NCLEX Quiz Labs

Quiz

1.
A 68 yr old man comes in and is having shortness of air and lower extremity swelling. Labs are drawn. The following abnormal results: BNP is elevated at 6538. What does this lab indicate?

 

 
 
 
 

2.
Breast cancer has been linked to mutations to which of the following 2 genes?

 
 
 
 

3.
A patient has atrial fibrillation and is on Coumadin. Labs show an INR of 1.7. What should be done first?

 

 
 
 
 

4.
Which is correct answer for the 2 pancreatic cancer tumor markers?

 
 
 
 

5.
A patient had a mechanical valve replacement done 2 months ago. They are placed on warfarin. What is the recommended range for a therapeutic INR for a mechanical valve replacement?

 
 
 
 

6.
If a patient has a significantly elevated ammonia level, what symptom would most likely be seen:

 

 
 
 
 

7.
A patient is an alcoholic. All of the following are common lab abnormalities seen in alcoholics except:

 

 
 
 
 

8.
The WBC level in splenomegaly: which of the following would be the most likely?

 

 
 
 

9.
If a patient has rhabdomyolysis, the CPK is a very important lab level. Which CPK level would most likely correlate with rhabdomyolysis?

 

 
 
 
 

10.
Your patient suddenly becomes very sleepy, lethargic, and disoriented. Some of their lab abnormalities include: C02 72, Na 130, K 6.1, Albumin 2.3 Which of the below would be the most likely to cause this?

 

 
 
 
 

11.
A patient has hyperkalemia. Which of the following is sometimes used as treatment for hyperkalemia?

 

 
 
 
 

12.
Which of the following is a cancer marker for Liver cancer?

 
 
 
 

13. What lab is the initial diagnostic lab for iron deficiency anemia?

 
 
 
 
 

14. Elevated triglycerides may be a sign of all of the following except?

 
 
 
 
 

15. Which lab level below would you be the most concerned about right away?

 
 
 
 
 

16. A patient is anemic. Their MCV is low. Based on just this info, what is the most likely cause of their anemia?

 

 
 
 
 
 

17. A patient is being evaluated for rheumatoid arthritis. Several labs were drawn. The rheumatoid factor (RF) came back negative, so further labs were done. What would be another important lab to use to help diagnose rheumatoid arthritis?
 
 
 
 

18. A patient is an alcoholic. Which lab level below would be the most likely to be seen on their lab profile?
 
 
 
 

19. Ace inhibitors are MOST often linked to which lab abnormality?

 
 
 
 
 

20. You suspect that your patient is dehydrated. They have dry mucous membranes, tenting skin turgor, and decreased urine output. Which lab value below would help to confirm your suspicion?
 
 
 
 

21. A patient's potassium is 6.2. Their renal function is normal. You are reviewing their home meds. Which of the following would be the least likely to cause a potassium of 6.2?

 
 
 
 

22. You are reviewing labs on a patient who is in for lab abnormalities related to bulimia. What lab value would you expect to be elevated in bulimia?
 
 
 
 

23. You are reviewing labs and see that your patient’s digoxin level is 2.8. What do you do next?
 
 
 
 

24. A patient has been on phenytoin for seizures. A phenytoin level is drawn. Which of the following results would indicate that the patient is within therapeutic level?
 
 
 
 

25. A patient has been on lithium for 1 week. Which of the following would be most concerning statement that they tell you?
 
 
 
 

26.
All of the following can cause hypokalemia except:

 
 
 
 
 

27.
Hyponatremia (sodium <135) is often seen in all of the following except:

 
 
 
 
 

28. A patient is receiving PO potassium. They are also getting their potassium drawn every 4 hours. Before giving the next dose of potassium you check the labs and see the most recent lab result for K is 4.9. What do you do next?

 
 
 
 
 

29. A patient is in hyperglycemic hyperosmolar state (HHS). Which value most likely correlates with a diagnosis of HHS?
 
 
 
 

30. MCV is 60 and MCH is 20. What diagnosis would be MOST likely with these lab findings?
 
 
 
 

31. Your patient's WBC level is at 26. They say "For years I've ran between 22-26. This is normal for me". Which diagnosis below (from their medical history)-would be the MOST likely cause of this?
 
 
 
 

32. A patient is in severe metabolic acidosis. They are given sodium bicarbonate to help correct this. Which value below would MOST likely be seen after administration?
 
 
 
 

33. All of the following are potential causes of chronically elevated WBCs except:
 
 
 
 

34. A patient is on dialysis. They tell you that "My skin is always itchy". Which lab level is most likely the cause of this in renal patients?
 
 
 
 

35. You are looking at a CBC panel and notice that the MCV is abnormal at 72. You know that this means the following:
 
 
 
 


 

Common NCLEX labs

  • Ammonia: 15-45 µ/dL
  • AST: 10-40 unit/L
  • BUN: 7–22m g/dL.
  • Calcium: 8.5-10.2 mg/dL
  • Chloride: 96-106 mEq/L
  • CPK: 21–232 U/L.
  • Creatinine: 0.6–1.35 mg/dL (< 2 in older adults)
  • Digoxin: 0.5-2.0 ng/ml
  • Dilantin: 10-20 mcg/dL
  • Glucose: 70–110 mg/dL
  • Hematocrit: Men: 40-54% Women 36-48%
  • Hemoglobin: Men: 13.5-17.5 Women: 12-15.5
  • INR: 2-3 therapeutic for DVT, PE history
  • LDH: 100–190 U/L.
  • Lithium: 0.8-1.5 mEq/L
  • Magnesium: 1.5-2.5 mEq/L
  • Phosphorus: 2.5-4.5 mg/dL
  • Platelets: 150,000 -450,000 
  • Potassium: 3.5-5.2 mEq/L
  • RBC: Men: 4.7-6.1 Women: 4.2-5.4
  • Sodium: 135-145 mEq/L
  • Triglyceride: Under 150 mg/dL
  • UA Specific gravity: 1.010–1.030.
  • Uric acid: 3.5–7.5 mg/dL.
  • WBC: 4,000-11,000

Also Don’t forget about the ABG’s!

  • pH: 7.35-7.45
  • PaCO2: 35-45 mm Hg
  • HCO3: 22-26 mEq/L
  • PaO2: 80-100 mm Hg
  • SaO2: >95%

Also know coagulation panel

This is not an all-inclusive list

Labs may vary slightly

NCLEX Study Ideas

Memorize Common Lab Values

  • See Common NCLEX labs tab
  • This tab includes common ones you need to know
  • You will most likely be asked assessment and clinical application questions
    • You may be given the lab and not told if abnormal or not. Questions may ask what intervention (or not) would you choose based on the lab

Know common lab abnormalities associated with certain diagnosis & surgeries, ex:

  • Addison disease: hyponatremia
  • Splenomegaly: leukocytosis
  • Alcoholism: hyponatremia, thrombocytopenia
  • Rhabdomyolysis: elevated CPK, renal failure, elevtaed liver enzymes
  • Pancreatitis: elevated lipase

Know ABGs:

  • It is not unusual to see a test question about ABGs
  • You may be asked to identify symptoms that you might expect with a certain set of ABG lab levels or vice versa
  • Or you might be asked to identify symptoms seen in a particular respiratory or metabolic abnormality (ex: metabolic acidosis: ex tachypnea-fast breathing)

Know symptoms of when basic electrolytes are high or low, ex:

  • Common symptoms of many electrolytes: weakness, muscle cramps, arrythmias
  • K: high: often EKG abnormalities. And can lead to heart attack
  • Na: low often see confusion
  • Ca: low can lead to bradycardia, hypotension, & parkinsonism

Know various lab abnormalities that are a result of common medications, ex:

  • Ace inhibitors: hyperkalemia
  • NSAIDS: Increased creatinine
  • Steroids: Hyperglycemia, leukocytosis, hypokalemia
  • HCTZ & other diuretics: hyponatremia, hypokalemia
  • Albuterol: Hypokalemia
  • Statins: elevated ck level, elevated liver enzymes

If you get a list of labs and are being asked to determine which is most emergent to address, ex–>

  • Always think ABC’s (airway, breathing circulation)
  • Low hemoglobin–worry about bleed–need to find source and address immediately. Check for – dizziness, shortness of air, hypotension, tachycardia
  • If patient is symptomatic with the lab abnormality that is a concern
  • If the abnormal lab is baseline for a patient- you might want to consider choosing another answer

Know signs & symptoms of specific lab abnormalities, ex:

  • Low Hgb: dizzy, SOA, tachycardcia, weakness
  • Low vitamin D: weakness
  • Low B12: numbness & tingling, weakness, memory problems
  • Hypoglycemia: confusion, diaphoretic, shaky, nausea

Guess What Game?

Hover Box Element

Congestive Heart Failure

Lupus

Hover Box Element

Pulmonary Embolism

Hover Box Element

Sepsis

Hover Box Element

Pancreatitis

Hover Box Element

Renal Failure

Hover Box Element

Addison's Disease

Hover Box Element

Primary Hypothyroidism

Hover Box Element

No. They're Supra-therapeutic

Lab Abnormalities

CONDITIONS ASSOCIATED WITH ABNORMALITIES

 

  • GLUCOSE
    • Hyperglycemia
      • Steroid use
      • Infection
      • Dehydration
      • Noncompliance with meds
      • ETOH use
  • HEMOGLOBIN
    • Low
      • Blood loss
      • Heavy menses
      • GI bleed
      • Chronic or acute wound
      • Cancer
      • Chronic kidney disease
      • Sickle cell anemia
      • Chemotherapy
  • PLATELETS
    • Thrombocytopenia (low)
      • Chronic alcohol use
      • Cancer
      • Antibiotics
      • Heparin use
      • ITP
  •  POTASSIUM
    • Hyperkalemia
      • Renal failure
      • Addison’s disease
      • Potassium supplementation
      • Lisinopril
      • Potassium sparing diuretics
    • Hypokalemia
      • Diuretic use
      • Steroid use
      • Insulin drip
      • Diarrhea
      • Vomiting
      • Cystic Fibrosis
      • Calcium Gluconate
  • SODIUM
    • Hypernatremia
      • Dehydration
      • Diabetes insipidus
    • Hyponatremia
      • SIADH
      • Alcoholism
      • Diuretics
      • Adrenal Insufficiency
      • Hypothyroidism
      • Dehydration
      • Uncontrolled Diabetes
  • WBC
    • Leukocytosis
      • Infection
      • Post op
      • CML
      • Steroid use
      • Stressor to body

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