The nurse is reviewing the laboratory test results of a client with long-standing hypertension. Which result would be of most concern to the nurse?
Creatinine 3.2 mg/dL
Potassium 3.4 mEq/L
Hemoglobin 12.8 g/dL
Blood urea nitrogen (BUN) 20 mg/dL
The Correct Answer is A
Choice A reason: This is the most concerning result for the nurse. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in the urine. A high creatinine level indicates impaired kidney function, which can be a complication of hypertension. The normal range of creatinine is 0.6 to 1.2 mg/dL for men and 0.5 to 1.1 mg/dL for women. A creatinine level of 3.2 mg/dL is more than twice the upper limit of normal and suggests severe kidney damage.
Choice B reason: This is not a concerning result for the nurse. Potassium is an electrolyte that is essential for the function of nerves and muscles, especially the heart. The normal range of potassium is 3.5 to 5.0 mEq/L. A potassium level of 3.4 mEq/L is slightly below the normal range, but not enough to cause serious problems. A low potassium level can be caused by diuretics, vomiting, diarrhea, or excessive sweating. The nurse should monitor the client's potassium level and symptoms, and advise the client to eat foods that are high in potassium, such as bananas, oranges, potatoes, and tomatoes.
Choice C reason: This is not a concerning result for the nurse. Hemoglobin is a protein in the red blood cells that carries oxygen to the tissues. The normal range of hemoglobin is 13.5 to 17.5 g/dL for men and 12.0 to 15.5 g/dL for women. A hemoglobin level of 12.8 g/dL is within the normal range for women and slightly below the normal range for men, but not enough to cause significant anemia. A low hemoglobin level can be caused by blood loss, iron deficiency, or bone marrow disorders. The nurse should assess the client's history, diet, and symptoms, and check for other signs of anemia, such as pallor, fatigue, and shortness of breath.
Choice D reason: This is not a concerning result for the nurse. Blood urea nitrogen (BUN) is a waste product of protein metabolism that is filtered by the kidneys and excreted in the urine. A high BUN level indicates impaired kidney function or dehydration. The normal range of BUN is 7 to 20 mg/dL. A BUN level of 20 mg/dL is at the upper limit of normal, but not enough to indicate serious kidney problems. The nurse should ensure that the client is well hydrated and monitor the client's urine output and specific gravity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While gaining weight and having pink buccal mucosa can be signs of overall improved health, they are not specific indicators of effective treatment for vitamin B12 deficiency¹².
Choice B reason: Paresthesia (a sensation of tingling, tickling, pricking, or burning of a person's skin) of the hands and feet is a common symptom of vitamin B12 deficiency¹². If the client no longer has this symptom, it could indicate that the treatment for vitamin B12 deficiency has been effective¹².
Choice C reason: Eating more iron-fortified cereals can contribute to overall nutritional health, but it's not directly related to the treatment of vitamin B12 deficiency¹².
Choice D reason: While stopping alcohol consumption can improve overall health, it's not a specific indicator of effective treatment for vitamin B12 deficiency¹²..
Correct Answer is C
Explanation
Choice A reason: This option is not correct because the cholesterol level is within the normal range of less than 200 mg/dL¹, the HDL level is slightly low but not too far from the recommended level of over 40 mg/dL for men and over 50 mg/dL for women¹, and the triglyceride level is also within the normal range of less than 150 mg/dL¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice B reason: This option is not correct because the cholesterol level is low, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications.
Choice C reason: This option is correct because the cholesterol level is high, the HDL level is low, and the triglyceride level is high. These are all unfavorable results that reflect a high risk of coronary artery disease¹. High cholesterol and triglycerides can lead to plaque buildup in the arteries, which can cause atherosclerosis and reduce blood flow to the heart². Low HDL can also increase the risk of heart disease because it does not help remove LDL (bad cholesterol) from the arteries². Therefore, this set of laboratory results indicates a need for dietary modifications, such as reducing saturated and trans fats, increasing fiber, and limiting alcohol³.
Choice D reason: This option is not correct because the cholesterol level is normal, the HDL level is high, and the triglyceride level is normal. These are all desirable results that reflect a low risk of coronary artery disease¹. Therefore, this set of laboratory results does not indicate a need for dietary modifications..
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