Metabolic panel nursing quiz (CMP vs. BMP) for students!
There are two types of metabolic panels that can be ordered on a patient. They are the comprehensive metabolic panel (CMP) and basic metabolic panel (BMP). These tests are routinely ordered just like the complete blood count (CBC).
As the nurse it is very important you know what this test assesses and how to interpret the results. If you are studying for NCLEX you will also want to check out labs to know for NCLEX review and quiz.
Don’t forget to watch the lecture on metabolic panel before taking the quiz.
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CMP and BMP (Metabolic Panel) Nursing Labs Quiz
1. The physician orders a Basic Metabolic Panel (BMP) on your patient. You know this blood test will assess all of the following EXCEPT? Select all that apply:
D. ALP (alkaline phosphatase)
E. AST (aspartate transaminase)
J. Total Protein
O. ALT (alanine transaminase)
The answers are A, D, E, J, L, N, and O. A BMP will assess electrolytes (ex: Glucose, Calcium, Sodium, Chloride, Potassium) and renal function, BUT it does NOT assess liver studies (ex: ALP, AST, ALT, Bilirubin, Total Protein, Albumin, Globulin). A Comprehensive Metabolic Panel (CMP) assesses everything a BMP assesses but it also goes further and assesses liver function, hence why it’s called a “comprehensive” metabolic panel.
2. The patient has been fasting overnight and arrives to the lab where a CMP is collected. CMP results show that the patient’s glucose is 98 mg/dL. This result is interpreted as?
The answer is A. Euglycemic means normal glucose level. A normal glucose is 70-100 mg/dL, if fasting. If NOT fasting a normal glucose is 70-125 mg/dL.
3. Your patient has liver disease. On assessment you note that your patient has an orangish/yellowish hue to their skin and the sclera of the eyes. In addition, you note that the patient’s urine is orange in color. What lab result on the CMP correlates with these findings?
A. ALP 50 U/L
B. Creatinine 1 mg/dL
C. Bilirubin 3 mg/dL
D. Albumin 4 g/dL
The answer is C. A normal Bilirubin is 0.1-1 mg/dL. Bilirubin is a waste product from the breakdown of RBCs. When RBCs breakdown it creates an orangish/yellowish substance. This breakdown is mainly performed in the liver, and this substance from the RBCs is normally excreted in the bile, which is then excreted in the stool. This substance gives stool it brown color and very little Bilirubin should be in the urine. If too much is in the blood it will leak into skin and mucous membranes along with the urine.
4. True or False: A normal estimated glomerular filtration rate (eGFR) is <60.
The answer is FALSE. A normal estimated glomerular filtration rate (eGFR) is >60 (NOT <60). This is an estimation of how well the glomerulus in the kidney is filtering water, ions, and water from the blood to create urine. The eGFR is determined by many factors such as the patient’s creatinine level, age, sex, and race.
5. The CMP ordered on your patient shows that the patient’s potassium level is 6.5 mEq/L. How do you interpret this potassium level, and which option below could cause this type of potassium level?
A. This potassium level is within normal limits.
B. Hypokalemia; loop diuretics
C. Hyperkalemia; Cushing’s Syndrome
D. Hyperkalemia; ACE Inhibitors
The answer is D. A normal potassium level is 3.5-5 mEq/L. A level of 6.5 mEq/L is known as HYPERkalemia. Causes of hyperkalemia include: renal failure, medications: ACE inhibitors, potassium-sparing diuretics, Addison’s Disease (causes low aldosterone production which causes the kidneys to keep more potassium, which increase’s blood levels).
6. A patient’s morning BMP results are back with the following results: Glucose 93 mg/dL, Calcium 8.5 mg/L, Sodium 115 mEq/L, Chloride 100 mEq/L, Potassium 7 mEq/L, CO2 30 mEq/L, BUN 40, Creatinine 3 mg/dL. Which labs results are abnormal? Select all that apply:
The answers are: C, E, G, and H. The Sodium, Potassium, BUN, and Creatinine are abnormal in this BMP.
7. ____________ is a protein made in the liver that plays a vital role in regulating oncotic pressure inside the blood vessel. Your patient’s level is 1 g/dL and this is considered to be: LOW or HIGH?
A. Globulin; LOW
B. Bilirubin; HIGH
C. AST (aspartate transaminase); HIGH
D. Albumin; LOW
The answer is D: Albumin is a protein made in the liver that plays a vital role in regulating oncotic pressure inside the blood vessel. A normal albumin level is 3.4-5.4 g/dL and a level of 1 g/dL is considered LOW.
8. Which result below represents hypercalcemia?
A. Potassium 7 mEq/L
B. Potassium 2.2 mEq/L
C. Calcium 9 mg/L
D. Calcium 15 mg/L
The answer is D. A normal calcium level is 8.5-10.5 mg/L. Hypercalcemia is a HIGH calcium level.
9. A patient is post-op from a parathyroidectomy. A CMP is drawn. The nurse will be monitoring the patient for?
The answer is A. The parathyroid gland regulates calcium levels. Therefore, if the parathyroid is removed (parathyroidectomy) there is a risk of HYPOcalcemia (low calcium levels).
10. Which lab results on the Comprehensive Metabolic Panel (CMP) measures the complete amount of proteins in the blood such as albumin and globulin?
B. Total Protein
C. AST (aspartate transaminase)
D. Anion Gap
The answer is B. A normal total protein is 6.2-8.2 g/dL and it measures the complete amount of proteins in the blood such as albumin and globulin.
11. A patient’s anion gap is 15 mEq/L. Which condition below can cause this lab result?
A. Diabetic Ketoacidosis
C. Over usage of antacids
The answer is A. A normal anion gap is 3-10 mEq/L. An anion gap assesses for an acid-base imbalance by looking at certain electrolytes from the metabolic panel (sodium, chloride, bicarbonate) and if there is a gap or difference between positively and negatively charge electrolytes. A HIGH gap or difference demonstrates metabolic acidosis such as Diabetic Ketoacidosis. All the other options actually cause alkalosis.
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