HEMATOLOGY
Red Blood Cells
RBC (Male) 4.2 - 5.6 M/µL
RBC (Female) 3.8 - 5.1 M/µL
RBC (Child) 3.5 - 5.0 M/µL
White Blood Cells
WBC (Male) 3.8 - 11.0 K / mm cubed
WBC (Female) 3.8 - 11.0 K / mm cubed
WBC (Child) 5.0 - 10.0 K / mm cubed
Hemoglobin
Hgb (Male) 14 - 18 g/dL
Hgb (Female) 11 - 16 g/dL
Hgb (child) 10 - 14 g/dL
Hgb (Newborn) 15 - 25 g/dL
Hematocrit
Hct (Male) 39 - 54%
Hct (Female) 34 - 47%
Hct (Child) 30 - 42%
MCV 78 - 98 fL
MCH 27 - 35 pg
MCHC 31 - 37%
Neutrophils 50 - 81%
Bands 1 - 5%
Lymphocytes 14 - 44%
Monocytes 2 - 6%
Eosinophils 1 - 5%
Basophils 0 - 1%
CARDIAC MARKERS
Troponin I 0 - 0.1 ng/ml (onset: 4-6 hrs, peak: 12-24 hrs, return to normal: 4-7 days)
Troponin T 0 - 0.2 ng/ml (onset: 3-4 hrs, peak: 10-24 hrs, return to normal: 10-14 days)
Myoglobin (Male) 10 - 95 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
Myoglobin (Female) 10 - 65 ng/ml (onset: 1-3 hrs, peak: 6-10 hrs, return to normal: 12-24 hrs)
GENERAL CHEMISTRY
Acetone 0.3 - 2.0 mg%
Albumin 3.5 - 5.0 gm/dL
Alkaline Phosphatase 32 - 110 U/L
Anion gap 5 - 16 mEq/L
Ammonia 11 - 35 µmol/L
Amylase 50 - 150 U/dL
AST, SGOT (Male) 7 - 21 U/L
AST, SGOT (Female) 6 - 18 U/L
Bilirubin, Direct 0.0 - 0.4 mg/dL
Bilirubin, Indirect total minus direct
Bilirubin, Total 0.2 - 1.4 mg/dL
BUN 6 - 23 mg/dL
Calcium (total) 8 - 11 mg/dL
Carbon dioxide 21 - 34 mEq/L
Carbon monoxide symptoms at greater than or equal to 10% saturation
Chloride 96 - 112 mEq/L
Creatine (Male) 0.2 - 0.6 mg/dL
Creatine (Female) 0.6 - 1.0 mg/dL
Creatinine 0.6 - 1.5 mg/dL
Ethanol 0 mg%; Coma: greater than or equal to 400 - 500 mg%
Folic acid 2.0 - 21 ng/mL
Glucose 70 - 110 mg/dL (diuresis greater than or equal to 180 mg/dL)
HDL (Male) 25 - 65 mg/dL
HDL (Female) 38 - 94 mg/dL
Iron 52 - 169 µg/dL
Iron binding capacity 246 - 455 µg/dL
Lactic acid 0.4 - 2.3 mEq/L
Lactate 0.3 - 2.3 mEq/L
Lipase 10 - 140 U/L
Magnesium 1.5 - 2.5 mg/dL
Osmolarity 276 - 295 mOsm/kg
Parathyroid hormone 12 - 68 pg/mL
Phosphorus 2.2 - 4.8 mg/dL
Potasssium 3.5 - 5.5 mEq/L
Protein (total) 6.0 - 9.0 gm/dL
SGPT 8 - 32 U/L
Sodium 135 - 148 mEq/L
T3 0.8 - 1.1 µg/dL
Thyroglobulin Less than 55 ng/mL
Thyroxine (T4) total 5 - 13 µg/dL
Total protein 5 - 9 gm/dL
TSH Less than 9 µU/mL
Urea nitrogen 8 - 25 mg/dL
Uric acid (Male) 3.5 - 7.7 mg/dL
Uric acid (Female) 2.5 - 6.6 mg/dL
LIPID PANEL (ADULT)
Cholesterol (total) Less than 200 mg/dL desirable
Cholesterol (HDL) 30 - 75 mg/dL
Cholesterol (LDL) Less than 130 mg/dL desirable
Triglycerides (Male) Greater than 40 - 170 mg/dL
Triglycerides (Female) Greater than 35 - 135 mg/dL
URINE
Color Straw
Specific Gravity 1.003 - 1.040
pH 4.6 - 8.0
Na 10 - 40 mEq/L
K Less than 8 mEq/L
Cl Less than 8 mEq/L
Protein 1 - 15 mg/dL
Osmolality 80 - 1300 mOsm/L
24 HOUR URINE
Amylase 250 - 1100 IU / 24 hr
Calcium 100 - 250 mg / 24 hr
Chloride 110 - 250 mEq / 24 hr
Creatinine 1 - 2 g / 24 hr
Creatine Clearance (Male) 100 - 140 mL / min
Creatine Clearance (Male) 16 - 26 mg / kg / 24 hr
Creatine Clearance (Female) 80 - 130 mL / min
Creatine Clearance (Female) 10 - 20 mg / kg / 24 hr
Magnesium 6 - 9 mEq / 24 hr
Osmolality 450 - 900 mOsm / kg
Phosphorus 0.9 - 1.3 g / 24 hr
Potassium 35 - 85 mEq / 24 hr
Protein 0 - 150 mg / 24 hr
Sodium 30 - 280 mEq / 24 hr
Urea nitrogen 10 - 22 gm / 24 hr
Uric acid 240 - 755 mg / 24 hr
COAGULATION
ACT 90 - 130 seconds
APTT 21 - 35 seconds
Platelets 140,000 - 450,000 / ml
Plasminogen 62 - 130%
PT 10 - 14 seconds
PTT 32 - 45 seconds
FSP Less than 10 µg/dL
Fibrinogen 160 - 450 mg/dL
Bleeding time 3 - 7 minutes
Thrombin time 11 - 15 seconds
CEREBRAL SPINAL FLUID
Appearance clear
Glucose 40 - 85 mg/dL
Osmolality 290 - 298 mOsm/L
Pressure 70 - 180 mm/H2O
Protein 15 - 45 mg/dL
Total cell count 0 - 5 cells
WBC's 0 - 6 / µL
HEMODYNAMIC PARAMETERS
Cardiac Index 2.5 - 4.2 L / min / m squared
Cardiac Output 4 - 8 LPM
Left Ventricular Stroke Work Index 40 - 70 g / m squared / beat
Mean Arterial Pressure 70 - 105 mm Hg
Pulmonary Vascular Resistance 155 - 255 dynes / sec / cm to the negative 5
Pulmonary Vaslular Resistance Index 255 - 285 dynes / sec / cm to the negative 5
Right Ventricular Stroke Work Index 7 - 12 g / m squared / beat
Stroke Volume 60 - 100 mL / beat
Stroke Volume Index 40 - 85 mL / m squared / beat
Systemic Vascular Resistance 900 - 1600 dynes / sec / cm to the negative 5
Systemic Vascular Resistance Index 1970 - 2390 dynes / sec / cm to the negative 5
Systolic Arterial Pressure 90 - 140 mm Hg
Diastolic Arterial Pressure 60 - 90 mm Hg
Central Venous Pressure 2 - 6 mm Hg; 2.5 - 12 cm H2O
Ejection Fraction 60 - 75%
Left Arterial Pressure 4 - 12 mm Hg
Pulmonary Artery Systolic 15 - 30 mm Hg
Pulmonary Artery Diastolic 5 - 15 mm Hg
Pulmonary Artery Pressure 10 - 20 mm Hg
Pulmonary Artery Wedge Pressure 4 - 12 mm Hg
Pulmonary Artery End Diastolic Pressure 8 - 10 mm Hg
Right Atrial Pressure 4 - 6 mm Hg
Right Ventricular End Diastolic Pressure 0 - 8 mm Hg
NEUROLOGICAL VALUES
Cerebral Perfusion Pressure 70 - 90 mm Hg
Intracranial Pressure 5 - 15 mm Hg or 5 - 10 cm H2O
ARTERIAL VALUES
pH 7.35 - 7.45
PaCO2 35 - 45 mm Hg
HCO3 22 - 26 mEq/L
O2 sat 92 - 100%
PaO2 80 - 100 mm Hg
BE -2 to +2 mmol/L
VENOUS VALUES
pH 7.31 - 7.41
PaCO2 41 - 51 mm Hg
HCO3 22 - 29 mEq/L
O2 sat 60 - 85%
PaO2 30 - 40 mm Hg
BE 0 to +4 mmol/L
Getting The Facts Straight On Swine Flu (H1N1 Virus)
While you may have been inundated with news about swine flu (H1N1 virus), you may not have gotten all the right information. Here are the important facts you need to know about swine flu this season.
This summer, health news was dominated by information on the H1N1 flu virus. And just like a child’s game of “telephone,” the facts about the disease got mixed up by the time they’d traveled person to person.
So we’ve put together a list of the most important swine flu facts and myths, as well as information on what you can do to keep you and your family healthy this cold and flu season.
How many people have been affected?
According to the U.S. Centers for Disease Control and Prevention (CDC), there have been 556 deaths from H1N1 as of late August, and 8,843 patients hospitalized because of the disease. More importantly, the CDC has found that the rates of hospitalization of H1N1 patients are similar to the number of people hospitalized for the seasonal flu every year.
What about the number of people predicted to get it?
Some health organizations believe there may be anywhere from 30,000 to 90,000 deaths from swine flu this year, and though those numbers can raise concerns, experts say people should be aware that 40,000 die annually from the typical seasonal flu. The numbers aren’t very different, and while there is every reason to be cautious and take your health seriously, experts agree that there is no reason to panic.
Who is affected?
One of the reasons people are concerned about H1N1 is because it appears to be worse in young people. According to the CDC, 42 children have died from swine flu. Ordinarily, the seasonal flu causes death mainly in very ill people and the elderly, but children and pregnant women appear to be at greater risk than normal with this swine flu strain.
The flu virus affects the upper and lower airways, which means that people who suffer from respiratory diseases such as asthma and COPD are also at higher risk, as are people under the age of 19 who have been on long-term aspirin therapy, and diabetics. Of the children who died, many of them had underlying diseases, such as lung disease, and one had leukemia.
Just like with the seasonal flu, people with compromised immune systems — such as those with HIV, chemotherapy patients, or those who take immune-suppressing drugs — are more at risk for complications.
But I’ve heard that swine flu kills healthy people too.
Some of the deaths from swine flu have been in apparently healthy, young people. But experts point out that with all illnesses, there are always “healthy” victims. Statistically, young people in crowded school settings are more likely to get the flu, which means that there is greater chance for more cases that become serious.
Experts say it’s important to remember that most of the people who contracted the H1N1 flu virus this year had a rough week and then recovered. In fact, the CDC estimates that up to a million Americans may have had swine flu this summer but were never tested because they got better without seeing a doctor.
Should I contact my doctor if I think I have H1N1?
Those who are in high-risk categories—such as pregnant women and people with lung diseases or compromised immune systems—should contact their doctor at the first sign of swine flu. However, it may be better to call or email them, since hospitals and doctor’s offices are some of the best places to “pick up” the swine flu virus.
For otherwise healthy people, the flu — any flu — is miserable at best. But experts say the best way to get on your feet soon is to combine the age-old remedies of rest, fluids, and time.
Why Uncle Sam needs YOU to help prevent swine flu!
Federal officials say everyone can do their part to help stop the threat of swine flu this season.
One reason for the caution is that vaccines will not be available until mid-October, and even for those at the highest risk who get vaccinated immediately will likely not be fully protected for several weeks. Until then, U.S. Department of Health and Human Services (HHS) and CDC officials say good hygiene and respect for others will go a long way toward helping keep people healthy.
So, what can you do?
You’ve heard these before, and though they’re simple, they’re also the easiest ways to keep yourself, your family, and your community members healthy.
- Wash your hands with soap and water, especially after coughing and sneezing. Alcohol-based hand cleaners are also effective with a concentration of 60% to 95% ethanol or isopropanol, as recommended by the Food and Drug Administration (FDA).
- Cover your mouth and nose with a tissue or your shirt when you cough or sneeze. You can also sneeze into the crook of your elbow, rather than your hands. Avoid touching your eyes, nose, or mouth; germs are spread this way.
- Know the signs and symptoms of the flu. Like the seasonal flu, swine flu symptoms include fever (a temperature equal to or greater than 100 degrees Fahrenheit), cough, sore throat, runny nose, body aches, headache, and chills.
- Stay home if you have flu or flu-like symptoms for at least 24 hours after you no longer have a fever; this should be determined without the use of fever reducing medications.
- Talk with your health care provider about getting vaccinated. For more information about people that may be at higher risk for complications and priority groups for vaccination, visit the CDC's Flu Vaccination Page.
Hospital Careers
Nursing is not a one size fits all occupation , and hasn’t been for a long time. The world of nursing has come a long way since the days of Clara Barton and Florence Nightingale, and there are all sorts of career options and specializations available for modern day nurses. While many nurses still work in hospitals, many do not, and in or out of the hospital, there’s an amazing variety of nursing careers available. So don’t feel pigeonholed into thinking in terms of the old nursing stereotype. We’ll talk about some of the different jobs open to today’s nurses, both in hospitals, and outside hospitals.
Nursing Jobs In Hospitals:
Nurse Practitioner-This is another option for nurses with advanced training and experience. Nurse Practitioners perform many of the functions that physicians perform, including prescribing medication (in most states). Nurse practitioners work under the supervision of a medical doctor, but they are largely independent in their day to day activities. Because of the ever growing tendency of M.D.s to specialize, the number of general practitioners has been dropping precipitously in the past few decades. To fill the gap, state medical boards created the N. P. position. Nurse practitioners are for many people their “family doctor”. They handle common illnesses, and give health counseling and advice on avoiding sickness. A master’s degree is required for this nursing career, and N.P. programs usually require candidates to have several years nursing experience before acceptance.
Nurse Anesthesiologist-This is another career option for nurses that requires a master’s degree, and advanced training. The vast majority of anesthesia administered in American hospitals is administered by nurses. Anesthesiology is one of the most important medical breakthroughs in history-before it came along, surgery was a horrifyingly painful ordeal. But now people can be operated on without fear thanks to anesthesia, and the nurses who deliver most of it. This is also one of the highest paying nursing careers.
Cardiac Care Nursing-Heart disease is one of the leading causes of death in America, and preventing and reversing it is one of the primary goals of modern medicine. Cardiac care nurses work with doctors who are treating victims of heart disease and other cardiac related ailments, by means of bypass surgery, angioplasty, pacemaker implants, etc. Most of the time their work is done in a hospital, but cardiac nurses can sometimes be found in specialty medical clinics, and some even visit patients at home.
Case Manager Nurse-Sometimes a patient, especially under long term care, will face a bewildering number of medical appointments, procedures, doctors, oncologists, surgeons, etc. Keeping track of them, as well as handling the interaction between the patient and the health care system is the job of the Nurse-Case Manager. Additionally, he or she not only makes sure the patient gets good health care, but also works to see to it that it’s done in a cost effective manner, saving the facility unnecessary expense. Nurse-Case Managers usually specialize in either a particular segment of the population, such as children or the elderly, or in certain medical specialties, such as AIDS, cancer, heart disease, etc.
Critical Care Nursing-You’re no doubt familiar with situations where someone has had a stroke, or been injured in a car accident, and news reports state that they’re listed in “critical condition”. Their situation is touch and go, they’re hanging between life and death. And critical care nurses are the ones who take care of them. This nursing specialty requires lots of compassion, empathy, split second decision making, intelligence, and good people skills. Not only are critical care nurses working to pull the patient back from the brink of death, but they’re also interacting and comforting the grieving and worried family members of the patients. It’s a tough job, but if you’re up to it, critical care nursing has some of the greatest emotional rewards of any nursing career.
Emergency Nursing-Nurses who work in emergency rooms deal with all kinds of situations that require immediate care, from appendicitis to car wrecks to gunshot wounds to strokes, etc. It takes a special kind of person to work in this environment-one who’s fast on their feet, can make split second decisions, isn’t easily shocked, etc. Life isn’t always exciting in the emergency room, but nurses who work there know that at any time they’re liable to encounter a life and death situation, and they have to be ready. Not everyone is cut out to work in emergency room setting, but many nurses would never work anywhere else.
Ob/Gyn Nursing-Obstetrics and gynecology nurses specialize in caring for women with regard to childbirth, pregnancy, and everything else related to the female reproductive system, from puberty all the way through menopause.
Hematology Nursing-Hematology has to do with diseases of the blood, such as sickle cell anemia and leukemia. This is a less common nursing specialty, but a very important one. If you’ve ever had a family member with hemophilia, you know just how important hematology nurses are. Much of their work involves educating patients and their family members on how to manage the disease, and cope with living with it.
Intravenous Nursing-Also known as infusion nursing, this is the nursing specialty that deals with delivering fluids, nutrients, and medications directly into the patient’s bloodstream. If you’ve heard the term “I. V. drip”, these are the nurses who administer the drips and other infusions. They also monitor the patients during delivery, and afterwards keep an eye on the opening of the skin to watch for infections.
Labor and Delivery Nursing-this is a popular career choice for nurses. It’s related to ob/gyn nursing, but focuses solely on pregnant mothers and their child immediately before, during, and immediately after labor and childbirth. Many L & D nurses wouldn’t trade jobs for anything as they can’t think of anything else that would give as much satisfaction as helping to bring new life into the world.
Medical Surgical Nursing-This specialty, commonly referred to as Med/Surg nursing, is the branch of nursing that most people have in mind when they think of a registered nurse. They help patients in hospitals and nursing homes and other facilities who are taking pharmaceutical drugs, and also care for them prior to and after surgery.
Neo-Natal Intensive Care Unit-Nurses who specialize in this field, which is called NICU for short, take care of premature babies, and other babies who have serious problems immediately after being delivered. Some nurses say that while it can be an emotionally draining job, it can also be immensely satisfying.
Oncology Nursing-Oncology nurses work with cancer patients. This is a growing field, as the rates of cancer in this country continue to increase. Nurses who work in oncology administer chemotherapy, counsel patients, work with the doctors and surgeons to create and coordinate a cancer treatment plan, and educate patients on their disease and its treatment.
Perioperative Nursing-These are nurses who work in operating rooms, also known as OR nurses, although preoperative is rapidly becoming the preferred terminology. They assist surgeons directly and indirectly during surgery, prepare and maintain a safe and sterile operating environment, and monitor patients vital signs and progress during and immediately after surgery. Many periop nurses further specialize in a particular kind of surgery, such as heart surgery or neurosurgery.
Otorhinolaryngology Nursing-Also known as Head and Neck nursing, this is the branch of nursing that cares for patients with injuries and diseases affecting these areas of the body, such as accident victims, allergies, cancers of the head or neck, cleft palates, etc.
Pediatric Nursing-Pediatric nurses care for younger patients, from infancy until adulthood. Many of them also have further specializations, such as pediatric oncology, which is treating children with cancer, or pediatric hematology, since so many blood diseases strike people during childhood.
Perianesthesia Nursing-these are the nurses who assist anesthesiologists by preparing patients for anesthesia before surgery, and after surgery is completed, slowly bringing them back to wakefulness. Nurse Anesthesiologists actually administer the anesthesia; these nurses don’t actually handle the medication but help the patients during the process.
Perinatal Nursing-Nurses who specialize in pregnancy and childbirth issues, sometimes known as prenatal nursing. Pregnant women and their families face a lot of issues preparing for childbirth, especially in the case of a first child, and perinatal nurses help them get ready, telling them what to expect, giving them health tips, watching for symptoms, offering general health advice for both mother and fetus.
Psychiatric Nursing-Psych nurses work with patients facing issues of mental health, from eating disorders, depression, anxiety, addiction, physical and sexual abuse, personality disorders, etc. This branch of nursing can be highly stressful and isn’t for everybody, but like all other nursing specialties, has its own rewards that go along with the drawbacks.
Radiology Nursing-This is one of the more technically advanced nursing specialties. Radiology nurses work in the field of medical imaging, which includes sonograms, ultrasound, magnetic resonance, x-rays, etc. It’s also quite physically demanding-nurses who work in radiology are often on their feet all day, and there’s a lot of walking involved, in addition to sometimes having to wear heavy protective aprons made of lead.
Respiratory Nursing-Respiratory nurses, also known as pulmonary care nurses, work with patients who have lung problems or difficulty breathing. Their patients will have such conditions as lung cancer, emphysema, asthma, tuberculosis, etc. Many of them will also be breathing with the assistance of ventilators or oxygen machines. Respiratory nursing is primarily an in hospital nursing specialty, but many respiratory nurses will make home visits as part of their job.
Rehabilitation Nursing-Rehab nurses work with patients who’ve become temporarily or permanently disabled and unable to function normally due to injury or illness. Many of their patients are in wheelchairs or use other devices to assist them in getting around. It can be a physically demanding job, and requires a lot of compassion and patience.
Telemetry Nursing-Telemetry nurses work with heart patients in the cardiac units of hospitals, where the patients are hooked up to sophisticated instruments used to monitor various functions of the cardio pulmonary system, such as electrocardiogram machines. Not only must these nurses know how to care for patients, they must also be familiar with the various types of instruments and how to interpret the feedback they get from them.
Trauma Nursing-Trauma nurse usually work in emergency rooms, or with patients who’ve just come out of the emergency room. Whether it’s a heart attack victim, a person who almost drowned, someone who fell off a ladder, or a person who’s been in a severe car accident, trauma victims need intense care as soon as possible. They’re often in shock, or bleeding profusely, and are many times near death. Trauma nurses work with doctors and surgeons to treat their condition, and then stabilize them so they can hopefully make a full recovery. This can be an extremely stressful nursing career, more so than many others.
Practice Questions
31. A nurse if reviewing a patient’s chart and notices that the patient suffers from conjunctivitis. Which of the following microorganisms is related to this condition?
A: Yersinia pestis
B: Helicobacter pyroli
C: Vibrio cholera
D: Hemophilus aegyptius
32. A nurse if reviewing a patient’s chart and notices that the patient suffers from Lyme disease. Which of the following microorganisms is related to this condition?
A: Borrelia burgdorferi
B: Streptococcus pyrogens
C: Bacilus anthracis
D: Enterococcus faecalis
33. A fragile 87 year-old female has recently been admitted to the hospital with increased confusion and falls over last 2 weeks. She is also noted to have a mild left hemiparesis. Which of the following tests is most likely to be performed?
A: FBC (full blood count)
B: ECG (electrocardiogram)
C: Thyroid function tests
D: CT scan
34. A 84 year-old male has been loosing mobility and gaining weight over the last 2 months. The patient also has the heater running in his house 24 hours a day, even on warm days. Which of the following tests is most likely to be performed?
A: FBC (full blood count)
B: ECG (electrocardiogram)
C: Thyroid function tests
D: CT scan
35. A 20 year-old female attending college is found unconscious in her dorm room. She has a fever and a noticeable rash. She has just been admitted to the hospital. Which of the following tests is most likely to be performed first?
A: Blood sugar check
B: CT scan
C: Blood cultures
D: Arterial blood gases
36. A 28 year old male has been found wandering around in a confused pattern. The male is sweaty and pale. Which of the following tests is most likely to be performed first?
A: Blood sugar check
B: CT scan
C: Blood cultures
D: Arterial blood gases
37. A mother is inquiring about her child’s ability to potty train. Which of the following factors is the most important aspect of toilet training?
A: The age of the child
B: The child ability to understand instruction.
C: The overall mental and physical abilities of the child.
D: Frequent attempts with positive reinforcement.
38. A parent calls the pediatric clinic and is frantic about the bottle of cleaning fluid her child drank 20 minutes. Which of the following is the most important instruction the nurse can give the parent?
A: This too shall pass.
B: Take the child immediately to the ER
C: Contact the Poison Control Center quickly
D: Give the child syrup of ipecac
39. A nurse is administering a shot of Vitamin K to a 30 day-old infant. Which of the following target areas is the most appropriate?
A: Gluteus maximus
B: Gluteus minimus
C: Vastus lateralis
D: Vastus medialis
40. A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do?
A: Contact the provider
B: Ask the child to write their name on paper.
C: Ask a co-worker about the identification of the child.
D: Ask the father who is in the room the child’s name.
Answer Key 31-40.
31. (D) Choice A is linked to Plague, Choice B is linked to peptic ulcers, Choice C is linked to Cholera.
32. (A) Choice B is linked to Rheumatic fever, Choice C is linked to Anthrax, Choice D is linked to Endocarditis.
33. (D) A CT scan would be performed for further investigation of the hemiparesis.
34. (C) Weight gain and poor temperature tolerance indicate something may be wrong with the thyroid function.
35. (C) Blood cultures would be performed to investigate the fever and rash symptoms.
36. (A) With a history of diabetes, the first response should be to check blood sugar levels.
37. (C) Age is not the greatest factor in potty training. The overall mental and physical abilities of the child is the most important factor.
38. (C) The poison control center will have an exact plan of action for this child.
39. (C) Vastus lateralis is the most appropriate location.
40. (D) In this case you are able to determine the name of the child by the father’s statement. You should not withhold the medication from the child following identification.
Practice Questions
21. A 65 year old man has been admitted to the hospital for spinal stenosis surgery. When does the discharge training and planning begin for this patient?
A: Following surgery
B: Upon admit
C: Within 48 hours of discharge
D: Preoperative discussion
22. A child is 5 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the child in?
A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation
23. A toddler is 16 months old and has been recently admitted into the hospital. According to Erickson which of the following stages is the toddler in?
A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation
24. A young adult is 20 years old and has been recently admitted into the hospital. According to Erickson which of the following stages is the adult in?
A: Trust vs. mistrust
B: Initiative vs. guilt
C: Autonomy vs. shame
D: Intimacy vs. isolation
25. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?
A: 11 year old male – 90 b.p.m, 22 resp/min. , 100/70 mm Hg
B: 13 year old female – 105 b.p.m., 22 resp/min., 105/60 mm Hg
C: 5 year old male- 102 b.p.m, 24 resp/min., 90/65 mm Hg
D: 6 year old female- 100 b.p.m., 26 resp/min., 90/70mm Hg
26. When you are taking a patient’s history, she tells you she has been depressed and is dealing with an anxiety disorder. Which of the following medications would the patient most likely be taking?
A: Elavil
B: Calcitonin
C: Pergolide
D: Verapamil
27. Which of the following conditions would a nurse not administer erythromycin?
A: Campylobacterial infection
B: Legionnaire’s disease
C: Pneumonia
D: Multiple Sclerosis
28. A patient’s chart indicates a history of hyperkalemia. Which of the following would you not expect to see with this patient if this condition were acute?
A: Decreased HR
B: Paresthesias
C: Muscle weakness of the extremities
D: Migranes
29. A patient’s chart indicates a history of ketoacidosis. Which of the following would you not expect to see with this patient if this condition were acute?
A: Vomiting
B: Extreme Thirst
C: Weight gain
D: Acetone breath smell
30. A patient’s chart indicates a history of meningitis. Which of the following would you not expect to see with this patient if this condition were acute?
A: Increased appetite
B: Vomiting
C: Fever
D: Poor tolerance of light
Answer Key 21-30.
21. (B) Discharge education begins upon admit.22. (B) Initiative vs. guilt- 3-6 years old
23. (A) Trust vs. Mistrust- 12-18 months old
24. (D) Intimacy vs. isolation- 18-35 years old
25. (B) HR and Respirations are slightly increased. BP is down.
26. (A) Elavil is a tricyclic antidepressant.
27. (D) Erythromycin is used to treat conditions A-C.
28. (D) Answer choices A-C were symptoms of acute hyperkalemia.
29. (C) Weight loss would be expected.
30. (A) Loss of appetite would be expected.
Practice Questions
11. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU?
A: A Guthrie test can check the necessary lab values.
B: The urine has a high concentration of phenylpyruvic acid
C: Mental deficits are often present with PKU.
D: The effects of PKU are reversible.
12. A patient has taken an overdose of aspirin. Which of the following should a nurse most closely monitor for during acute management of this patient?
A: Onset of pulmonary edema
B: Metabolic alkalosis
C: Respiratory alkalosis
D: Parkinson’s disease type symptoms
13. A fifty-year-old blind and deaf patient has been admitted to your floor. As the charge nurse your primary responsibility for this patient is?
A: Let others know about the patient’s deficits.
B: Communicate with your supervisor your patient safety concerns.
C: Continuously update the patient on the social environment.
D: Provide a secure environment for the patient.
14. A patient is getting discharged from a SNF facility. The patient has a history of severe COPD and PVD. The patient is primarily concerned about their ability to breath easily. Which of the following would be the best instruction for this patient?
A: Deep breathing techniques to increase O2 levels.
B: Cough regularly and deeply to clear airway passages.
C: Cough following bronchodilator utilization
D: Decrease CO2 levels by increase oxygen take output during meals.
15. A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present?
A: Slow pulse rate
B: Weight gain
C: Decreased systolic pressure
D: Irregular WBC lab values
16. A mother has recently been informed that her child has Down’s syndrome. You will be assigned to care for the child at shift change. Which of the following characteristics is not associated with Down’s syndrome?
A: Simian crease
B: Brachycephaly
C: Oily skin
D: Hypotonicity
17. A patient has recently experienced a (MI) within the last 4 hours. Which of the following medications would most like be administered?
A: Streptokinase
B: Atropine
C: Acetaminophen
D: Coumadin
18. A patient asks a nurse, “My doctor recommended I increase my intake of folic acid. What type of foods contain the highest concentration of folic acids?”
A: Green vegetables and liver
B: Yellow vegetables and red meat
C: Carrots
D: Milk
19. A nurse is putting together a presentation on meningitis. Which of the following microorganisms has noted been linked to meningitis in humans?
A: S. pneumonia
B: H. influenza
C: N. meningitis
D: Cl. difficile
20. A nurse is administering blood to a patient who has a low hemoglobin count. The patient asks how long to RBC’s last in my body? The correct response is.
A: The life span of RBC is 45 days.
B: The life span of RBC is 60 days.
C: The life span of RBC is 90 days.
D: The life span of RBC is 120 days.
Answer Key 11-20.
11. (D) The effects of PKU stay with the infant throughout their life.12. (D) Aspirin overdose can lead to metabolic acidosis and cause pulmonary edema development.
13. (D) This patient’s safety is your primary concern.
14. (C) The bronchodilator will allow a more productive cough.
15. (B) Weight gain is associated with CHF and congenital heart deficits.
16. (C) The skin would be dry and not oily.
17. (A) Streptokinase is a clot busting drug and the best choice in this situation.
18. (A) Green vegetables and liver are a great source of folic acid.
19. (D) Cl. difficile has not been linked to meningitis.
20. (D) RBC’s last for 120 days in the body.
Practice Questions
1. A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.
A: Coumadin
B: Finasteride
C: Celebrex
D: Catapress
E: Habitrol
F: Clofazimine
2. A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.
A: Cipro
B: Sulfonamide
C: Noroxin
D: Bactrim
E: Accutane
F: Nitrodur
3. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?
A: Sulfasalazine
B: Levodopa
C: Phenolphthalein
D: Aspirin
4. You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?
A: Corgard
B: Humulin (injection)
C: Urokinase
D: Epogen (injection)
5. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?
A: IgA
B: IgD
C: IgE
D: IgG
6. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?
A: Immediately see a social worker
B: Start prophylactic AZT treatment
C: Start prophylactic Pentamide treatment
D: Seek counseling
7. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?
A: Atherosclerosis
B: Diabetic nephropathy
C: Autonomic neuropathy
D: Somatic neuropathy
8. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?
A: Multiple sclerosis
B: Anorexia nervosa
C: Bulimia
D: Systemic sclerosis
9. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?
A: Diverticulosis
B: Hypercalcaemia
C: Hypocalcaemia
D: Irritable bowel syndrome
10. Rho gam is most often used to treat____ mothers that have a ____ infant.
A: RH positive, RH positive
B: RH positive, RH negative
C: RH negative, RH positive
D: RH negative, RH negative
Answer Key
1. (A) and (B) are both contraindicated with pregnancy.
2. (F) All of the others have can cause photosensitivity reactions.
3. (D) All of the others can cause urine discoloration.
4. (A) Corgard could be removed from the refigerator.
5. (D) IgG is the only immunoglobulin that can cross the placental barrier.
6. (B) AZT treatment is the most critical innervention.
7. (C) Autonomic neuropathy can cause inability to urinate.
8. (B) All of the clinical signs and systems point to a condition of anorexia nervosa.
9. (B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.
10. (C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.
