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Harr: Clinical Chemistry Exam Practice Questions and Answers 100% Pass Select the most appropriate adult reference range for fasting blood glucose. A. 40-105 mg/dL (2.22-5.82 mmol/L) B. 60-140 mg/dL (3.33-7.77 mmol/L) C. 65-99 mg/dL (3.61-5.50 mmol/L) D. 75-150 mg/dL (4.16-8.32 mmol/L) - ANSW...

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  • November 3, 2024
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Copyright © KAYLIN 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH NOVEMBER, 2024




Harr: Clinical Chemistry Exam Practice

Questions and Answers 100% Pass


Select the most appropriate adult reference range for fasting blood glucose.




A. 40-105 mg/dL (2.22-5.82 mmol/L)


B. 60-140 mg/dL (3.33-7.77 mmol/L)


C. 65-99 mg/dL (3.61-5.50 mmol/L)


D. 75-150 mg/dL (4.16-8.32 mmol/L) - ANSWER✔✔-C. 65-99 mg/dL (3.61-5.50 mmol/L)




C Reference ranges vary slightly depending upon method and specimen type. Enzymatic methods

specific for glucose have an upper limit of normal no greater than 99 mg/dL. This is the cutoff value for

impaired fasting plasma glucose (prediabetes) recommended by the American Diabetes Association.

Although 65 mg/dL is considered the 2.5 percentile, a fasting level below 50 mg/dL is often seen without

associated clinical hypoglycemia, and neonates have a lower limit of approximately 40 mg/dL owing to

maternal insulin


When preparing a patient for an oral glucose tolerance test (OGTT), which of the following conditions

will lead to erroneous results?




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A. The patient remains ambulatory for 3 days prior to the test


B. Carbohydrate intake is restricted to below 150 g/day for 3 days prior to test


C. No food, coffee, tea, or smoking is allowed 8 hours before and during the test


D. Administration of 75 g of glucose is given to an adult patient following a 10-12-hour fast -

ANSWER✔✔-B. Carbohydrate intake is restricted to below 150 g/day for 3 days prior to test




B Standardized OGTTs require that patients receive at least 150 grams of carbohydrate per day for 3 days

prior to the test in order to stabilize the synthesis of inducible glycolytic enzymes. The 2-hour OGTT test

is no longer recommended for screening and should be reserved for confirmation of diabetes in cases

that are difficult to diagnose, such as persons who lack symptoms and signs of fasting hyperglycemia.


Which of the following 2-hour glucose challenge results would be classified as impaired glucose

tolerance (IGT)?


Two-hour serum glucose:




A. 130 mg/dL


B. 135 mg/dL


C. 150 mg/dL


D. 204 mg/dL - ANSWER✔✔-C. 150 mg/dL




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C With the exception of pregnant females, impaired glucose tolerance is defined by the ADA as a serum

or plasma glucose at 2 hours following a 75-g oral glucose load of ≥140 mg/dL and < 200 mg/dL. Persons

who have a fasting plasma glucose of ≥100 but < 126 mg/dL are classified as having impaired fasting

glucose (IFG). Both IGT and IFG are risk factors for developing diabetes later in life. Such persons are

classified as having prediabetes and should be tested annually.


Which statement regarding gestational diabetes mellitus (GDM) is correct?




A. Is diagnosed using the same oral glucose tolerance criteria as in nonpregnancy


B. Converts to diabetes mellitus after pregnancy in 60%-75% of cases


C. Presents no increased health risk to the fetus


D. Is defined as glucose intolerance originating during pregnancy - ANSWER✔✔-D. Is defined as glucose

intolerance originating during pregnancy




D Control of GDM reduces perinatal complications such as respiratory distress syndrome, high birth

weight, and neonatal jaundice. Women at risk are usually screened between 24 and 28 weeks' gestation.

The screening test can be performed nonfasting and consists of an oral 50-g glucose challenge followed

by serum or plasma glucose measurement at 1 hour. A result ≥ 140 mg/dL is followed by a 2-hour or 3-

hour oral glucose tolerance test to confirm gestational diabetes. For the 3-hour test, a 100-g dose of

glucose is used and at least two of the following cutoffs must be exceeded: fasting, ≥ 95 mg/dL or higher;

1 hour, ≥ 180 mg/dL or higher; 2 hour ≥ 155 mg/dL or higher; 3 hour, ≥ 140 mg/dL or higher. The same

cutpoints are used for the 2-hour test except that a 75-g dose is used. GDM converts to diabetes mellitus



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within 10 years in 30%-40% of cases. ADA recommends testing persons with GDM for diabetes 6-12

weeks after delivery


Which of the following findings is characteristic of all forms of clinical hypoglycemia?




A. A fasting blood glucose value below 55 mg/dL


B. High fasting insulin levels


C. Neuroglycopenic symptoms at the time of low blood sugar


D. Decreased serum C peptide - ANSWER✔✔-C Clinical hypoglycemia can be caused by insulinoma,

drugs, alcoholism, and reactive hypoglycemia. Neuroglycopenic symptoms at the time of low blood sugar




C. Reactive hypoglycemia is characterized by delayed or excessive insulin output after eating and is very

rare. Fasting insulin is normal but postprandial levels are increased. High fasting insulin levels (usually > 6

μg/L) are seen in insulinoma, and patients with insulinoma almost always display fasting hypoglycemia,

especially when the fast is extended to 48 72 hours. C peptide is a subunit of proinsulin that is

hydrolyzed when insulin is released. In hypoglycemia, low levels indicate an exogenous insulin source,

whereas high levels indicate overproduction of insulin.


Which statement regarding glycated (glycosylated) Hgb (G-Hgb) is true?




A. Has a sugar attached to the C-terminal end of the β chain


B. Is a highly reversible aminoglycan



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