CH 13

Below which serum sodium concentration might convulsions or coma occur? A) 142 mEq/L B) 135 mEq/L C) 140 mEq/L D) 145 mEq/L

B

The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction? A) "I'll drink cranberry juice with my breakfast instead of coffee." B) "I will not salt my food: instead I'll use salt substitute." C) "I need to check to see whether my cola beverage has potassium in it." D) "Bananas have a lot of potassium in them; I'll stop buying them.

B

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? A) Negative Chvastek sign B) Slurred speech C) Muscle weakness D) Presence of Trousseau sign

D

The nurse has been assigned to care for various clients. Which client is at the highest risk for a fluid and electrolyte imbalance? A) A 79-yr-old client admitted with a diagnosis of pneumonia B) A 45-yr-old client who had a laparoscopy appendectomy 2 hours ago and in being advanced to regular diet C) A 66-yr-old client who had an open cholecystectomy with a T-tube placed that is draining 125 ml of bile per shift D) An 82-yr-old client who receives all nutrition via tube feedings and whose medications include carvedilol and torsemide

D

Which is a correct route of administration for potassium? A) oral B) subcutaneous C) IV push D) intramuscular

A

Which is considered an isotonic solution? A) 0.9% normal saline B) 0.45% normal saline C) 3% NaCl D) Dextran in normal saline

A

Which is the most common cause of symptomatic hypomagnesemia? A) Alcoholism B) Burns C) IV drug use D) Sedentary lifestyle

A

Which electrolyte is a major anion in body fluid? A) Chloride B) Calcium C) Sodium D) Potassium

A

A client with a magnesium concentration of 2.6 mEq/L (1.3 mmol/L) is being treated on a medical-surgical unit. Which treatment should the nurse anticipate will be used? A) IV furosemide B) Oral magnesium oxide C) Dialysis D) Fluid restriction

A

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the A) malignancy is causing the electrolyte imbalance B) client has hx of alcohol use C) client may be developing hyperaldosteronism D) client's diet is lacking in calcium-rich food products

A

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? A) pH: 7.42, PaCO2: 45 mm Hg, HCO3: 22 mEq/L B) pH: 7.20, PaCO2 : 65 mm Hg, HCO3: 26 mEq/L C) pH: 7.50, PaCO2 : 30 mm Hg, HCO3: 24 mEq/L D) pH: 7.32, PaCO2: 40 mm Hg, HCO3: 18 mEq/L

B

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? a) "I will be sure to buy frozen vegetables when I grocery shop." B) "I will be sure to buy frozen vegetables when I grocery shop" C) "I will take potassium supplement daily as prescribed." D) "I can use laxatives and enemas but only once a week."

D

The nurse is caring for a patient with a metabolic acidosis (pH 7.25). Which of the following values is useful to the nurse in determining whether the cause of the acidosis is due to acid gain or to bicarbonate loss? A) serum sodium level B) PaCO2 C) Bicarbonate level D) Anion gap

D

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? A) O saturation 95% B) HCO 21 mEq/L C) PaCO 36 D) pH 7.48

D

Which electrolyte is a major cation in body fluid? A) Bicarbonate B) Chloride C) Sodium D) Potassium

D

Which could be a potential cause of respiratory acidosis? A) Hyperventilation B) Vomiting C) Hypoventilation D) Diarrhea

C

Which factor increases blood urea nitrogen (BUN)? A) Decreased protein intake B) Hypothermia C) Gastrointestinal bleeding D) Overhydration

C

The nurse is participating in the care of a client who had a peripherally inserted central catheter (PICC) placed in the right arm. After catheter placement, the nurse should complete which action? A) send client for a chest x-ray B) obtain written consent for the procedure C) admin the prescribed IV fluids D) assess the clients BP on the right arm

A

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering? A) Lactated Ringer solution B) 0.9% NaCl C) 0.45% NaCl D) 5% NaCl

C

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? A) hypocalcemia B) Hyponatremia C) hyperchloremia D) hypermagnesemia

A

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? A) Confusion B) Nausea C) Headache D) Hallucinations

A

Early signs of hypervolemia include A) thirst. B) moist breath sounds. C) increased breathing effort and weight gain. D) a decrease in blood pressure.

C

Hypokalemia can cause which symptom to occur? A) Production of concentrated urine B) Decreased sensitivity to digitalis C) Excessive thirst D) Increased release of insulin

C

The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely? A) Phosphorus B) Calcium C) Magnesium D) Potassium

C

When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? A) BP 96/53 mmHG B) Irregular HR C) Mild confusion D) Wt loss of 4 lbs.

B

Which is an insensible mechanism of fluid loss? A) Urination B) Breathing C) Bowel elimination D) Nausea

B

A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be A) 7.50 B) 7.45 C) 7.30 D) 7.35

A

Clients diagnosed with hypervolemia should avoid sweet or dry food because it A) increases the client's desire to consume fluid. B) can lead to weight gain. C) obstructs water elimination. D) can cause dehydration.

A

The calcium concentration in the blood is regulated by which mechanism? A) Parathyroid Hormone (PTH) B) Adrenal gland C) Androgens D) Thyroid Hormone (TH)

A

The normal serum value for potassium is A) 3.5-5.0 mEq/L (3.5-5.0 mmol/L) B) 96-106 mEq/L (96-106 mmol/L) C) 135-145 mEq/L (135-145 mmol/L) D) 8.5-10.5 mEq/L (2.13-2.63 mmol/L)

A

The nurse is caring for a client with a serum potassium concentration of 6.0 mEq/L (6.0 mmol/L). The client is ordered to receive oral sodium polystyrene sulfonate and furosemide. What other order should the nurse anticipate giving? A) Discontinue the IV lactated ringer solution B) Change the lactated ringer solution to 2.5% dextrose C) Change the lactated ringer solution to 3% saline D) Increase the rate of the IV lactated Ringer solution

A

The nurse is assessing a client for local complications of intravenous therapy. Which are local complications? Select all that apply. A) phlebitis B) hematoma C) extravasation D) air embolism E) infection

A, B, C

The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply. A) BP, HR, and rhythm B) Skin assessment for edema and turgor C) strength testing for muscle wasting D) I&O, urine volume, and color E) Nutritional status and diet

A, B, D

A nurse is caring for a client with acute renal failure and hypernatremia. In this case, which action can be delegated to the nursing assistant? A) Assess the client's et daily for trends. B) Provide oral care every 2-3 hours. C) Teach the client about increased fluid intake. D) Monitor for signs and symptoms of dehydration.

B

Oncotic pressure refers to the A) Amount of pressure needed to stop the flow of water by osmosis. B) Osmotic pressure exerted by proteins. C) Number of dissolved particles contained in a unit of fluid. D) Excretion of substances such as glucose through increased urine output.

B

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be A) 145 mEq/L (145 mmol/L) B) 155 mEq/L (155 mmol/L) C) 125 mEq/L (125 mmol/L) D) 135 mEq/L (135 mmol/L)

B

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? A) pH: 7.28, PaCO2: 25 mm Hg, HCO3: 15 B) pH: 7.55, PaCO2: 60 mm Hg, HCO3: 28 C) pH: 7.45, PaCO2: 32 mm Hg, HCO3: 21 D) pH: 7.34, PaCO2: 60 mm Hg, HCO3: 34

B

Which condition leads to chronic respiratory acidosis in older adults? A) Overuse of sodium bicarbonate B) Thoracic skeletal change C) Erratic meal patterns D) Decreased renal function

B

Which solution is hypotonic? A) Lactated Ringer solution B) 0.45% NaCl C) 0.9% NaCl D) 5% NaCl

B

Which statement accurately reflects a rule of thumb on which the nurse may rely in assessing a client's fluid balance? A) Minimal intake of 2 L/day B) Minimal intake of 1.5 L/day C) Minimal urine output of 10ml/hour D) Minimal urine output of 50 ml/hour

B

The nurse is caring for a client diagnosed with hyperchloremia. Which are signs and symptoms of hyperchloremia? Select all that apply. A) dehydration B) weakness C) lethargy D) tachypnea E) hypotension

B, C, D

What percentage of potassium excreted daily leaves the body by way of the kidneys? A) 20 B) 40 C) 80 D) 60

C

Which condition might occur with respiratory acidosis? A) Decreased BP B) Decreased Pulse C) Increased intracranial pressure D) Mental alertness

C

The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? A) metabolic alkalosis B) respiratory alkalosis C) respiratory acidosis D) metabolic acidosis

D