HC2A Unit 1 Exam
Transcellular Fluids
- Cerebrospinal Fluid - Synovial Fluid - Peritoneal Fluid - Pleural Fluid
What can cause hypocalcemia?
- Diarrhea - Diuretics - Inadequate intake of vitamins
Symptoms of Acidosis
- Headache - Confusion - Lethargy - Muscle Weakness - Fatigue
Normal Range of Magnesium
1.8-2.6 mEq/L
Match the abnormality with the correct lab value: Hyponatremia A) 6.2 mEq/L B) 125 mEq/L C) 2.9 mEq/L D) 152 mEq/L
125 mEq/L
Normal Sodium Range:
135-145 mEq/L
Match the abnormality with the correct lab value: Hypernatremia A) 6.2 mEq/L B) 125 mEq/L C) 2.9 mEq/L D) 152 mEq/L
152 mEq/L
Match the abnormality with the correct lab value: Hypokalemia A) 6.2 mEq/L B) 125 mEq/L C) 2.9 mEq/L D) 152 mEq/L
2.9 mEq/L
Normal serum osmolarity for adults is:
270-300
Isotonic Solutions
270-300 osmo
Which of the following potassium levels would be of greatest concern for the nurse, in a client that is taking an oral diuretic medication, that depletes postassium? A) 5.4 mEq/L B) 4.3 mEq/L C) 3.5 mEq/L D) 3.1 mEq/L
3.1 mEq/L
Insensible water loss averages about _____ to ______ mL a day.
500-1000 mL
Normal Blood pH Range
7.35-7.45
A patient with cerebral edema would most likely be ordered what type of solution? A) 3% Saline B) 0.9% Normal Saline C) Lactated Ringer's D) 0.225% Normal Saline
A) 3% Saline
Match the abnormality with the correct lab value: Hyperkalemia A) 6.2 mEq/L B) 125 mEq/L C) 2.9 mEq/L D) 152 mEq/L
A) 6.2 mEq/L
Which of the following is most likely to be present in your assessment of a patient with hyperkalemia? A) Abdominal Cramps B) Vertigo C) Restlessness D) Photophobia
A) Abdominal Cramps
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Anxiety B) Increased Respirations C) Chvostek's Sign D) Flank Pain
A) Anxiety
Which of the following is most likely a finding associated with hypokalemia? A) Arrhythmia B) Hypertension C) Diarrhea D) Hyper-pigmented Skin
A) Arrhythmia
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Arrhythmias B) Jaw Claudication C) Unilateral Headache D) Pulsus Paradoxus
A) Arrhythmias
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Arrhythmias B) Hyperreflixia C) Diarrhea D) Confusion
A) Arrhythmias
Isotonic solutions are given for what conditions? SATA. A) Blood Volume Expander B) Blood Loss C) Surgery D) Dehydration Maintenance
A) Blood Volume Expander B) Blood Loss C) Surgery D) Dehydration Maintenence
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Bradycardia B) Tachycardia C) Sweating D) White Spots on Tongue
A) Bradycardia
What are the uses for hypertonic solutions? SATA. A) Burns B) Cerebral Edema C) Severe Hyponatremia
A) Burns B) Cerebral Edema C) Severe Hyponatremiaf
Which electrolytes are most detrimentally affected by low magnesium levels? SATA. A) Calcium B) Chloride C) Hydrogen D) Potassium E) Sodium F) Sulfate
A) Calcium D) Potassium
How does the corresponding increase in carbon dioxide levels that occurs when arterial pH drops assist in maintaining acid-base balance? A) Carbon dioxide loss through exhalation can raise arterial pH levels B) Carbon dioxide retention during exhalation can lower arterial pH levels C) Carbon dioxide is a base that can convert free hydrogen ions into a neutral substance D) Carbon dioxide is a buffer that can bind free hydrogen ions and form a neutral substance
A) Carbon dioxide loss through exhalation can raise arterial pH levels
A nurse, when caring for a client with hyponatremia, is aware that the following body system(s) most affected is: A) Cerebral & Nerves B) Respiratory C) Cardiac D) GI
A) Cerebral & Nerves
What is most likely a long-term effect of hypocalcemia? A) Decreased Bone Density B) Blurred Vision C) Peripheral Neuropathy D) Photophobia
A) Decreased Bone Density
What best defines metabolic acidosis? A) Decreased HCO3 < 22 B) Increased pH > 7.55 C) Increased HCO3 > 26 D) Increased pH > 7.45
A) Decreased HCO3 < 22
Which of the following findings is most likely to be seen in a patient with hyponatremia? A) Decreased LOC B) Bruising C) Photophobia D) Kicking Movements
A) Decreased LOC
Which of the following is most likely a treatment for hypermagnesemia? A) Dialysis B) Bone Marrow Transplant C) Plasmapheresis D) Avoid Fructose and Galactose
A) Dialysis
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Flushing B) Tremor C) Calcifcations D) Tachypnea
A) Flushing
Diffusion is the movement of molecules from an area of? A) Higher concentration to an area of lower concentration B) Lower concentration to an area of higher concentration
A) Higher concentration to an area of lower concentration
An adult client has a history of diabetes insipidus. The nurse identifies which imbalance is most likely to develop if this medical problem recurs? A) Hypernatremia B) Hyponatremia C) Hyperkalemia D) Hypokalemia
A) Hypernatremia
Which electrolyte imbalance can cause extreme thirst and orthostatic hypotension? A) Hypernatremia B) Hyponatremia C) Hypercalcemia D) Hypocalcemia
A) Hypernatremia
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Hyperventilation B) Hemoptysis C) Glucose: 50-75 mg/dL D) Amenorrhea
A) Hyperventilation
The ED nurse knows which cause is most frequently associated with tetany? A) Hypocalcemia B) Puncture wound from dirty and rusty metal C) Hypermagesemia D) Genetic cardiac defect
A) Hypocalcemia
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Hyporeflexia B) Decreased PaCO2 < 35 mmHg C) Hyperoxia D) Cold Intolerance
A) Hyporeflexia
________ fluids remove water from the extracellular space into the intracellular space. A) Hypotonic B) Hypertonic C) Isotonic D) Colloids
A) Hypotonic
Which of the following interventions is most commonly used to treat isolated hypernatremia? A) Hypotonic Solutions B) Glucagon C) Hypertonic Solutions D) Activated Charcoal
A) Hypotonic Solutions
Which of the following physical findings is most likely seen in patients with hypocalcemia? A) Increased DTR B) Cranial Nerve Palsy C) Loss of Ambulation D) Decreased Visual Acuity
A) Increased DTR
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Increased Electrolytes B) Increased Respirations C) Increased pH > 7.45 D) Increased Bleeding Time
A) Increased Electrolytes
Which of the following is most likely seen in respiratory acidosis? A) Increased PaCO2 > 45 B) Normal pH C) Decreased PaCO2 < 35 mmHg D) Trousseau's Sign
A) Increased PaCO2 > 45
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Kussmaul Respirations B) Sciatica C) Hyperorality D) Polydipsia
A) Kussmaul Respirations
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Lethargy B) Increased deep tendon reflexes C) Tachycardia D) Hyperpigmentation
A) Lethargy
Which of the following is the most appropriate recommendation in the management of hypercalcemia? A) Loop Diuretics instead of Thiazide Diuretics B) Restrict Fluids C) Calcium Channel Blockers instead of Diuretics D) Kayexalate for Constipation
A) Loop Diuretics instead of Thiazide Diuretics
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Muscle Cramps B) Increased Respirations C) Jaundice D) Increased T3
A) Muscle Cramps
Which of the following findings is most likely associated with hypocalcemia? A) Muscle Spasms B) Blurred Vision C) Angioedema D) Photophobia
A) Muscle Spasms
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Muscle Weakness B) Trousseau's Sign C) Hyperoxia D) Increased Intracranial Pressure
A) Muscle Weakness
Which of the following is most likely to be present in your assessment of a patient with hyperkalemia? A) Muscle Weakness B) Blurred Vision C) Tinnitus D) Syncope
A) Muscle Weakness
Which of the following findings is most likely to be seen in a patient with hyponatremia? A) Nausea and Vomiting B) Drooling C) Constipation D) Dehydration
A) Nausea and Vomiting
Which of the following best describes a generalized assessment finding associated with hypomagnesemia? A) Neuromuscular Irritability B) Neuromuscular Paralysis C) Neuromuscular Toxicity D) Neuromuscular Relaxation
A) Neuromuscular Irritability
Which of the following is most commonly an objective sign or symptom of hypernatremia? A) Orthostatic Hypotension B) Photophobia C) Mydriasis D) Hyper-pigmented Skin
A) Orthostatic Hypotension
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Parathesias B) Hypercholesterolemia C) CD4+ < 200 D) ALT: 10-40 U/L
A) Parasthesias
What responses does the nurse expect as a result of infusing 500 mL liter of a 3% saline intravenous solution into a client over a 1-hour time period? A) Plasma volume osmolarity increases, blood pressure increases B) Plasma volume osmolarity decreases, blood pressure increases C) Plasma volume osmolarity increases, blood pressure decreases D) Plasma volume osmolarity decreases, blood pressure decreases
A) Plasma volume osmolarity increases, blood pressure increases
The nurse provides care for a client admitted to the hospital for persistent vomiting and abdominal pain. A nasogastric (NG) tube is inserted and connected to suction. An intravenous infusion of 1000 mL of D5W with 20 mEq of potassium chloride is started to infuse at 100 mL per hour. The nurse understands potassium chloride has been added to the infusion for which reason? A) Replaces the potassium lost in the gastric fluid B) Replaces decreased dietary potassium due to NPO status C) Prevents the loss of sodium in the urine D) Prevents the loss of potassium in the urine
A) Replaces the potassium lost in the gastric fluid
Which of the following findings is most likely to be seen in a patient with hyponatremia? A) Seizures B) Mydriasis B) Cardiomyopathy D) Polyneuritis
A) Seizures
Which of the following findings is most likely associated with hypocalcemia? A) Tetany B) Osteoporosis C) Aphasia D) Peripheral Neuropathy
A) Tetany
The nurse knows which client is most likely to manifest symptoms of fluid volume deficit? A) The client diagnosed with Addison disease B) The client diagnosed with cirrhosis of the liver C) The client diagnosed with epilepsy D) The client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)
A) The client diagnosed with Addison disease
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Tingling Lips or Fingers B) Hypoventilation C) Blindness D) Hyporeflexia
A) Tingling Lips or Fingers
Which of the following is most likely a neuromuscular assessment finding associated with hypomagnesemia? A) Tremors B) Spastic Paralysis C) Facial Paralysis D) Photophobia
A) Tremors
Hydrostatic pressure of blood is the force exerted by blood against blood vessels. A) True B) False
A) True
The nurse in caring for at team of clients, should be aware that the following are considered risk factors for fluid volume deficit (dehydration). SATA. A) Inadequate fluid intake B) Vomiting C) Diarrhea D) Oliguria
A, B, C
Which electrolyte imbalance(s) can cause decreased DTRs? SATA. A) Hypokalemia B) Hyperkalemia C) Hypercalcemia D) Hypermagnesemia
A, D
Which clinical indicators are most relevant for the nurse to monitor during IV fluid replacement therapy for a client with dehydration? SATA. A) Blood Pressure B) Deep Tendon Reflexes C) Hand-Grip Strength D) Pulse Rate and Quality E) Skin Turgor F) Urine Output
A, D, F
A client is receiving an intravenous infusion of 100 mEq of potassium chloride in 1000 mL of normal saline. How many mEq of potassium per hour does the nurse calculate the client will receive if the IV is infused at a rate of 150 mL/hour? A) 12 mEq B) 15 mEq C) 18 mEq D) 20 mEq
B) 15 mEq
The primary health care provider has prescribed 1 L of D5NS to infuse at a rate of 125 mL/hr. The nurse begins the infusion at 0700. When will the nurse anticipate completion of the infusion? A) 1300 hours B) 1500 hours C) 1900 hours D) 2100 hours
B) 1500 hours
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Pruritus B) Abdominal Pain C) Skin Rash D) Polydipsia
B) Abdominal Pain
Which of the following is a priority intervention for hyponatremia? A) Bowel Control B) Assess Airway C) Gastric Lavage D) Bowel Control
B) Assess Airway
Which of the following is most likely a treatment for hypermagnesemia? A) NPO B) Avoid antacids and laxatives containing Magnesium C) Avoid potassium supplements D) Avoid grapefruit juice
B) Avoid antacids and laxatives containing Magnesium
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Amnesia B) CNS Depression C) Hyperthermia D) Optic Neuritis
B) CNS Depression
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Angioedema B) Change in LOC C) Hyperreflexia D) Chvostek's Sign
B) Change in LOC
Which of the following is most commonly seen in a patient with hypernatremia? A) Shortness of Breath B) Change in LOC C) Spiking Fevers D) Hypercoagulation
B) Change in LOC
Which of the following is most helpful to lower serum levels of calcium in patients with hypercalcemia? A) Antibiotics B) Chelating Drugs C) NSAID D) Beta Blockers
B) Chelating Drugs
Which of the following clinical features is most likely associated with hypercalcemia? A) Hyper-irritability B) Constipation C) Blindness D) Melena
B) Constipation
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Cold Intolerance B) Cyanosis C) Hyperreflexia D) Hepatotoxicity
B) Cyanosis
Which of the following is not a hypertonic fluid? A) 3% Saline B) D5W C) 10% Dextrose in Water (D10W) D) 5% Dextrose in Lactated Ringer's
B) D5W
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Neutrophils B) Decreased PaCO2 < 35 mmHg C) Increased PaCO2 > 45 mmHg D) ALT: 10-40 U/L
B) Decreased PaCO2 < 35 mmHg
Which of the following clinical findings is most likely associated with hypermagesemia? A) Increased bone density B) Decreased deep tendon reflexes C) Hypertension D) Glaucoma
B) Decreased deep tendon reflexes
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Tetany B) Decreased respirations C) Tachycardia D) Pancreatitis
B) Decreased respirations
Which assessment data is most relevant for the nurse to obtain from a client who has a serum potassium of 2.9 mEq/L? A) Asking about the use of sugar substitutes B) Determining what drugs are taken daily C) Measuring the client's response to Chvostek testing D) Asking about a history of kidney disease
B) Determining what drugs are taken daily
Which of the following classes, drugs, or instructions is most commonly indicated in the treatment of hypernatremia? A) ACE Inhibitors B) Diuretics C) Steroids D) Glucagon
B) Diuretics
Which of the following is most likely a treatment for hypermagnesemia? A) ACE Inhibitors B) Diuretics C) Sedatives D) Prostaglandin
B) Diuretics
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Ataxia B) ECG Changes C) Hyperventilation D) Diplopia
B) ECG Changes
Which of the following findings is most likely to be seen in patients with hypocalcemia? A) Diffuse Pulmonary Infiltrates B) ECG Changes C) Coronary Aneurysm D) Conjunctivitis
B) ECG Changes
Which population is at greater risk for dehydration? A) Middle-Age Adult B) Elderly C) Young Adult D) Adolescent
B) Elderly
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Impaired Blood Clotting B) Excitable State C) Pill-Rolling D) Hyperreflexia
B) Excitable State
Which of the following is most likely an intervention for fluid excess (hypervolemic) hyponatremia? A) Tea and Toast B) Fluid Restriction C) Encourage Fluids D) Hypertonic Solution
B) Fluid Restriction
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Hematuria B) Flushed, Warm, Dry Skin C) Amnesia D) Increased Urinary Frequency
B) Flushed, Warm, Dry Skin
Which one of the following is most likely a treatment for hypomagnesemia? A) Fluids and Fiber B) Foods High in Magnesium C) Ingestion of Raw Eggs D) Hamburger Meat
B) Foods High in Magnesium
Which electrolyte imbalance should Kayaxelate be administered for? A) Hypernatremia B) Hyperkalemia C) Hypocalcemia D) Hypermagnesemia
B) Hyperkalemia
What type of fluid would a patient with severe hyponatremia most likely be started on? A) Hypotonic B) Hypertonic C) Isotonic D) Colloid
B) Hypertonic
The nurse understands that fatigue, weakness, nausea, and vomiting are signs of which problem? A) Hyponatremia B) Hypokalemia C) Hypernatremia D) Hyperkalemia
B) Hypokalemia
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Chest Pain B) Hypotension C) Metallic Taste D) Increased Urinary Frequency
B) Hypotension
Which of the following medications is most likely used for short-term stabilization of patients with hyperkalemia? A) IV Glucagon B) IV Calcium C) Kayexalate D) Caffeine
B) IV Calcium
Which of the following best describes the proper repletion methods for hypokalemia? A) Hypertonic Solution B) IV Potassium Infusion at 5-10 mEq/hr C) Must Administer with Cilastatin D) 1/2 of Fluid Given in First 8 Hours
B) IV Potassium Infusion at 5-10 mEq/hr
Which of the following is most commonly a finding associated with hypokalemia? A) Heartburn B) Ileus C) Diarrhea D) Slow Thinking
B) Ileus
Which of the following interventions is most appropriate in the management of a patient with hypercalcemia? A) Increase Iron Intake B) Increase Fluids C) Increase Calcium Intake D) Increase Potassium Intake
B) Increase Fluids
Which of the following is most likely a neuromuscular assessment finding associated with hypomagnesemia? A) Shuffling Gait B) Increased Deep Tendon Reflexes C) Facial Paralysis D) Ascending Paralysis
B) Increased Deep Tendon Reflexes
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Decreased pH less than 7.35 B) Increased HCO3 > 26 C) Blindness D) Peripheral Edema
B) Increased HCO3 > 26
The nurse provides care for a client receiving a blood transfusion. The nurse observes which symptoms if fluid overload occurs during the transfusion? A) Decreased pulse rate, increased BP, decreased respirations B) Increased pulse rate, increased BP, increased respirations C) Increased pulse rate, increased BP, decreased respirations D) Decreased pulse rate, decreased BP, increased respirations
B) Increased pulse rate, increased BP, increased respirations
Which of the following interventions is most likely indicated in the treatment of hyperkalemia? A) Vitamin K B) Infusion of Glucose and Insulin C) Albumin D) Calcitonin
B) Infusion of Glucose and Insulin
Which of the following is most likely a sleep-related finding associated with hypomagnesemia? A) Restless Leg Syndrome B) Insomnia C) Sleep Paralysis D) Hypnagogic Jerking
B) Insomnia
Which term defines fluid found within the cells of the body? A) Extracellular Fluid (ECF) B) Intracellular Fluid (ICF) C) Interstitial Fluid D) Intravascular Fluid (Plasma)
B) Intracellular Fluid (ICF)
Which one of the following is most likely a treatment for hypomagnesemia? A) Hypertonic Solution (3% or 5% NaCl) B) Magnesium Sulfate C) IV Calcium Gluconate D) Normal Saline (0.9%)
B) Magnesium Sulfate
The nurse is aware that potassium is responsible for what in her client? A) Building muscle mass B) Maintaining heart beat C) Building bone structure strength D) Maintaining weight
B) Maintaining heartbeat
Which of the following is most likely a musculoskeletal or integumentary finding associated with hypomagnesemia? A) Myalgia B) Muscle Cramps C) Easy Bruising D) Cold Intolerance
B) Muscle Cramps
The nurse evaluates a client's fluid balance. Which finding most likely requires an intervention? A) Output is 300 mL less than intake B) Output is 800 mL less than intake C) Intake is 1800 mL in 24 hours D) Intake and output are equal
B) Output is 800 mL less than intake
Which patient below would NOT be a candidate for a hypotonic solution? A) Patient with Diabetic Ketoacidosis B) Patient with increased intracranial pressure C) Patient experiencing Hyperosmolar Hyperglycemia D) All of the options are correct
B) Patient with increased intracranial pressure
Which of the following is most likely a priority consideration or intervention in the treatment of hypernatremia? A) Aspirin B) Prevent Dehydration C) Hypertonic Solution D) Prednisone
B) Prevent Dehydration
When administering a hypertonic solution the nurse should closely watch for? A) Signs of dehydration B) Pulmonary Edema C) Fluid volume deficit D) Increased lactate level
B) Pulmonary Edema
Which of the following is most likely seen in respiratory acidosis? A) Trousseau's Sign B) Reduced Respirations C) Flank Pain D) Shortened PR Interval
B) Reduced Respirations
A client receives magnesium sulfate IV for treatment of preeclampsia. The nurse knows it is most important to have which interventions at the bedside? A) Oxygen and padded tongue blade B) Reflex hammer and calcium gluconate C) Protamine sulfate and Vitamin K D) Particulate respirator and suction equipment
B) Reflex hammer and calcium gluconate
A patient is brought into the ED with respiratory depression. The patient has a history of COPD. What acid-base balance is most likely? A) Metabolic Alkalosis B) Respiratory Acidosis C) Metabolic & Respiratory Acidosis D) Metabolic & Respiratory Alkalosis
B) Respiratory Acidosis
Which of the following is most likely a neurological finding associated with hypomagnesemia? A) Dizziness B) Seizures C) Hypersomnia D) Phonophobia
B) Seizures
A nursing instructor is educating students about sodium imbalance. Which statement by the nursing instructor is correct? A) Sodium is the least abundant anion in the ECF B) Sodium is the most abundant cation in the ECF C) Sodium is the least abundant cation in the ECF D) Sodium is the most abundant anion in the ECF
B) Sodium is the most abundant cation in the ECF
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Hyperreflexia B) Tachycardia C) Ptosis D) Pupillary Constriction
B) Tachycardia
Which of the following is an objective cardiovascular sign or symptom of hypomagnesemia? A) Vasodilation B) Tachycardia C) Cough D) Dizziness
B) Tachycardia
What can cause rapid, deep respirations? SATA. A) Respiratory Acidosis B) Respiratory Alkalosis C) Metabolic Acidosis D) Metabolic Alkalosis
B, C
Which electrolyte imbalance(s) can cause positive Trousseau's and Chvostek's signs? SATA. A) Hyperkalemia B) Hypocalcemia C) Hypomagnesemia D) Hypermagnesemia
B, C
A nurse assesses a client who is admitted for treatment of fluid overload. Which signs and symptoms should the nurse expect to find? SATA. A) Dark amber urine B) Distended neck veins C) Shortness of breath D) Abnormal breath sounds with crackles
B, C, D
Which laboratory finding does the nurse expect if a client is diagnosed with a fluid volume deficit? SATA. A) Specific Gravity 1.020 B) Specific Gravity 1.034 C) Potassium 5.8 mEq/L D) Potassium 4.8 mEq/L E) BUN 32 mg/100 mL F) BUN 15 mg/100 mL
B, C, E
Which electrolyte imbalance(s) can cause increased DTRs? SATA. A) Hypernatremia B) Hypocalcemia C) Hypercalcemia D) Hypomagnesemia
B, D
What can cause hyponatremia?
Burns & Diuretics
The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid? A) 0.9% Normal Saline B) Lactated Ringer's C) 0.45% Saline D) 5% Dextrose in 0.225% saline
C) 0.45% Saline
Which of the following is most likely to be present in your assessment of a patient with hyperkalemia? A) Shuffling Gait B) Hoarseness C) Arrhythmia D) Neuropathy
C) Arrhythmia
A client had a 20 gauge short peripheral catheter (SPC) inserted for antibiotic administration 48 hours ago. Which nursing intervention is appropriate? A) Discontinue the SPC B) Relocate the SPC for infection control C) Assess the SPC for redness, swelling, or pain D) Change the occlusive dressing covering the SPC
C) Assess the SPC for redness, swelling, or pain
The handgrasp strength of a client with metabolic acidosis has diminished since the previous assessment 1 hour ago. What is the nurse's best first action? A) Measure the client's pulse and blood pressure B) Apply humidified oxygen by nasal cannula C) Assess the client's oxygen saturation D) Notify the Rapid Response Team
C) Assess the client's oxygen saturation
A client with severe diarrhea reports tingling lips and foot cramps. What is the nurse's best first action to prevent harm? A) Hold the next dose of the prescribed antidiarrheal drug B) Assess bowel sounds in all four abdominal quadrants C) Assess the client's response to the Chvostek test D) Increase the IV flow rate of the normal saline infusion
C) Assess the client's response to the Chvostek test
Which of the following interventions is most likely recommended among patients with hypercalcemia after adequate fluid resuscitation? A) Thiazide Diuretics B) Vitamin D C) Bisphosphonates D) Calcium Gluconate
C) Bisphosphonates
Which of the following drugs is used to inhibit calcium resorption from the bone? A) Ascorbic Acid B) Raloxifene C) Calcitonin D) Foscarnet
C) Calcitonin
With which client does the nurse remain alert for the possibility of metabolic alkalosis? SATA. A) Client who has been NPO for 36 hours without fluid replacement B) Client receiving a rapid infusion of normal saline C) Client who has been self-managing indigestion with chronic ingestion of bicarbonate D) Client who has had continuous gastric suction for 48 hours E) Client having a sudden severe asthma attack F) Client with uncontrolled diabetes mellitus
C) Client who has been self-managing indigestion with chronic ingestion of bicarbonate D) Client who has had continuous gastric suction for 48 hours
Which of the following is most likely a neurological finding associated with hypomagnesemia? A) Narcolepsy B) Flaccid Paralysis C) Confusion D) Shuffling Gait
C) Confusion
Which of the following findings is most likely to be seen in patients with hyponatremia? A) Flatulence B) Drooling C) Confusion/Lethargy D) Tetany
C) Confusion/Lethargy
What normal physiologic process contributes most to the need for acid-base balance? A) Continuous organ production of bicarbonate from carbonic acid B) Continuous alveolar exchange of oxygen and carbon dioxide C) Continuous metabolic production of free hydrogen ions D) Continuous kidney formation of urine from blood
C) Continuous metabolic production of free hydrogen ions
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Increased Urinary Frequency B) Mydriasis C) Decreased Respiratory Effort D) Basophils
C) Decreased Respiratory Effort
What best defines metabolic acidosis? A) Increased pH > 7.45 B) Increased HCO3 > 45 C) Decreased pH < 7.35 D) Increased HCo3 > 26
C) Decreased pH < 7.35
Which of the following is most likely to be present in your assessment of a patient with hyperkalemia? A) Ascites B) Glaucoma C) Diarrhea D) Hearing Loss
C) Diarrhea
Which of the following is most commonly an objective sign or symptom of hypernatremia? A) Fever B) Bleeding C) Dry Flushed Skin D) Hepatomegaly
C) Dry Flushed Skin
Which of the following is most commonly a subjective sign or symptom of hypernatremia? A) Diarrhea B) Asymptomatic C) Extreme Thirst D) Photophobia
C) Extreme Thirst
Which electrolyte imbalance increases the risk for an ileus? A) Hyperkalemia B) Hypomagnesemia C) Hypokalemia D) Hypernatermia
C) Hypokalemia
Which of the following is most likely a finding associated with hypokalemia? A) Oliguria B) Nystagmus C) Hyporeflexia D) Hyperthermia
C) Hyporeflexia
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Wheezing or Crackles B) Tachycardia C) Hypotension D) Hypertension
C) Hypotension
Which condition below could lead to cell lysis, if not properly monitored? A) Isotonicity B) Hypertonicity C) Hypotonicity D) None of the options are correct
C) Hypotonicity
Which of the following is most likely a treatment for hypermagnesemia? A) Dextrose 10% in Water (D10W) B) Folic Acid C) IV Calcium Gluconate D) Albumin
C) IV Calcium Gluconate
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Aseptic Meningitis B) Dark Stools C) Increased Respirations D) Increased Urinary Frequency
C) Increased Respirations
Patients with hypercalcemia are at increased risk of developing which of the following? A) Increased Risk of Lactic Acidosis B) Increased Risk of Tetany C) Increased Risk of Renal Calculi D) Increased Risk of Iron Deficiency Anemia
C) Increased Risk of Renal Calculi
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Nystagmus B) Neutrophils C) Increased pH > 7.45 D) Hyporeflexia
C) Increased pH > 7.45
When the cell presents with the same concentration on the inside and outside with no shifting of fluids what is this called? A) Hypotonic B) Hypertonic C) Isotonic D) Osmosis
C) Isotonic
Which of the following interventions is most likely indicated in the treatment of hyperkalemia? A) Spironolactone B) Calcitonin C) Kayexalate D) Hydralazine
C) Kayexalate
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Hearing Loss B) Ptosis C) Lightheadedness D) Hypoventilation
C) Lightheadedness
Which of the following interventions is most likely indicated in the treatment of hyperkalemia? A) Lactulose B) Hydroxychloroquine C) Loop or Thiazide Diuretics D) Interferon BEta
C) Loop or Thiazide Diuretics
Which of the following is most likely an intervention for fluid excess (hypervolemic) hyponatremia? A) Calcium Citrate B) Hydrochlorothiazide C) Mannitol D) Infusion of Glucose and Insulin
C) Mannitol
Which of the following is often an objective sign or symptom of hypernatremia? A) Pulsating Nail Bed B) Rash C) Muscle Twitching D) Alopecia
C) Muscle Twitching
Which of the following clinical findings is most likely associated with hypermagnesemia? A) Bone Pain B) Shortness of Breath C) Muscle Weakness D) Blurred Vision
C) Muscle Weakness
Which of the following is most likely a finding associated with hypokalemia? A) Pruritus B) Vertigo C) Muscle Weakness D) Blurred Vision
C) Muscle Weakness
Which of the following interventions is most likely recommended among patients with hypercalcemia? A) Avoid Calcium Supplements B) Avoid Alcohol C) No Calcium Intake D) Avoid Grapefruit
C) No Calcium Intake
Which of the following interventions is most likely recommended among patients with severe hypocalcemia? A) Calcitonin B) IV Replacement of Calcium and Magnesium C) Oral and IV Replacement of Calcium D) Dietary Replacement Only
C) Oral and IV replacement of Calcium
The nurse is reviewing the standing orders for a patient who was admitted for evaluation of chest pain. The patient has a history of COPD and his laboratory results and assessment reveal that he has mild respiratory acidosis. The nurse would question which order? A) Encourage oral fluids B) Keep head of bed elevated C) Oxygen therapy at 4 L/min as needed D) Bedrest with bathroom privileges only
C) Oxygen therapy at 4 L/min as needed
Which of the following clinical findings is most likely associated with hypercalcemia? A) Dry Skin B) Diarrhea C) Pathologic Fractures D) Chvostek's Sign
C) Pathologic Fractures
Which of the following recommendations is most appropriate in the management of hyperkalemia? A) High Sodium Diet B) Diabetic Diet C) Prevention Education D) Check BP Daily
C) Prevention Education
In reviewing the electrolytes of a client, the nurse nots the serum potassium level has increased from 4.6 mEq/L to 6.1 mEq/L. Which assessment does the nurse perform first to prevent harm? A) Deep Tendon Reflexes B) Oxygen Saturation C) Pulse Rate & Rhythm D) Respiratory Rate & Depth
C) Pulse Rate & Rhythm
The client who is confined to bed in the recumbent position has gained 5 lb in the past 24 hours. In which area does the nurse assess skin turgor for accurate determination of dependent edema? A) Foot and Ankle B) Forehead C) Sacrum D) Chest
C) Sacrum
An older adult client receiving an infusion of 5% dextrose in 0.9% normal saline at 150 mL/hr has developed shortness of breath with a decrease in oxygen saturation to 86%. What is the priority nursing intervention? A) Notify the health care provider B) Place the client on oxygen C) Sit the client upright in bed D) Assess the client's lung sounds
C) Sit the client upright in bed
Which of the following is most likely a priority consideration or intervention in the treatment of hypernatremia? A) Dialysis B) High Sodium Diet C) Sodium Restriction D) Hypertonic Solution
C) Sodium Restriction
The nurse identifies which sign or symptom indicates a client may have fluid volume excess? SATA. A) Cyanosis B) Diarrhea C) Edema D) Hypotension E) Crackles F) Tachycardia
C, E, F
What 3 populations are at greatest risk for fluid and electrolyte imbalances? A) Young Adult B) Children C) Infants D) Older Adult
Children, Infants, & Older Adults
Common areas third spacing occurs. SATA. A) Connective Tissue B) Nasal Cavity C) Cerebral Edema D) Peritoneal Cavity E) GI Tract
Connective tissues, cerebral edema, peritoneal cavity, and GI tract
Which solution below is NOT a hypertonic solution? A) 5% Dextrose in 0.9% Saline B) 5% Saline C) 5% Dextrose in Lactated Ringer's D) 0.33% Saline (1/3 NS)
D) 0.33% Saline (1/3 NS)
A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you expect the patient to be started on? A) 5% Dextrose in 0.9% Saline B) 0.33% Saline C) 0.225% Saline D) 0.9% Normal Saline
D) 0.9% Normal Saline
The nurse identifies which central venous pressure (CVP) reading indicates fluid overload? A) 0 mmHg B) 3 mmHg C) 8 mmHg D) 15 mmHg
D) 15 mmHg
A client is semiconscious and restless, and exhibits tremors and muscle weakness. Physical examination reveals a dry, swollen tongue and a body temperature of 99.8 degrees Farenheit. The nurse anticipates that the serum sodium value for this client is most likely to be which of the following? A) 120 mEq/L B) 132 mEq/L C) 142 mEq/L D) 155 mEq/L
D) 155 mEq/L
With which client does the nurse remain alert for and assess most frequently for signs and symptoms of hypokalemia to prevent harm? A) 72-year old taking the diuretic spironolactone for control of hypertension B) 62-year old receiving an IV solution of Ringer's lactate at a rate of 200 mL/hr C) 42-year old trauma victim receiving a third infusion of packed red blood cells in 12 hours D) 22-year old receiving an IV infusion of regular insulin to manage an episode of ketoacidosis
D) 22-year old receiving an IV infusion of regular insulin to manage an episode of ketoacidosis
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Ptosis B) Cyanosis C) Peripheral Edema D) Anxiety
D) Anxiety
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Decreased pH < 7.35 B) Monocytes C) Amenorrhea D) Brainstem Stimulation
D) Brainstem Stimulation
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Hyperthermia B) Hearing Loss C) Cyanosis D) Coma
D) Coma
Which of the following clinical features is typically seen in a patient with respiratory acidosis? A) Normal pH B) Increased Respirations C) Decreased PaCO2 < 35 mmHg D) Decreased pH < 7.35
D) Decreased pH < 7.35
Which of the following interventions is most likely to be used for the treatment of hyperkalemia in patients with ESRD? A) Potassium Sparing Diuretics B) Loop Diuretics C) Thiazide Diuretics D) Dialysis
D) Dialysis
Patients with hypercalcemia are most likely to show which of the following? A) Vasodilation B) Visual Field Abnormality C) Desquamative Skin Rash D) ECG Changes
D) ECG Changes
What instructions should be given regarding oral potassium supplements? A) Do Not Shake B) Monitor Blood Count C) Must Not Take with Milk, Antacids, or Iron D) Give Orally with Food
D) Give Orally with Food
After teaching a client who is prescribed a restricted sodium diet, a nurse assesses the client's understanding of the teaching. Which food choice for lunch indicates the client correctly understood the teaching? A) Salami and cheese on whole wheat crackers B) Slices of smoked ham with potato salad C) Bowl of tomato soup with a grilled cheese sandwich D) Grilled chicken breast with fresh steamed green beans
D) Grilled chicken breast with fresh steamed green beans
Which of the following assessments is most likely indicative of respiratory alkalosis? A) Hearing Loss B) Hepatomegaly C) Rhinorrhea D) Head Injury
D) Head Injury
Patients with hypercalcemia are most likely at increased risk of developing which of the following? A) Hepatotoxicity B) Bleeding C) Diarrhea D) Hypercoagulation
D) Hypercoagulation
___________ solutions cause cell dehydration and help increase fluid in the extracellular space. A) Hypotonic B) Osmosis C) Isotonic D) Hypertonic
D) Hypertonic
Which of the following is most likely an intervention for fluid deficit (hypovolemic) hyponatremia? A) Albumin B) Fluid Restricion C) Dextrose 5% in Water (D5W) D) Hypertonic Solution
D) Hypertonic Solution
The nurse identifies nasogastric drainage, vomiting, diarrhea, and the use of diuretics as likely the cause of which electrolyte imbalance? A) Hypernatremia B) Hyperkalemia C) Hyponatremia D) Hypokalemia
D) Hypokalemia
Which electrolyte imbalance increases the risk for digoxin/digitalis toxicity? A) Hyponatremia B) Hyperkalemia C) Hypocalcemia D) Hypomagnesemia
D) Hypomagnesemia
Which of the following neurological findings is most likely associated with hypercalcemia? A) Vivid Dreams B) Visual Hallucinations C) Dyskinesia D) Lethargy
D) Lethargy
Which of the following is an important consideration when treating a patient with severe hypokalemia? A) Central Venous Lines B) Cryotherapy C) Irrigation D) Monitor Respiratory Status
D) Monitor Respiratory Status
During your assessment of a patient with metabolic acidosis which of the following is most likely to be seen? A) Rash on Palms and Soles B) Alopecia C) Clubbing D) Muscle Weakness
D) Muscle Weakness
Which of the following assessments would most likely be indicative of metabolic alkalosis? A) Increased Respirations B) Jaundice C) Trousseau's Sign D) Muscle Weakness
D) Muscle Weakness
Which of the following is a priority intervention for hyponatremia? A) Nasal Cannula B) Insulin C) Monitor LFTs D) Reduce Diuretic Dosage
D) Reduce Diuretic Dosage
Which of the following is an important consideration in patients with hypocalcemia? A) Suicide Precautions B) Avoid Aspirin Products C) Avoid Milk, Antacids, and Iron D) Seizure Precautions
D) Seizure Precautions
Which of the following is often an objective sign or symptom of hypernatremia? A) Hypercoagulable B) Mydriasis C) Nystagmus D) Seizures
D) Seizures
The nurse is evaluating the laboratory work of a patient who has uncontrolled metabolic acidosis. Which outcome would result from this condition? A) pH 7.40 B) PaO2 98mmH C) Bicarbonate 38 mEq/L D) Serum Potassium 5.7 mEq/L
D) Serum Potassium 5.7 mEq/L
A client receiving gentamycin intravenously reports that the peripheral IV insertion site has become painful and reddened. What is the priority nursing action? A) Contact the primary health care provider B) Document findings in the electronic health record C) Change the IV site to a new location D) Stop the infusion of the drug
D) Stop the infusion of the drug
Which condition or manifestation in the client with a serum sodium level of 149 mEq/L indicates to the nurse that this electrolyte imbalance may be caused by excessive fluid loss? A) The client has calf muscle cramping B) The serum chloride level is low C) The urine specific gravity is high D) The hematocrit is 52%
D) The hematocrit is 52%
Which set of client arterial blood gas (ABG) values indicate to the nurse that some mechanisms are working to partially compensate for an acid-base imbalance? A) pH 7.42; Pao2 92 mm Hg; CO2 41 mm Hg; HCO3 − 28 mEq/L (mmol/L) B) pH 7.46; Pao2 98 mm Hg; CO2 38 mm Hg; HCO3 − 30 mEq/L (mmol/L) C) pH 7.22; Pao2 60 mm Hg; CO2 80 mm Hg; HCO3 − 22 mEq/L (mmol/L) D) pH 7.29; Pao2 78 mm Hg; CO2 82 mm Hg; HCO3 − 36 mEq/L (mmol/L)
D) pH 7.29; Pao2 78 mm Hg; CO2 82 mm Hg; HCO3 − 36 mEq/L (mmol/L)
In metabolic acidosis, what happens to a patient's breathing?
Decreased Respiratory Effect
What are hypotonic solutions used for?
Dehydration and DKA
Concentration Gradient
Exists when two fluid spaces have different concentrations of the same type of particles
Isotonic fluids cause shifting of water from the extracellular space to the intracellular space. True or False?
False
Thirst mechanism is more sensitive in the older adult therefore increasing the risk for dehydration. True or False?
False
Hypertonic Solutions
Greater than 300
Natriuretic Peptides
Hormones secreted by special cells that line the atria (ANP) and the ventricles (BNP) of the heart
How often should the nurse check a patients deep tendon reflexes when administering Magnesium?
Hourly
Acidosis can cause?
Hyperkalemia and Hypercalcemia
What is the most common type of fluid loss problem?
Isotonic Dehydration
Of the three lines of defenses for acid-base regulation, which one is the most powerful buffer, but more slow to respond?
Kidneys
What organ(s) control bicarbonate levels?
Kidneys
LATTE (Third-Space)
L - Look A- Assess T-Test T- Treat E- Educate
Hypotonic Solutions
Less than 270 osmo
What organ(s) control CO2 levels?
Lungs
When bicarbonate levels decrease and pH increases what is caused?
Metabolic Acidosis
When bicarbonate levels increase and pH decreases what is caused?
Metabolic Alkalosis
Osmosis is the movement of what?
More fluid to less fluid
Osmosis
Movement of WATER ONLY through a semipermeable membrane
Diffusion
Movement of particles (solute) across a permeable membrane from an area of higher concentration to an area of lower concentration
Name one symptom a patient might complain of with hypocalcemia?
Muscle spasm in calf or foot
Which population of persons has less body water?
Obese
Solute
Particles dissolved in a liquid (solvent) (salt, sugar)
Antidiuretic Hormone (ADH)
Released from the posterior pituitary gland in response to changes in blood osmolarity
Fluid volume overload is caused by what?
Renal & Heart Failure
When CO2 levels increase (Carbon Dioxide Retention) and pH decreases what is caused?
Respiratory Acidosis
A patient comes to you in the ER and is having a panic attack and is hyperventilating, they are at risk for what?
Respiratory Alkalosis
When CO2 levels decrease (Excess Carbon Dioxide Excretion) and pH increases what is caused?
Respiratory Alkalosis
Osmolarity
The number of milliosmoles in a liter of solution
A positive Trousseau's Sign is a clinical characteristic of hypocalcemia. True or False?
True
Acidosis can create Hyperkalemia. True or False?
True
Chvostek's Sign is a clinical characteristic of hypocalcemia. True or False?
True
D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution because after the body metabolizes the dextrose the solution acts as a hypotonic solution. True or False?
True
Phosphorus has a reciprocal effect with calcium. True or False?
True
When CO2 levels decrease, pH increases causing an alkaline state. True or False?
True
When CO2 levels increase, pH decreases causing acidosis. True or False?
True
What does Aldosterone prevent?
Water and sodium loss
Solvent
Water portion of fluids
Aldosterone
`Secreted by the adrenal cortex whenever sodium levels in the ECF are low.
