🌡NCLEX Lab Values

Question 1

BLood urea nitrogen (BUN)

Answer 1

8-25 mg/dL
(Kidney function)

LOW = liver failure, cirrhosis, over-hydration, nephrotic syndrome, starvation

HIGH = burns, low blood volume, dehydration, shock, HF, kidney disease, drug toxicity, post-renal obstruction

Question 2

Serum Creatinine (Cr)

Answer 2

0.6-1.3 mg/dL

LOW = muscle mass

HIGH = hypothyroidism, renal failure, urinary tract obstruction

Question 3

Glucose, fasting

Answer 3

70-110 mg/dL

Question 4

Glucose, monitoring

Answer 4

60-110 mg/dL

Question 5

Glucose, 2hr post prandial

Answer 5

<140 mg/dL

Question 6

Glycosylated hemoglobin (HbA1c)

Answer 6

7% or lower (good control of diabetes)
7% to 8% (fair control of diabetes)
Higher than 8 % (poor control of diabetes)

Question 7

Red Blood Cell Count (RBC)

Answer 7

Male adult: 4.5 – 6.2 million/mm3

Female adult: 4.5 – 5.0 million/mm3

Question 8

Hemoglobin (Hgb)

Answer 8

Male: 14-16.5 g/dL
Female: 12-15 g/dL

Question 9

Hematocrit (Hct)

Answer 9

Male: 42 – 52%
Female: 35 – 47%

Question 10

Mean corpuscular volume (MCV)

Answer 10

Male: 78 – 100 μm3
Female: 78 – 102 μm3

Question 11

Serum iron

Answer 11

Male: 65 – 175 mcg/dL
Female: 50 – 170 mcg/dL

Question 12

White Blood Cell (WBC) Count

Answer 12

4,500 to 11,000 cells/mm³

Question 13

Neutrophils

Answer 13

55 – 70%
or
1,800 - 7,800 cells/mm³

IMMUNE DEFENSE

Question 14

Lymphocytes

Answer 14

20 – 40%
or
1,000 - 4,800 cells/mm³

INFECTION/antibody production

Question 15

Monocytes

Answer 15

2 – 8%
or
0.0 - 800 cells/mm³

INFLAMMATION and stress

Question 16

Eosinophils

Answer 16

1 – 4%
or
0.0 - 450 cells/mm³

Parasitic infection, allergic rxn, paraneoplastic response

Question 17

Basophils

Answer 17

0–2%
or
0.0 - 200 cells/mm³

Parasitic infection and allergic reaction

Question 18

Platelet count (PLT)

Answer 18

150,000 - 400,000 cells/mm³

LOW (Thrombocytopenia) = hemorrhage, DIC, hypersplenism, hemolytic anemia, infection, leukaemia, lupus

HIGH (Thrombocytosis) = iron deficiency anemia, postsplenectomy syndrome, rheumatoid arthritis

Question 19

Activated partial thromboplastin time (APTT)

Answer 19

20 to 60 seconds, depending on the type of activator used.

LOW = Early stages of DIC, Extensive cancer

HIGH = Congenital clotting factor deficiencies, DIC, Hemophilia, Heparin, Hypofibrinogenemia von Willebrand’s disease, Leukemia, Liver cirrhosis, Vitamin K deficiency

Question 20

Prothrombin time (PT)

Answer 20

11 – 13 seconds

LOW = too much Vitamin K

HIGH = Bile duct obstruction, DIC, hepatitis, Liver cirrhosis, massive blood transfusion, vitamin K deficiency

Question 21

Partial Thromboplastin Time (PTT)

Answer 21

25 – 35 seconds

Question 22

International Normalized Ratio (INR)

Answer 22

> 1.5-2.0

LOW = blood too thick

HIGH = blood too thin, warfarin

Question 23

Fibrinogen

Answer 23

203 – 377 mg/dL

Question 24

Bleeding time

Answer 24

Duke method: 1 to 3 minutes

Ivy method: 3 to 6 minutes

Question 25

D-Dimer

Answer 25

< 500 ng/mL HIGHER = Active blood clot DVT, PE, stroke, DIC

Question 26

Potassium (K+)

Answer 26

3.5 – 5.0 mEq/L Hypokalemia = Ascites, Burns, Cushing’s syndrome, Cystic fibrosis, Deficient dietary intake, Deficient IV intake, Diuretics, insulin, Renal artery stenosis Hyperkalemia = Acidosis, renal failure, aldosterone-inhibiting diuretics, crush injuries, dehydration, excessive dietary intake, Hemolysis, infection, hemolyzed blood transfusion.

Question 27

Sodium (Na+)

Answer 27

135-145 mEq/L Hyponatremia = AIDS, CHF, cirrhosis, nephrotic syndrome, excessive sweating, vomiting Hypernatremia = dehydration, dietary intake, DM, IV

Question 28

Chloride (Cl-)

Answer 28

95 – 105 mEq/L Hypocloremia = Addison’s, diarrhea, metabolic alkalosis, resp acidosis, vomiting Hypercloremia = cardiac decompression, met acidosis, resp alkalosis, corticosteroids, uremia

Question 29

Calcium (Ca+)

Answer 29

Total calcium: 4.5 – 5.5 mEq/L (8.5 to 10.5 mg/dL) Ionized calcium: 2.5 mEq/L (4.0 – 5.0 mg/dL) 56% of total calcium Hypocalcemia = prancreatitis, low Vit D, low PTH, chronic kidney issues, low mobility Hypercalcemia = hyperthyroidism, dec excretion, lithium, glucocorticoids, addisons

Question 30

Phosphorus (P)

Answer 30

1.8 – 2.6 mEq/L (2.7 to 4.5 mg/dL) LOW = alcoholism, diarrhea, hypercalcemia, refeeding syndrome, vomiting, Vit D deficiency HIGH = cirrhosis, renal failure

Question 31

Magnesium (Mg)

Answer 31

1.6 to 2.6 mg/dL Hypomagnesium = neuro excitability, limites intake, alcohol, malabsorption, glycemic issues Hypermagnesium = antacids, Addisons, Glomerular filtration insufficiency

Question 32

Alanine Aminotransferase (ALT)

Answer 32

Male: 10 to 55 units/L Female: 7 to 30 units/L Alanine Aminotransferase (ALT) test is used to identify hepatocellular injury and inflammation of the liver. HIGH = cirrhosis, cholestasis, hepatitis, hepatic ischemia, mononucleosis, MI, myositis, pancreatitis, shock, severe burns

Question 33

Aspartate Aminotransferase (AST)

Answer 33

Male: 10 – 40 units/L Female: 9 – 25 units/L

Question 34

Total bilirubin

Answer 34

0.3 – 1.0 mg/dL ``` Direct bilirubin (conjugated): 0.0 to 0.2 mg/dL Indirect bilirubin (unconjugated): 0.1 to 1 mg/dL; Critical level: > 12 mg/dL ```

Question 35

Albumin

Answer 35

3.4 to 5 g/dL Hypoalbuminemia = Acute liver failure, cirrhosis, increased capillary permeability, burns, malnutrition Hyperalbuminemia = dehydration, severe diarrhea, severe vomiting

Question 36

Ammonia

Answer 36

35 – 65 mcg/dL (adult)

Question 37

Amylase

Answer 37

25 to 151 units/L

Question 38

Lipase

Answer 38

10 to 140 units/L

Question 39

Protein

Answer 39

6 to 8 g/dL

Question 40

Cholesterol

Answer 40

Less than 200 mg/dL

Question 41

High-density lipoprotein (HDL)

Answer 41

30 to 70 mg/dL

Question 42

Low density lipoprotein (LDL)

Answer 42

Less than 130 mg/dL

Question 43

Triglycerides

Answer 43

Less than 150 mg/dL

Question 44

Creatine kinase (CK)

Answer 44

Male: 38 – 174 U/L Female: 26 – 140 U/L

Question 45

Myoglobin

Answer 45

5–70 ng/mL

Question 46

Troponin:

Answer 46

Troponin: Less than 0.04 ng/mL; above 0.40 ng/mL may indicate MI Troponin T: Greater than 0.1 to 0.2 ng/mL may indicate MI Troponin I: Less than 0.6 ng/mL; >1.5 ng/mL indicates myocardial infarction

Question 47

Atrial natriuretic peptide (ANP)

Answer 47

22 to 27 pg/mL

Question 48

Brain natriuretic peptide (BNP)

Answer 48

less than 100 pg/mL

Question 49

Thyroid function test

Answer 49

Triiodothyronine (T₃): 80 to 230 ng/dL Thyroxine (T₄): 5 to 12 mcg/dL Thyroxine, free (FT₄): 0.8 to 2.4 ng/dL Thyroid-stimulating hormone (thyrotropin): 0.2 to 5.4 microunits/mL

Question 50

Urinalysis

Answer 50

Specific gravity: 1.016 to 1.022 pH: 4.5 to 7.8 ``` Protein: Negative Ketones: Negative Bilirubin: Negative Glucose: >0.5 g/day Red blood cells: < 3 cells/HPF White blood cells: < or = 4 cells/HPF ```

Question 51

Therapeutic Drug Levels

Answer 51

Acetaminophen (Tylenol): 10 to 20 mcg/mL Carbamazepine (Tegretol): 5 to 12 mcg/mL Digoxin (Lanoxin): 0.5 to 2 ng/mL Gentamicin (Garamycin): 5 – 10 mcg/mL (peak); <2.0 mcg/mL (trough) Lithium (Lithobid): 0.5 to 1.2 mEq/L Magnesium sulfate: 4 to 7 mg/dL Phenobarbital (Luminal): 10 to 30 mcg/mL Phenytoin (Dilantin): 10 to 20 mcg/mL Salicylate: 100 to 250 mcg/mL Theophylline: 10 to 20 mcg/dL Tobramycin (Tobrex): 5 – 10 mcg/mL (peak); 0.5 – 2.0 mcg/mL (trough) Valproic acid (Depakene): 50 – 100 mcg/mL Vancomycin (Vancocin): 20 – 40 mcg/mL (peak); 5 – 15 mcg/mL (trough)

Question 52

Partial pressure of carbon dioxide (PCO2)

Answer 52

35 – 45 mmHg

Question 53

Bicarbonate (HCO3)

Answer 53

22 – 26 mEq/L