low for older adults

Question 6

A patient's oxygen saturation is 98%,but the patient reports shortness of breath with activity.What action by the nurse is best?

Accepted Answer

A)  Assess the patient's hemoglobin.
B)  Apply oxygen at 2L/nasal cannula.
C)  Consult respiratory therapy.
D)  Administer a bronchodilator.

Question 7

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:

Accepted Answer

A)  asks if the patient has been using a nonsteroidal antiinflammatory drug (NSAI
D)  .
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.

Question 8

A 91-year-old patient learns that his urine protein is 8.2 mg/100 mL.When asked to explain the significance of the result,the nurse replies:

Accepted Answer

A)  "It may be elevated because of a urinary tract infection."
B)  "The result is not significant because it's within normal limits."
C)  "The level is usually elevated in people your age."
D)  "Mild chronic renal failure causes a decrease in urine protein."

Question 9

The nurse suspects that an acute postoperative infectious process may be developing in your older adult patient.What abnormal finding best supports this suspicion?

Accepted Answer

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

Question 10

A patient was admitted for heart failure,and over the past 3 days the patient's brain natriuretic peptide has decreased.What action by the nurse is best?

Accepted Answer

A)  Prepare to administer extra diuretics.
B)  Continue with the plan of care.
C)  Prepare to intubate and ventilate the patient.
D)  Discuss end-of-life care with the patient.

Question 11

A patient has a low sodium level but normal blood osmolarity.What does the nurse understand about this condition?

Accepted Answer

A)  The two values are not related.
B)  The patient is overhydrated.
C)  The patient has pseudohyponatremia.
D)  The patient has end-stage kidney disease.

Question 12

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:

Accepted Answer

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.

Question 13

An older adult patient is experiencing symptoms commonly associated with hyperglycemia.Which laboratory test is most reliable for detecting hyperglycemia in older adults?

Accepted Answer

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

Question 14

An older adult patient has an elevated prostate-specific antigen (PSA)level.The nurse shares with him that a diagnosis of prostate cancer would be confirmed with an analysis of his:

Accepted Answer

A)  alkaline phosphatase level.
B)  acid phosphatase level.
C)  serum amylase level.
D)  uric acid level.

Question 15

An older patient has a pressure ulcer that is resistant to healing despite aggressive therapy.The nurse suspects the need for a protein supplement based on a(n):

Accepted Answer

A)  serum creatinine level of 1.1 mg/dL.
B)  acid phosphate level of 0.9 U/L.
C)  folate level of 18.2 ng/mL.
D)  serum albumin level of 3.1 g/dL.

Question 16

A patient takes digoxin (Lanoxin)for heart failure with atrial fibrillation.The patient reports yellow vision and nausea.The patient's digoxin level is 1.9 ng/mL.How does the nurse explain the situation to the patient?

Accepted Answer

A)  "Even with a normal blood level you may have digoxin toxicity."
B)  "You may have a gastrointestinal virus that is causing these symptoms."
C)  "You may not be getting a high enough dose of digoxin;I'll call the doctor."
D)  "Your cataracts may be worsening and you may need to have them removed."

Question 17

The nurse explains to an older patient that the assessment of her thyroid health will require both a physical examination as well as laboratory test because:

Accepted Answer

A)  thyroid studies are less accurate in older adults.
B)  symptoms are similar to those caused by various infections.
C)  thyroid problems can be present without overt symptoms.
D)  T3 levels are normally increased during aging.

Question 18

An older female patient develops gout and says,"Why did I get this now?" What response by the nurse is best?

Accepted Answer

A)  "Gout can strike anyone at any time."
B)  "Your body apparently makes more uric acid now."
C)  "Uric acid rarely rises in premenopausal women."
D)  "Women actually have more gout than men do."

Question 19

A patient has increased total iron binding capacity and transferrin levels.What action by the nurse is best?

Accepted Answer

A)  Prepare to administer vitamin B12.
B)  Encourage the patient to eat protein.
C)  Ensure the patient gets sun exposure.
D)  Prepare the patient for chelating therapy.

Question 20

The nurse is caring for an 88-year-old patient who was admitted to the long-term care facility after a recent conviction of driving while intoxicated.On reviewing the laboratory work and observing a folic acid level of 2 ng/ml,the nurse:

Accepted Answer

A)  increases the patient's caloric intake.
B)  performs a dietary assessment on the patient.
C)  provides the patient with sodium-rich foods.
D)  immediately notifies the patient's physician.

Exam 19: Laboratory and Diagnostic Tests

A patient has heart failure and takes spironolactone (aldactone) .What diet selection from the menu shows that the patient needs more education?

A 66-year-old patient has a decreased calcium level.The nurse anticipates a(n) :