EXAM 2 PREP U questions

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching?

"I can use laxatives and enemas but only once a week."

The nurse has just received the lab results of a client's calcium level. The nurse identifies a normal calcium level as:

8.5 to 10.5 mg/dL (2.251 mmol/L to 2.6 mmol/L))

A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid-base imbalance?

Administering an antiemetic to treat the client's frequent vomiting

Which is an insensible mechanism of fluid loss?

Breathing

The nurse is caring for a client with a tumor obstructing the lymphatic system. For which consequence does the nurse assess?

Fluid accumulating in the interstitial spaces distal to the tumor

Respiratory alkalosis can be caused by a respiratory rate in excess of that which maintains normal plasma PCO2 levels. What is a common cause of respiratory alkalosis?

Hyperventilation

A nurse is caring for a client with hypoparathyroidism. Which imbalance is a major concern for the client?

Hypocalcemia

A female client with a history of chronic renal failure has a total serum calcium level of 7.9 mg/dL (1.98 mmol/L). While performing an assessment, the nurse should focus on which clinical manifestation associated with this calcium level?

Intermittent muscle spasms and reports of numbness around her mouth

Lymph fluid arises directly from which space

Interstitial

The nurse is evaluating a client's blood gases. The client has a pH of 7.35. How does the nurse interpret this value?

It is within a normal range

The effective circulating volume is the major regulator of water balance in the body. What else does it regulate?

Sodium

The nurse at a long-term care facility encourages the older adults to drink even though they may not feel thirsty at the time. Which statement supports the nurse's action?

Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.

Water movement from the side of the membrane having a lesser number of particles and greater concentration of water to the side having a greater number of particles and lesser concentration of water is termed:

Osmosis

The renal control mechanism of restoring the acid-base balance is accomplished through which process?

Reabsorption of HCO3 and excretion of H+ restores acid-base balance through the renal control mechanisms

Which unit of measure best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?

mEq/L

As other mechanisms prepare to respond to a pH imbalance, immediate buffering is a result of increased:

bicarbonate/carbonic acid regulation

In which client would the nurse be most likely to assess the signs and symptoms of an acid-base imbalance?

A client with chronic obstructive pulmonary disease (COPD) whose most recent arterial blood gases reveal a PCO2 of 51 mm Hg

Of the following clients, who would be at highest risk for developing hyperkalemia?

A male admitted for acute renal failure following a drug overdose

The nurse is caring for a client with an acid-base imbalance. Which of these does the nurse recognize is correct regarding compensation?

A pH moves toward the normal range.

A change in the pH of the body affects all organ systems. When the pH falls to less than 7.0, what can occur in the cardiovascular system? Select all that apply.

A reduction in cardiac contractility, causing cardiac dysrhythmias.

A client with a diagnosis of end-stage liver failure has arterial blood gas results indicating altered pH. Which of these consequences of liver failure has most likely caused the acid-base disturbance?

Low albumin and plasma globulin levels.

The nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mm Hg (5.05 kPa) HCO3:18 mEq/L (18 mmol/L) The nurse would interpret this as:

Metabolic acidosis

A nurse in the Medical ICU has orders to infuse a hypertonic solution into a patient with low blood pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. What term or terms are associated with this process?

Osmosis and osmolality

Vitamin D, officially classified as a vitamin, functions as a hormone in the body. What other hormone is necessary in the body for vitamin D to work?

Parathyroid hormone

When caring for clients with disorders of sodium balance, the nurse know that which finding is consistent with hypernatremia?

Sodium 158 mEq/L (158 mmol/L) and serum osmolality of 320 mOsm/kg (320 mmol/kg)

The condition of a client with metabolic acidosis from an intestinal fistula is not improving. The pulse is 125 beats/min and the BP 84/56 mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L (18 mmol/L), PCO2 57 mm Hg (7.58 kPa). What IV medication should the nurse expect to provide next?

Sodium bicarbonate

A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis?

The client had a liver transplant 2 years ago.

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation?

Urine pH of 3.0

Which clinical manifestation would lead the nurse to suspect a client has developed fluid volume excess?

Weight gain

Which statement is true about carbon dioxide (CO2) transport in the circulation?

Were it not for carbonic anhydrase, the reaction between water and CO2 would occur too slowly to be of any significance in maintaining acid-base balance.

The nurse is caring for a client who has developed hypoxemia and tissue hypoxia. Which of these interventions does the nurse set as a priority intervention

Administration of supplemental oxygen

An older adult has had a "sour stomach" and has treated it at home by taking frequent doses of baking soda (sodium bicarbonate). What nursing action is most appropriate

Assess the client for signs and symptoms of hypokalemia

Which assessment should be prioritized in the care of a client who is being treated for a serum potassium level of 2.7 mEq/L (2.7 mmol/L)?

Cardiac monitoring looking for prolonged PR interval and flattening of the T wave

The client with diabetes mellitus has fatigue, nausea, a fruity odor to the breath, and polyuria. Which should the nurse do first?

Check blood glucose.