NCLEX Prep: Fluids and Electrolytes: Balance and Disturbance

A client who is recovering from partial- and full-thickness burns has been advanced to a general diet. Which foods should the nurse encourage the client to eat most often? 1. Meats, citrus fruits, milk 2. Vegetables, cheese, pasta 3. Milkshakes, salads, soups 4. Breads, cereals, yogurt

1 - clients with burns need increased amounts of protein (meat) and vitamin C (citrus fruits) and D (milk) until the wounds are completely healed.

A nurse notes the client's albumin level is 2.4 grams/dL. The nurse should plan to assess the client for which of the following at this time? Select all that apply. 1. Peripheral edema 2. Inelastic skin turgor 3. Hypoactive bowel sounds 4. Dry mucous membranes 5. Lung crackles

1 and 5 -albumin is responsible for increasing osmotic pressure and maintaining intravascular fluid volume; low albumin level would reduce intravascular osmotic pressure, which would allow fluid to move out of blood vessels and into interstitial spaces. The fluid retention will be assessed as peripheral edema and wet crackles heard upon auscultation. -skin turgor will be elastic -bowel sounds and mucous membranes would not be affected

The nurse is caring for a client who has sustained partial- and full-thickness burns over 30% of his body 18 hours ago. The nurse assesses for which fluid and electrolyte imbalances at this time? Select all that apply. 1. Hyperkalemia 2. Hypokalemia 3. Hypervolemia 4. Hypercalcemia 5. Hypovolemia

1 and 5 -during major burn injury, potassium shifts from the ICF to the ECF because of cell death, leading to high serum (blood) potassium levels; the client with burns is more likely to be hypocalcemic rather than hypercalcemic and hypovolemic rather than hypervolemic because of fluid and electrolyte loss.

Which finding in a client's history would alert the nurse to assess for signs of hypophosphatemia? 1. Alcohol abuse 2. Oliguric phase of acute tubular necrosis 3. Short-term gastric suction 4. Occasional use of aluminum-containing antacids

1. Alcohol abuse - prolonged (NOT occasional) use of antacids can cause this problem - oliguria (not enough urine) would lead to HYPERphsphotemia -prolonged (not short-term) gastric suction can cause this

A client with end-stage renal disease is experiencing hypermagnesemia. The nurse explains that which treatment will decrease the magnesium level most effectively? 1. Dialysis 2. Diuretics 3. Fluid restriction 4. High-volume IV fluids

1. Dialysis -either hemodialysis or peritoneal dialysis i used to remove excess magnesium in the client with renal failure -diuretics will not work if kidneys are not functioning -fluid restriction won't be effective by itself, and fluid overload is contraindicated because kidneys won't be able to excrete.

The family of a client with hypercalcemia states that the client is "not acting like himself." The nurse focuses assessment on which manifestation? 1. Personality change 2. Anxiety 3. Seizure activity 4. Carpal spasms

1. Personality change -others are associated with HYPOcalcemia

Which medication reported by a client during a nursing history could be associated with the development of hypocalcemia? 1. Phenytoin 2. Calcium carbonate 3. Calcitriol 4. Hydrochlorothiazide

1. Phenytoin -antiepileptics alter vitamin D metabolism and lead to hypocalcemia -all other medications lead to increased calcium and retention of it.

The nurse is caring for a client who has a sodium level of 149 mEq/L. The nurse anticipates that this client would benefit from which therapy? 1. Cough suppressant. 2. 3% saline solution 3. 5% dextrose in water solution 4. Lactulose

3 (D5W, isotonic) - all other solutions are hypertonic and can increase hypernatremia (more than 145)

The nurse concludes that which sign reliably indicates that ascites fluid is being effectively mobilized in response to therapy? Select all that apply. 1. Weight gain of 0.45 kg (1 lb) in 24 hours 2. Increase in urine output. 3. Drop in blood pressure 4. Hand veins fill slowly. 5. Abdominal girth has decreased by 2.5 cm (1 in.) in 24 hours.

2 and 5 -Loss of fluid results in proper excretion of urine by the kidneys and decreased abdominal girth. drop in BP and venous congestion (hand veins) indicate FVE is still there.

Which assessment of an adult client is a reliable indicator that therapy for FVE is achieving the desired outcome? (Select all that apply) 1. Full, bounding peripheral pulses. 2. Flat neck veins with the head with the head of the bed elevated 3. Hand vein emptying longer than 20 seconds. 4. S3 heart sound clearly audible on auscultation. 5. Lung sounds are clear.

2 and 5 -other sings represent FVE or venous congestion; absence of crackles suggests normal fluid balance and flat neck veins suggest absence of venous congestion.

A home health nurse is making a visit to an older adult client with a history of heart failure (HF). The client was prescribed diuretics twice a day and a low-sodium diet. The nurse should be most concerned about which current laboratory result? 1. Sodium 145 mEq/L 2. Chloride 90 mEq/L 3. K+ 4.2 mEq/L 4. HCO3 27 mEq/L

2. Chloride of 90 -chloride works close with sodium; low sodium= low chloride; heart failure places this client at risk for fluid retention. -other lab levels are NORMAL

The nurse concludes that a history of which condition places a client at risk for possible hypokalemia? 1. Chronic obstructive pulmonary disease (COPD) 2. Cirrhosis 3. Addison's disease 4. Chronic renal failure (CRF)

2. Cirrhosis -increased amounts of aldosterone are secreted, which leads to sodium retention and potassium excretion from the kidneys; COPD would cause hyperkalemia due to retention of acids and potassium; Addison's (hypofunctional adrenal gland) would have hyperkalemia due to high sodium loss; CRF (chronic renal failure) would cause hyperkalemia because they cannot excrete potassium.

A client admitted to the hospital with a 13.6-kg (30-lb) weight gain over the past month has moon facies. Admission laboratory results indicate low serum potassium and magnesium, and high serum chloride and sodium levels. The nurse interprets that which disorder is most consistent with these electrolyte abnormalities? 1. Addison's disease 2. Cushing's syndrome 3. Rhabdomyolysis 4. Syndrome of inappropriate ADH (SIADH)

2. Cushing's -it causes low potassium and magnesium levels and high sodium and chloride levels - "Cushing"= moon face

A 10-month-old infant is admitted to the ED with a 102F rectal temp and a history of vomiting and diarrhea for 48 hours. For what signs should the nurse look related to this client? 1. bulging fontanels, tearless cry, and low urine output 2. sunken eyes, lethargy, and dry, furrowed tongue 3. weight loss, dilute urine, and peripheral edema 4. dry skin, thready pulse, and neck vein distension

2. FVD and dehydration -bulging fontanels, peripheral edema, and neck vein distension are signs of FVE.

The nurse assessing a client for signs of hypocalcemia would conclude that this electrolyte imbalance exists after noting which finding? 1. Negative Chvostek sign 2. Positive Trousseau sign 3. Positive Kernig sign 4. Hypoactive bowel sounds

2. Positive Trousseau -there are two signs for calcium imbalances: Chvostek's and Trousseau's and both of them would be positive (NOT negative) -Kernig sign is a sign of meningitis -hypoactive bowel sounds are a sign of HYPERcalcemia.

The nurse inserts a nasogastric tube, and it immediately drains 1000 mL of fluid. Which electrolyte assessment is of greatest concern to the nurse at this time? 1. Sodium 2. Potassium 3. Chloride 4. CO2 content

2. Potassium -loss of hydrogen ions result in metabolic alkalosis

Which postoperative client would be at risk for developing a sodium imbalance? 1. A client who has just had a tonsillectomy 2. A client who has a primary cesarean delivery for failure to progress in labor. 3. A client who has a transurethral resection of the prostate (TURP) 4. A client who has a right knee arthroscopy

3 -due to increased fluid irrigation of the bladder used during and after surgery; others do not require lengthy fluid and dietary restrictions.

A client is admitted with dehydration secondary to prolonged nausea and vomiting. Which serum laboratory test results would the nurse expect to note as a result of the dehydration? Select all that apply. 1. Sodium 138 mEq/dL 2. Potassium 4.2 mEq/dL 3. Blood urea nitrogen (BUN) 30 mg/dL 4. Hematocrit 49% 5. Total protein 6.8 mg/dL

3 and 4 -dehydration results in loss of fluids, causing a hemoconcentration of BUN (more than 20), which is elevated -the hematocrit would be elevated secondary to hemoconcentration from dehydration -all other levels are NORMAL

The nurse should review a client's electrolyte levels to detect a possible increase in magnesium if the client has which condition? Select all that apply. 1. Cushing's syndrome 2. Diabetes 3. Addison's disease 4. Splenomegaly 5. Dehydration

3 and 5 -Addison's (adrenal insufficiency) and dehydration (deficient fluid volume) can cause magnesium levels -Cushing's and Diabetes Mellitus could lead to low magnesium levels -Splenomegaly is an unrelated finding

The nurse includes in the plan of care to periodically monitor which item for a client who is at risk for developing hypocalcemia? Select all that apply. 1. Blood urea nitrogen (BUN) and creatinine levels 2. Constipation 3. Serum albumin level 4. Fluid overload related to intravenous saline therapy 5. Serum magnesium level

3 and 5 -albumin provides relevant information about physiologically available calcium and decreased magnesium levels often seen together with decreased calcium levels. -assessing BUN, creatinine and constipation are indicated for hypercalcemia; fluid overload would be important for a client being treated with fluid therapy for hypercalcemia

The nurse concludes that which behavior by the client is consistent with adherence to a 2-gram sodium-restricted diet? 1. Using only the two packets of salt found on the meal tray 2. Limiting milk to one cup per day 3. Avoiding use of salt in cooking 4. Using salted butter with meals

3. AVOID salt -no table salt, no salt with cooking and avoiding high sodium foods

Which concurrent electrolyte imbalance should the nurse anticipate while caring for a client with hyperphosphatemia? 1. Potassium 2.8 mEq/L 2. Sodium 131 mEq/L 3. Calcium 6.8 mEq/L 4. Magnesium 3.4 mEq/L

3. Calcium -calcium and phosphorus always work OPPOSITE of each other; when phosphorus is high, calcium gets low (lower than 9) -other electrolytes do not have this relationship with phosphorus

The nurse concludes that a client does not have an increased magnesium level based on which finding? 1. Hypotension 2. Bradycardia 3. Supraventricular tachycardia (SVT) 4. Flushing and sweating

3. SVT -others are associated with hypermagnesemia

A client is placed on enteral feedings via nasogastric tube to meet nutritional goals. Which intervention should the nurse include in the plan of care to help maintain fluid balance? 1. Assess the skin area around the tube site. 2. Weigh the client every other day. 3. Maintain strict I&O and flush the tube once a day to ensure patency. 4. Irrigate the tube with water as ordered and include this fluid in total I&O.

4 -a client who is receiving enteral feedings via nasogastric tube can be at risk for dehydration, caused by inadequate fluid intake; irrigating the tube before and after feedings or medication administration is important!

The community health nurse makes a home visit to a client newly discharged from the hospital with resolving hypernatremia. During the initial interview, what information should the nurse follow up on to determine an effective plan of care? 1. The client lives on the second floor of an apartment building that has an elevator. 2. The client needs to walk 100 feet each day to reach the mailbox for the apartment building. 3. The client performs self-monitoring of blood glucose once a day. 4. The client uses antacids on a frequent basis for gastrointestinal complaints.

4 -frequent used of antacids can cause hypernatremia; other answers do not have risks of it.

Which healthcare provider prescription for potassium chloride (KCl) should the nurse question for a client with severe hypokalemia? 1. Infuse 1000 mL normal saline with 20 mEq KCl IV over 8 hours. 2. Give KCl 20 mEq PO daily after meals. 3. Infuse 1000 mL normal saline with 40 mEq KCl IV at 200 mL/hour. 4. Give 20 mEq KCl IV over 10 minutes.

4 -potassium is NEVER given as a bolus when it is administered IV; it should never be given rapidly or by IV push because serious arrhythmias or cardiac arrest can occur.

Which treatment option does the nurse anticipate will be most appropriate for a client with a potassium level of 3.5 mEq/L? 1. Give sodium polystyrene sulfate (Kayexalate) per rectum. 2. Use salt substitutes in the diet. 3. Administer oral potassium chloride (KCl). 4. Continue to monitor and offer foods high in potassium.

4 -potassium is within normal range (3.5 and 5); no interventions needed, just monitor the levels in case they drop.

The nurse should assess for Trousseau's sign in a client after noting which electrolyte abnormality? 1. Potassium 3.3 mEq/L 2. Sodium 131 mEq/L 3. Chloride 94 mEq/L 4. Calcium 7.7 mEq/L

4. Calcium -HYPOcalcemia causes excitability of skeletal, cardiac and smooth muscle tissues -Trousseau is one of the two tests administered to patients with calcium imbalances

The nurse reviews the laboratory test results for a client with preeclampsia, expecting to find which value? 1. Sodium 148 mEq/L 2. Sodium 125 mEq/L 3. Magnesium 3.1 mEq/L 4. Magnesium 1.2 mEq/L

4. Decreased magnesium -sodium is not a concern to this client and high magnesium would be opposite concern for this client.

The nurse would be most concerned about which laboratory value obtained for a client receiving furosemide (Lasix) therapy? 1. Blood urea nitrogen 20 mg/dL 2. Hematocrit 46% 3. Creatinine 1.1 mg/dL 4. Potassium 3.2 mEq/L

4. Potassium (low) -Furosemide inhibits reabsorption of sodium, water and potassium from the distal renal tubules and the loop of Henle, leading to diuresis; the most common electrolyte disturbance associated with Furosemide is HYPOkalemia.

The nurse would report to the charge nurse that an assigned client has hyperkalemia after noting that the serum potassium level drawn that morning was greater than how many mEq/L? Provide a numerical answer. Fill in your answer below: Answer: mEq/L

5.1 - normal range is between 3.5 and 5 (anything above 5 is HYPER)

The nurse is providing care for a patient with chronic obstructive pulmonary disease. When describing the process of respiration, the nurse explains how oxygen and carbon dioxide are exchanged between the pulmonary capillaries and the alveoli. The nurse is describing what process? A) Diffusion B) Osmosis C) Active transport D) Filtration

A -Diffusion is the natural tendency of a substance to move from an area of higher concentration to one of lower concentration. It occurs through the random movement of ions and molecules. -Examples of diffusion are the exchange of oxygen and carbon dioxide between the pulmonary capillaries and alveoli and the tendency of sodium to move from the ECF compartment, where the sodium concentration is high, to the ICF, where its concentration is low

You are the nurse caring for a 77-year-old male patient who has been involved in a motor vehicle accident. You and your colleague note that the patients labs indicate minimally elevated serum creatinine levels, which your colleague dismisses. What can this increase in creatinine indicate in older adults? A) Substantially reduced renal function B) Acute kidney injury C) Decreased cardiac output D) Alterations in ratio of body fluids to muscle mass

A -Renal function declines with age, as do muscle mass and daily exogenous creatinine production. Therefore, high-normal and minimally elevated serum creatinine values may indicate substantially reduced renal function in older adults. -Acute kidney injury is likely to cause a more significant increase in serum creatinine.

You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patient's most recent laboratory reports, you note that the patient's magnesium levels are high. You should prioritize assessment for which of the following health problems? A) Diminished deep tendon reflexes B) Tachycardia C) Cool, clammy skin D) Acute flank pain

A -To gauge a patients magnesium status, the nurse should check deep tendon reflexes. If the reflex is absent, this may indicate high serum magnesium. -Tachycardia, flank pain, and cool, clammy skin are not typically associated with hypermagnesemia.

The nurse is caring for a patient in metabolic alkalosis. The patient has an NG tube to low intermittent suction for a diagnosis of bowel obstruction. What drug would the nurse expect to find on the medication orders? A) Cimetidine B) Maalox C) Potassium chloride elixir D) Furosemide

A -cimetidine (Tagamet), reduce the production of gastric HCl, thereby decreasing the metabolic alkalosis associated with gastric suction. -Maalox is an oral simethicone used to break up gas in the GI system and would be of no benefit in treating a patient in metabolic alkalosis. -KCl would only be given if the patient were hypokalemic, which is not stated in the scenario. -Furosemide (Lasix) would only be given if the patient were fluid overloaded, which is not stated in the scenario.

A nurse is caring for a client who has a blood sodium level of 133 and blood potassium level of 3.4. The nurse should recognize that which of the following treatments can result in these laboratory findings? A) Three tap water enemas B) 0.9% sodium chloride solution IV at 50 mL/hr C) 5% dextrose with 0.45% sodium chloride solution with 20 of K+ IV at 80 mL/hr D) Antibiotic therapy

A) Three tap water enemas -can decrease both because tap water is hypotonic and GI losses are isotonic -B and C are both isotonic -antibiotic therapy is irrelevant

A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that apply. A) Decreased kidney mass B) Increased conservation of sodium C) Increased total body water D) Decreased renal blood flow E) Decreased excretion of potassium

A, D and E -Dehydration in the elderly is common as a result of decreased kidney mass, decreased glomerular filtration rate, decreased renal blood flow, decreased ability to concentrate urine, inability to conserve sodium, decreased excretion of potassium, and a decrease of total body water.

A nurse is admitting a client who reports nausea, vomiting, and weakness. The client has a dry oral mucous membranes and BP of 102/64. Which of the following findings should the nurse identify as manifestations of FVD? (Select all that apply) A) Decreased skin turgor B) Concentrated urine C) Bradycardia D) Low-grade fever E) Tachypnea

All except C -with FVD, they would have tachycardia in attempt to maintain a normal BP

A nurse is admitting an older client who reports a weight gain of 5lb in 48 hours. Which of the following manifestations of FVE should the nurse expect? (Select all that apply) Dyspnea Edema Bradycardia Hypertension Weakness

All except for bradycardia -they would have tachycardia with hypotension

You are doing discharge teaching with a patient who has hypophosphatemia during his time in hospital. The patient has a diet ordered that is high in phosphate. What foods would you teach this patient to include in his diet? Select all that apply. A) Milk B) Beef C) Poultry D) Green vegetables E) Liver

Ans: A, C, E -If the patient experiences mild hypophosphatemia, foods such as milk and milk products, organ meats, nuts, fish, poultry, and whole grains should be encouraged.

A medical nurse educator is reviewing a patients recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis? A) The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance. B) The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. C) The kidneys react rapidly to compensate for imbalances in the body. D) The kidneys regulate the bicarbonate level in the intracellular fluid.

B

You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a vague historian. The patient appears malnourished and on day 3 of the patient's admission total parenteral nutrition (TPN) has been started. Why would you know to start the infusion of TPN slowly? A) Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly. B) Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively. C) Malnourished patients who receive fluids too rapidly are at risk for hypernatremia. D) Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate

B

The nurse caring for a patient post colon resection is assessing the patient on the second postoperative day. The nasogastric tube (NG) remains patent and continues at low intermittent wall suction. The IV is patent and infusing at 125 mL/hr. The patient reports pain at the incision site rated at a 3 on a 0-to-10 rating scale. During your initial shift assessment, the patient complains of cramps in her legs and a tingling sensation in her feet. Your assessment indicates decreased deep tendon reflexes (DTRs) and you suspect the patient has hypokalemia. What other sign or symptom would you expect this patient to exhibit? A) Diarrhea B) Dilute urine C) Increased muscle tone D) Joint pain

B -If prolonged, hypokalemia can lead to an inability of the kidneys to concentrate urine, causing dilute urine (resulting in polyuria, nocturia) and excessive thirst.

A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial 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. This process is best described as which of the following? A) Hydrostatic pressure B) Osmosis and osmolality C) Diffusion D) Active transport

B -Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane.

You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect? A) Hypophosphatemia B) Hypocalcemia C) Hypermagnesemia D) Hyperkalemia

B -Tetany is the most characteristic manifestation of hypocalcemia and hypomagnesemia. Sensations of tingling may occur in the tips of the fingers, around the mouth, and, less commonly, in the feet. -Hypophosphatemia creates central nervous dysfunction, resulting in seizures and coma. -Hypermagnesemia creates hypoactive reflexes and somnolence. -signs of hyperkalemia include paresthesia's and anxiety.

You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide your assessment of the patients skin turgor? A) Overhydration is common among healthy older adults. B) Dehydration causes the skin to appear spongy. C) Inelastic skin turgor is a normal part of aging. D) Skin turgor cannot be assessed in patients over 70.

C

You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornings blood work, you notice that the patients potassium is below reference range. You should recognize that the patient may be at risk for what imbalance? A) Hypercalcemia B) Metabolic acidosis C) Metabolic alkalosis D) Respiratory acidosis

C -Probably the most common cause of metabolic alkalosis is vomiting or gastric suction with loss of hydrogen and chloride ions. The disorder also occurs in pyloric stenosis in which only gastric fluid is lost. Vomiting, gastric suction, and pyloric stenosis all remove potassium and can cause hypokalemia. -This patient would not be at risk for hypercalcemia; hyperparathyroidism and cancer account for almost all cases of hypercalcemia. The nasogastric tube is removing stomach acid and will likely raise pH. -Respiratory acidosis is unlikely since no change was reported in the patients respiratory status.

The nurse in the medical ICU is caring for a patient who is in respiratory acidosis due to inadequate ventilation. What diagnosis could the patient have that could cause inadequate ventilation? A) Endocarditis B) Multiple myeloma C) Guillain-Barr syndrome D) Overdose of amphetamines

C -Respiratory acidosis can also occur in diseases that impair respiratory muscles, such as muscular dystrophy, myasthenia gravis, and Guillain-Barr syndrome. -The other listed diagnoses are not associated with respiratory acidosis.

When planning the care of a patient with a fluid imbalance, the nurse understands that in the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur? A) Active transport of hydrogen ions across the capillary walls B) Pressure of the blood in the renal capillaries C) Action of the dissolved particles contained in a unit of blood D) Hydrostatic pressure resulting from the pumping action of the heart

D -An example of filtration is the passage of water and electrolytes from the arterial capillary bed to the interstitial fluid; in this instance, the hydrostatic pressure results from the pumping action of the heart.

You are caring for a patient with a secondary diagnosis of hypermagnesemia. What assessment finding would be most consistent with this diagnosis? A) Hypertension B) Kussmaul respirations C) Increased DTRs D) Shallow respirations

D -If hypermagnesemia is suspected, the nurse monitors the vital signs, noting hypotension and shallow respirations. The nurse also observes for decreased DTRs and changes in the level of consciousness. -Kussmaul breathing is a deep and labored breathing pattern associated with severe metabolic acidosis, particularly diabetic ketoacidosis (DKA), but also renal failure. -This type of patient is associated with decreased DTRs, not increased DTRs.

The ICU nurse is caring for a patient who experienced trauma in a workplace accident. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, PaCO2 50 mm Hg, HCO3 23 mEq/L. The nurse should recognize the likelihood of what acid base disorder? A) Respiratory acidosis B) Metabolic alkalosis C) Respiratory alkalosis D) Mixed acid base disorder

D -Patients can simultaneously experience two or more independent acid base disorders. ABG shows respiratory acidosis but the symptom of abdominal pain which can be metabolic too.

The baroreceptors, located in the left atrium and in the carotid and aortic arches, respond to changes in the circulating blood volume and regulate sympathetic and parasympathetic neural activity as well as endocrine activities. Sympathetic stimulation constricts renal arterioles, causing what effect? A) Decrease in the release of aldosterone B) Increase of filtration in the Loop of Henle C) Decrease in the reabsorption of sodium D) Decrease in glomerular filtration

D -Sympathetic stimulation constricts renal arterioles; this decreases glomerular filtration, increases the release of aldosterone, and increases sodium and water reabsorption. None of the other listed options occurs with increased sympathetic stimulation.

You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance? A) Hypernatremia B) Hypomagnesemia C) Hypophosphatemia D) Hypercalcemia

D -The most common causes of hypercalcemia are malignancies and hyperparathyroidism. Anorexia, nausea, vomiting, and constipation are common symptoms of hypercalcemia. Dehydration occurs with nausea, vomiting, anorexia, and calcium reabsorption at the proximal renal tubule. Abdominal and bone pain may also be present. -Primary manifestations of hypernatremia are neurologic and would not include abdominal pain and dehydration. -Tetany is the most characteristic manifestation of hypomagnesemia, and this scenario does not mention tetany. --The patients presentation is inconsistent with hypophosphatemia.

You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance? A) Metabolic alkalosis B) Hypermagnesemia C) Hypercalcemia D) Hypovolemia

D -Third-spacing fluid shift, which occurs when fluid moves out of the intravascular space but not into the intracellular space, can cause hypovolemia. -Increased calcium and magnesium levels are not indicators of third-spacing fluid shift. -Burns typically cause acidosis, not alkalosis

A newly graduated nurse is admitting a patient with a long history of emphysema. The new nurses preceptor is going over the patients past lab reports with the new nurse. The nurse takes note that the patients PaCO2 has been between 56 and 64 mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurse's best response? A) The patient's calcium will rise dramatically due to pituitary stimulation. B) Oxygen will increase the patient's intracranial pressure and create confusion. C) Oxygen may cause the patient to hyperventilate and become acidotic. D) Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.

D -When PaCO2 chronically exceeds 50 mm Hg, it creates insensitivity to CO2 in the respiratory medulla, and the use of oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.

A nurse is caring for a client in a long-term care facility who has become weak, confused, and experienced dizziness when standing. The client's temperature is 100.9 F, pulse 92/min, RR 20/min, and BP of 108/60. Which of the following actions should the nurse take? A) Initiate fluid restrictions B) Check for peripheral edema C) Encourage to ambulate D) Monitor for orthostatic hypotension

D -client has manifestations of dehydration, so other 3 would make it worse and client may fall

You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your patients plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patient's health? A) Nutritional status B) Potassium balance C) Calcium balance D) Fluid volume status

D -deficit or excess