checking your understanding chps: 22,23,24,25

When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse's best response is a. "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated." b. "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria." c. "If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated." d. "If he doesn't wet his diaper all afternoon and his neck veins look flat when he is lying down, then he is probably dehydrated."

a. "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."

Which acid are the kidneys unable to excrete? a. Carbonic b. Metabolic c. Ammonia d. Bicarbonate

a. Carbonic

A patient who reports an intestinal fistula also reports feeling "weak and dizzy" when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician? a. Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting. b. Sit her up again, with proper support, so you can have an accurate upright blood pressure and heart rate to report. c. Assess small vein filling time, look for ankle edema, and ask if she had any fluid to drink yet today. d. Give her a drink of water or juice, talk with her to calm her down, and ask if she slept well last night.

a. Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.

Cystic fibrosis is associated with a. bronchiectasis. b. asthma. c. emphysema. d. chronic bronchitis.

a. bronchiectasis.

Clinical manifestations of hyponatremia include a. confusion, lethargy, coma, and perhaps seizures. b. weak pulse, low blood pressure, and increased heart rate. c. cardiac dysrhythmias, paresthesias, and muscle weakness. d. thirst, dry mucous membranes, and diarrhea.

a. confusion, lethargy, coma, and perhaps seizures.

Effects of hypernatremia on the central nervous system typically include a. confusion. b. insomnia. c. excitation. d. hallucinations.

a. confusion.

A restrictive respiratory disorder is characterized by a. decreased residual volume. b. increased total lung capacity. c. expiratory wheezing. d. inspiratory wheezing.

a. decreased residual volume.

Lack of α-antitrypsin in emphysema causes a. destruction of alveolar tissue. b. chronic mucous secretion and airway fibrosis. c. pulmonary edema and increased alveolar compliance. d. bronchoconstriction and airway edema.

a. destruction of alveolar tissue.

Obstructive disorders are associated with a. low expiratory flow rates. b. increased expiratory reserve volume. c. low residual volumes. d. decreased total lung capacity.

a. low expiratory flow rates.

Emesis causes a. metabolic alkalosis. b. respiratory alkalosis. c. respiratory acidosis. d. metabolic acidosis.

a. metabolic alkalosis.

A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for a. pneumothorax. b. pulmonary embolus. c. pneumonia. d. pulmonary edema.

a. pneumothorax.

Causes of metabolic acidosis include a. tissue anoxia. b. massive blood transfusion. c. hypoventilation. d. hyperventilation.

a. tissue anoxia.

To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a. paralyzes the cilia, causing impaired mucociliary clearance. b. impairs α1-antitrypsin, allowing elastase to predominate. c. introduces carcinogens into the lungs. d. predisposes to respiratory infections.

b. impairs α1-antitrypsin, allowing elastase to predominate.

Hyperaldosteronism causes a. ECV deficit and hyperkalemia. b. ECV excess and hypokalemia. c. excessive water reabsorption without affecting sodium concentration. d. hyponatremia and hyperkalemia.

b. ECV excess and hypokalemia.

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? a. Salty soup, because he needs nutrition as well as fluid b. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid c. Bottled water, because it will rehydrate his cells d. Bottled water, because he is so weak that he might choke on the fluid when he swallows, and water would be less damaging to the lungs than salty soup

b. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

Croup is characterized by a. an inability to cough. b. a barking cough. c. drooling, sore throat, and difficulty swallowing. d. a productive cough.

b. a barking cough.

Viral pneumonia is characterized by a. significant ventilation-perfusion imbalance. b. a dry cough. c. exudative consolidation. d. a productive cough.

b. a dry cough.

After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is a. of unknown pathogenesis. b. associated with specific allergic triggers. c. associated with respiratory infections. d. induced by psychological factors (stress).

b. associated with specific allergic triggers.

Total body water in older adults is a. increased because of decreased renal function and hormonal fluctuations. b. decreased because of increased adipose tissue and decreased muscle mass. c. increased because of decreased adipose tissue and decreased bone mass. d. decreased because of renal changes that cause diuresis with sodium excretion.

b. decreased because of increased adipose tissue and decreased muscle mass.

The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient a. has fatty stools from taking an OTC weight loss product that decreases absorption of fat. b. has chronic heart failure that is treated with diuretics. c. takes very large doses of vitamin D to supplement during chemotherapy for breast cancer. d. experiences anorexia and chronic oliguric renal failure.

b. has chronic heart failure that is treated with diuretics.

The body compensates for metabolic alkalosis by a. increasing bicarbonate ion excretion. b. hypoventilation. c. hyperventilation. d. decreasing arterial carbon dioxide.

b. hypoventilation.

A known cause of hypokalemia is a. hyperparathyroidism. b. insulin overdose. c. pancreatitis. d. oliguric renal failure.

b. insulin overdose.

A person with acute hypoxemia may hyperventilate and develop a. metabolic alkalosis. b. respiratory alkalosis. c. respiratory acidosis. d. metabolic acidosis.

b. respiratory alkalosis.

The fraction of total body water (TBW) volume contained in the intracellular space in adults is a. one half. b. two thirds. c. one third. d. three fourths.

b. two thirds.

A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is a. "Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." b. "Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling." c. "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell." d. "Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling."

c. "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."

Which pulmonary function test result is consistent with a diagnosis of asthma? a. Increased FEV1 b. Reduced total lung volume c. Reduced forced expiratory volume in 1 second (FEV1) d. Decreased functional residual capacity

c. Reduced forced expiratory volume in 1 second (FEV1)

A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a. viral pneumonia. b. tuberculosis. c. bacterial pneumonia. d. acute respiratory distress syndrome.

c. bacterial pneumonia.

A common characteristic of viral pneumonia is a. increased white blood cell count. b. high fever. c. dry cough. d. alveolar infiltrates on a chest x-ray.

c. dry cough.

Early manifestations of a developing metabolic acidosis include a. short and shallow respirations. b. coma. c. headache. d. muscle cramps.

c. headache.

Empyema is defined as an a. infection localized in the lung. b. infection in the blood. c. infection in the pleural space. d. exudative bronchitis.

c. infection in the pleural space.

Allergic (extrinsic) asthma is associated with a. hyporesponsiveness of airways. b. unknown precipitating factors. c. irreversible airway obstruction. d. IgE-mediated airway inflammation.

d. IgE-mediated airway inflammation.

How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance? a. Serum potassium, Chvostek and Trousseau signs b. Serum calcium, Chvostek and Trousseau signs c. Serum potassium, bowel function, level of consciousness d. Serum calcium, bowel function, level of consciousness

d. Serum calcium, bowel function, level of consciousness

COPD leads to a barrel chest, because it causes a. muscle atrophy. b. pulmonary edema. c. prolonged inspiration. d. air trapping.

d. air trapping.

Signs and symptoms of extracellular fluid volume excess include a. tachycardia. b. increased serum sodium concentration. c. increased hematocrit. d. bounding pulse.

d. bounding pulse.

Manifestations from sodium imbalances occur primarily as a result of a. vascular collapse. b. hypervolemia. c. hyperosmolarity. d. cellular fluid shifts.

d. cellular fluid shifts.

If an individual has a fully compensated metabolic acidosis, the blood pH is a. high. b. either high or low, depending on the type of compensation. c. low. d. in the normal range.

d. in the normal range.

A patient has a positive Chvostek sign. The nurse interprets this as a sign of a. decreased neuromuscular excitability. b. hypercalcemia. c. hypermagnesemia. d. increased neuromuscular excitability.

d. increased neuromuscular excitability

A person who experiences a panic attack and develops hyperventilation symptoms may experience a. acute compensatory metabolic acidosis. b. anxiety acidosis. c. neuromuscular depression. d. numbness and tingling in the extremities.

d. numbness and tingling in the extremities.

The process responsible for distribution of fluid between the interstitial and intracellular compartments is a. filtration. b. active transport. c. diffusion. d. osmosis.

d. osmosis.

The ________ system compensates for metabolic acidosis and alkalosis. a. renal b. cardiovascular c. gastrointestinal d. respiratory

d. respiratory