Med Surge PrepU F&E

b

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? a) Abdominal pain or diarrhea b) Light-headedness or paresthesia c) Hallucinations or tinnitus d) Nausea or vomiting

hypertonic

5% dextrose and normal saline solution is considered (hypotonic/hypertonic)

d

A 160-pound patient, diagnosed with hypovolemia, is weighed every day. The health care provider asked to be notified if the patient loses 1,000 mL of fluid in 24 hours. Choose the weight that would be consistent with this amount of fluid loss. a) 159 lbs b) 157 lbs c) 156 lbs d) 158 lbs

135 mEq/L

A 42-year-old client has chronic hypo natremia, which requires weekly blood labs to keep him from lapsing into convulsions or a coma. What is the level of serum sodium below which convulsions or coma can occur? (word answer) a) 140 mEq/L b) 147 mEq/L c) 135 mEq/L d) 142 mEq/L

Third-spacing

A 57-year-old homeless female with a history of alcohol abuse has been admitted to your hospital unitwith signs and symptoms of hypovolemia—minus the weight loss. She exhibits a localized enlargement of her abdomen. What condition could she be presenting? (word answer) a) Pitting edema b) Hypovolemia c) Third-spacing d) Anasarca

a

A client has a respiratory rate of 38 breaths/min. What effect does breathing faster have on arterial pH level? a) Increases arterial pH b) Provides long-term pH regulation c) No effect d) Decreases arterial pH

ECG results

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority should be to assess her: a) bowel sounds. b) electrocardiogram (ECG) results. c) respiratory rate. d) neuromuscular function.

a, b, e

A client was admitted to your unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and his family? Select all letters (abcde) that apply. a) Drink water as an inexpensive way to meet fluid needs. b) Respond to thirst c) Drink carbonated beverages to help balance fluid volume. d) Drink caffeinated beverages to retain fluid. e) Drink at least eight glasses of fluid each day.

b

A group of nursing students are studying for a test over acid-base imbalance. One student asks another what the major chemical regulator of plasma pH is. What should the second student respond? (letter answer) a) Renin-angiotensin-aldosterone system b) Bicarbonate-carbonic acid buffer system c) Sodium-potassium pump d) ADH-ANP buffer system

Acidic

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? (word answer) a) Alkaline b) Neutral c) Basic d) Acidic

Hypercalcemia

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? (word answer) a) Hypokalemia b) Hypocalcemia c) Hypercalcemia d) Hyperkalemia

b

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? a) Absence of protein b) Urine pH of 3.0 c) Absence of glucose d) Specific gravity of 1.02

a

A patient is being treated in the ICU 24 hours after having a radical neck dissection completed. The patient's serum calcium level is 7.6 mg/dL. Which of the following physical examination findings is consistent with this electrolyte imbalance? a) Presence of Trousseau's sign b) Negative Chvostek's sign c) Slurred speech d) Muscle weakness

b

A patient is diagnosed with hypocalcemia. The nurse advises the patient and his family to immediately report the most characteristic manifestation. What is the most characteristic manifestation? a) Dyspnea and laryngospasm b) Tingling or twitching sensation in the fingers c) Confusion and depression d) Hyperactive bowel sounds.

c

A patient is ordered to receive hypotonic IV solution to provide free water replacement. Which of the following solutions will the nurse anticipate administering? a) 5% NaCl b) 0.9% NaCl c) 0.45% NaCl d) Lactated Ringer's solution

Lactated Ringer's solution

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? a) 10% dextrose in water b) Half-normal saline solution c) 5% dextrose and normal saline solution d) Lactated Ringer's solution

chest pain

Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism? (word answer) a) Hypertension b) Slow pulse c) Jaundice d) Chest pain

Hypokalemia

An elderly client takes 40 mg of Lasix twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? a) Hypophosphatemia b) Hypernatremia c) Hypokalemia d) Hyperkalemia

Hypokalemia

Bulimia can cause decreased K+, AKA:

Kidneys

Fluid and electrolyte balances affect this organ most commonly/the most:

8.6

Hypocalcemia starts when the levels reach less than ____ mEq/L

42

In respiratory acidosis, the PaCO2 level is greater than ____ mmHg

low

Metabolic acidosis is characterized by (low/high) pH

high

Metabolic alkalosis is characterized by (low/high) pH

0.9

Normal saline is ____% NaCl

4.5-8

Normal urine pH=

b

Oncotic pressure refers to the: (letter answer) a) number of dissolved particles contained in a unit of fluid. b) osmotic pressure exerted by proteins. c) amount of pressure needed to stop the flow of water by osmosis. d) excretion of substances such as glucose through increased urine output.

Hypothalamus

Oral intake is controlled by the thirst center, located in which of the following cerebral areas? (word answer) a) Brainstem b) Cerebellum c) Thalamus d) Hypothalamus

b

Patients diagnosed with hypervolemia should avoid sweet or dry food because a) it can lead to weight gain. b) it increases the patient's desire to consume fluid. c) it obstructs water elimination. d) it can cause dehydration.

True

T/F: When the heart rate goes up, decreased fluid volume is occurring

7.35

Respiratory acidosis: pH is less than:

7.45

Respiratory alkalosis: pH is greater than:

True

T/F: A patient with decreased calcium levels should be eating more bananas

False

T/F: A patient with decreased potassium levels should be using laxatives

True

T/F: When fluid volume is high, you have increased urine output

False

T/F: When fluid volume is low, you have increased urine output

calcium; phosphate

Tetany (muscle spasms) occur when there is a low level of _____ and a high level of _____

muscle spasms

Tetany, AKA:

neurological

Tetany, seizures, and spasms caused by hypocalcemia are (musculoskeletal/neurological)

parathyroid hormone

The calcium level of the blood is regulated by which mechanism? word a) Parathyroid hormone (PTH) b) Androgens c) Adrenal gland d) Thyroid hormone (TH)

a

The nurse is assigned a client with calcium level of 4.0 mg/dL. Which system assessment would the nurse ask detailed questions? a) Neurological system b) Musculoskeletal system c) Gastrointestinal system d) Endocrine system

d

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium level of 2.9 mEq/L. Which of the following statements made by the patient indicates the need for further teaching? a) "I will be sure to buy frozen vegetables when I grocery shop." b) "I will take a potassium supplement daily as prescribed." c) "A good breakfast for me will include milk and a couple of bananas." d) "I can use laxatives and enemas but only once a week."

Dark, concentrated urine

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? a) Distended jugular veins b) Cool and pale skin c) Crackles in the lung fields d) Dark, concentrated urine

155 mEq/L

The nurse is caring for a patient in the intensive care unit (ICU) following a saltwater near-drowning event. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen dry tongue, flushed skin, and peripheral edema. The nurse anticipated that the patient's serum sodium value would be which of the following? (word answer) a) 145 mEq/L b) 125 mEq/L c) 155 mEq/L d) 135 mEq/L

b

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for? a) Metabolic alkalosis b) Metabolic acidosis c) Respiratory alkalosis d) Respiratory acidosis

Metabolic acidosis

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for? a) Respiratory alkalosis b) Metabolic acidosis c) Metabolic alkalosis d) Respiratory acidosis

cerebral edema

The nurse is caring for a patient with hypernatremia. What complication of hypernatremia should the nurse continuously monitor for? a) Renal failure b) Red blood cell crenation c) Red blood cell hydrolysis d) Cerebral edema

Tachycardia

To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body? a) Increased urine output b) Vasodilation c) Tachycardia d) Bradycardia

doubling

The serum osmolality can be calculated by ______ the serum sodium

Osmosis

Translocation is a term used to describe the general movement of fluid and chemicals within body fluids. In every client's body, fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? (word answer) a) Osmosis b) Evaporation c) Active transport d) Filtration

Tetany

Trousseau's sign is a weaker form of:

Tetany

What clinical indication of hyperphosphatemia does the nurse assess in a patient?

c

What foods can the nurse recommend for the patient with hypokalemia? a) Milk and yogurt b) Green, leafy vegetables c) Fruits such as bananas and apricots d) Nuts and legumes

80

What percentage of potassium that is excreted daily, leaves the body by way of the kidneys? (word answer) a) 20 b) 60 c) 80 d) 40

Caron dioxide

When a client's ventilation is impaired, the body retains which substance? word a) Sodium bicarbonate b) Carbon dioxide (CO2) c) Oxygen d) Nitrous oxide

c

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? a) PaCO 36 b) O saturation 95% c) pH 7.48 d) HCO 21 mEq/L

high

When there is a problem with blood concentration, there is a (high/low) WBC count

b

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? letter a) Offer the client fluids frequently. b) Instruct the client to breathe into a paper bag. c) Administer an ordered decongestant. d) Administer ordered supplemental oxygen.

c

Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? a) Low urine specific gravity b) Abnormal potassium level c) Elevated hematocrit level d) Low white blood count

Facial

Which nerve is implicated in the Chvostek's sign? (word answer) a) Hypoglossal b) Optic c) Spinal accessory d) Facial

Breathing

Which of the following are the insensible mechanisms of fluid loss? (word answer) a) Nausea b) Urination c) Bowel elimination d) Breathing

c

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? a) pH 7.26 b) Serum bicarbonate of 21 mEq/L c) Serum bicarbonate of 28 mEq/L d) pH 7.30

c

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? (letter answer) a) pH 7.26 b) pH 7.30 c) Serum bicarbonate of 28 mEq/L d) Serum bicarbonate of 21 mEq/L

b

Which of the following electrolytes is a major cation in body fluid? a) Chloride b) Potassium c) Bicarbonate d) Phosphate

Sodium

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? (word answer) a) Calcium b) Magnesium c) Sodium d) Potassium

Oral

Which of the following is a correct route of administration for potassium? a) IV (intravenous) push b) Subcutaneous c) Intramuscular d) Oral

b

Which of the following is considered an isotonic solution? letter a) Dextran in NS b) 0.45% normal saline c) 0.9% normal saline d) 3% NaCl

Alcoholism

Which of the following is the most common cause of symptomatic hypomagnesemia in the United States? a) Intestinal resection b) Alcoholism c) Inflammatory bowel disease d) Loss of gastric acid

Alcoholism

Which of the following is the most common cause of symptomatic hypomagnesemia? (word answer) a) Burns b) IV drug use c) Sedentary lifestyle d) Alcoholism

a

Your clients lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap? a) Metabolic acidosis b) Respiratory acidosis c) Respiratory alkalosis d) Metabolic alkalosis

half

_____ strength saline is considered hypotonic (0.45% NaCl)

b

A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/l. Should the nurse start salt tablets when caring for this client? (letter answer) a) Yes, along with the hypotonic IV. b) No, sodium intake should be restricted. c) No, start with the sodium chloride IV. d) Yes, this will correct the sodium deficit.

c

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings? a) Metabolic alkalosis b) Respiratory acidosis c) Respiratory alkalosis d) Metabolic acidosis

Metabolic acidosis

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? a) Respiratory acidosis b) Respiratory alkalosis c) Metabolic acidosis d) Metabolic alkalosis

d

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? a) Respiratory acidosis b) Respiratory alkalosis c) Metabolic alkalosis d) Metabolic acidosis

0.45% NaCl

Which of the following solutions is hypotonic? (word answer) a) Lactated Ringer's solution b) 5% NaCl c) 0.45% NaCl d) 0.9% NaCl

hypoventilation

Which of the following would be a potential cause of respiratory acidosis? a) Hyperventilation b) Vomiting c) Hypoventilation d) Diarrhea

a

Which set of arterial blood gas (ABG) results requires further investigation? a) pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L b) pH 7.38, partial pressure of arterial carbon dioxide (PaCO2) 36 mm Hg, partial pressure of arterial oxygen (PaO2) 95 mm Hg, bicarbonate (HCO3-) 24 mEq/L c) pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L d) pH 7.44, PaCO2 43 mm Hg, PaO2 99 mm Hg, and HCO3- 26 mEq/L

Kidney failure

With which condition should the nurse expect that a decrease in serum osmolality will occur? a) Hyperglycemia b) Diabetes insipidus c) Kidney failure d) Uremia

sweet, dry

which food flavors can cause the patient want to drink more water?