MedSurg electrolytes

A client who had a recent surgery has been vomiting and becomes dizzy while standing up to go to the bathroom. After assisting the client back to bed, the nurse notes that the blood pressure is 55/30 and the pulse is 140. The nurse hangs which of the following IV fluids to correct this condition? D5.45 NS at 50 ml/hr 0.9 NS at an open rate D5W at 125 ml/hr 0.45 NS at open rate

0.9 NS at an open rate

The client diagnosed with diabetes insipidus weighed 180 pounds when the daily weight was taken yesterday. This morning's weight is 175.6 pounds. One liter of fluid weighs approximately 2.2 pounds. How much fluid has the client lost (in milliliters)? 500 mL 1000 mL 2000 mL 4400 mL

2000 mL

The nurse evaluates which of the following clients to be at risk for developing hypernatremia? 50-year-old with pneumonia, diaphoresis, and high fevers 62-year-old with congestive heart failure taking loop diuretics 39-year-old with diarrhea and vomiting 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH)

50-year-old with pneumonia, diaphoresis, and high fevers

The registered nurse is delegating client assignments to unlicensed assistive personnel. Which of the following clients does not require additional monitoring and assessment and may be delegated to unlicensed assistive personnel? A client who has been experiencing diarrhea and has a serum chloride level of 100 mEq/L A client with renal failure who has a serum magnesium level of 3.0 mEq/L A client who has experienced a fracture of the femur and has a serum phosphate of 5.0 mg/dl A client with dehydration who has a serum sodium level of 128 mEq/L

A client who has been experiencing diarrhea and has a serum chloride level of 100 mEq/L

The nurse evaluates which of the following clients to have hypermagnesemia? A client who has chronic alcoholism and a magnesium level of 1.3 mEq/L A client who has hyperthyroidism and a magnesium level of 1.6 mEq/L A client who has renal failure, takes antacids, and has a magnesium level of 2.9 mEq/L A client who has congestive heart disease, takes a diuretic, and has a magnesium level of 2.3 mEq/L

A client who has renal failure, takes antacids, and has a magnesium level of 2.9 mEq/L

The nurse should monitor for clinical manifestations of hypophosphatemia in which of the following clients? A client with osteoporosis taking vitamin D and calcium supplements A client who is alcoholic receiving total parenteral nutrition A client with chronic renal failure awaiting the first dialysis run A client with hypoparathyroidism secondary to thyroid surgery

A client who is alcoholic receiving total parenteral nutrition

A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume? A client with a colostomy A client with congestive heart failure A client with decreased kidney function A client receiving frequent wound irrigations

A client with a colostomy

The nurse is evaluating the serum laboratory results on the following four clients. Which of the following laboratory results is a priority for the nurse to report first? A client with osteoporosis and a calcium level of 10.6 mg/dl A client with renal failure and a magnesium level of 2.5 mEq/L A client with bulimia and a potassium level of 3.6 mEq/L A client with dehydration and a sodium level of 149 mEq/L

A client with dehydration and a sodium level of 149 mEq/L

A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4 mEq/L. Which of the following assessments would alert the nurse to immediately stop the infusion? Absent patellar reflex Diarrhea Premature ventricular contractions Increase in blood pressure

Absent patellar reflex

The nurse is admitting a client with a potassium level of 6.0 mEq/L. The nurse reports this finding as a result of Acute renal failure. Malabsorption syndrome. Nasogastric drainage. Laxative abuse

Acute renal failure

A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level? Alcoholism Renal insufficiency Hypoparathyroidism Tumor lysis syndrome

Alcoholism

The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present? Weight loss Flat neck and hand veins An increase in blood pressure A decreased central venous pressure (CVP)

An increase in blood pressure

A nurse instructs a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is: Apples Carrots Spinach Avocado

Apples

A client with a serum sodium of 115 mEq/L has been receiving 3% NS at 50 ml/hr for 16 hours. This morning the client feels tired and short of breath. Which of the following interventions is a priority? Turn down the infusion Check the latest sodium level Assess for signs of fluid overload Place a call to the physician

Assess for signs of fluid overload

Which of the following should the nurse include in the diet teaching for a client with a sodium level of 158 mEq/L? Pretzels Baked chicken Chicken bouillon Baked potato Baked ham

Baked chicken Baked potato

The nurse assists a client with a serum potassium of 3.2 mEq/L to make which of the following menu selections? Select all that apply. Baked cod Ham and cheese omelet Fried eggs Baked potato Spinach

Baked cod Baked potato Spinach

A client with a potassium level of 5.5 mEq/L is to receive sodium polystyrene sulfonate (Kayexalate) orally. After administering the drug, the priority nursing action is to monitor: Urine output. Blood pressure. Bowel movements. ECG for tall, peaked T waves.

Bowel movements

A client admitted with squamous cell carcinoma of the lung has a serum calcium level of 14 mg/dl. The nurse should instruct the client to avoid which of the following foods upon discharge? Select all that apply. Eggs Broccoli Organ meats Nuts Canned salmon

Broccoli Nuts Canned salmon

A client with heart failure is complaining of nausea. The client has received IV furosemide (Lasix), and the urine output has been 2500 ml over the past 12 hours. The client's home drugs include metoprolol (Lopressor), digoxin (Lanoxin), furosemide, and multivitamins. Which of the following are the appropriate nursing actions before administering the digoxin? Select all that apply. Administer an antiemetic prior to giving the digoxin Encourage the client to increase fluid intake Call the physician Report the urine output Report indications of nausea

Call the physician Report the urine output Report indications of nausea

A client with chronic renal failure reports a 10 pound weight loss over 3 months and has had difficulty taking calcium supplements. The total calcium is 6.9 mg/dl. Which of the following would be the first nursing action? Assess for depressed deep tendon reflexes Call the physician to report calcium level Place an intravenous catheter in anticipation of administering calcium gluconate Check to see if a serum albumin level is available

Check to see if a serum albumin level is available

Which of the following should the nurse include when preparing to teach a class on the regulation and functions of electrolytes? Sodium is essential to maintain intracellular fluid water balance Magnesium is essential to the function of muscle, red blood cells, and nervous system Less calcium is excreted with aging Chloride is lost in hydrochloride acid

Chloride is lost in hydrochloride acid

A nurse caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the nurse note in a client with this condition? Lung congestion Decreased hematocrit Increased blood pressure Decreased central venous pressure (CVP)

Decreased central venous pressure (CVP)

Which of the following assessment findings would indicate to the nurse that a client's diabetic ketoacidosis is deteriorating? Deep tendon reflexes decreasing from +2 to +1 Bicarbonate rising from 20 mEq/L to 22 mEq/L Urine pH less than 6 Serum potassium decreasing from 6.0 mEq/L to 4.5 mEq/L

Deep tendon reflexes decreasing from +2 to +1

The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition would be a cause for these findings? Overhydration Anemia Dehydration Renal failure

Dehydration

A nurse caring for a client with severe malnutrition reviews the laboratory results and notes a magnesium level of 1.0 mg/dL. Which electrocardiographic change would the nurse expect to note based on the magnesium level? Prominent U waves Prolonged PR interval Depressed ST segment Widened QRS complexes

Depressed ST segment

A client is admitted with diabetic ketoacidosis who, with treatment, has a normal blood glucose, pH, and serum osmolality. During assessment, the client complains of weakness in the legs. Which of the following is a priority nursing intervention? Request a physical therapy consult from the physician Ensure the client is safe from falls and check the most recent potassium level Allow uninterrupted rest periods throughout the day Encourage the client to increase intake of dairy products and green leafy vegetables.

Ensure the client is safe from falls and check the most recent potassium level

A client recently diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) complains of headache, weight gain, and nausea. Which of the following is an appropriate nursing diagnosis for this client? Deficient fluid volume related to decreased fluid intake Excess fluid volume related to increased water retention Deficient fluid volume related to excessive fluid loss Risk for injury related to fluid volume loss

Excess fluid volume related to increased water retention

A nurse is caring for a client with acute congestive heart failure who is receiving high doses of a diuretic. On assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in this client if hyponatremia were present? Dry skin Decreased urinary output Hyperactive bowel sounds Increased specific gravity of the urine

Hyperactive bowel sounds

A client with hypoparathyroidism complains of numbness and tingling in his fingers and around the mouth. The nurse would assess for what electrolyte imbalance? Hyponatremia Hypocalcemia Hyperkalemia Hypermagnesemia

Hypocalcemia

The nurse assesses a client to be experiencing muscle cramps, numbness, and tingling of the extremities, and twitching of the facial muscle and eyelid when the facial nerve is tapped. THe nurse reports this assessment as consistent with which of the following? Hypokalemia Hypernatremia Hypermagnesemia Hypocalcemia

Hypocalcemia

A client with pancreatitis has been receiving potassium supplementation for four days since being admitted with a serum potassium of 3.0 mEq/L. Today the potassium level is 3.1 mEq/L. Which of the following laboratory values should the nurse check before notifying the physician of the client's failure to respond to treatment? Sodium Phosphorus Calcium Magnesium

Magnesium

A client with chronic renal failure receiving dialysis complains of frequent constipation. When performing discharge teaching, which over-the-counter products should the nurse instruct the client to avoid at home? Bisacodyl (Dulcolax) suppository Fiber supplements Docusate sodium Milk of magnesium

Milk of magnesia

A client who is post-gallbladder surgery has a nasogastric tube, decreased reflexes, pulse of 110 weak and irregular, and blood pressure of 80/50 and is weak, mildly confused, and has a serum of potassium of 3.0 mEq/L. Based on the assessment data, which of the following is the priority intervention? Withhold furosemide (Lasix) Notify the physician Administer the prescribed potassium supplement Instruct the client on foods high in potassium

Notify the physician

A client is receiving intravenous potassium supplementation in addition to maintenance fluids. The urine output has been 120 ml every 8 hours for the past 16 hours and the next dose is due. Before administering the next potassium dose, which of the following is the priority nursing action? Encourage the client to increase fluid intake Administer the dose as ordered Draw a potassium level and administer the dose if the level is low or normal Notify the physician of the urine output and hold the dose

Notify the physician of the urine output and hold the dose

The registered nurse is delegating nursing tasks for the day. WHich of the following tasks may the nurse delegate to a licensed practical nurse? Assess a client for metabolic acidosis Evaluate the blood gases of a client with respiratory alkalosis Obtain a glucose level on a client admitted with diabetes mellitus Perform a neurological assessment on a client suspected of having hypocalcemia

Obtain a glucose level on a client admitted with diabetes mellitus

The client who has undergone an exploratory laparotomy and subsequent removal of a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at 150 mL/hr via an IV pump. Which data should be reported to the health care provider? The pump keeps sounding an alarm that the high pressure has been reached. Intake is 1800 mL, NGT output is 550 mL, and Foley output 950 mL. On auscultation, crackles and rales in all lung fields are noted. Client has negative pedal edema and an increasing level of consciousness.

On auscultation, crackles and rales in all lung fields are noted

The nurse provides instructions to a client with a low magnesium level about the foods that are high in magnesium and tells the client to consume which foods? Select all that apply. Peas Oranges Cauliflower Peanut butter Canned white tuna

Peas Cauliflower Peanut butter Canned white tun

The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention should be implemented? Encourage fluids orally. Administer 10% saline solution IVPB. Administer antidiuretic hormone intranasally. Place on seiz

Place on seizure precautions

The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select all that apply. Place the solution on an IV pump at the prescribed rate. Monitor blood glucose every six (6) hours. Weigh the client weekly, first thing in the morning. Change the IV tubing every three (3) days. Monitor intake and output every shift.

Place the solution on an IV pump at the prescribed rate. Monitor blood glucose every six (6) hours. Monitor intake and output every shift.

A client who is admitted with malnutrition and anorexia secondary to chemotherapy is also exhibiting generalized edema. The client asks the nurse for an explanation for the edema. Which of the following is the most appropriate response by the nurse? "The fluid is an adverse reaction to chemotherapy." "A decrease in activity has allowed extra fluid to accumulate in the tissues." "Poor nutrition has caused decreased blood protein levels, and fluid has moved from the blood vessels into the tissues." "Chemotherapy has increased your blood pressure, and fluid was forced out into the tissues."

Poor nutrition has caused decreased blood protein levels, and fluid has moved from the blood vessels into the tissues."

A client with a recent thyroidectomy complains of numbness and tingling around the mouth. Which of the following findings indicates the serum calcium is low? Bone pain Depressed deep tendon reflexes Positive Chvostek's sign Nausea

Positive Chvostek's sign

A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium? Obtaining a controlled IV infusion pump Monitoring urine output during administration Diluting in appropriate amount of normal saline Preparing the medication for bolus administration

Preparing the medication for bolus administration

A nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the physician and the physician prescribes dietary instructions based on the sodium level. Which food item does the nurse instruct the client to avoid? Peas Cauliflower Low-fat yogurt Processed oat cereals

Processed oat cereals

A nurse caring for a client with hypocalcemia would expect to note which of the following changes on the electrocardiogram? Widened T wave Prominent U wave Prolonged QT interval Shortened ST segment

Prolonged QT interval

A nurse is reviewing a client's laboratory report and notes that the serum calcium level is 4.0 mg/dL. The nurse understands that which condition most likely caused this serum calcium level? Prolonged bed rest Renal insufficiency Hyperparathyroidism Excessive ingestion of vitamin D

Prolonged bed rest

The nurse is caring for a bedridden client admitted with multiple myeloma and a serum calcium level of 13 mg/dl. Which of the following is the most appropriate nursing action? Provide passive ROM exercises and encourage fluid intake Teach the client to increase intake of whole grains and nuts Place a tracheostomy tray at the bedside Administer calcium gluconate IM as ordered

Provide passive ROM exercises and encourage fluid intake

The nurse is caring for a client who has been in good health up to the present and is admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate nursing action? Call the physician and report results Question the results and redraw the specimen Encourage the client to increase the intake of bananas Initiate seizure precautions

Question the results and redraw the specimen

A nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client: Has renal failure. Requires nasogastric suction. Has a history of Addison's disease. Is taking a potassium-sparing diuretic.

Requires nasogastric suction

A nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client: Has renal failure. Requires nasogastric suction. Has a history of Addison's disease. Is taking a potassium-sparing diuretic.

Requires nasogastric suction.

The nurse writes the nursing problem of "fluid volume excess" (FVE). Which intervention should be included in the plan of care? Change the IV fluid from 0.9% NS to D5W. Restrict the client's sodium in the diet. Monitor blood glucose levels. Prepare the client for hemodialysis.

Restrict the client's sodium in the diet.

The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor? Serum calcium. Serum phosphorus. Serum potassium. Serum sodium

Serum potassium.

A nurse is caring for a client with a nasogastric tube. Nasogastric tube irrigations are prescribed to be performed once every shift. The client's serum electrolyte results indicate a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these laboratory findings, the nurse selects which solution to use for the nasogastric tube irrigation? Tap water Sterile water Sodium chloride Distilled water

Sodium chloride

The nurse should include which of the following instructions to assist in controlling phosphorus levels for a client in renal failure? Increase intake of dairy products and nuts Take aluminum-based antacids such as aluminum hydroxide (Amphojel) with or after meals Reduce intake of chocolate, meats, and whole grains Avoid calcium supplements

Take aluminum-based antacids such as aluminum hydroxide (Amphojel) with or after meals

A nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.4 mEq/L. Which of the following would the nurse expect to note on the electrocardiogram as a result of the laboratory value? ST depression Inverted T wave Prominent U wave Tall peaked T waves

Tall peaked T waves

The client post-thyroidectomy complains of numbness and tingling around the mouth and the tips of the fingers. Which intervention should be implemented first? Notify the health care provider immediately. Tap the cheek about two (2) centimeters anterior to the ear lobe. Check the serum calcium and magnesium levels. Prepare to administer calcium gluconate IVP.

Tap the cheek about two (2) centimeters anterior to the ear lobe.

The telemetry monitor technician notifies the nurse of the morning telemetry readings. Which client should the nurse assess first? The client in normal sinus rhythm with a peaked T wave. The client diagnosed with atrial fibrillation with a rate of 100. The client diagnosed with a myocardial infarction who has occasional PVC. The client with a first-degree AV block and a rate of 92.

The client in normal sinus rhythm with a peaked T wave.

A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level? The client with colitis The client with Cushing's syndrome The client who has been overusing laxatives The client who has sustained a traumatic burn

The client who has sustained a traumatic burn

A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level? The client with renal failure The client who is taking diuretics The client with hyperaldosteronism The client who is taking corticosteroids

The client who is taking diuretics

A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume? The client taking diuretics The client with renal failure The client with an ileostomy The client who requires gastrointestinal suctioning

The client with renal failure

Which statement best explains the scientific rationale for Kussmaul's respirations in the client diagnosed with diabetic ketoacidosis (DKA)? The kidneys produce excess urine and the lungs try to compensate. The respirations increase the amount of carbon dioxide in the bloodstream. The lungs speed up to release carbon dioxide and increase the pH. The shallow and slow respirations will increase the HCO3 in the serum.

The lungs speed up to release carbon dioxide and increase the pH.

A nurse is reading a physician's progress notes in the client's record and reads that the physician has documented "insensible fluid loss of approximately 800 mL daily." The nurse understands that this type of fluid loss can occur through: The skin Urinary output Wound drainage gastrointestinal tract

The skin

An older adult client admitted with heart failure and a sodium level of 113 mEq/L is behaving aggressively toward staff and does not recognize family members. When the family expresses concern about the client's behavior, the nurse would respond most appropriately by stating "The client may be suffering from dementia, and the hospitalization has worsened the confusion." "Most older adults get confused in the hospital." "The sodium level is low, and the confusion will resolve as the levels normalize." "The sodium level is high and the behavior is a result of dehydration."

The sodium level is low, and the confusion will resolve as the levels normalize.

A nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which of the following clinical manifestations would the nurse expect to note in the client? Twitching Negative Trousseau's sign Hypoactive bowel sounds Hypoactive deep tendon reflexes

Twitching

A nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse note on the electrocardiogram as a result of the laboratory value? U waves Absent P waves Elevated T waves Elevated ST segment

U waves