Adult I Exam I Practice Questions Fall '19
A patient is being discharged after being hospitalized with a phosphate level of 1.8. What type of foods will you encourage the patient to consume in your diet teaching? a. Organs meats and beef b. Fresh fruits and vegetables c. Beans and beets d. Turnips and cauliflower
A
A patient is in high anion gap metabolic acidosis due to diabetic ketoacidosis. Which of the following signs and symptoms would you expect to see in this patient? A. Kussmaul's respirations B. Glucose 110 C. Hypoventilation D. Neuro-excitability
A
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. What is your next nursing intervention? A. Hold the dose of Lasix and notify the doctor for further orders B. Administered the Lasix and notify the doctor for further orders C. Turn off the nasogastric suctioning and administered a laxative D. No intervention is need the potassium level is within normal range
A
A patient's calcium level is 6.9. Which of the following is a nursing priority? A. Initiate seizure precautions B. Educate patient about foods rich in calcium C. Administer Calcitonin D. Administer Vitamin D supplements as ordered
A
Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by: a. muscle weakness. b. tremors. c. diaphoresis. d. constipation.
A
Magnesium is absorbed by what system of the body? A. Gastrointestinal B. Hepatic C. Lymphatic D. Renal
A
On admission, a patient blood alcohol limit is greater than 400 mg/dL. The patient reports drinking a 12 pack of beer on a daily basis. Which of the following conditions is this patient MOST at risk for? A. Hypomagnesemia B. Hypermagnesemia C. Hyponatremia D. Hypernatremia
A
The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction? a. "I will not salt my food; instead I'll use salt substitute." b. "Bananas have a lot of potassium in them; I'll stop buying them." c. "I'll drink cranberry juice with my breakfast instead of coffee." d. "I need to check to see whether my cola beverage has potassium in it."
A
When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? a. Irregular heart rate b. Weight loss of 4 lb c. Mild confusion d. Blood pressure 96/53 mm Hg
A
Which of the following is not a symptom of hyperkalemia? A. Positive Chvostek's sign B. Decreased blood pressure C. Muscle twitches/cramps D. Weak and slow heart rate
A
Which patient below is considered hypernatremic? A. A patient with a sodium level of 155 B. A patient with a sodium level of 145 C. A patient with a sodium level of 120 D. A patient with a sodium level of 136
A
Lithium is known to affect the parathyroid by increasing ______ levels and decreasing _____ levels? A. calcium, phosphate B. phosphate, calcium C. calcium, sodium D. sodium, calcium
A, "crazy likes calcium"
The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. a. Tachypnea b. Weakness c. Lethargy d. Dehydration e. Hypotension
A, B, C
The nurse is caring for a patient with a diagnosis of hyponatremia. What nursing intervention is appropriate to include in the plan of care for this patient? (Select all that apply.) a. Assessing for symptoms of nausea and malaise b.Encouraging the intake of low-sodium liquids c.Monitoring neurologic status d. Restricting tap water intake e. Encouraging the use of salt substitute instead of salt
A, C, D
Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. a. Distended neck veins b. Bradycardia c. Crackles in the lung fields d. Shortness of breath e. Decreased blood pressure
A, C, D.
A client with emphysema is at a greater risk for developing which acid-base imbalance? a. chronic respiratory acidosis b. metabolic alkalosis c. metabolic acidosis d. respiratory alkalosis
A, CO2 (acid) retainer
Checking for orthostatic hypotension allows the nurse to detect early signs of: A. hypovolemia B. low serum osmolality C. high serum osmolality D. hypervolemia
A.
Diabetic ketoacidosis, aspirin toxicity, and renal failure are examples of the causes of ___________________. A. High anion gap metabolic acidosis B. Normal anion gap metabolic acidosis C. Low anion gap metabolic acidosis D. Normal anion gap respiratory acidosis
A.
The nurse evaluates which of the following clients to be at risk for developing hypernatremia? a. 50-year-old with pneumonia, diaphoresis, and high fevers b. 62-year-old with congestive heart failure taking loop diuretics c. 39-year-old with diarrhea and vomiting d. 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH)
A.
Giving a hypertonic I.V. solution to a patient may cause too much fluid to be: A. pulled from the cells into the bloodstream, which may cause the cells to shrink B. pulled out of the bloodstream into the cells C. pushed out of the bloodstream into the extravascular spaces D. pulled from the cells into the bloodstream, which may cause the cells to increase in size
A. Because the concentration of solutes in the IV solution is greater than the concentration of solutes in the patient's blood, a hypertonic solution may cause fluid to be pulled from the cells into the bloodstream, causing the cells to shrink.
A patient with cerebral edema would most likely be ordered what type of solution? A. 3% Saline B. 0.9% NS C. LR D. 0.225% NS
A. 3% Saline
The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? a. Hypocalcemia b. Hyperchloremia c. Hypermagnesemia d. Hyponatremia
A. Because of the reciprocal relationship between phosphorus and calcium, a high serum phosphorus concentration tends to cause a low serum calcium concentration.
Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? a. Confusion and seizures b. Sunken eyeballs and spasticity c. Flaccidity and thirst d. Tetany and increased blood urea nitrogen (BUN) levels
A. Classic signs of water intoxication include confusion and seizures, both of which are caused by cerebral edema. Weight gain will also occur.
A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following? a. Extracellular fluid volume deficit b. Altered blood urea nitrogen (BUN) value c. Metabolic alkalosis d. Respiratory acidosis
A. Fluid volume deficit (FVD) occurs when the loss extracellular fluid (ECF) volume exceeds the intake of fluid. FVD results from loss of body fluids and occurs more rapidly when coupled with decreased fluid intake. A cause of this loss is hemorrhage.
_____ fluids remove water from the extracellular space into the intracellular space. A. Hypotonic B. Hypertonic C. Isotonic D. Colloids
A. Hypotonic
The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? a. Metabolic acidosis b. Respiratory acidosis c. Metabolic alkalosis d. Respiratory alkalosis
A. Metabolic acidosis is caused by diarrhea, lower intestinal fistulas, ureterostomies, and use of diuretics; early renal insufficiency; excessive administration of chloride; and the administration of parenteral nutrition without bicarbonate or bicarbonate-producing solutes (e.g., lactate).
A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder. If the client doesn't comply with the recommended treatment, which complication may arise? a. Cerebral edema b. Hypovolemic shock c. Severe hyperkalemia d. Tetany
A. Noncompliance with treatment for SIADH may lead to water intoxication from fluid retention caused by excessive antidiuretic hormone. This, in turn, limits water excretion and increases the risk for cerebral edema.
Populations at risk for dehydration include: A. infants B. adolescents C. pt's with SIADH D. young adults
A. Patients at risk for dehydration are those who either have an impaired thirst mechanism or can't respond to the thirst reflex.
If you were walking across the Sahara desert with an empty canteen, the amount of ADH secreted would most likely: A. increase B. decrease C. stay the same D. have no effect
A. increase Because your body would be dehydrated, it would try to retain as much fluid as possible. To retain fluid, ADH secretion increases.
Which of the following would you NOT expect to see with a phosphate level of 1.2? a. Positive Trousseau's Sign b. Weakness c. Confusion d. Osteomalacia
A. inverse relationship w/ Ca
If you placed two containers next to each other, separated only by a semipermeable membrane, and the solution in one container was hypotonic relative to the other, fluid in the hypotonic container would: A. move out of the hypotonic container into the other B. pull fluid from the other container into the hypotonic container C. cause osmosis to occur D. stay unchanged within the hypotonic container
A. move out of the hypotonic into the other. Fluid would move out of the hypotonic container into the other container to equalize the concentration of fluid within the two containers.
Which patient below would not be a candidate for a hypotonic solution? A. Patient with increased intracranial pressure B. Patient with diabetic ketoacidosis C. Patient with hyperosmolar hyperglycemia D. All of the options are correct
A. patient with increased intracranial pressure
When a person's blood pressure drops, the kidneys respond by: A. secreting renin B. producing aldosterone C. slowing the release of ADH D. secreting ANP
A. secreting renin Cells in the kidney secrete renin in response to low blood flow or low sodium level. The eventual effect of renin secretion is an increase in BP.
A patient with hypovolemic hyponatremia is started on IV fluids. Which of the following fluids do you expect the patient to be started on? A. 0.45% Saline B. 3% Saline C. D5W D. 0.33% Saline
B, Patients with hypovolemic hyponatremia are started on a hypertonic solution (the circulatory system is dehydrated & and the cells are swollen...so a hypertonic solution will shrink the cells and increase fluid volume) and 3% Saline is the only hypertonic solution
A patient is experiencing hypercalcemia and has developed renal calculi. What is the affect on the phosphate level in hypercalcemia? a. Phosphate level increases b. Phosphate level decreases c. Phosphate level remain the same d. Phosphate level normalizes
B, d/t inverse relationship
A client with hypoparathyroidism complains of numbness and tingling in his fingers and around the mouth. The nurse would assess for what electrolyte imbalance? a. hyponatremia b. hypocalcemia c. hyperkalemia d. hypermagnesemia
B.
Of the following options, the first step you should take for a patient with hypovolemic shock is to: A. assess for dehydration B. administer I.V. fluids C. insert a urinary catheter D. prepare for surgery
B.
Older adults are at an increased risk for electrolyte imbalances because, with age, the kidneys have: A. increased GFR B. fewer functioning nephrons C. increased ability to concentrate urine D. increased blood flow
B.
Potassium is essential for conducting electrical impulses because it causes ions to: A. clump together to generate a current B. shift in and out of the cell to conduct a current C. trap sodium inside the cell to maintain a current D. adhere to each other to create a current
B.
Water intoxication can be caused by: A. administering too much hypertonic fluid B. administering too much hypotonic fluid C. encouraging fluid intake D. administering too much isotonic fluid
B.
Water intoxication can be caused by: A. administering too much hypertonic fluid B. administering too much hypotonic fluid C. encouraging fluid intake D. administering too much isotonic fluid
B. Administering too much hypotonic fluid can cause water to shift from the blood vessels into the cells, leading to water intoxication and cellular edema.
A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? a. No effect b. Increases arterial pH c. Decreases arterial pH d. Provides long-term pH regulation
B. CO2 (acid) being excreted excessively leads to alkalotic pH
Which of the following is not a hypertonic fluid? A. 3% Saline B. D5W C. 10% Dextrose in water D. 5% Dextrose in LR
B. D5W
What type of fluid would a patient with severe hyponatremia most likely be started on? A. Hypotonic B. Hypertonic C. Isotonic D. Colloid
B. Hypertonic
Jon has a potassium level of 6.5 mEq/L, which medication would nurse Wilma anticipate? A. Potassium supplements B. Kayexalate C. Calcium gluconate D. Sodium tablets
B. Kayexalate Kayexalate is a cation-exchange resin, which can be given orally, by nasogastric tube, or by retention enema. Potassium is drawn from the bowel and excreted through the feces. Because the client's potassium level is already elevated, potassium supplements would not be given. Neither calcium gluconate nor sodium tablets would address the client's elevated potassium level.
A patient has a potassium level of 2.0. What would you expect to be ordered for this patient? A. Potassium 30 meq IV push B. Infusion of Potassium intravenously C. An oral supplement of potassium D. Intramuscular injection of Potassium
B. Never IVP and never IM
When administering a hypertonic solution, the nurse should watch closely for? A. signs of dehydration B. pulmonary edema C. fluid volume deficit D. increased lactate level
B. pulmonary edema
A client is admitted with diabetic ketoacidosis who, with treatment, has a normal blood glucose, pH, and serum osmolality. During assessment, the client complains of weakness in the legs. Which of the following is a priority nursing intervention? a. Request a physical therapy consult from the physician b. Ensure the client is safe from falls and check the most recent potassium level c. Allow uninterrupted rest periods throughout the day d. Encourage the client to increase intake of dairy products and green leafy vegetables.
B... In the treatment of diabetic ketoacidosis, the blood sugar is lowered, the pH is corrected, and potassium moves back into the cells, resulting in low serum potassium. Client safety and the correction of low potassium levels are a priority. The weakness in the legs is a clinical manifestation of the hypokalemia.
A patient's magnesium level is 0.9. The doctor orders Magnesium Sulfate IV. Which nursing intervention takes PRIORITY? A. Assessing for hypertension B. Monitoring deep tendon reflexes C. Monitoring potassium levels D. Monitoring skin turgor
B... to ensure to rebound hypermagnesemia occurs
A patient complains of tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the patient's laboratory work has returned? a. Potassium b. Phosphorus c. Calcium d. Magnesium
C
A patient has a calcium level of 12.5. Which medication will most likely be ordered for this patient? A. Calcium Chloride B. 10% Calcium Gluconate C. Calcitonin D. Hydrochlorothiazide
C
A patient has a sodium level of 119. Which of the following is NOT related to this finding? A. Over secretion of ADH (antidiuretic hormone) B. Low salt diet C. Inadequate water intake D. Hypotonic fluid infusion (overload)
C
A patient is admitted to the ER. The patient receives dialysis on Tuesdays and Thursdays of every week, and presents with a palpable AV shunt (thrill present) in the left upper arm. The patient is extremely lethargic and family members are present to help answer questions. While collecting the patient's medication history the daughter states her mother has been taking "a lot" of Maalox lately due to upset stomach. You note this to be a significant finding. Which of the following lab values correlates with this finding? A. Magnesium level of 1.0 B. Magnesium level of 2.4 C. Magnesium level of 3.6 D. Magnesium level of 1.4
C
A patient is being discharged after being hospitalized with a Magnesium level of 0.7. After diet teaching with this patient, which statement by the patient warrants you to re-educate the patient? A. "I love eating salads with kale and spinach". B. "I'm shocked mackerel contains magnesium". C. "I can't believe I have to give up dark chocolate". D. "Tonight I'm cooking fried potatoes with a side dish of peas".
C
A patient is presenting with an orthostatic blood pressure of 80/40 when she stands up, thready and weak pulse of 58, and shallow respirations. In addition, the patient has been having frequent episodes of vomiting and nausea and is taking hydrochlorothiazide. Which of the following findings would explain the patient's condition? A. Potassium level of 7.0 B. Potassium level of 3.5 C. Potassium level of 2.4 D. None of the options are correct
C
A patient is recovering from parathyroid surgery. Morning labs values are back. Which of the following lab values would correlate as a complication from this type of surgery? A. Calcium 8.7 B. Calcium 12.5 C. Calcium 6.9 D. Calcium 9.2
C
A patient's magnesium level is 3.0. The cater associate brings the patient a dinner tray. Which item on the tray would you remove to ensure the patient does not eat? A. Macaroni B. Tomatoes C. Kale D. Onions
C
You have completed diet teaching with a patient who has hypernatremia. Which statement by the patient causes concern? A. "I will buy fresh vegetables and fruits." B. "I will avoid eating canned foods." C. "I'm glad I can still eat sandwiches with bologna." D. "I will avoid cooking with butter."
C
The nurse is reading a health care provider's (HCP) progress notes in the client's record and reads that the HCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse interprets that this type of fluid loss can occur through which route? A. The Skin B. Urinary Output C. Wound Drainage D. The gastrointestinal tract
Answer: A Insensible losses may occur without the person's awareness. Insensible losses occur daily through the skin and the lungs. Sensible losses are those of which the person is aware, such as through urination, wound drainage, and gastrointestinal tract losses.
A client who is at risk for fluid imbalance is to be admitted to the nursing unit. In planning care for this client, the nurse is aware that which conditions cause the release of antidiuretic hormone (ADH)? Select all that apply. A. Dehydration B. HTN C. Physiological stress D. Decreased blood volume E. Decreased plasma osmolarity
Answer: A, C, and D Antidiuretic hormone, or vasopressin, is produced in the brain and stored in the posterior pituitary gland. Its release from the posterior pituitary gland is controlled by the hypothalamus in response to changes in blood osmolarity. Stimuli for ADH release are increased plasma osmolality, decreased blood volume, hypotension, pain, dehydration from nausea, vomiting, or diarrhea, and stress.
The nurse is caring for a client with a diagnosis of dehydration, and the client is receiving intravenous (IV) fluids. Which assessment data would indicate to the nurse that the dehydration remains unresolved? A. An oral temperature of 98.8 F B. A urine specific gravity of 1.043 C. A urine output that is pale yellow D. A blood pressure of 120/80 mmHg
Answer: B Rationale: The client who is dehydrated will have a urine specific gravity greater than 1.030. Normal values for urine specific gravity are 1.010 to 1.030. A temperature of 98.8° F is only 0.2 point above the normal temperature and would not be as specific an indicator of hydration status as would the urine specific gravity. Pale yellow urine is a normal finding. A blood pressure of 120/80 mm Hg is within normal range.
A patient with Celiac disease is at risk for which of the following? A. Hypokalemia B. Hypocalcemia C. Hypomagnesemia D. Hypercalcemia
B
A patient with a sodium level of 112 is taking Lithium. Which of the following is a nursing priority? A. Hold further doses of Lithium B. Monitor Lithium drug level due to risk of toxicity C. Monitor potassium level due to increased risk of toxicity D. No priority is need. 112 is a normal sodium level
B
Stimulation of the facial nerve via the masseter muscle causes twitching of the nose/lips in hypocalcemia is known as? A. Trousseau's Sign B. Chvostek's Sign C. Homan's Sign D. Goodell's Sign
B
The nurse is caring for a client in heart failure with signs of hypervolemia. Which vital sign is indicative of the disease process? a. Low heart rate b. Elevated blood pressure c. Rapid respiration d. Subnormal temperature
B
What of the following is NOT a cause of metabolic alkalosis? A. Hyperaldosteronism B. Usage of Diamox C. Nasogastric suctioning D. Diuretic therapy
B
Which could be a potential cause of respiratory acidosis? a. Vomiting b. Hypoventilation c. Diarrhea d. Hyperventilation
B
Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? a. Abnormal potassium level b. Elevated hematocrit level c. Low white blood count d. Low urine specific gravity
B
The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation? a. Kidney and liver b. Heart and lungs c. Lungs and kidney d. Pancreas and stomach
C.
The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid? A. 0.9% NS B. LR C. 0.45% Saline D. 5% Dextrose in 0.225% Saline
C. 0.45% Saline
Which condition could lead to cell lysis, if not monitored? A. Isotonicity B. Hypertonicity C. Hypotonicity D. None of the above
C. Hypotonicity
When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called? A. Hypotonic B. Hypertonic C. Isotonic D. Osmosis
C. Isotonic
Joshua is receiving furosemide and Digoxin, which laboratory data would be the most important to assess in planning the care for the client? A. Sodium B. Magnesium C. Potassium D. Calcium
C. Potassium Diuretics such as furosemide may deplete serum potassium, leading to hypokalemia. When the client is also taking digoxin, the subsequent hypokalemia may potentiate the action of digoxin, placing the client at risk for digoxin toxicity. Diuretic therapy may lead to the loss of other electrolytes such as sodium, but the loss of potassium in association with digoxin therapy is most important. Hypocalcemia is usually associated with inadequate vitamin D intake or synthesis, renal failure, or use of drugs, such as aminoglycosides and corticosteroids. Hypomagnesemia generally is associated with poor nutrition, alcoholism, and excessive GI or renal losses, not diuretic therapy.
Which patient is likely to present with a phosphate level of 6.0? a. A patient taking an aluminum hydroxide-based antacid four times a day. b. A patient on total parenteral nutrition therapy (TPN). c. A patient who reports drinking a 12 pack of beer daily. d. A patient in end-stage renal failure who is scheduled for dialysis tomorrow.
D
A patient is in metabolic alkalosis due to diuretic therapy. How do you expect the potassium level and bicarbonate level to be affected? A. Increased potassium level and increased bicarb level B. Decreased potassium level and decreased bicarb level C. Increased potassium level and decreased bicarb level D. Decreased potassium level and increase bicarb level
D, b/c diuretics waste K+, alkalosis = increase bicarb (base)
One sign of hypervolemia is: A. increased urine output B. clear, watery sputum C. severe hypertension D. a rapid, bounding pulse
D.
The main extracellular cation is: A. calcium B. Potassium C. bicarbonate D. sodium
D.
A patient is being admitted w/ dehydration d/t n/v. Which fluid would you expect the patient to be started on? A. 5% Dextrose in 0.9% Saline B. 0.33% Saline C. 0.225% Saline D. 0.9% NS
D. 0.9% NS
Which solution is not a hypertonic solution? A. 5% Dextrose in 0.9% Saline B. 5% Saline C. 5% Dextrose in LR D. 1/3 NS
D. 1/3 NS
A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? a. Blood pressure b. Respirations c. Temperature d. Pulse
D. An elevated serum potassium level may lead to a life-threatening cardiac arrhythmia, which the nurse can detect immediately by palpating the pulse. The nurse also may delay assessing respirations and temperature because these aren't affected by the serum potassium level.
______ solutions cause cell dehydration and help increase fluid in the intracellular space? A. Hypotonic B. Osmosis C. Isotonic D. Hypertonic
D. Hypertonic
A patient with a sodium level of 178 is ordered to be started on 0.45% Saline. What is the most IMPORTANT nursing intervention for this patient? A. Maintain patent IV B. Give rapidly to ensure fluids levels are shifted properly C. Clarify doctor's order because 0.45% saline is contraindicated in hypernatremia D. Give slowly and watch for signs and symptoms of cerebral edema
D. The most important intervention is to give slowly and watch for S&S of cerebral edema because a hypotonic solution can cause rapid swelling of the cell.
Which of the following patients is MOST at risk for hypermagnesemia? A. A patient with alcoholism B. A patient taking a proton-pump inhibitor called Protonix C. A patient suffering from Crohn's Disease D. A patient with a magnesium level of 0.6 receiving IV magnesium sulfate
D... d/t rebound hypermagnesemia
Isotonic fluids cause shifting of water from the extracellular space to the intracellular space. True False
False
D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution because after the body metabolizes the dextrose the solution acts as a hypotonic solution. True False
True; D5W is classified as an isotonic fluid but after administration the body metabolizes the dextrose and the fluid left over is a hypotonic solution
Which of the following is not a cause of hypocalcemia? A. Low parathyroid hormone B. Crohn's Disease C. Acute Pancreatitis D. Thiazide Diuretics
D
A nurse is caring for a client with acute renal failure and hypernatremia. In this case, which action can be delegated to the nursing assistant? a. Provide oral care every 2-3 hours. b. Monitor for signs and symptoms of dehydration. c. Teach the client about increased fluid intake. d. Assess the client's weight daily for trends.
A
A patient has a sodium level of 130. What is this condition called? A. Hyponatremia B. Hypernatremia C. Normal Sodium Level D. Hypercalcemia
A
Oncotic pressure refers to the a. number of dissolved particles contained in a unit of fluid. b. excretion of substances such as glucose through increased urine output. c. amount of pressure needed to stop the flow of water by osmosis. d. osmotic pressure exerted by proteins.
D
One sign of hypervolemia is: A. increased urine output B. clear, watery sputum C. severe hypertension D. a rapid, bounding pulse
D
Which of the following is NOT a cause of metabolic acidosis? A. Aspirin toxicity B. Ileostomy C. Hyperaldosteronism D. Carbonic anhydrase inhibitors
C. hyperaldosteronism causes metabolic ALKalosis
A patient is admitted with exacerbation of congestive heart failure. What would you expect to find during your admission assessment? A. Flat neck and hand veins B. Furrowed dry tongue C. Increased blood pressure and crackles throughout the lungs D. Bradycardia and pitting edema in lower extremities
C. increased blood pressure and crackles throughout the lungs. Patients with CHF are in fluid volume overload and the heart can not compensate for the extra fluid volume, therefore, the fluid starts to "backup". You would find an increased blood pressure and crackles in the lungs. You would also see pitting edema in the lower extremities but NOT bradycardia.
Hydrostatic pressure, which pushes fluid out of the capillaries, is opposed by oncotic pressure, which involves: A. reduced renin secretion B. decrease aldosterone C. the pulling power of albumin to reabsorb water D. an increase in ADH secretion
C. the pulling power of albumin to reabsorb water. Albumin in capillaries draws water toward it, a process called reabsorption.
Diuretics affect the kidneys by altering the reabsorption and excretion of: A. water only B. electrolytes only C. water and electrolytes D. other drugs
C. water and electrolytes
A client with a potassium level of 5.5 mEq/L is to receive sodium polystyrene sulfonate (Kayexalate) orally. After administering the drug, the priority nursing action is to monitor: a. Urine output. b. Blood pressure. c. Bowel movements. d. ECG for tall, peaked T waves.
C... Kayexalate causes potassium to be exchanged for sodium in the intestines and excreted through bowel movements. If client does not have stools, the drug cannot work properly. Blood pressure and urine output are not of primary importance. The nurse would already expect changes in T waves with hyperkalemia. Normal serum potassium is 3.5 to 5.5 mEq/L.
A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis
D
A patient has a Magnesium level of 1.3. Which of the following is NOT a sign or symptom of this condition? A. Tall T-wave and depressed ST segment B. Torsades de pointes C. Positive Trouesseau's and Chvostek's D. Absent deep tendon reflexes
D
A patient with a magnesium level of 3.6 would exhibit which of the signs and symptoms EXCEPT? A. Hypotension B. Profound Lethargy C. Respiratory failure D. Hyperreflexia of the deep tendons
D
A patient's lab work shows that they have a high parathyroid hormone level. Which condition is the patient at risk for? A. Hyperkalemia B. Hypocalcemia C. Hypokalemia D. Hypercalcemia
D
