Deck 5: Laboratory Values and Diagnostics

Question 1

You are caring for an elderly male client in a long-term care facility.As part of his annual physical examination,the nurse practitioner orders some laboratory tests,including a complete blood count,serum electrolytes,and thyroid tests.The resident's wife questions these tests stating: "He seems fine to me,a little sleepy,but he is 85 years old,you know." In explaining the rationale for these tests,you base your response on your knowledge that:

A) his wife has an excellent point; you should speak to the nurse practitioner about canceling them.
B) when conducted annually,all of the tests are helpful in promoting maximum health for older adults in the long-term care setting.
C) the tests are useful,but only if clinically indicated.
D) the complete blood count and serum electrolytes are useful screening tests,but you will question the nurse practitioner about the thyroid tests.

Answer 1

when conducted annually,all of the tests are helpful in promoting maximum health for older adults in the long-term care setting.

Question 2

A 77-year-old woman with breast cancer has completed a course of external radiation and is receiving chemotherapy.After her recent chemotherapy treatment,she complains of severe weakness and lethargy,and is admitted to the hospital.She has an unsteady gait,and complains of dizziness when arising from the chair.Her platelet count is 45,000.Based on this scenario,what nursing intervention is of the highest priority?

A) Preventing falls
B) Maintaining skin integrity
C) Preventing infection
D) Replacing fluids

Answer 2

Preventing falls

Question 3

You are a nurse working in a community health center that is sponsoring a program that offers free prostate-specific antigen (PSA)blood tests to all men older than age 50.A man approaches you and asks,"What is this all about?" What is the best response to him?

A) "PSA is one of the primary screening tests for prostate cancer.All men older than 50 should be screened for prostate cancer."
B) "PSA is a definitive way to diagnose prostate cancer.All men older than 50 should be screened for prostate cancer."
C) "PSA is indicated when a man has other symptoms of prostate cancer."
D) "PSA is invalid unless a digital rectal exam is done immediately before the blood sample being drawn."

Answer 3

"PSA is one of the primary screening tests for prostate cancer.All men older than 50 should be screened for prostate cancer."

Question 4

While looking at your patient's laboratory values,you note the following values.Which contains an alteration (increase or decrease)that you might expect with aging?

A) Potassium 4.5 mEq/L
B) Blood urea nitrogen (BUN)10 mg/dL
C) Creatinine 0.8 mg/dL
D) Erythrocyte sedimentation rate (ESR)20 mm/hr

Question 5

An 83-year-old resident of a long-term care facility has dementia.She is usually able to feed herself and perform basic ADLs with minimal assistance.She is continent of bowel and bladder,but needs assistance with toileting.The nurse aide who routinely cares for her reports to the nurse that the resident has had three episodes of urinary incontinence and has a decreased appetite.Her daughter reports that her mother seems "different" and "a bit more confused." You speak with the physician who orders a complete blood count and serum electrolytes and states "Call me if any of the labs are abnormal." The lab tests are all within normal limits.The nurse should:

A) attribute the changes in the resident's functioning to advancing dementia.The lab values are OK,so nothing acute is happening.
B) speak with the physician and suggest that the resident be placed on broad-spectrum antibiotics to prevent infections.
C) speak with the physician because,although the laboratory values are within normal limits,the changes in function (decreased appetite,change in mental status,and incontinence)may be subtle signs of illness.
D) change the plan of care to include bladder training and implement a 24-hour calorie count.

Question 6

A 69-year-old patient in the geriatric clinic has his annual physical examination,and a complete blood count and serum electrolytes are drawn.His laboratory results show an elevated blood urea nitrogen (BUN).What is the next action of the nurse?

A) Assume that the laboratory result was a false-positive because the patient did not exhibit any symptoms of renal failure.
B) Look at his medication list because an elevated BUN may be the result of specific medications.
C) Instruct him on collecting a 24-hour urine specimen for protein analysis.
D) Tell him that an elevated BUN is normal in older adults.

Question 7

What is true concerning laboratory values in older adults?

A) There are age-adjusted ranges for older adults for all of the common laboratory findings,similar to those for infants and children.
B) There are no age-adjusted ranges for older adults due to the large variations within the age group and the increasing number of factors that influence the results.
C) There are age-adjusted ranges only for the over-85 age-group; there are no expected changes in the 65- to 84-year-old age-group.
D) There are age-adjusted ranges only for the hematological tests,which are due mostly to changes in the bone marrow.