cha fluids and electrolytes practice questions
When caring for a client who has hypokalemia, which electrocardiogram change will the nurse expect to observe?
flattened T waves
An older client is admitted to the hospital for rehydration therapy after 3 days of diarrhea. In addition to sodium, which electrolyte would the nurse be most concerned about?
potassium
Which assessment finding would the nurse recognize as a sign that intravenous lactated Ringer solution was effective in treating an infant with dehydration from acute gastroenteritis?
3 wet diapers in 24 hours
An older adult client states, "I walk 2 miles [3.2 km] a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated." Which statement would the nurse use to respond to this client?
"Fluids should be increased if the urine becomes darker."
Which instructions would the nurse include when providing teaching to the parents of a child prescribed diuretics? Select all that apply. One, some, or all responses may be correct.
- Fluid intake should be adequate - Diuretics should be taken at the same time each day - Diuretics may interfere with normal laboratory test values
Which complication would the nurse prevent by addressing the needs of a hyperventilating client?
Carbonic acid deficit
When caring for a client who has hyponatremia, the nurse would monitor for which symptom?
Change in LOC
Which diagnosis is a client most likely to have who has an arterial blood gas report indicating that pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L (20 mmol/L)?
DKA
An older client who was found unconscious at home was admitted to the hospital with a fractured hip, renal failure, and dehydration. In the 24 hours since admission, the client has received 3 L of intravenous fluid. The client has also developed hyponatremia. Which element would the nurse conclude is the most likely to have contributed to the client developing hyponatremia?
IV fluid infusion
Which statement explains why metabolic acidosis develops with kidney failure?
Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate
Which nursing action is the priority for a client who has a serum potassium level of 6.7 mEq/L (6.7 mmol/L)?
Monitor for cardiac dysrhythmias
Intravenous (IV) potassium is prescribed for a client with a diagnosis of hypokalemia. Which statement about administration of IV potassium is accurate?
Oliguria is an indication for withholding IV potassium
The nurse assesses for hypocalcemia in a postoperative client. Which is one of the initial signs that might be present?
Paresthesias
The client's serum sodium is 123 mEq/L (123 mmol/L). Which prescription would the nurse question?
Provide 0.45% sodium chloride (NaCL) intravenously at 125 mL/h
Which medication requires the nurse to monitor the client for signs of hyperkalemia?
Spironolactone
The nurse determined a client's arterial blood gases reflected a compensated respiratory acidosis. The pH was 7.34; which additional laboratory value did the nurse consider?
The bicarbonate (HCO3) value is 50 mEq/L (50 mmol/L)
The arterial blood gases for a client with acute respiratory distress are pH 7.30, PaO2 80 mm Hg (10.64 kPa), PaCO2 55 mm Hg (7.32 kPa), and HCO3 23 mEq/L (23 mmol/L). How would the nurse interpret these findings?
Uncompensated respiratory acidosis
The nurse assesses an older adult client with a diagnosis of dehydration. Which finding is an early sign of dehydration?
change in mental status
Which clinical indicator(s) would the nurse expect a client with hyperkalemia to exhibit? Select all that apply. One, some, or all responses may be correct.
confusion weakness dysrhythmias
A client who experienced extensive burns is receiving intravenous fluids to replace fluid loss. The nurse would monitor for which initial symptom of fluid overload?
crackles in the lungs
A client is in a state of uncompensated acidosis. Which approximate arterial blood pH does the nurse expect the client to have?
decreased
The client with hypokalemia reports nausea, vomiting, and seeing a yellow light around objects. Which of the client's medications is the likely cause of the client's symptoms?
digoxin
Which clinical finding would the nurse anticipate when admitting a client with an extracellular fluid volume excess?
distended jugular veins
Postoperative arterial blood gas values for a client in the postanesthesia care unit are pH 7.32, PaCO2 53 mm Hg (7.05 kPa), HCO3 25 mEq/L (25 mmol/L), and PaO2 85 mm Hg (11.3 kPa). Which action would the nurse take?
encourage deep breathing and coughing
When arterial blood gas results for an alert client who is in the postanesthesia care unit (PACU) after abdominal surgery are pH 7.37, PaCO2 42 mm Hg (5.59 kPa), HCO3 25 mEq (25 mmol/L), PaO2 65 mm Hg (8.64 kPa), and SaO2 90% (0.90), which action would the nurse take?
increase oxygen flow rate
A client is admitted with severe diarrhea that resulted in hypokalemia. The nurse would monitor for which clinical manifestations of the electrolyte deficiency? Select all that apply. One, some, or all responses may be correct.
leg cramps muscle weakness
The laboratory data for a client with prolonged vomiting reveal arterial blood gases of pH 7.51, Pco2 of 45 mm Hg, HCO3 of 58 mEq/L (59 mmol/L), and a serum potassium level of 3.8 mEq/L (3.8 mmol/L). The nurse concludes that the findings support which diagnosis?
metabolic alkalosis
The nurse is caring for a client with the following arterial blood gas (ABG) values: PO2 89 mm Hg, PCO2 35 mm Hg, and pH of 7.37. These findings indicate that the client is experiencing which condition?
normal acid base balance
Which result would the nurse expect to see on the electrocardiogram (ECG) tracing monitor when a client has diabetic ketoacidosis and a potassium level of 5.4 mEq/L (5.4 mmol/L)?
peaked T waves and widened QRS complex
A client is admitted with metabolic acidosis. Which two body systems would the nurse assess for compensatory changes?
resp and urinary
A client with chronic obstructive pulmonary disease (COPD) has a blood pH of 7.25 and a partial pressure of carbon dioxide (PCO2) of 60 mm Hg. Which complication would the nurse suspect the client is experiencing?
respiratory acidosis
The nurse is planning care for a client with hyperparathyroidism and subsequent hypocalcemia and low bone density. Which information would the nurse provide the unlicensed assistive personnel (UAP) to prevent injury?
use a lift sheets for transfers
A client is admitted for dehydration and an intravenous (IV) infusion of normal saline at 125 mL/h has been started. One hour after the IV initiation the client begins screaming, "I can't breathe!" Which action is the nurse's priority?
Elevate the head of the bed and obtain vital signs
The nurse is evaluating the effectiveness of a treatment for a client with excessive fluid volume. Which clinical finding indicates that treatment was successful?
clear breathe sounds
An arterial blood gas report indicates that pH is 7.25, Pco2 is 60 mm Hg, and HCO3 is 26 mEq/L (26 mmol/L). Which client is most likelyto exhibit these blood gas results?
A client with pulmonary fibrosis
Which clinical manifestation would the nurse associate with successful fluid replacement therapy?
A trended urinary output of at least 30 mL/h
An arterial blood gas report indicates the client's pH is 7.25, PCO2 is 35 mm Hg, and HCO3 is 20 mEq/L. Which disturbance would the nurse identify based on these results?
metabolic acidosis
A client is receiving furosemide. For which sign of hypokalemia will the nurse monitor the client?
muscle weakness
Which collaborative action would be best to rehydrate an alert client seen in the urgent care center with dehydration, a heart rate of 100 beats/minute, and blood pressure of 104/62 mm Hg?
offer frequent oral fluids over several hours