1.
These are part of the Basic Metabolic Panel.
Correct Answer
B. Sodium, creatinine, calcium
Explanation
Basic:
sodium, potassium, chloride, carbon dioxide, BUN, creatinine, glucose, calcium
Complete:
all basic + AST, ALT, alkaline phosphatase, total bilirubin, total protein, albumin
2.
This is NOT an indication for a metabolic panel.
Correct Answer
A. Patient requests one
3.
Abnormalities in sodium level usually are reflecting a true sodium abnormality.
Correct Answer
A. False
Explanation
Abnormal levels usually reflect a variation in serum water volume rather than sodium content.
4.
Your patient has an abnormal sodium test result. She is very lethargic and confused. Is this hyponatremia or hypernatremia?
Correct Answer
B. Hyponatremia
5.
Your patient has an abnormal sodium test result. He is agitated and restless, with hyperreflexia. Is this hyponatremia or hypernatremia?
Correct Answer
A. Hypernatremia
6.
Your patient has secondary hypertension due to hyperaldosteronism. Would you expect to find hypernatremia or hyponatremia in this patient?
Correct Answer
B. Hypernatremia
Explanation
Aldosterone causes sodium retention
7.
Your CHF patient has abnormal sodium test results. Would you expect this to be hyponatremia or hypernatremia?
Correct Answer
A. Hyponatremia
8.
Your patient has an arrhythmia. In a general sense, which electrolyte is likely the problem?
Correct Answer
D. Potassium
9.
In your patient with abnormal sodium levels due to hyperaldosteronism, what other electrolyte problem are they likely to have?
Correct Answer
A. Hypokalemia
Explanation
Aldosterone increases potassium excretion
10.
These can be causes of hyperkalemia (check all that apply):
Correct Answer(s)
A. ACE inhibitors
D. Spironolactone
Explanation
Bumetanide is a loop diuretic - would be more likely to cause LOSS of potassium, hypokalemia
11.
If you are unable to correct for low potassium, what should you check?
Correct Answer
B. Magnesium
12.
If your patient is hypercalcemic, what other electrolyte should you check in order to help determine the cause of the hypercalcemia?
Correct Answer
A. Chloride
Explanation
If chloride is high, then the cause of the hypercalcemia is primary hyperparathyroidism.
If chloride is normal, then the cause of the hypercalcemia is malignancy.
13.
Carbon dioxide level is a reflection of the body's pH. What would you expect to see in severe vomiting?
Correct Answer
C. Increased carbon dioxide
14.
Carbon dioxide level is a reflection of the body's pH. What would you expect to see in chronic diarrhea?
Correct Answer
B. Decreased carbon dioxide
15.
What is the most common cause of electrolyte imbalance?
Correct Answer
B. Kidney injury
16.
Which drugs can increase serum glucose? Check all that apply.
Correct Answer(s)
A. Corticosteroids
B. Thiazides
C. Caffeine
17.
All of these can be causes of LOW blood glucose except:
Correct Answer
A. Thiazides
Explanation
thiazides can cause hyperglycemia
18.
BUN serves as a index of function of both liver and kidney, and is used clinically as a rough measurement of renal function.
Correct Answer
A. True
19.
BUN is ________ in kidney injury and ________ in hepatic failure.
Correct Answer
B. Increased, decreased
20.
Creatinine is a measure of ______ function, and decreases with age (less muscle mass).
Correct Answer
D. Kidney
21.
BUN:Creatine ration is usually ___.
Correct Answer
C. 10:1
Explanation
If greater than 20:1 consider pre-renal causes of azotemia (high BUN) such as dehydration or GI bleed.
22.
Your patient is somnolent and has a shortened QT interval. Is this hypocalcemia or hypercalcemia?
Correct Answer
A. Hypercalcemia
23.
Your patient is nervous and excitable. You observe tetany and find a prolonged QT interval. Is this hypocalcemia or hypercalcemia?
Correct Answer
B. Hypocalcemia
24.
If you order a serum calcium (instead of a free calcium), what else do you need to order along with it?
Correct Answer
C. Albumin level
Explanation
Half of calcium is bound to albumin. If albumin is low, then calcium level will also be low.
(You can run an equation to get a corrected calcium using a "normal" albumin of 4)