Study Guide for NGN NCLEX
Basic Metabolic Panel (BMP)
The BMP provides key information about a patient’s metabolic state, including kidney function,
blood sugar levels, and electrolyte balance.
1. Sodium (Na⁺)
○ Normal Range: 135–145 mEq/L
○ High (Hypernatremia): Dehydration, kidney disease, or excessive salt intake
○ Low (Hyponatremia): Overhydration, heart failure, kidney disease, or SIADH
2. Potassium (K⁺)
○ Normal Range: 3.5–5.0 mEq/L
○ High (Hyperkalemia): Renal failure, potassium-sparing diuretics, acidosis
○ Low (Hypokalemia): Diuretics, vomiting, diarrhea, alkalosis
3. Chloride (Cl⁻)
○ Normal Range: 98–106 mEq/L
○ High (Hyperchloremia): Dehydration, kidney disease, or metabolic acidosis
○ Low (Hypochloremia): Vomiting, metabolic alkalosis, diuretic therapy
4. Carbon Dioxide (CO₂ or Bicarbonate HCO₃)
○ Normal Range: 23–30 mEq/L
○ High (Hypercapnia): Respiratory depression, metabolic alkalosis
○ Low (Hypocapnia): Respiratory alkalosis, renal failure, or diarrhea
5. Blood Urea Nitrogen (BUN)
○ Normal Range: 7–20 mg/dL
○ High: Renal impairment, dehydration, high protein intake
○ Low: Liver disease, malnutrition
6. Creatinine
○ Normal Range: 0.6–1.2 mg/dL
○ High: Kidney failure, dehydration
○ Low: Low muscle mass or pregnancy (rare)
7. Glucose
○ Normal Range: 70–100 mg/dL (fasting)
○ High (Hyperglycemia): Diabetes, stress, infection
○ Low (Hypoglycemia): Starvation, insulin overdose, Addison’s disease
Complete Blood Count (CBC)
A CBC helps assess the overall health and detect a variety of disorders, such as anemia,
infection, and leukemia.
1. White Blood Cell Count (WBC)
○ Normal Range: 4,500–11,000 cells/µL
○ High (Leukocytosis): Infection, inflammation, leukemia
, ○ Low (Leukopenia): Viral infections, bone marrow issues, autoimmune disorders
2. Red Blood Cell Count (RBC)
○ Normal Range: Men: 4.7–6.1 million cells/µL; Women: 4.2–5.4 million cells/µL
○ High (Polycythemia): Dehydration, lung disease, high altitude
○ Low (Anemia): Blood loss, nutritional deficiencies, bone marrow problems
3. Hemoglobin (Hgb)
○ Normal Range: Men: 13.8–17.2 g/dL; Women: 12.1–15.1 g/dL
○ High: Dehydration, lung disease
○ Low: Anemia, blood loss
4. Hematocrit (Hct)
○ Normal Range: Men: 40–54%; Women: 37–47%
○ High: Dehydration, polycythemia
○ Low: Anemia, blood loss
5. Platelet Count
○ Normal Range: 150,000–450,000/µL
○ High (Thrombocytosis): Infection, inflammation, bleeding disorders
○ Low (Thrombocytopenia): Bone marrow failure, certain medications, liver disease
Liver Function Tests (LFTs)
These tests measure the health of the liver by assessing enzymes and proteins produced or
processed by the liver.
1. Alanine Aminotransferase (ALT)
○ Normal Range: 7–56 U/L
○ High: Liver damage, hepatitis, liver cirrhosis, fatty liver disease
2. Aspartate Aminotransferase (AST)
○ Normal Range: 10–40 U/L
○ High: Liver disease, heart disease, muscle injury
3. Alkaline Phosphatase (ALP)
○ Normal Range: 44–147 U/L
○ High: Liver disease, bone disease, pregnancy
4. Bilirubin
○ Normal Range: Total: 0.1–1.2 mg/dL; Direct: 0.0–0.3 mg/dL
○ High: Jaundice, liver disease, hemolysis
5. Albumin
○ Normal Range: 3.5–5.0 g/dL
○ Low: Liver disease, malnutrition, kidney disease
Coagulation Profile
These tests assess the blood’s ability to clot properly and can indicate bleeding disorders or liver
dysfunction.
, 1. Prothrombin Time (PT)
○ Normal Range: 11–13.5 seconds
○ High: Liver disease, vitamin K deficiency, warfarin therapy
2. International Normalized Ratio (INR)
○ Normal Range: 0.8–1.1 (for patients not on anticoagulants)
○ High: Risk for bleeding, vitamin K deficiency, liver disease, or anticoagulant
therapy
3. Activated Partial Thromboplastin Time (aPTT)
○ Normal Range: 25–35 seconds
○ High: Hemophilia, heparin therapy, liver disease
Thyroid Function Tests (TFTs)
These tests assess thyroid function and help diagnose conditions like hyperthyroidism or
hypothyroidism.
1. Thyroid Stimulating Hormone (TSH)
○ Normal Range: 0.4–4.0 mU/L
○ High: Hypothyroidism
○ Low: Hyperthyroidism
2. Free T4
○ Normal Range: 0.8–2.8 ng/dL
○ High: Hyperthyroidism
○ Low: Hypothyroidism
3. Free T3
○ Normal Range: 2.3–4.2 pg/mL
○ High: Hyperthyroidism
○ Low: Hypothyroidism
Arterial Blood Gases (ABG)
These tests assess oxygenation, ventilation, and acid-base balance.
1. pH
○ Normal Range: 7.35–7.45
○ High: Alkalosis
○ Low: Acidosis
2. Partial Pressure of Oxygen (PaO₂)
○ Normal Range: 80–100 mmHg
○ High: Hyperoxia
○ Low: Hypoxia
3. Partial Pressure of Carbon Dioxide (PaCO₂)
○ Normal Range: 35–45 mmHg
, ○ High: Respiratory acidosis
○ Low: Respiratory alkalosis
4. Bicarbonate (HCO₃)
○ Normal Range: 22–26 mEq/L
○ High: Metabolic alkalosis
○ Low: Metabolic acidosis
Key Takeaways for Nurses:
● Always verify the normal ranges for your specific hospital or lab.
● Critical Values: Pay attention to abnormal results (both high and low), as they may be
life-threatening and require immediate action.
● Context Matters: Consider the patient's medical history, clinical presentation, and any
ongoing treatments when interpreting lab results.
Understanding lab values is essential in nursing because they offer critical insights into a
patient's health status, assist in diagnosing conditions, inform treatment decisions, and help
monitor the effectiveness of interventions. Let’s explore why lab values matter, how they
influence patient care, and what abnormal results can reveal.
1. The Importance of Lab Values in Nursing
a. Diagnostic Tool
Lab tests provide objective data that help nurses and the healthcare team assess a patient's
internal health. Abnormal lab results can serve as early warning signs for specific conditions. For
instance:
● High blood glucose levels could indicate diabetes.
● An elevated WBC count might point to an infection or inflammation.
By identifying abnormalities, nurses and healthcare providers can make a timely and accurate
diagnosis.
b. Monitoring Disease Progression and Response to Treatment
Lab tests are vital for tracking how diseases progress and assessing how well a treatment plan is
working. For example:
● Creatinine and BUN levels are regularly monitored in patients with kidney disease to
evaluate renal function.
● Liver function tests (ALT, AST, ALP) are crucial for patients with liver cirrhosis or
hepatitis to monitor liver health and assess disease progression.
By observing trends in lab results, nurses can detect changes and alert the healthcare team if
interventions need to be adjusted.
, c. Guiding Clinical Interventions
When lab results fall outside of normal ranges, they can signal the need for immediate
intervention. For instance:
● If a patient’s potassium level is dangerously low (hypokalemia), they may require
potassium replacement to prevent cardiac arrhythmias.
● If a patient’s INR (International Normalized Ratio) is elevated, they may be at increased
risk for bleeding, prompting adjustments in their anticoagulant therapy.
Abnormal lab values act as a red flag, guiding nurses and healthcare providers in making critical
decisions to adjust treatment or intervene before complications arise.
d. Predicting Patient Outcomes
Lab values can also help predict the likely course or outcome of a condition. For example:
● Severely low hemoglobin (Hgb) could indicate significant blood loss or anemia, which
may require a blood transfusion to stabilize the patient and prevent shock.
By recognizing trends or extreme values, healthcare providers can anticipate complications and
take proactive steps to manage the patient’s care more effectively.
1. Question:
A patient’s potassium level comes back at 2.9 mEq/L. What is the most likely consequence of
this low potassium level?
● A) Seizures
● B) Cardiac arrhythmias
● C) Hyperglycemia
● D) Respiratory alkalosis
Answer:
B) Cardiac arrhythmias
Rationale:
Hypokalemia (low potassium) is most commonly associated with cardiac arrhythmias, as
potassium plays a critical role in maintaining normal heart rhythm. Severe hypokalemia can lead
to potentially life-threatening arrhythmias, such as ventricular fibrillation.
2. Question:
A nurse is reviewing a patient's lab results and sees an elevated BUN level. What could this
indicate?
● A) Liver failure
● B) Dehydration
Basic Metabolic Panel (BMP)
The BMP provides key information about a patient’s metabolic state, including kidney function,
blood sugar levels, and electrolyte balance.
1. Sodium (Na⁺)
○ Normal Range: 135–145 mEq/L
○ High (Hypernatremia): Dehydration, kidney disease, or excessive salt intake
○ Low (Hyponatremia): Overhydration, heart failure, kidney disease, or SIADH
2. Potassium (K⁺)
○ Normal Range: 3.5–5.0 mEq/L
○ High (Hyperkalemia): Renal failure, potassium-sparing diuretics, acidosis
○ Low (Hypokalemia): Diuretics, vomiting, diarrhea, alkalosis
3. Chloride (Cl⁻)
○ Normal Range: 98–106 mEq/L
○ High (Hyperchloremia): Dehydration, kidney disease, or metabolic acidosis
○ Low (Hypochloremia): Vomiting, metabolic alkalosis, diuretic therapy
4. Carbon Dioxide (CO₂ or Bicarbonate HCO₃)
○ Normal Range: 23–30 mEq/L
○ High (Hypercapnia): Respiratory depression, metabolic alkalosis
○ Low (Hypocapnia): Respiratory alkalosis, renal failure, or diarrhea
5. Blood Urea Nitrogen (BUN)
○ Normal Range: 7–20 mg/dL
○ High: Renal impairment, dehydration, high protein intake
○ Low: Liver disease, malnutrition
6. Creatinine
○ Normal Range: 0.6–1.2 mg/dL
○ High: Kidney failure, dehydration
○ Low: Low muscle mass or pregnancy (rare)
7. Glucose
○ Normal Range: 70–100 mg/dL (fasting)
○ High (Hyperglycemia): Diabetes, stress, infection
○ Low (Hypoglycemia): Starvation, insulin overdose, Addison’s disease
Complete Blood Count (CBC)
A CBC helps assess the overall health and detect a variety of disorders, such as anemia,
infection, and leukemia.
1. White Blood Cell Count (WBC)
○ Normal Range: 4,500–11,000 cells/µL
○ High (Leukocytosis): Infection, inflammation, leukemia
, ○ Low (Leukopenia): Viral infections, bone marrow issues, autoimmune disorders
2. Red Blood Cell Count (RBC)
○ Normal Range: Men: 4.7–6.1 million cells/µL; Women: 4.2–5.4 million cells/µL
○ High (Polycythemia): Dehydration, lung disease, high altitude
○ Low (Anemia): Blood loss, nutritional deficiencies, bone marrow problems
3. Hemoglobin (Hgb)
○ Normal Range: Men: 13.8–17.2 g/dL; Women: 12.1–15.1 g/dL
○ High: Dehydration, lung disease
○ Low: Anemia, blood loss
4. Hematocrit (Hct)
○ Normal Range: Men: 40–54%; Women: 37–47%
○ High: Dehydration, polycythemia
○ Low: Anemia, blood loss
5. Platelet Count
○ Normal Range: 150,000–450,000/µL
○ High (Thrombocytosis): Infection, inflammation, bleeding disorders
○ Low (Thrombocytopenia): Bone marrow failure, certain medications, liver disease
Liver Function Tests (LFTs)
These tests measure the health of the liver by assessing enzymes and proteins produced or
processed by the liver.
1. Alanine Aminotransferase (ALT)
○ Normal Range: 7–56 U/L
○ High: Liver damage, hepatitis, liver cirrhosis, fatty liver disease
2. Aspartate Aminotransferase (AST)
○ Normal Range: 10–40 U/L
○ High: Liver disease, heart disease, muscle injury
3. Alkaline Phosphatase (ALP)
○ Normal Range: 44–147 U/L
○ High: Liver disease, bone disease, pregnancy
4. Bilirubin
○ Normal Range: Total: 0.1–1.2 mg/dL; Direct: 0.0–0.3 mg/dL
○ High: Jaundice, liver disease, hemolysis
5. Albumin
○ Normal Range: 3.5–5.0 g/dL
○ Low: Liver disease, malnutrition, kidney disease
Coagulation Profile
These tests assess the blood’s ability to clot properly and can indicate bleeding disorders or liver
dysfunction.
, 1. Prothrombin Time (PT)
○ Normal Range: 11–13.5 seconds
○ High: Liver disease, vitamin K deficiency, warfarin therapy
2. International Normalized Ratio (INR)
○ Normal Range: 0.8–1.1 (for patients not on anticoagulants)
○ High: Risk for bleeding, vitamin K deficiency, liver disease, or anticoagulant
therapy
3. Activated Partial Thromboplastin Time (aPTT)
○ Normal Range: 25–35 seconds
○ High: Hemophilia, heparin therapy, liver disease
Thyroid Function Tests (TFTs)
These tests assess thyroid function and help diagnose conditions like hyperthyroidism or
hypothyroidism.
1. Thyroid Stimulating Hormone (TSH)
○ Normal Range: 0.4–4.0 mU/L
○ High: Hypothyroidism
○ Low: Hyperthyroidism
2. Free T4
○ Normal Range: 0.8–2.8 ng/dL
○ High: Hyperthyroidism
○ Low: Hypothyroidism
3. Free T3
○ Normal Range: 2.3–4.2 pg/mL
○ High: Hyperthyroidism
○ Low: Hypothyroidism
Arterial Blood Gases (ABG)
These tests assess oxygenation, ventilation, and acid-base balance.
1. pH
○ Normal Range: 7.35–7.45
○ High: Alkalosis
○ Low: Acidosis
2. Partial Pressure of Oxygen (PaO₂)
○ Normal Range: 80–100 mmHg
○ High: Hyperoxia
○ Low: Hypoxia
3. Partial Pressure of Carbon Dioxide (PaCO₂)
○ Normal Range: 35–45 mmHg
, ○ High: Respiratory acidosis
○ Low: Respiratory alkalosis
4. Bicarbonate (HCO₃)
○ Normal Range: 22–26 mEq/L
○ High: Metabolic alkalosis
○ Low: Metabolic acidosis
Key Takeaways for Nurses:
● Always verify the normal ranges for your specific hospital or lab.
● Critical Values: Pay attention to abnormal results (both high and low), as they may be
life-threatening and require immediate action.
● Context Matters: Consider the patient's medical history, clinical presentation, and any
ongoing treatments when interpreting lab results.
Understanding lab values is essential in nursing because they offer critical insights into a
patient's health status, assist in diagnosing conditions, inform treatment decisions, and help
monitor the effectiveness of interventions. Let’s explore why lab values matter, how they
influence patient care, and what abnormal results can reveal.
1. The Importance of Lab Values in Nursing
a. Diagnostic Tool
Lab tests provide objective data that help nurses and the healthcare team assess a patient's
internal health. Abnormal lab results can serve as early warning signs for specific conditions. For
instance:
● High blood glucose levels could indicate diabetes.
● An elevated WBC count might point to an infection or inflammation.
By identifying abnormalities, nurses and healthcare providers can make a timely and accurate
diagnosis.
b. Monitoring Disease Progression and Response to Treatment
Lab tests are vital for tracking how diseases progress and assessing how well a treatment plan is
working. For example:
● Creatinine and BUN levels are regularly monitored in patients with kidney disease to
evaluate renal function.
● Liver function tests (ALT, AST, ALP) are crucial for patients with liver cirrhosis or
hepatitis to monitor liver health and assess disease progression.
By observing trends in lab results, nurses can detect changes and alert the healthcare team if
interventions need to be adjusted.
, c. Guiding Clinical Interventions
When lab results fall outside of normal ranges, they can signal the need for immediate
intervention. For instance:
● If a patient’s potassium level is dangerously low (hypokalemia), they may require
potassium replacement to prevent cardiac arrhythmias.
● If a patient’s INR (International Normalized Ratio) is elevated, they may be at increased
risk for bleeding, prompting adjustments in their anticoagulant therapy.
Abnormal lab values act as a red flag, guiding nurses and healthcare providers in making critical
decisions to adjust treatment or intervene before complications arise.
d. Predicting Patient Outcomes
Lab values can also help predict the likely course or outcome of a condition. For example:
● Severely low hemoglobin (Hgb) could indicate significant blood loss or anemia, which
may require a blood transfusion to stabilize the patient and prevent shock.
By recognizing trends or extreme values, healthcare providers can anticipate complications and
take proactive steps to manage the patient’s care more effectively.
1. Question:
A patient’s potassium level comes back at 2.9 mEq/L. What is the most likely consequence of
this low potassium level?
● A) Seizures
● B) Cardiac arrhythmias
● C) Hyperglycemia
● D) Respiratory alkalosis
Answer:
B) Cardiac arrhythmias
Rationale:
Hypokalemia (low potassium) is most commonly associated with cardiac arrhythmias, as
potassium plays a critical role in maintaining normal heart rhythm. Severe hypokalemia can lead
to potentially life-threatening arrhythmias, such as ventricular fibrillation.
2. Question:
A nurse is reviewing a patient's lab results and sees an elevated BUN level. What could this
indicate?
● A) Liver failure
● B) Dehydration
