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Which of the following findings indicate a left shift and bacterial infection in an adult?
- A. WBC: 13,900/mm'³; total neutrophils: 76% (bands: 30%, segmented: 46%); eosinophils: 2.5%; basophils: 0.5%; monocytes: 4%; lymphocytes: 17%
- B. WBC: 4,600/mm'³; total neutrophils: 59% (bands: 3%, segmented: 56%); eosinophils: 4%; basophils: 1%; monocytes: 6%; lymphocytes: 30%
- C. WBC: 11,350/mm'³; total neutrophils: 55% (bands: 3%, segmented: 52%); eosinophils: 12%; basophils: 2%; monocytes: 8%; lymphocytes: 23%
- D. WBC: 9,450/mm'³; total neutrophils: 61% (bands: 5%, segmented: 65%); eosinophils: 4%; basophils: 1%; monocytes: 3%; lymphocytes: 28%
Correct Answer: A
Rationale: A left shift is indicated by an elevated band neutrophil count (>10%), as seen in option A (30% bands), suggesting a bacterial infection.
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Which of the following tests or procedures is (are) beneficial in evaluation of the kidneys?
- A. IV pyelogram
- B. 24-hour urine
- C. Oral glucose tolerance test
- D. Urinalysis
- E. Glomerular filtration rate
- F. Creatinine
Correct Answer: A,B,D,E,F
Rationale: IV pyelogram, 24-hour urine, urinalysis, GFR, and creatinine tests assess kidney function, structure, or waste excretion.
Which of the following preparatory steps would you be likely to perform prior to a barium enema?
- A. Start an IV line the day prior to the test
- B. Keep the patient NPO 48 hours prior to the test
- C. Administer a laxative the day before the test
- D. Place the patient on a clear liquid diet for 24 hours prior to the test
- E. Administer an enema the evening before the test
Correct Answer: C,D,E
Rationale: A laxative, clear liquid diet, and enema are standard preparations to ensure the colon is clear for a barium enema.
Which of the following urinalysis findings would you need to report to the physician?
- A. Protein: 30 mg/dL
- B. Bacteria: 0
- C. WBCs: 3 to 4 per high-power field
- D. pH: 4.1
- E. Specific gravity: 1.025
- F. RBCs: 10 per high-power field
Correct Answer: A,D,F
Rationale: Protein (30 mg/dL), low pH (4.1), and RBCs (10 per high-power field) may indicate renal issues, infection, or other abnormalities requiring physician attention.
Which of the following tests would be helpful for evaluating the large intestine?
- A. Colonoscopy
- B. EGD
- C. Barium enema
- D. ECG
- E. Intravenous pyelogram
- F. Hgb and Hct
Correct Answer: A,C
Rationale: Colonoscopy and barium enema are diagnostic tests specifically used to evaluate the large intestine for abnormalities.
You should measure the abdominal girth and weight of a patient who is about to undergo:
- A. a glucose tolerance test
- B. a CT scan of the cerebrum
- C. an alkaline phosphatase test
- D. a paracentesis
- E. a lumbar puncture
Correct Answer: D
Rationale: Measuring abdominal girth and weight is critical before paracentesis to monitor fluid removal and assess for complications.