Nokea
When reviewing the laboratory results for a patient's total calcium level, which of the following information should the nurse consider?
- A. The blood glucose is elevated.
- B. The phosphate level is normal.
- C. The serum albumin level is low.
- D. The magnesium level is normal.
Correct Answer: C
Rationale: Part of the total calcium is bound to albumin, so hypoalbuminemia can lead to misinterpretation of calcium levels. Ionized calcium is unaffected by albumin levels. The other laboratory values will not affect total calcium interpretation.
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The nurse is caring for a patient who is preparing for a growth hormone stimulation test. Which of the following adverse effects should the nurse monitor for during the test?
- A. Bradycardia
- B. Hypotension
- C. Hyperglycemia
- D. Tachypnea
Correct Answer: B
Rationale: During a growth hormone stimulation test, the nurse should continually assess for hypoglycemia and hypotension. There is no indication to monitor for bradycardia or tachypnea.
The nurse is evaluating the laboratory results for a patient who has increased secretion of the anterior pituitary hormones. Which of the following findings should the nurse anticipate when reviewing the laboratory findings?
- A. Decreased serum thyroxine levels
- B. Elevated serum aldosterone levels
- C. An increase in urinary free cortisol
- D. Low urinary excretion of catecholamines
Correct Answer: C
Rationale: Increased secretion of adrenocorticotropic hormone (ACTH) by the anterior pituitary gland will lead to an increase in serum and urinary cortisol levels. An increase, rather than a decrease, in thyroxine level would be expected with increased secretion of thyroid-stimulating hormone (TSH) by the anterior pituitary. Aldosterone and catecholamine levels are not controlled by the anterior pituitary.
A patient has a total serum calcium level of 3.3 mmol/L. Which of the following laboratory results should the nurse assess next?
- A. Calcitonin
- B. Catecholamine
- C. Thyroid hormone
- D. Parathyroid hormone
Correct Answer: D
Rationale: Parathyroid hormone is the major controller for blood calcium levels. Although calcitonin secretion is a counter-mechanism to parathyroid hormone, it does not play a major role in calcium balance. Catecholamine and thyroid hormone levels do not affect serum calcium level.
The nurse is caring for a patient in the outpatient clinic who has a prescription for blood cortisol testing. Which of the following instructions should the nurse provide for the patient?
- A. Avoid adding any salt to your foods for 24 hours before the test.
- B. You will need to lie down for 30 minutes before the blood is drawn.
- C. Come to the laboratory to have the blood drawn early in the morning.
- D. Do not have anything to eat or drink before the blood test is obtained.
Correct Answer: C
Rationale: Cortisol levels are usually drawn in the morning when levels are highest. The other instructions would be given to patients who were having other endocrine testing.
During a physical examination, the nurse finds that a patient's thyroid gland cannot be palpated. Which of the following is the best action for the nurse to take?
- A. Palpate the patient's neck more deeply.
- B. Document that the thyroid was nonpalpable.
- C. Notify the health care provider immediately.
- D. Teach the patient about thyroid hormone testing.
Correct Answer: B
Rationale: The thyroid is frequently nonpalpable. The nurse should simply document the finding. There is no need to notify the health care provider immediately about a normal finding. There is no indication for TSH testing unless there is evidence of thyroid dysfunction. Deep palpation of the neck is not appropriate.