PrepU sets Fluid/Lytes

The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance? a) A 7-year-old with a fracture tibia b) A 72-year-old with a total knee repair c) A 65-year-old with a myocardial infarction d) A 52-year-old with diarrhea

A 52-year-old with diarrhea

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following? a) Respiratory acidosis b) Metabolic alkalosis c) Extracellular fluid volume deficit d) Altered blood urea nitrogen (BUN) value

Extracellular fluid volume deficit

The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance does a positive Chvostek's sign indicate? a) Hyperkalemia b) Hypocalcemia c) Hypercalcemia d) Hypermagnesemia

Hypocalcemia

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? a) Limit sodium and water intake. b) Assess for dehydration. c) Teach client behaviors that decrease urination. d) Give medications that promote fluid retention.

Limit sodium and water intake.

The nurse is caring for a patient undergoing alcohol withdrawal. Which of the following serum laboratory values should the nurse monitor most closely? a) Potassium b) Magnesium c) Calcium d) Phosphorus

Magnesium

A nurse is caring for a patient with acute renal failure and hypernatremia. Which of the following actions can be delegated to the nursing assistant? a) Monitor for signs and symptoms of dehydration. b) Assess the patient's daily weights for trends. c) Teach the patient about increased fluid intake. d) Provide oral care every 2-3 hours.

Provide oral care every 2-3 hours.

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH? a) Restricting fluids to 800 ml/day b) Elevating the head of the client's bed to 90 degrees c) Restricting sodium intake to 1 gm/day d) Administering vasopressin as ordered

Restricting fluids to 800 ml/day

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

0.9% normal saline

A 77-year-old retired male client visits your general practice office twice monthly to maintain control of his congestive heart failure. He measures his weight daily and phones it to your office for his medical record. In a 24-hour period, how much fluid is this client retaining if his weight increases by 2 lb? a) 1500 ml b) 1250 ml c) 1 L d) 500 ml

1 L

You are the nurse caring for a 77-year-old male who fell off his roof. You note that the patient's labs indicate minimally elevated serum creatinine levels. What can this indicate in older adults? a) Reduced respiratory function b) Substantially reduced renal function c) Increased cardiac function d) Alterations in ratio of body fluids to muscle mass

...Substantially reduced renal function

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) Lactated Ringer's solution b) 0.9% NaCl c) 5% NaCl d) 0.45% NaCl

0.45% NaCl

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

0.45% NaCl

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? a) 140 mEq/L b) 142 mEq/L c) 147 mEq/L d) 135 mEq/L

135 mEq/L

Below which serum sodium level may convulsions or coma can occur? a) 145 mEq/L b) 142 mEq/L c) 140 mEq/L d) 135 mEq/L

135 mEq/L

You are caring for a patient admitted with a diagnosis of renal failure. When you review your patient's laboratory reports, you note that the patient's magnesium levels are high. What would be important for you to assess? a) Diminished deep tendon reflexes b) Tachycardia c) Cool, clammy skin d) Increased serum magnesium

Diminished deep tendon reflexes

You are caring for a patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion. Your patient has specific gravities ordered every 4 hours. What does this test detect? a) Hypercalcemia b) Hyperkalemia c) Nutritional deficit d) Fluid volume status

Fluid volume status

While admitting a new patient to your medical-surgical unit, you note that the patient is oliguric. You notify the acute-care nurse practitioner who orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. What do you know this intervention will do? a) Help distinguish hyponatremia from hypernatremia b) Help evaluate pituitary gland function c) Help distinguish reduced renal blood flow from decreased renal function d) Help provide an effective treatment for hypertension-induced oliguria

Help distinguish reduced renal blood flow from decreased renal function

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? a) Hypercalcemia b) Hyperkalemia c) Hypermagnesemia d) Hyponatremia

Hypercalcemia

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? a) Hyponatremia b) Hypermagnesemia c) Hyperkalemia d) Hypercalcemia

Hypercalcemia

A physician orders regular insulin 10 units I.V. along with 50 ml of dextrose 50% for a client with acute renal failure. What electrolyte imbalance is this client most likely experiencing? a) Hypercalcemia b) Hypernatremia c) Hyperglycemia d) Hyperkalemia

Hyperkalemia

A patient is being treated with loop diuretics; gastric suctioning has been initiated. The nurse understands the patient is at risk for developing which of the following electrolyte imbalances? a) Hypomagnesium b) Hypokalemia c) Hyponatremia d) Hypocalcemia

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

During his annual physical exam, your 72-year-old male client complains of muscle cramps in his calves and that he feels "tired a lot." He is taking ethacrynic acid (Edecrin) for his hypotension. Your client will be evaluated for which of the following electrolyte imbalance based on his symptoms? a) Hypokalemia b) Hyperkalemia c) Hypercalcemia d) Hypocalcemia

Hypokalemia

A patient with a magnesium level of 2.6 mEq/L is being treated on a medical-surgical unit. Which of the following treatments should the nurse anticipate will be used? a) Fluid restriction b) Dialysis c) Oral magnesium oxide (MagOx) d) IV furosemide (Lasix)

IV furosemide (Lasix)

A nurse is assessing a client with syndrome of inappropriate antidiuretic hormone. Which finding requires further action?

Jugular vein distention

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) 5% dextrose and normal saline solution c) Half-normal saline solution 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) Lactated Ringer's solution b) Half-normal saline solution c) 5% dextrose and normal saline solution d) 10% dextrose in water

Lactated Ringer's solution

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

No, sodium intake should be restricted.

Translocation is a term used to describe the general movement of fluid and chemicals within body fluids. In every client's body, fluid-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? a) Diffusion b) Filtration c) Osmosis d) Active transport

Osmosis

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? a) Calcium: 10 mg/dL b) Sodium: 138 mEq/L c) Magnesium:2 mEq/L d) Potassium: 5.8 mEq/L

Potassium: 5.8 mEq/L

The nurse is analyzing the electrocardiographic (ECG) rhythm tracing of a patient experiencing hypercalcemia. Which of the following ECG changes is typically associated with this electrolyte imbalance? a) Prolonged PR intervals b) Elevated ST segments c) Prolonged QT intervals d) Peaked T waves

Prolonged PR intervals

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? a) Pulse b) Temperature c) Respirations d) Blood pressure

Pulse

A client with an intravenous infusion is rubbing his arm. The nurse assesses the site and decides to discontinue the current infusion because of concern that the client has developed phlebitis. Which of the following clinical manifestations would the nurse assess with phlebitis? Select all that apply. a) Rapid, shallow respirations b) Tender area around the insertion site c) Ecchymosis at the insertion site d) Cool area around the insertion site e) Reddended area along the path of the vein

Reddended area along the path of the vein • Tender area around the insertion site

The nurse is participating in the care of a patient who had a peripherally inserted central catheter (PICC) inserted in the right arm. Following catheter placement, the nurse should complete which of the following actions? a) Send the patient for a chest x-ray. b) Obtain written consent for the procedure. c) Administer the prescribed IV fluids. d) Assess the patient's blood pressure (BP) on the right arm.

Send the patient for a chest x-ray.

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant? a) Urine specific gravity of 1.025 b) Serum sodium level of 132 mEq/L c) Blood urea nitrogen (BUN) level of 29 mg/dl d) Serum potassium level of 3 mEq/L

Serum potassium level of 3 mEq/L

A patient with cancer is being treated on the oncology unit for bilateral breast cancer. The patient is undergoing chemotherapy. The nurse notes the patient's serum calcium level is 12.3 mg/ dL. Given this laboratory finding, the nurse should suspect which of the following statements? a) The patient's diet is lacking in calcium-rich food products. b) The patient may be developing hyperaldosteronism. c) The patient's malignancy is causing the electrolyte imbalance. d) The patient has a history of alcohol abuse.

The patient's malignancy is causing the electrolyte imbalance.

The nurse is providing afternoon shift report and relates morning assessment findings to the oncoming nurse. Which daily assessment data is necessary to determine changes in hypervolemia status? a) Intake and output b) Vital signs c) Edema d) Weight

Weight

Early signs of hypervolemia include a) thirst. b) moist breath sounds. c) increased breathing effort and weight gain d) a decrease in blood pressure.

increased breathing effort and weight gain

Oncotic pressure refers to the 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.

osmotic pressure exerted by proteins.

The nurse is assessing a patient for local complication of IV therapy. Local complications include which of the following? Select all that apply. a) Phlebitis b) Air embolism c) Extravasation d) Hematoma e) Infection

phlebitis extravasation hematoma

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. a) Decreased blood pressure b) Crackles in the lung fields c) Distended neck veins d) Shortness of breath e) Bradycardia

• Crackles in the lung fields • Distended neck veins • Shortness of breath

In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply. a) Heart failure b) Severe hemorrhage c) Pulmonary edema d) Renal impairment e) Burns

• Heart failure • Pulmonary edema • Renal impairment

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? a) Hypercalcemia b) Hyperkalemia c) Hypokalemia d) Hypocalcemia

Hypercalcemia

You are the nurse caring for a 65-year-old female patient who is in renal failure. During your shift assessment, the patient complains of tingling in her lips and fingers whenever anyone takes her blood pressure. She tells you that she gets a spasm in her wrist and hand and that it is very painful. What would you suspect? a) Hypophosphatemia b) Hypocalcemia c) Hypermagnesemia d) Hyperkalemia

Hypocalcemia

A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings? a) Hypernatremia b) Hypokalemia c) Hyperchloremia d) Hypophosphatemia

Hypokalemia

You are working on a burn unit. One of your patients is exhibiting signs and symptoms of third spacing, which occurs when fluid moves out of the intravascular space but not into the intracellular space. Based upon this fluid shift, what would you expect the patient to demonstrate? a) Hypovolemia b) Hypertension c) Hypervolemia d) Bradycardia

Hypovolemia

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

Alcoholism

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

Sodium

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

Urine pH of 3.0

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

Alcoholism

Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus? a) Tetany and increased blood urea nitrogen (BUN) levels b) Sunken eyeballs and spasticity c) Confusion and seizures d) Flaccidity and thirst

Confusion and seizures

You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults? a) Hypovolemia b) Dehydration c) Hypervolemia d) Fluid volume excess

Dehydration

Hypokalemia can cause which of the following symptoms to occur? a) Increased release of insulin b) Decreased sensitivity to digitalis c) Excessive thirst d) Production of concentrated urine

Excessive thirst

Which of the following is a factor that increases blood urea nitrogen (BUN)? a) Overhydration b) GI bleeding c) Hypothermia d) Decreased protein intake

GI bleeding

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? a) Hyperkalemia b) Hypercalcemia c) Hypocalcemia d) Hypokalemia

Hypercalcemia

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

Oral

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

Potassium

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result? a) Serum creatinine level of 0.4 mg/dl b) Hematocrit of 52% c) Serum blood urea nitrogen (BUN) level of 8.6 mg/dl d) Serum sodium level of 124 mEq/L

Serum sodium level of 124 mEq/L

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

Tachycardia

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess: a) Hegar's sign. b) Homans' sign. c) Trousseau's sign. d) Goodell's sign.

Trousseau's sign.

The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. a) A low urine specific gravity b) Electrolyte imbalance c) Absence of ketones in urine d) An elevated hematocrit level e) Low protein level in the urine

• An elevated hematocrit level • Electrolyte imbalance

The nurse is caring for a patient who was admitted with fluid volume excess (FVE). Which of the following nursing assessments should the nurse include in the ongoing monitoring of the patient? Select all that apply. a) Intake and output, urine volume, and color b) Skin assessment for edema and turgor c) Blood pressure, heart rate, and rhythm d) Nutritional status and diet e) Strength testing for muscle wasting

• Blood pressure, heart rate, and rhythm • Intake and output, urine volume, and color • Skin assessment for edema and turgor

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. a) Decreased blood pressure b) Shortness of breath c) Distended neck veins d) Bradycardia e) Crackles in the lung fields

• Distended neck veins • Crackles in the lung fields • Shortness of breath

Which of the following would be appropriate nursing interventions for a client with hypokalemia? Select all that apply. a) Monitor intake and output every shift. b) Administer the ordered potassium 40 mg IV push. c) Administer the ordered Kayexalate enema. d) Administer the ordered Furosemide (lasix) 60 mg po. e) Offer a diet with fruit juices and citrus fruits.

• Offer a diet with fruit juices and citrus fruits. • Monitor intake and output every shift.

Which of the following is a function of calcitonin? Select all that apply. a) Decreases deposition of phosphorous in bones b) Decreases urinary excretion of phospate c) Increases urinary excretion of calcium d) Increases deposition of calcium in bones e) Reduces bone resorption

• Reduces bone resorption • Increases urinary excretion of calcium • Increases deposition of calcium in bones

The nurse is caring for a patient diagnosed with hyperchloremia. Signs and symptoms of hyperchloremia include which of the following? Select all that apply. a) Dehydration b) Hypotension c) Tachypnea d) Lethargy e) Weakness

• Tachypnea • Weakness • Lethargy

What is one process by which dissolved chemicals from one area of the body to another? a) Passive osmosis b) Active transport c) Passive elimination d) Free flow

Active transport

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

Alcoholism

A nurse is caring for a client in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat: a) hypernatremia. b) hypokalemia. c) hypercalcemia. d) hyperkalemia.

hyperkalemia.

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

it increases the patient's desire to consume fluid.

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 take a potassium supplement daily as prescribed." b) "I will be sure to buy frozen vegetables when I grocery shop." 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."

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

The nurse is instructing a patient with recurrent hyperkalemia about following a potassium-restricted diet. Which of the following patient statements indicates the need for additional instruction? a) "I'll drink cranberry juice with my breakfast instead of coffee." b) "Bananas have a lot of potassium in them, I'll stop buying them." c) "I need to check if my cola beverage has potassium in it." d) "I will not salt my food, instead I'll use salt substitute."

"I will not salt my food, instead I'll use salt substitute."

The home health nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The nurse notes that the woman seems confused and has poor skin turgor. When asked about her fluid intake, the patient states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response? a) "I will need to have your medications adjusted so you will need to be readmitted to the hospital for a complete workup." b) "Limiting your fluids can create imbalances in your body that can result in confusion. Maybe we need to adjust the timing of you fluids." c) "It is normal to be a little confused following surgery, and it's safe not to urinate a night." d) "Confusion following surgery is common in the elderly due to a loss of sleep."

"Limiting your fluids can create imbalances in your body that can result in confusion. Maybe we need to adjust the timing of you fluids."

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

0.9% normal saline

A 42-year-old client has chronic hyponatremia 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? a) 142 mEq/L b) 135 mEq/L c) 145 mEq/L d) 140 mEq/L

135 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? a) 155 mEq/L b) 125 mEq/L c) 135 mEq/L d) 145 mEq/L

155 mEq/L

The normal serum value for potassium is a) 135 to 145 mEq/L. b) 8.5 to 10.5 mg/dL. c) 3.5 to 5.5 mEq/L. d) 96 to 106 mEq/L.

3.5 to 5.5 mEq/L.

The normal serum value for potassium is a) 135 to 145 mEq/L. b) 96 to 106 mEq/L. c) 8.5 to 10.5 mg/dL. d) 3.5 to 5.5 mEq/L.

3.5 to 5.5 mEq/L.

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

80

The nurse has been assigned to care for the following patients. Which patient is at the highest risk for a fluid and electrolyte imbalance? a) An 82-year-old woman who receives all nutrition via tube feedings. Her medications include carvedilol (Coreg) and torsemide (Demadex). b) A 45-year-old man who had a laparoscopic appendectomy 24 hours ago being advanced to a regular diet. c) A 79-year-old man admitted with a diagnosis of pneumonia. d) A 66-year-old woman who had an open cholecystectomy with a T-tube placed that is draining 125 mL of bile per shift.

An 82-year-old woman who receives all nutrition via tube feedings. Her medications include carvedilol (Coreg) and torsemide (Demadex).

A patient's lab results show a slight decrease in potassium. The physician has declined to treat with drug therapy but has suggested increasing potassium through diet. Which of the following would be a good source of potassium? a) Apples b) Bananas c) Asparagus d) Carrots

Bananas

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

Breathing

The nurse is caring for a patient with a serum sodium level of 113 mEq/L. The nurse should monitor the patient for the development of which of the following? a) Nausea b) Confusion c) Hallucinations d) Headache

Confusion

The nurse is assigned to care for a patient with a serum phosphorus level of 5.0 mg/dL. The nurse anticipates that the patient will also experience which of the following electrolyte imbalances? a) Hypermagnesemia b) Hyponatremia c) Hypocalcemia d) Hyperchloremia

Hypocalcemia

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) Dilute urine b) Joint pain c) Diarrhea d) Increased muscle tone

Dilute urine

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) Acute flank pain b) Tachycardia c) Diminished deep tendon reflexes d) Cool, clammy skin

Diminished deep tendon reflexes

The nurse is caring for a patient with a serum potassium level of 6.0 mEq/L. The patient is ordered to receive oral sodium polystyrene sulfonate (Kayexelate) and furosemide (Lasix). What other orders should the nurse anticipate giving? a) Change the lactated Ringer's solution to 2.5% dextrose. b) Change the lactated Ringer's solution to 3% saline. c) Increase the rate of the IV lactated Ringer's solution. d) Discontinue the IV lactated Ringer's solution.

Discontinue the IV lactated Ringer's solution.

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

Elevated hematocrit level

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following? a) Extracellular fluid volume deficit b) Altered blood urea nitrogen (BUN) value c) Respiratory acidosis d) Metabolic alkalosis

Extracellular fluid volume deficit

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

Facial

Which of the following is a factor affecting an increase in serum osmolality? a) Overhydration b) Diuretic use c) Hyponatremia d) Free water loss

Free water loss

Which of the following electrolyte imbalances occur with adrenal insufficiency? a) Hypokalemia b) Hyponatremia c) Hypernatremia d) Hyperkalemia

Hyperkalemia

You are caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. You know that you should take extra care to check for signs of bruising or bleeding in what condition? a) Hypokalemia b) Hypomagnesemia c) Dehydration d) Hypocalcemia

Hypocalcemia

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) Hypermagnesemia b) Hypophosphatemia c) Hypocalcemia d) Hyperkalemia

Hypocalcemia

A client presents with fatigue, nausea, vomiting, muscle weakness, and leg cramps. Laboratory values are as follows: Na + 147 mEq/L K + 3.0 mEq/L Cl - 112 mEq/L Mg ++ 2.3 mg/dL Ca ++ 1.5 mg/dL Which of the following is consistent with the client's findings? a) Hypokalemia b) Hyperchloremia c) Hypernatremia d) Hypophosphatemia

Hypokalemia

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values: Na+ 134 mEq/L K+ 3.2 mEq/L Cl- 111 mEq/L Mg++ 1.1 mg/dL Ca++ 8.4 mg/dL Identify which of the following alterations is consistent with the client's findings. a) Hyponatremia b) Hypokalemia c) Hypomagnesemia d) Hypocalcemia

Hypomagnesemia

Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia? a) Hypercalcemia b) Hypervolemia c) Hypomagnesemia d) Hypermagnesemia

Hypomagnesemia

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

Hypothalamus

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

Hypothalamus

The nurse is conducting a lecture on the difference between hypovolemia and dehydration. When completing a verbal comparison, which point needs clarified? a) Similar causes are present in both conditions. b) In dehydration, only extracellular is depleted. c) Hypovolemia contains only low blood volume. d) Both conditions result in abnormal laboratory studies.

In dehydration, only extracellular is depleted.

You are the nurse evaluating a newly admitted patient's laboratory results, which include several values that are outside of reference ranges. Which of the following would cause the release of antidiuretic hormone (ADH)? a) Increased platelets b) Decreased serum potassium c) Decreased hemoglobin d) Increased serum sodium

Increased serum sodium

You are doing an admission assessment on an elderly patient newly admitted for end-stage liver disease. You must assess the patient's skin turgor. What should you remember when evaluating skin turgor? a) Dehydration causes the skin to appear edematous and spongy. b) Overhydration causes the skin to tent. c) Normal skin turgor is moist and boggy. d) Inelastic skin turgor is a normal part of aging.

Inelastic skin turgor is a normal part of aging.

The nurse is caring for a geriatric client in the home setting. Due to geriatric changes decreasing thirst, the nurse is likely to see a decrease in which fluid location which contains the most body water? a) Intracellular fluid b) Intravascular fluid c) Interstitial fluid d) Extracellular fluid

Intracellular fluid

When caring for a patient who has risk factors for fluid and electrolyte imbalances, which of the following assessment findings is the highest priority for the nurse to follow up? a) Irregular heart rate b) Weight loss of 4 lb c) Blood pressure 96/53 mm Hg d) Mild confusion

Irregular heart rate

When caring for a patient who has risk factors for fluid and electrolyte imbalances, which of the following assessment findings is the highest priority for the nurse to follow up? a) Weight loss of 4 lb b) Blood pressure 96/53 mm Hg c) Mild confusion d) Irregular heart rate

Irregular heart rate

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

It increases the client's desire to consume fluid.

Which of the following statements accurately reflects a rule of thumb upon which the nurse may rely in assessing the patient's fluid balance? a) Minimal intake of 2 liters per day b) Minimal urine output of 10 mL per hour c) Minimal intake of 1.5 liters per day d) Minimal urine output of 50 mL per hour

Minimal intake of 1.5 liters per day

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

Neurological system

A client is experiencing edema in the tissue. The nurse is correct in anticipating which tonicity of intravenous fluid? a) Hypotonic solution b) No intravenous solution c) Hypertonic solution d) Isotonic fluid

No intravenous solution

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? a) Yes, this will correct the sodium deficit. b) No, start with the sodium chloride IV. c) No, sodium intake should be restricted. d) Yes, along with the hypotonic IV.

No, sodium intake should be restricted.

The nurse is adding the intake and output results for a client diagnosed with dehydration. The nurse notes a 24-hour intake of 1500 mL/day between oral fluids and intravenous solutions. The output total is calculated as 2800 mL/day from urine output, emesis, and Hemovac drainage. Which nursing action is best to maintain an acceptable fluid balance? a) Remove the Hemovac. b) Encourage oral fluids. c) Suggest a fluid restriction. d) Offer a prescribed antiemetic medication.

Offer a prescribed antiemetic medication.

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

Oral

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

Parathyroid hormone (PTH)

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? a) CO2 b) Potassium c) Chloride d) Sodium

Potassium

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? a) CO2 b) Sodium c) Potassium d) Chloride

Potassium

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first? a) Blood pressure b) Pulse c) Temperature d) Respirations

Pulse

A client with nausea, vomiting, and abdominal cramps and distention is admitted to the health care facility. Which test result is most significant? a) Serum sodium level of 132 mEq/L b) Urine specific gravity of 1.025 c) Serum potassium level of 3 mEq/L d) Blood urea nitrogen (BUN) level of 29 mg/dl

Serum potassium level of 3 mEq/L

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

Sodium

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

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? a) Pitting edema b) Anasarca c) Third-spacing d) Hypovolemia

Third-spacing

A client has a serum calcium level of 7.2 mg/dl. During the physical examination, the nurse expects to assess: a) Hegar's sign. b) Goodell's sign. c) Homans' sign. d) Trousseau's sign.

Trousseau's sign.

In a pre-nursing pathophysiology class the instructor is teaching about the regulation of fluid volume. How is fluid volume primarily regulated? a) Urine excretion b) Breathing c) Bowel elimination d) Perspiration

Urine excretion

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.

electrocardiogram (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) respiratory rate. b) electrocardiogram (ECG) results. c) neuromuscular function. d) bowel sounds.

electrocardiogram (ECG) results.