patho chapter 8 practice quizzes, Prep U CH.8, Chapter 8- PrepU, Pathophysiology Chapter 8 PrepU
A patient is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in the lower lung fields bilaterally. What is the patient's most likely diagnosis?
Fluid volume excess
A 14-year-old boy, appearing to be intoxicated, is brought to the emergency room by ambulance. The EMTs report that the boy has denied consuming anything out of the ordinary, but an open antifreeze container was found in the boy's room.
Fomepizole
The nurse volunteering in the medical tent for a road race on a hot, humid day is asked to see a runner who has collapsed on the road. The nurse notes he has sunken eyes, a temperature of 100 degrees Fahrenheit, and dizziness. These are signs of a fluid volume deficit. Recognizing fluid volume deficit, which of these interventions does the nurse carry out first?
Give him an electrolyte solution by mouth.
The nurse is aware that the major role of the kidneys is regulated acid-base balance is to increase the production of?
HCO3-
the nurse is aware that a major role of the kidneys in regulating acid-base balance is to increase the production of:
HCO3-
the nurse is aware that the major role of the kidneys in regulating acid-base balance is to increase the production of:
HCO3-
The nurse is assessing a client for early manifestations of hyponatremia. The nurse would assess the client for:
Muscle weakness
The nurse is caring for a client with a longstanding diagnosis of hypocalcemia secondary to kidney disease. For which of the following clinical manifestations does the observe in this patient?
Muscular spasms and complaints of tingling in hands/feet.
Hypothalamic sensory neurons that promote thirst when stimulated are called which of the following?
Osmoreceptors
When caring for patients with disorders of sodium balance, the nurse asks the provider which of the following findings are consistent with hypernatremia?
Sodium 158 mEq/L and serum osmolality of 320 mOsm/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 84/56mm Hg. ABG values are: pH 7.1, HCO3- 18 mEq/L, PCO2 57mm Hg. What IV medication should the nurse expect to provide next?
Sodium bicarbonate
A nurse is caring for a patient with a low sodium level and increased water retention. Hematocrit and blood urea nitrogen levels are decreased, urine osmolality is low. A chest x-ray shows a possible lung mass. Based on these findings, which of the following problems could the patient be diagnose with ?
Syndrome of inappropriate antidiuretic hormone (ADH)
a client is brought to the emergency department with complaints of shortness of breath. assessment reveals a full, bounding pulse, severe edema and audible crackles in lower lung fields bilaterally. the nurse notifies the physician to obtain orders for which of these problems?
fluid volume excess
the nurse volunteering in the medical tent for a road race on a hot, humid day is asked to see a runner who has collapsed on the road. the nurse notes he has sunken eyes, a temperature of 100 degrees Fahrenheit, and dizziness. these are signs of a fluid volume deficit. recognizing fluid volume deficit, which of these interventions does the nurse carry out first?
give him an electrolyte solution by mouth
the nurse is caring for a patient who takes lithium to manage his bipolar disorder. the nurse carefully observes the patient for which of the following electrolyte imbalance?
hypercalcemia
a teenage patient presents to his physician with symptoms of generalized muscle weakness, muscle cramps, nausea, vomiting, and diarrhea. based on these symptoms, the nurse anticipates that the patient has which of the following problems?
hyperkalemia
a nurse is caring for a patient with hypoparathyroidism. which of the following is a major concern for the patient?
hypocalcemia
the nurse is caring for a patient with ketoacidosis, who is complaining of increasing lethargy and occasional confusion following several weeks of rigid adherence to a carbohydrate-free diet. the nurse understands which of the following phenomena is most likely occurring?
in the absence of carbohydrate energy sources, her body is metabolizing fat and releasing ketoacids
a client with ethylene glycol toxicity is restless, and stating he has flank pain. what intervention should the nurse perform to minimize complications?
increase IV fluids
lymph fluid arises directly from which of the following spaces?
interstitial
the nurse is performing an assessment for a patient that is experiencing shortness of breath. the nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. the nurse recognizes symptoms of which of these problems?
isotonic fluid volume excess
a client has an increase in her anion gap (AG). what does the nurse determine is the significance of this finding?
it indicates the client has metabolic acidosis
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 normal range
a client has these arterial blood gas volumes: anion gap 20 mEq/L, pH 7.29, pCO2 37mm Hg, HCO3- 11 mEq/L, base excess -6 mEq/L. with what condition do these values correspond?
lactic acidosis
the nurse is administering the medications to a patient on the cardiac unit. giving which of the following medications causes the nurse to be alert for hypokalemia?
loop diuretic
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
Which of the following best describes the concentration of solute in a particular volume of fluid based on electrolyte equivalency?
mEq/L
when caring for a patient with diabetes insipidus (DI), the nurse plans to evaluate which of the following laboratory studies?
measurement of antidiuretic hormone (ADH) and plasma/urine osmolality
the nurse is caring for a client with worsening respiratory acidosis. which of these interventions does the nurse anticipate if the client's condition continues to deteriorate?
mechanical ventilation
The nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mm Hg HCO3: 18 mEq/L The nurse would interpret this as? a) metabolic alkalosis b) respiratory alkalosis c) metabolic acidosis d) respiratory acidosis
metabolic acidosis
a child accidentally consumes a container of wood alcohol. the ED physician knows that the child is at risk of developing which of the following?
metabolic acidosis
the nurse is caring for a client who has excessive diarrhea. which of these acid base disturbances does the nurse anticipate uncovering during evaluation of the arterial blood gas?
metabolic acidosis
the nurse is reviewing the following lab results of a client diagnosed with renal failure: pH: 7.24 PCO2: 38 mmHg HCO3: 18 mEq/L The nurse would interpret this as:
metabolic acidosis
the nurse is administering a unit of packed red blood cells to a patient and piggybacks the unit of blood through a solution of 0.9% NaCl. blood cells placed in a solution of 0.9% saline will do which of the following?
neither shrink nor swell
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 of the following statements supports the nurse's action?
older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high
hypothalmic sensory neurons that promote thirst when stimulated are called which of the following?
osmoreceptors
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
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
pressure generated as water moves across a membrane is known as which of the following?
osmotic pressure
a client with chronic obstructive pulmonary disease (COPD) receives oxygen in the emergency department at a rate of 4 L/min for acute respiratory distress.
pH 7.29, pCO2 67mm HG, HCO3- 26 mEq/L, pO2 64mm Hg
Which arterial blood gas (ABG) values tell the nurse a client is in respiratory alkalosis? Select all that apply.
pH 7.52 pCO2 of 27 mm Hg
the nurse caring for a client with metabolic acidosis examines arterial blood gas (ABG) results. which change from the initial value indicates the client's metabolic acidosis is improving?
pH has increased
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
the nurse is assessing a patient who is receiving mechanical ventilation. which of the following assessment data obtained by the nurse may indicate that the patient is experiencing respiratory alkalosis?
positive Chvostek sign
a patient with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. the nurse recognizes this behavior is consistent with which of these problems?
psychogenic polydipsia
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
the nurse is caring for a client who complains of headache and blurred vision. the nurse recognizes these symptoms, accompanied by increased plasma partial pressure carbon dioxide (PCO2) level and decreased pH level are consistent with which of these diagnoses?
respiratory acidosis
When caring for the client with a hyperkalemia, the nurse recognizes the body should respond in which of these ways?
secrete potassium in the distal tubules for excretion
a client with anemia is showing signs of acidosis. how can a decline in red blood cells cause someone to be acidotic?
the RBCs are potent buffers and their loss results in less bicarbonate production
what is the nurse's expectation about a client's ability to compensate for a metabolic blood gas disorder?
the client will compensate with the respiratory system
a patient hospitalized for dehydration has orders for daily weight. on admission, the patient's weight was 68 kg. this morning the patient weight is 66.6 kg, which represents a weight loss of 1.4 lb or 2% of client body weight. based on this calculation, the nurse determines which of the following?
the patient has a mild extracellular fluid (ECF) deficit
the effective circulating volume is the major regulator of water balance in the body. what else does it regulate?
sodium
when caring for patients with disorders of sodium balance, the nurse asks the provider which of the following findings are consistent with hypernatremia?
sodium 158 mEq/L and serum osmolality of 320 mOsm/kg
The nurse is caring for a client who is experiencing an increased level of aldosterone secretion. The nurse anticipates that the client may develop:
sodium and water retention
the nurse is caring for a client who is experiencing an increased level of aldosterone secretion. the nurse anticipates that the client may develop:
sodium and water retention
A client has been diagnosed with metabolic acidosis. What assessment finding does the nurse expect?
Decreased pH below 7.35
A male patient with a history of heavy alcohol use has been admitted to hospital for malnutrition and suspected pancreatitis. The patient's diagnostic workup suggests alcoholic ketoacidosis as a component of his current health problems. He is somewhat familiar with the effect that drinking has had on his nutrition and pancreas, but is wholly unfamiliar with the significance of acid-base balance. How best could his care provider explain the concept to him?
"The chemical processes that take place throughout your body are thrown off very easily when your body is too acidic or not acidic enough.
The nurse teaches the client with end-stage kidney disease and hyperphosphatemia to take sevelamer HCl (Renagel), a phosphate binder, with meals. How does the nurse explain the rationale for the timing of this medication?
"The medication should be taken at meal time to allow the binding of phosphate."
a male patient with a history of heavy alcohol use has been admitted to the hospital for malnutrition and suspected pancreatitis. the patient's diagnostic workup suggests alcoholic ketoacidosis as a component of his current health problems. he is somewhat familiar with the effect that drinking has had on his nutrition and pancreas, but is wholly unfamiliar with the significance of acid-base balance. how best could his care provider explain the concept to him?
"the chemical processes that take place throughout your body are thrown off very easily when your body is too acidic or not acidic enough
the nurse teaches the client with end-stage kidney disease and hyperphosphatemia to take sevelamer HCl (Renagel), a phosphate binder, with meals. how does the nurse explain the rationale for the timing of this medication?
"the medication should be taken at meal time to allow the binding of phosphate"
the nurse on the cardiac unit has noted that the client's potassium level is 6.1 mEq/L. the nurse has notified the physician and removed the banana from the client's meal tray. when explaining the nursing actions to the client, which of these statements is appropriate?
"your potassium level is high so I need you to let me know if you feel numbness, tingling or weakness"
A patient is admitted to the emergency department after being involved in an automobile accident with possible internal bleeding. What type of isotonic intravenous (IV) solution does the nurse prepare to infuse?
0.9% NaCl
a patient is admitted to the emergency department after being involved in an automobile accident with possible internal bleeding. what type of isotonic intravenous (IV) solution does the nurse prepare to infuse?
0.9% NaCl
during a period of extreme excess fluid volume, a renal dialysis patient may be administered which type of IV solution to shrink the swollen cells by pulling water out of the cell?
3% sodium chloride (NaCl)
Body weight consists of which of the following percentages of body water?
60%
The nurse is caring for a client with an acid base imbalance. Which of these does the nurse recognize is correct regarding compensatio
A pH moves toward the normal range
Which of the following individuals would be considered to be at risk for the development of edema? Select all that apply. A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa A 77-year-old woman who has an active gastrointestinal bleed and consequent anemia An 81-year-old man with right-sided heart failure and hypothyroidism A 34-year-old industrial worker who has suffered extensive burns in a job-related accident A 60-year-old obese female with a diagnosis of poorly controlled diabetes mellitus
An 81-year-old man with right-sided heart failure and hypothyroidism A 34-year-old industrial worker who has suffered extensive burns in a job-related accident A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa
the nurse caring for a client with respiratory acidosis examines arterial blood gas (ABG) results. which change from the initial value indicates the client's respiratory acidosis is improving?
CO2 has decreased
Serum phosphorus level has a reciprocal relationship with which of the following serum electrolytes?
Calcium
A patient has been diagnosed with a brain tumor that cannot be removed surgically. During each office visit, the nurse will be assessing the patient for syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following assessments would alert the clinic nurse that the patient may be developing this complication?
Complaints that his urine output is decreased, no edema noted in ankles, and increasing headache
The nurse is providing teaching to a student nurse about how antidiuretic hormone (ADH) plays a central role in the reabsorption of water by the kidneys. The nursing student is correct to place the following components of the homeostatic action of ADH in the correct sequence. Use all the options.
D, B, E, A, C A) Stored ADH is released into circulation. B) ADH is transported along a neural pathway to the posterior pituitary gland. C) Aquaporins are inserted into tubular cell membranes. D) ADH is synthesized by cells in the supraoptic and paraventricular nuclei of the hypothalamus. E) Serum osmolality increases.
A client has an increase in respiratory rate. What assessment findings does the nurse expect?
Decreased PCO2
The nurse caring for the client with respiratory alkalosis and renal compensation determines which of these diagnostic findings is consistent with this disorder?
Decreased PCO2 and HCO3, and increased pH
A nurse is reviewing laboratory values for an elderly patient admitted for changes in mental status. The laboratory values are a urine-serum ratio of 4:1 and urine osmolality of 1100 mOsm/kg H2O. Based on these lab results, the nurse anticipates treatment for which of the following problems?
Dehydration
Respiratory alkalosis is caused by hyperventilation, which is recognized as 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 patient with hypoparathyroidism. Which of the following is a major concern for the patient?
Hypocalcemia
A community health nurse who is attending a marathon recognizes which of the following types of hypotonic hyponatremia is likely when a patient reports muscle weakness, cramping, and general fatigue in spite of adequate water hydration during the run?
Hypovolemic
a nurse is caring for a patient whose serum potassium level is 2.6 mEq/L. the nurse anticipates which of the following interventions will be prescribed?
IV infusion of 10 mEq potassium chloride in 100-mL normal saline solution over 1 hour times three doses
The nurse is performing an assessment for a patient that is experiencing shortness of breath. The nurse notes a full and bounding pulse, crackles in the lung fields, and jugular vein distention. The nurse recognizes symptoms of which of these problems?
Isotonic fluid volume excess
Lymph fluid arises directly from which one of the following spaces?
Interstitial
A nurse is providing care for a client who has been diagnosed with metabolic alkalosis after several days of antacid use. Which of the following treatments should the nurse prepare to give?
Intravenous administration of a KCl solution.
A client has these arterial blood gas values: anion gap 20 mEq/L, pH 7.29, pCO2 37mm Hg, HCO3- 11 mEq/L, base excess -6 mEq/L. With what condition do these values correspond?
Lactic acidosis
the nurse is caring for a patient with a tumor obstructing the lymphatic system. for which of the following consequences does the nurse assess?
fluid accumulating in the interstitial spaces distal to the tumor
Potassium is the major cation in the body. It plays many important roles, including the excitability of nerves and muscles. Where is this action particularly important?
The heart
The nurse is assessing blood gas results for a patient with diabetes and ketoacidosis and notes a pH level of 7.15. Which of the following dysrhythmias should the nurse closely monitor while treating this patient?
Ventricular tachycardia
the nurse is caring for the following group of clients. select the client most likely to be diagnosed with respiratory alkalosis
a 26-year old female with anxiety who has been hyperventilating
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
The nurse has just received the lab results of a client's calcium level. The nurse identifies a normal calcium level as? a) 9.0 to 10.5 mg/dL b) 3.5 to 5.3 mg/dL c) 13.5 to 14.5 mg/dL d) 12.0 to 15.0 mg/dL
a) 9.0 to 10.5 mg/dL
an elderly client is admitted reporting polyuria and showing signs of alkalosis. he is severely constipated, and his blood pressure drops significantly upon standing. while awaiting the results of the client's blood work, what action by the nurse is the most appropriate?
facilitate a STAT ECG
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
which of the following is a condition that can cause decreased antidiuretic hormone (ADH) level or action?
alcohol
serum phosphorus level has a reciprocal relationship with which of the following serum electrolytes?
calcium
when explaining how carbon dioxide combines with water to form carbonic acid as part of acid-base lecture, the faculty instructor emphasized that which enzyme is needed as catalysis for this reaction?
carbonic anhydrase
which of the following buffer systems acts immediately?
chemical buffer systems
the body regulates the pH of its fluids by what mechanism? select all that apply
chemical buffer systems of the body fluids the lungs the kidneys
a patient has been diagnosed with a brain tumor that cannot be removed surgically. during each office visit the nurse will be assessing the patient for syndrome of inappropriate antidiuretic hormone (SIADH). which of the following assessments would alert the clinic nurse that the patient may be developing this complication?
complaints of urine output is decreased, no edema noted in ankles, increasing headache
The nurse is assessing a client with fluid volume excess. The nurse anticipates the client would manifest? a) decreased blood pressure b) weak, rapid pulse c) increased BUN d) weight gain
d) weight gain
the nurse is caring for a client with isotonic fluid volume deficit. the nurse would anticipate the client to manifest: select all that apply
decreased urine output hypotension tachycardia and weak pulse increased hematocrit and BUN
the nurse is caring for a client with diabetic ketoacidosis. which breathing pattern does the nurse recognize is characteristic of metabolic acidosis?
deep and rapid respirations
the nurse is caring for a patient who receives hemodialysis. the nurse knows that hemodialysis involves movement of charged or uncharged particles along a concentration gradient. which of the following best describe this process?
diffusion
