NCLEX Unit 3

The nurse is told in a report that the client has hypocalcemia and a positive Chvostek's sign. Which signs should the nurse expect to note during the data collection? Select all that apply. 1.Coma 2.Tetany 3.Diarrhea 4.Hypoactive bowel sounds 5.A positive Trousseau's sign

2.Tetany 3.Diarrhea 5.A positive Trousseau's sign

Which pts are at risk for the development of hypercalcemia? Select all that apply. 1. the pt with a malignancy 2. the pt taking lithium 3. the pt who uses sunscreen to excess 4. the pt with hyperparathyroidism 5. the pt who overuses antacids

1. the pt with a malignancy 2. the pt taking lithium 4. the pt with hyperparathyroidism 5. the pt who overuses antacid

While caring for a client admitted to the hospital with suspected seizure activity, the client acknowledges the use of the herbal supplement ginkgo, to the nurse. Which follow-up questions by the nurse would be most appropriate? Select all that apply. 1.Do you have a history of seizures? 2.How long have you been using ginkgo? 3.Do you have a history of a clotting disorder? 4.Have you been diagnosed with diabetes mellitus? 5.On what area of your body have you been applying ginkgo

1.Do you have a history of seizures? 2.How long have you been using ginkgo? 3.Do you have a history of a clotting disorder? 4.Have you been diagnosed with diabetes mellitus?

A client's arterial blood gases reveal a pH of 7.51 and a bicarbonate level of 31 mEq/L. The nurse prepares for the administration of which medication that should be prescribed to treat this acid-base disorder? 1.Sodium bicarbonate 2.Furosemide (Lasix) 3.Acetazolamide (Diamox) 4.Spironolactone (Aldactone)

Acetazolamide (Diamox)

The nurse is reading the health care provider's (HCP's) progress notes in the client's record and sees that the HCP has documented "insensible fluid loss of approximately 800 mL daily." Which client is at risk for this loss? 1.Client with a draining wound 2.Client with a urinary catheter 3.Client with a fast respiratory rate 4.Client with a nasogastric tube to low suction

Client with a fast respiratory rate

The nurse is monitoring the fluid balance of a client with human immunodeficiency disease (HIV). Because loss of subcutaneous adipose tissue and muscle atrophy occur in such clients, the nurse understands that which will provide a reliable indicator of fluid balance? 1.Moistness of the skin 2.Skin turgor with tenting 3.Decreased urine output and hypotension 4.Precise measurement of vomitus and diarrhea

Decreased urine output and hypotension

A postoperative pt is diagnosed with fluid volume overload. Which of the following should the nurse assess in this pt? 1. poor skin turgor 2. decreased urine output 3. distended neck veins 4. concentrated hemoglobin & hematocrit levels

Distended neck veins

The nurse is reviewing the laboratory results from the lumbar puncture performed on a client with a diagnosis of meningitis. Which finding is indicative of a bacterial infection? Select all that apply. 1.Clear fluid sample 2.Increased glucose level 3.Protein level of 20 mg/dL 4.Increased white blood cells 5.A cerebrospinal fluid (CSF) pressure of 250 mm H2O

3. Protein level of 20 mg/dL 4.Increased white blood cells 5.A cerebrospinal fluid (CSF) pressure of 250 mm H2O

The nurse is reviewing the laboratory results of several clients receiving pharmacologic therapy. Which laboratory test results indicate a therapeutic value and that the nurse can safely administer the medication as prescribed? Select all that apply. 1. Gentamicin 8 mcg/mL 2. Tobramycin 20 mcg/mL 3. Digoxin (Lanoxin) 3 ng/mL 4. Phenytoin (Dilantin) 28 mcg/mL 5. Theophylline (Theo-24) 10 mcg/mL 6. Carbamazepine (Tegretol) 10 mcg/mL

Gentamicin 8 mcg/mL Theophylline (Theo-24) 10 mcg/mL Carbamazepine (Tegretol) 10 mcg/mL

The nurse is planning care for a pt with severe burns. Which of the following is this pt at risk for developing? 1. intracellular fluid deficit 2. intracellular fluid overload 3. extracellular fluid deficit 4. interstitial fluid deficit

Intracellular fluid deficit

The nurse is reinforcing instructions to a client on how to decrease the intake of potassium in the diet. The nurse should tell the client that which food contains the least amount of potassium? 1.Lettuce 2.Potatoes 3.Apricots 4.Avocados

Lettuce

When positioning for a surgical procedure, the nurse understands that the client's respiratory system is most at risk for dysfunction when in which position? 1.Sims' 2.Supine 3.Lateral 4.Lithotomy

Lithotomy

A 28-year-old male pt is admitted with diabetic ketoacidosis. The nurse realizes that this pt will have a need for which of the following electrolytes? 1. sodium 2. potassium 3. calcium 4. magnesium

Magnesium

A 3-year-old child is hospitalized because of persistent vomiting. Which condition should the nurse expect to occur in this child? 1.Diarrhea 2.Metabolic acidosis 3.Metabolic alkalosis 4.Hyperactive bowel sound

Metabolic alkalosis

A pt is admitted for treatment of hypercalcemia. The nurse realizes that this pt's intravenous fluids will most likely be which of the following? 1. dextrose 5% & water 2. dextrose 5% & ? normal saline 3. dextrose 5% & ? normal saline 4. normal saline

Normal Saline

A newly pregnant client is asking how to prevent neural-tube birth defects. Which food choice should the nurse recommend? 1. Milk 2. Peanuts 3. Oranges 4. Egg yolks

Oranges

The nurse is admitting a pt who was diagnosed with acute renal failure. Which of the following electrolytes will be most affected with this disorder? 1. calcium 2. magnesium 3. phosphorous 4. potassium

Potassium

According to Kohlberg's theory of moral development, at the preconventional level, moral development is thought to be motivated by which factor? 1.Peer pressure 2.Social pressures 3.The parents' behavior 4.Punishment and reward

Punishment and reward

The nurse is reviewing the health records of assigned clients. The nurse should plan care knowing that which client is at risk for a potassium deficit?

The client receiving nasogastric suction

Condition in the pt's health history that might put pt. at risk for fluid & electrolyte imbalance.

Vomiting, diarrhea,kidney diseases, diabetes, salicylate poisoning, burns, congestive heart failure, cerebral injuries, ulcerative colitis, and hormonal imbalance