Acid/Base, Electrolyte, Lab Values NCLEX Prep

The nurse is caring for a client with hypocalcemia. Which patterns would the nurse watch for on the electrocardiogram as a result of the laboratory value? Select all that apply. 1. U waves 2. Widened T wave 3. Prominent U wave 4. Prolonged QT interval 5. Prolonged ST segment

4,5

The nurse is obtaining the intershift report for a group of assigned clients. Which assigned client should the nurse monitor closely for signs of hyperkalemia? A client with ulcerative colitis A client with Cushing's syndrome A client admitted 6 hours ago with a 40% burn injury A client who has a history of long-term laxative abuse

A client admitted 6 hours ago with a 40% burn injury

The nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is most likely at risk for a fluid volume deficit? A client with an ileostomy A client with heart failure A client on long-term corticosteroid therapy A client receiving frequent wound irrigations

A client with an ileostomy

The nurse is caring for a client with a diagnosis of dehydration, and the client is receiving intravenous (IV) fluids. Which assessment finding would indicate to the nurse that the dehydration remains unresolved? An oral temperature of 98.8º F (37.1º C) A urine specific gravity of 1.043 A urine output that is pale yellow A blood pressure of 120/80 mm Hg

A urine specific gravity of 1.043

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

An increase in blood pressure and increased respirations

A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths per minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats per minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding? A decreased pH and an increased Paco2 An increased pH and a decreased Paco2 A decreased pH and a decreased HCO3- An increased pH and an increased HCO3-

An increased pH and an increased HCO3-

The nurse is assisting in the care of a client with pheochromocytoma who has been experiencing clinical manifestations of hypermagnesemia. When evaluating the client, the nurse should determine that the client's status is returning to normal if which is no longer exhibited? Tetany Tremors Areflexia Muscular excitability

Areflexia

The nurse is caring for a client with a nasogastric (NG) tube who has a prescription for NG tube irrigation once every 8 hours. To maintain homeostasis, which solution should the nurse use to irrigate the NG tube? Tap water Sterile water 0.9% sodium chloride 0.45% sodium chloride

0.9% sodium chloride

The nurse is monitoring the client with a serum calcium level of 6.2 mg/dL (1.55 mmol/L). Which findings should the nurse assess for in the client? Select all that apply. 1. Irritability 2. Muscle cramps 3. Tingling sensations 4. Hyperactive reflexes 5. Memory impairment 6. Severe muscle weakness

1,2,3,4,5

Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which laboratory test results should the nurse report? Select all that apply. 1. Platelets 35,000 mm3 (35 × 109/L) 2. Sodium 150 mEq/L (150 mmol/L) 3. Potassium 5.0 mEq/L (5.0 mmol/L) 4. Segmented neutrophils 40% (0.40) 5. Serum creatinine, 1 mg/dL (88.3 mcmol/L) 6. White blood cells, 3000 mm3 (3.0 × 109/L)

1,2,4,6

The nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 2.5 mEq/L (2.5 mmol/L). Which patterns should the nurse watch for on the electrocardiogram (ECG) as a result of the laboratory value? Select all that apply. 1. U waves 2. Absent P waves 3. Inverted T waves 4. Depressed ST segment 5. Widened QRS complex

1,3,4

The nurse in the respiratory care unit completes a lung assessment and reviews the laboratory results of a serum medication level assay for a client with obstructive pulmonary disease receiving theophylline. The nurse determines that a therapeutic medication level has been achieved by indication of which value? 8 mcg/mL (44 mcmol/L) 9 mcg/mL (50 mcmol/L) 18 mcg/mL (100 mcmol/L) 26 mcg/mL (144 mcmol/L)

18 mcg/mL

A client with acute glomerulonephritis has had a urinalysis sample sent to the laboratory. The report reveals the presence of hematuria and proteinuria. The nurse interprets these results as which condition? Consistent with glomerulonephritis Inconsistent with glomerulonephritis Unclear; no conclusion can be drawn Indicative of impending acute kidney injury

Consistent with glomerulonephritis

The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse notes that the red blood cell (RBC) count is increased. The nurse interprets that this finding may be related to which condition or treatment? Iron deficiency Vitamin deficiency Corticosteroid therapy Bone marrow depression

Corticosteroid therapy

The nurse is reviewing the laboratory test results and notes that the prothrombin time (PT) is 7.0 seconds. The nurse understands that this PT value would be noted in which condition? Hepatic disease Cirrhosis of the liver Factor VII deficiency Deep vein thrombosis

DVT

The nurse is caring for a client with a diagnosis of fluid volume overload. The nurse reviews the laboratory test results and would expect to note which finding about the hematocrit level? Normal Increased Decreased Insignificant related to the condition

Decreased

The nurse is reviewing the laboratory test results for a client with a diagnosis of thrombocytopenia purpura. The nurse should expect the results for platelet aggregation to be at which level? Normal Increased Decreased Insignificant

Decreased

A client is undergoing a 2-hour glucose tolerance test. The nurse assesses for which client factors that can interfere with the test period results? Select all that apply. Experiencing stress Fasting before the test period Voiding during the test period Eating a small snack or candy during the test period Having an episode of diarrhea before the test period Being unable to eat the entire test meal or vomiting some or all of the meal

Experiencing stress Eating a small snack or candy during the test period Being unable to eat the entire test meal or vomiting some or all of the meal

A client with a history of lung disease is at risk for developing respiratory acidosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder? Bradycardia and hyperactivity Decreased respiratory rate and depth Headache, restlessness, and confusion Bradypnea, dizziness, and paresthesias

Headache, restlessness, and confusion

A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium has a prothrombin time (PT) of 35 seconds. On the basis of these laboratory values, the nurse anticipates which prescription? Adding a dose of heparin sodium Holding the next dose of warfarin Increasing the next dose of warfarin Administering the next dose of warfarin

Holding the next dose of warfarin

The nurse is caring for a client with 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 a client with hyponatremia? Muscle twitches Decreased urinary output Hyperactive bowel sounds Increased specific gravity of the urine

Hyperactive bowel sounds

The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which cardiovascular manifestation would the nurse expect to note? Hypotension Increased heart rate Bounding peripheral pulses Shortened QT interval on electrocardiography (ECG)

Hypotension

The nurse is reviewing the laboratory results of a client admitted to the hospital with a diagnosis of venous thrombosis. The nurse expects the platelet aggregation to be reported as which level in this client? Normal Increased Decreased Insignificant

Increased

The nurse is reviewing the laboratory test results for a client with a diagnosis of leukemia. The nurse notes that the granulocyte count is decreased. The nurse interprets that the client is at risk for which condition? Anemia Infection Bleeding Dehydration

Infection

An adult female client has a hemoglobin level of 10.8 g/dL (108 mmol/L). The nurse interprets that this result is most likely caused by which condition noted in the client's history? Dehydration Heart failure Iron deficiency anemia Chronic obstructive pulmonary disease

Iron deficiency anemia

A client experiencing metabolic acidosis is to be admitted to the nursing unit. The nurse plans care knowing that what reaction is the most powerful regulator of acid-base balance? Buffer Kidney Cations Respiratory

Kidney

A client's blood gas results reveal acidosis. What are some signs and symptoms the nurse would expect to see? Select all that apply. Seizures Lethargy Headache Weakness Confusion Hyperactivity

Lethargy Headache Weakness Confusion

The nurse is caring for a client with suspected hepatitis. What diagnostic test results will assist in confirming this client's diagnosis? Select all that apply. Leukopenia Elevated hemoglobin Elevated liver enzymes Elevated serum bilirubin level Elevated blood urea nitrogen (BUN) Elevated serum erythrocyte sedimentation rate (ESR)

Leukopenia Elevated Liver Enzymes Elevated bilirubin Elevated ESR

The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate) level is 1.8 mg/dL (0.58 mmol/L). Which condition most likely caused this serum phosphorus level? Malnutrition Renal insufficiency Hypoparathyroidism Tumor lysis syndrome

Malnutrition

The client tells the nurse that he ingests large amounts of oral antacids on a daily basis. The nurse plans care knowing that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic Alkalosis

A client with diabetes mellitus has a blood glucose level of 644 mg/dL (35.7 mmol/L). The nurse plans care knowing that the client is at risk for the development of which type of acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis

A client with diabetes mellitus is most likely to experience which type of acid-base imbalance as a complication of the disorder? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis

The nurse is caring for a client with hyperglycemia and diabetic ketoacidosis (DKA) who now has developed Kussmaul's respirations. The nurse knows that the purpose of this type of breathing is to correct what imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic acidosis

The nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse monitors the client for which clinical manifestations associated with these ABG results? Select all that apply. Nausea Confusion Bradypnea Tachycardia Hyperkalemia Lightheadedness

Nausea Confusion Tachycardia Lightheadedness

The nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the primary health care provider (PHCP), and the PHCP prescribes dietary instructions based on the sodium level. Which acceptable food items does the nurse instruct the client to consume? Select all that apply. Peas Nuts Cheese Cauliflower Processed oat cereals

Peas Nuts Cauliflower

A client in the later stages of chronic kidney disease (CKD) has hyperkalemia. With CKD, what other factors besides tissue breakdown can cause high potassium levels? Select all that apply. Blood transfusions Metabolic alkalosis Bleeding or hemorrhage Decreased sodium excretion Ingestion of potassium in medications Failure to restrict dietary potassium

Blood transfusions Bleeding or hemorrhage Ingestion of potassium in meds Failure to restrict dietary potassium

The nurse is caring for a client with diabetic ketoacidosis whose respirations are abnormally deep, regular, and increased in rate. What is the purpose of this type of respiration? Select all that apply. Correct bradypnea Blow off carbon dioxide Correct metabolic acidosis Correct an acid-base imbalance Cause respiratory compensation Stimulate Cheyne-Stokes respirations

Blow off carbon dioxide Correct metabolic acidosis Correct an acid-base imbalance Cause respiratory compensation

The nurse aspirates 40 mL of undigested formula from the client's nasogastric (NG) tube. Before administering an intermittent tube feeding, what should the nurse do with the 40 mL of gastric aspirate? Pour the aspirate into the NG tube through a syringe with the plunger removed. Dilute with water and inject into the NG tube by putting pressure on the plunger. Discard properly and record as output on the client's intake and output (I&O) record. Mix with the formula and pour into the NG tube through a syringe with the plunger removed.

Pour the aspirate into the NG tube through a syringe with the plunger removed.

A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 8%. On the basis of this test result, the nurse plans to teach the client about the need for which measure? Avoiding infection Taking in adequate fluids Preventing and recognizing hypoglycemia Preventing and recognizing hyperglycemia

Preventing and recognizing hyperglycemia

The nurse is reviewing the laboratory results for a client who is receiving magnesium sulfate by intravenous infusion. The nurse notes that the magnesium level is 5 mEq/L (2.5 mmol/L). On the basis of this laboratory result, the nurse should expect to note which in the client? Tremors Hyperactive reflexes Respiratory depression No specific signs or symptoms because this value is a normal level

Respiratory depression

The nurse is admitting a client who has a cough, dyspnea, and abnormal chest x-ray who is otherwise healthy. The client has an elevated serum angiotensin-converting enzyme (SACE) level. Based on this result, what condition is the client at risk for? Sarcoidosis Pulmonary fibrosis Bacterial pneumonia Chronic obstructive pulmonary disease (COPD)

Sarcoidosis

The nurse is reviewing laboratory results for a client with chronic kidney disease before a hemodialysis treatment. The serum electrolyte levels are sodium 142 mEq/L (142 mmol/L), chloride 103 mEq/L (103 mmol/L), potassium 5.2 mEq/L (5.2 mmol/L), and bicarbonate 23 mEq/L (23 mmol/L). What action should the nurse take? Take no action. Order a stat hemodialysis treatment. Recheck the labs because these values are all abnormal. Page the primary health care provider (PHCP) with the results.

Take no action

The nurse notes that a client's total serum calcium level is 6.0 mg/dL (1.5 mmol/L). Which assessment findings should be anticipated in this client? Select all that apply. Tetany Constipation Renal calculi Hypotension Prolonged QT interval Positive Chvostek's sign

Tetany Hypotension Prolonged QT interval Positive Chvostek's sign

The nurse is caring for a client whose arterial blood gas results reveal alkalosis. What client reactions would the nurse expect to see? Select all that apply. Tetany Lethargy Tingling Confusion Numbness Restlessness

Tetany Tingling Numbness Restlessness

Which client is at risk for the development of a sodium level at 130 mEq/L (130 mmol/L)? The client who is taking diuretics The client with hyperaldosteronism The client with Cushing's syndrome The client who is taking corticosteroids

The client who is taking diuretics

The nurse is caring for a hospitalized client who is retaining carbon dioxide (CO2) because of respiratory disease. The nurse anticipates which physical response will initially occur? The client will lose consciousness. The client's sodium and chloride levels will rise. The client will complain of facial numbness and tingling. The client's arterial blood gas results will reflect acidosis.

The client's arterial blood gas results will reflect acidosis

The nurse is reviewing the white blood cell (WBC) count and differential on a client and notes that the results indicate a left shift. What are the possible indications for these laboratory results? Select all that apply. The total number of WBCs An increased number of bands The presence of an acute infectious process An increased number of mature neutrophils An increased number of immature neutrophils

The total number of WBCs An increased number of bands The presence of an acute infectious process An increased number of immature neutrophils

The nurse is reviewing an adult male's serum creatinine level of 4.0 mg/dL (353 mcmol/L). What does this level indicate? Low Normal Slightly elevated and needs referral Very high, indicating severe renal failure

Very high, indicating severe renal failure

The nurse caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assessment finding would the nurse note in a client with this condition? Weight loss and poor skin turgor Lung congestion and increased heart rate Decreased hematocrit and increased urine output Increased respirations and increased blood pressure

Weight loss and poor skin turgor

The nurse has a prescription to hang a crystalloid intravenous solution of lactated Ringer's on a newly admitted client. The nurse notices that the client has a history of alcoholic cirrhosis. What action should the nurse take first? Hang the solution. Contact the primary health care provider (PHCP). Check the client's daily laboratory results. Ask the client if any liver study tests have ever been done.

Contact the PHCP

The long-term care nurse about to give a daily dose of digoxin is told that a serum digoxin level drawn earlier in the day measured 2.4 ng/mL (2.7 nmol/L). Which action should the nurse take first? Report the finding to the cardiologist. Administer the daily dose of the medication. Record the normal value on the intershift report sheet. Gather data from the client related to signs of toxicity.

Gather data from the client related to signs of toxicity

The nurse is collecting a 24-hour composite urine specimen. Besides electrolytes and glucose, what other components are measured? Select all that apply. Blood Protein Minerals Creatinine 17-ketosteroids Catecholamines

Protein Minerals Creatinine 17-ketosteroids Catecholamines

Which client is at risk for the development of a potassium level of 5.5 mEq/L (5.5 mmol/L)? 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

The nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac monitor as a result of the laboratory value? Select all that apply. 1. ST depression 2. Prominent U wave 3. Tall peaked T waves 4. Prolonged ST segment 5. Widened QRS complexes

3,5

The nurse has a prescription to obtain an arterial blood sample from a client. Prior to the procedure the nurse assesses the adequacy of the client's radial artery by performing the Allen's test. In which order should the Allen's test be performed? Place in correct order of priority. All options must be used. 1. Apply pressure over the ulnar and radial arteries simultaneously. 2. Release pressure from the ulnar artery while compressing the radial artery. 3. Ask the client to open and close the hand repeatedly. 4. Assess the color of the extremity distal to the pressure point. 5. Explain the procedure to the client. 6. Document the findings.

5,1,3,2,4,6

The nurse is caring for a client with Paget's disease who has a serum calcium level of 12.3 mg/dL (3.1 mmol/L). The nurse should check to see that which medication is available in the stock medication supply for possible use to reverse this elevation? Calcitonin Vitamin D Calcium chloride Calcium gluconate

Calcitonin

The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that which level indicates the need for follow-up and immediate notification of the primary health care provider (PHCP)? Calcium 4.0 mg/dL (1.0 mmol/L) Sodium 140 mEq/L (145 mmol/L) Potassium 4.0 mEq/L (4.0 mmol/L) Magnesium 2.0 mEq/L (1 mmol/L)

Calcium 4.0 mg/dL

The nurse is reviewing the laboratory test results for a client and notes that the albumin level is 3.0 g/dL (30 g/L). The nurse understands that this laboratory value would be noted in which condition? Diarrhea Dehydration Multiple myeloma Cirrhosis of the liver

Cirrhosis of the liver

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The client's prothrombin time is 20 seconds, with a control of 11 seconds. How should the nurse interpret these results? The client needs to have the test repeated. Client results are within the therapeutic range. Client results are higher than the therapeutic range. Client results are lower than the needed therapeutic level.

Client results are within the therapeutic range

The nurse is reviewing the laboratory results for a client with a diagnosis of leukemia and notes that the absolute neutrophil count is decreased. The nurse interprets this to mean that the client is at risk for which problem? Anemia Bleeding Infection Dehydration

Infection

A client is receiving an intravenous infusion of 1000 mL of normal saline with 40 mEq of potassium chloride. The care unit nurse is monitoring the client for signs of hyperkalemia. Which finding initially will be noted in the client if hyperkalemia is present? Confusion Muscle weakness Mental status changes Depressed deep tendon reflexes

Muscle weakness

The ambulatory care nurse is reviewing an adult client's laboratory test results and notes that the hematocrit level is 60% (0.60). The nurse recognizes that this level is most likely to be found in clients with which diagnosis? Leukemia Hemolytic anemia Pernicious anemia Iron deficiency anemia

Pernicious anemia The normal hematocrit level is approximately 42% to 52% (0.42 to 0.52) in a male and 37% to 47% (0.37 to 0.47) in a female. The hematocrit level measures the percentage of red blood cells in whole blood. Elevated hematocrit levels are seen in persons with dehydration, pernicious anemia, or polycythemia. Therefore, the conditions in the remaining options are incorrect.

A client is being treated for metabolic acidosis with medication therapy and other measures. The nurse should plan to monitor the results of which electrolyte, which could dramatically decline with effective treatment of the acidosis? Sodium Potassium Magnesium Phosphorus

Potassium

The nurse reviews a client's record and determines that the client is at risk for developing a potassium deficit if which situation is documented? Sustained tissue damage Requires nasogastric suction Has a history of Addison's disease Uric acid level of 9.4 mg/dL (557 mcmol/L)

Requires nasogastric suction

On review of the clients' medical records, the nurse determines that which client is at risk for fluid volume excess? The client taking diuretics and has tenting of the skin The client with an ileostomy from a recent abdominal surgery The client who requires intermittent gastrointestinal suctioning The client with kidney disease and a 12-year history of diabetes mellitus

The client with kidney disease and a 12-year history of diabetes mellitus

The nurse is monitoring the fluid balance of a client with a burn injury. The nurse determines that the client is less than adequately hydrated if which information is noted during assessment? Urine pH of 6 Urine that is pale yellow Urine output of 40 mL/hr Urine specific gravity of 1.032

Urine specific gravity of 1.032

The nurse is evaluating the laboratory test results for a client with diabetes mellitus seen in the health care clinic. The nurse determines that which glycosylated hemoglobin level value shows poor adherence to therapy? 6% 7% 7.5% 10%

10%

The nurse is caring for a client with a diagnosis of breast cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which value? 2000 mm3 (2.0 × 109/L) 5800 mm3 (5.8 × 109/L) 8400 mm3 (8.4 × 109/L) 11,500 mm3 (11.5 × 109/L)

2000 mm3

The nurse preceptor and the orientee note that the reticulocyte count for a client is increased. The preceptor determines that the orientee understands the significance of reticulocytes if the orientee makes which statement with regard to red blood cells (RBCs)? "A reticulocyte is a mature RBC." "A reticulocyte is an immature RBC." "A reticulocyte is decreased whenever there is accelerated production of RBCs." "A reticulocyte is increased when the bone marrow has slowed production of RBCs."

"A reticulocyte is an immature RBC"

A client is about to have arterial blood gases drawn, and the nurse explains what an Allen's test is. What comment shows that the client understands the nurse's explanation? "Blood is drawn from the ulnar artery." "I know I have to lie down while blood is drawn." "This test is done to ensure adequate collateral circulation." "Direct pressure has to be placed over the site for 15 minutes after blood is drawn."

"This test is done to ensure adequate collateral circulation"

The nurse checks the laboratory results of a serum medication level assay for a newly admitted client with a history of heart failure taking digoxin 0.125 mg orally daily. Which value would indicate a therapeutic level? 0.1 ng/mL (0.13 nmol/L) 0.6 ng/mL (0.76 nmol/L) 2.4 ng/mL (2.30 nmol/L) 2.8 ng/mL (3.07 nmol/L)

0.6 ng/mL

The nurse is reviewing the laboratory test results for a client seen in the clinic. The nurse determines that the urine specific gravity is normal if which value is noted on the laboratory results? 1.001 1.003 1.019 1.036

1.019 The normal range for urine specific gravity is between 1.005 and 1.030. Values of 1.001 and 1.003 represent low values, and 1.036 reflects an elevated value.

A client has a prescription to have blood drawn to measure peak and trough vancomycin levels to determine the effectiveness of therapy with this medication. The nurse arranges with the laboratory to have the peak level specimen drawn at which time? 1 hour before administration of the scheduled dose 1.5 hours after completion of the scheduled infusion Immediately after administration of the scheduled dose 30 minutes before administration of the scheduled dose

1.5 hours after completion

The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the serum lipase level is normal if which value is noted on the laboratory report? 4 U/L (4 U/L) 100 U/L (100 U/L) 210 U/L (210 U/L) 360 U/L (360 U/L)

100 U/L

The nurse just completed an assessment and reviewed the laboratory test results for an adult female client seen in the clinic. The client complains of being tired. The nurse determines that the hemoglobin level is normal if which value is noted on the laboratory report? 8 g/dL (80 mmol/L) 14 g/dL (140 mmol/L) 22 g/dL (220 mmol/L) 32 g/dL (320 mmol/L)

14 g/dL

The nurse is reviewing the laboratory test results for a client seen in the clinic. The nurse reports to the client that the total cholesterol level is within the recommended guidelines if which value is noted on the laboratory report? 146 mg/dL (4 mmol/L) 224 mg/dL (6 mmol/L) 256 mg/dL (7 mmol/L) 301 mg/dL (8 mmol/L)

146 mg/dL

A client has been admitted to the hospital for gastroenteritis and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value? 3 mg/dL (1.08 mmol/L) 15 mg/dL (5.4 mmol/L) 29 mg/dL (10.44 mmol/L) 35 mg/dL (12.6 mmol/L)

15 mg/dL

A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value? 3 mg/dL (1.05 mmol/L) 15 mg/dL (5.25 mmol/L) 29 mg/dL (10.15 mmol/L) 35 mg/dL (12.25 mmol/L)

15 mg/dL

The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the client's platelet level is normal if which value is noted? 70,000 mm3 (70 × 109/L) 110,000 mm3 (110 × 109/L) 160,000 mm3 (160 × 109/L) 500,000 mm3 (500 × 109/L)

160,000 mm3

The nurse is caring for a client with diabetic ketoacidosis and documents that the client is experiencing Kussmaul's respirations. Which patterns did the nurse observe? Select all that apply. 1. Respirations that are shallow 2 Respirations that are increased in rate 3. Respirations that are abnormally slow 4. Respirations that are abnormally deep 5. Respirations that cease for several seconds

2,4

A client has a prescription to begin an infusion of 1000 mL of 5% dextrose in lactated Ringer's solution. The client has an intravenous (IV) cannula inserted, and the nurse prepares the solution and IV tubing. Arrange the actions in the order that they should be performed. All options must be used. 1. Uncap the distal end of the tubing. 2. Close the roller clamp on the IV tubing. 3. Open the roller clamp and fill the tubing. 4. Attach the distal end of the tubing to the client. 5. Spike the IV bag and half-fill the drip chamber.

2,5,3,1,4

The nurse is caring for a client with a diagnosis of lung cancer who is immunosuppressed. The nurse would consider implementing neutropenic precautions if the client's white blood cell count was which value? 2000 mm3 (2.0 × 109/L) 5800 mm3 (5.8 × 109/L) 8400 mm3 (8.4 × 109/L) 11,500 mm3 (11.5 × 109/L)

2000 mm3

The nurse is reviewing the laboratory results of a serum medication level assay for a client seen in the health care clinic who has been taking phenytoin for the control of seizures. The nurse determines that a subtherapeutic level of phenytoin is present and that additional medication is required if which level is found? 3 mcg/mL (12 mcmol/L) 16 mcg/mL (63 mcmol/L) 18 mcg/mL (71 mcmol/L) 24 mcg/mL (95 mcmol/L)

3 mcg/mL

A client with a history of heart failure is due for a morning dose of furosemide. Which serum potassium level, if noted in the client's laboratory report, should be reported before administering the dose of furosemide? 3.2 mEq/L (3.2 mmol/L) 3.8 mEq/L (3.8 mmol/L) 4.2 mEq/L (4.2 mmol/L) 4.8 mEq/L (4.8 mmol/L)

3.2 mEq/L

The nurse is calculating a client's fluid intake for a 24-hour period. The client is on hemodialysis and urinates about 100 mL a day. The client is on a fluid restriction of 750 mL per day. The client drank 4 oz of tea and 4 oz of orange juice for breakfast, 4 oz of water at 1200 and at 1700 when taking his medications, and 4 oz of iced tea at lunch and supper. At 0800 and again at 1400, the client received his intravenous antibiotics in 50 mL of normal saline. How many mL of fluid does the client have left to drink for the day? Fill in the blank.

30 mL

The nurse is reviewing the electrolyte panel results for an assigned client who is taking a potassium supplement. The nurse should determine that a therapeutic effect is present if which value is noted? 2.8 mEq/L (2.8 mmol/L) 3.0 mEq/L (3.0 mmol/L) 3.3 mEq/L (3.3 mmol/L) 4.0 mEq/L (4.0 mmol/L)

4.0 mEq/L

The nurse is reviewing the results of the electrolyte panel for a client seen in the health care clinic. The nurse determines that the client's potassium level is normal if which value is noted? 2.0 mEq/L (2.0 mmol/L) 4.0 mEq/L (4.0 mmol/L) 5.3 mEq/L (5.3 mmol/L) 6.0 mEq/L (6.0 mmol/L)

4.0 mEq/L

A client with a diagnosis of hyperphosphatemia has been treated with dietary management and phosphate binding gels. The client reports to the clinic, and the nurse is reviewing the laboratory results. Which reported serum phosphate level would indicate improvement in the client's condition? 4.0 mg/dL (1.3 mmol/L) 5.2 mg/dL (1.7 mmol/L) 6.0 mg/dL (1.9 mmol/L) 6.5 mg/dL (2.1 mmol/L)

4.0 mg/dL Normal range is 3.0-4.5 mg/dL

A client is at risk for developing disseminated intravascular coagulopathy (DIC). The nurse determines that which fibrinogen level is normal? 170 mg/dL (1.7 g/L) 400 mg/dL (4.0 g/L) 480 mg/dL (4.8 g/L) 500 mg/dL (5.0 g/L)

400 mg/dL Normal range 200-400

An adult male client admitted to the hospital with shock has received fluid volume replacement. The nurse should determine that the client has had adequate fluid resuscitation if the client's repeat hematocrit level has decreased to which value in the normal range? 56% (0.56) 48% (0.48) 37% (0.38) 34% (0.34)

48%

The nurse is reviewing the laboratory test results for an adult male client seen in the health care clinic. The nurse determines that the hematocrit level is normal if which value is noted on the laboratory report? 58% (0.58) 50% (0.50) 40% (0.40) 32% (0.32)

50%

The nurse instructs a client with diabetes mellitus who takes insulin about blood glucose monitoring and monitoring for signs of hypoglycemia. The nurse should inform the client that a blood glucose level of which value indicates hypoglycemia? 60 mg/dL (3.3 mmol/L) 90 mg/dL (5.0 mmol/L) 110 mg/dL (6.1 mmol/L) 120 mg/dL (6.7 mmol/L)

60 mg/dL

The nurse is reviewing the laboratory test results for a client with a diagnosis of severe dehydration. The nurse should expect the hematocrit level for this client to be noted at which level? 60% (0.60) 47% (0.47) 45% (0.45) 32% (0.32)

60%

The nurse is reviewing the laboratory test results for a client seen in the health care clinic. The nurse determines that the client's fasting serum glucose level is normal if which value is noted? 99 mg/dL (5.5 mmol/L) 120 mg/dL (6.9 mmol/L) 130 mg/dL (7.4 mmol/L) 140 mg/dL (8 mmol/L)

99 mg/dL

A client is admitted with possible hepatic encephalopathy. The nurse determines that which noted serum laboratory abnormality supports this suspicion? Protein level of 72 g/L (7.2 g/dL) Ammonia level of 98 mcg/dL (60 mcmol/L) Magnesium level of 1.7 mEq/L (0.85 mmol/L) Total bilirubin level of 1.2 mg/dL (20.5 mcmol/L)

Ammonia The normal serum ammonia level ranges from 10 to 80 mcg/dL (6 to 47 mcmol/L). High levels of ammonia can result in encephalopathy and coma. The other blood levels are not related to hepatic encephalopathy and are also normal values.

The clinic nurse is caring for an infant who has been diagnosed with primary hypothyroidism. The nurse is reviewing the results of the laboratory tests for thyroxine (T4) and thyroid-stimulating hormone (TSH). Which laboratory finding indicates a diagnosis of primary hypothyroidism? A normal T4 level An elevated T4 level An elevated TSH level A decreased TSH level

An elevated TSH level

A client with a 3-day history of nausea and vomiting presents to the emergency department. The client is hypoventilating and has a respiratory rate of 10 breaths/minute. The electrocardiogram (ECG) monitor displays tachycardia, with a heart rate of 120 beats/minute. Arterial blood gases are drawn and the nurse reviews the results, expecting to note which finding? A decreased pH and an increased Paco2 An increased pH and a decreased Paco2 A decreased pH and a decreased HCO3- An increased pH and an increased HCO3-

An increased pH and an increased HCO3

The nurse is performing a change-of-shift assessment on a client. The client had an arterial blood gas specimen drawn during an admission workup on the previous day and has a hematoma at the puncture site. What is the priority nursing intervention? Perform the Allen's test. Apply a warm compress. Administer the antidote for heparin. Notify the hospital laboratory supervisor.

Apply a warm compress

The nurse is caring for a client who is receiving immunosuppressant therapy, including corticosteroids, after renal transplantation. The nurse should plan to carefully monitor results of which laboratory test for this client? Blood glucose level Serum calcium level Serum magnesium level Serum albumin concentration

Blood Glucose Level

The nurse is caring for a client with metabolic alkalosis. The nurse plans care knowing that most problems of metabolic alkalosis are related to increased stimulation of what systems? Select all that apply. Buffer Cardiac Nervous Chemical Respiratory Neuromuscular

Cardiac Nervous Neuromuscular Most problems of alkalosis are related to increased stimulation of the cardiac, nervous, and neuromuscular systems. Chemical reactions are also called buffer systems and are not related to most problems of alkalosis. The respiratory system is related to respiratory alkalosis and not metabolic alkalosis.

During an assessment of skin turgor in an older client, the nurse discovers that skin tenting occurs when the skin is pinched on the client's forearm. What should the nurse do next? Document this assessment finding. Call another nurse to verify this finding. Check skin turgor over the client's sternum. Call the primary health care provider (PHCP) to obtain a prescription for fluid replacement.

Check skin turgor over client's sternum

The nurse is caring for a group of clients on the clinical nursing unit. Which client should the nurse plan to monitor for signs of fluid volume deficit? Client in heart failure Client in acute kidney injury Client with diabetes insipidus Client with controlled hypertension

Client with diabetes insipidus

Which outcome should the nurse expect to observe in the client who is recovering from viral hepatitis without complications? Presence of asterixis Increasing prothrombin time values Decrease in aspartate aminotransferase (AST) Decreased absorption of vitamin K in the intestine

Decrease in AST

A client has been diagnosed with metabolic alkalosis as a result of excessive antacid use. The nurse monitoring this client should expect to note which signs/symptoms? Disorientation and dyspnea Decreased respiratory rate and depth Drowsiness, headache, and tachypnea Tachypnea, dizziness, and paresthesias

Decreased respiratory rate and depth

A client is undergoing a series of diagnostic tests. The laboratory results indicate an increased blood urea nitrogen (BUN) to creatinine ratio. The nurse determines that which potential conditions could contribute to these results? Select all that apply. Dehydration Catabolic state High-protein diet Fluid volume excess Obstructive uropathy Acute renal tubular acidosis

Dehydration Catabolic state High-protein diet Obstructive uropathy Causes of an increased BUN to creatinine ratio include dehydration, a catabolic state, a high-protein diet, and obstructive uropathy. A decreased ratio is caused by fluid volume excess or acute renal tubular acidosis.

A client who is at risk for fluid imbalance is to be admitted to the nursing unit. In planning care for this client, the nurse is aware that which conditions cause the release of antidiuretic hormone (ADH)? Select all that apply. Dehydration Hypertension Physiological stress Decreased blood volume Decreased plasma osmolarity

Dehydration Physiological stress Decreased blood volume

The nurse is providing care to a client with the following arterial blood gas results: pH of 7.50 (7.50), Pao2 of 90 mm Hg (90 mm Hg), Paco2 of 40 mm Hg (40 mm Hg), and bicarbonate of 35 mEq/L (35 mmol/L). When the nurse notifies the primary health care provider about these levels, the nurse should anticipate receiving from the PHCP which prescription for this client? Obtain a serum alcohol level. Obtain a serum salicylate level. Discontinue nasogastric suctioning. Discontinue the client's fentanyl patch.

Discontinue nasogastric suctioning

The nurse is reviewing the laboratory results from a lumbar puncture performed in a client with a diagnosis of meningitis. Which laboratory findings are expected to be noted with bacterial meningitis? Select all that apply. Increased glucose level Elevated protein level Increased white blood cells (WBCs) Clear appearance of the cerebrospinal fluid (CSF) Elevated CSF pressure

Elevated protein Increased WBC Elevated CSF pressure

The nurse has a prescription to obtain a urinalysis specimen from a client with an indwelling urinary catheter. Which actions should the nurse include in performing this procedure? Select all that apply. Explaining the procedure to the client Clamping the tubing of the drainage bag Obtaining the specimen from the urinary drainage bag Aspirating a sample from the port on the drainage tubing Wiping the port with an alcohol swab before inserting the syringe

Explaining procedure Clamping tubing Aspirating sample Wiping the port with alcohol swab

The nurse is reviewing the client's results of preadmission laboratory studies for a complete blood count, electrolytes, coagulation studies, and creatinine before a surgical procedure. Which laboratory result should the nurse report immediately to the surgeon? Platelet count 210,000 mm3 (210 x 109/L) Hemoglobin (Hgb) level 8.9 g/dL (89 mmol/L) Serum sodium level 141 mEq/L (141 mmol/L) Serum creatinine level 0.8 mg/dL (71 mcmol/L)

Hemoglobin (Hgb) level 8.9 g/dL

The nurse is caring for a client in the early stages of disseminated intravascular coagulation (DIC). At this stage, what medication would the nurse expect to be prescribed? Heparin Platelets Antibiotic Clotting factors

Heparin During the early phase of DIC, anticoagulants (especially heparin) are given to limit clotting and prevent the rapid consumption of circulating clotting factors and platelets. Antibiotics are given when sepsis is suspected in an attempt to prevent DIC from occurring.

To detect the development of a chronic carrier state in a client with hepatitis, which laboratory test should the nurse assess? Hepatitis B virus DNA Prolonged prothrombin time Hepatitis B surface antigen (HBsAg) Antibody to surface antigen (anti-HBs)

Hepatitis B surface antigen (HBsAg)

The nurse is preparing to test a client's blood glucose level with a glucometer. Which steps would facilitate obtaining an accurate result? Select all that apply. Hold the finger in a dependent position during the test. Use gentle pressure to obtain an adequate amount of blood. Obtain the blood specimen by puncturing the central tip of the finger. Obtain the blood specimen by puncturing the lateral side of the finger. Allow the drop of blood to form without squeezing near the puncture site. Clean the site with an antiseptic swab, and then puncture the site immediately.

Hold the finger in dependent position Use gentle pressure to obtain Obtain the blood specimen by puncturing the lateral side of the finger

A client with a history of atrial fibrillation is receiving oral anticoagulant therapy with warfarin. The result of a newly drawn prothrombin time (PT) is 40 seconds. The nurse should anticipate which prescription to be prescribed for this client? Hold the next dose of warfarin. Increase the next dose of warfarin. Administer the next dose of warfarin. Stop the warfarin, and administer heparin.

Hold the next dose of warfarin

The nurse is reading a primary health care provider's (PHCP's) progress notes in the client's record and reads that the PHCP has documented "insensible fluid loss of approximately 800 mL daily." The nurse makes a notation that insensible fluid loss occurs through which type of excretion? Urinary output Wound drainage Integumentary output The gastrointestinal tract

Integumentary output

The nurse is reviewing the laboratory test results for a client seen in the health care clinic and notes that the red blood cell (RBC) count is decreased. The nurse determines that this finding occurs in which condition? Dehydration Iron deficiency Severe diarrhea Polycythemia vera

Iron deficiency

The nurse is reviewing the laboratory test results for a client seen in the health care clinic and notes that the hematocrit value is 30% (0.30). The nurse determines that this hematocrit value is most likely to be associated with which condition? Dehydration Pernicious anemia Polycythemia vera Iron deficiency anemia

Iron deficiency anemia

A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin time (aPTT) is 65 seconds. The nurse anticipates that which action is needed? Discontinuing the heparin infusion Increasing the rate of the heparin infusion Decreasing the rate of the heparin infusion Leaving the rate of the heparin infusion as is

Leaving the rate of the heprain infusion as is

An anxious preoperative client is at risk for developing respiratory alkalosis. The nurse should assess the client for which signs and symptoms characteristic of this disorder? Headache and tachypnea Hyperactivity and dyspnea Muscle twitches and cyanosis Lightheadedness and paresthesias

Lightheadedness and paresthesias

The nurse is caring for a client whose magnesium level is 3.5 mEq/L (1.75 mmol/L). Which assessment finding should the nurse most likely expect to note in the client based on this magnesium level? Tetany Twitches Positive Trousseau's sign Loss of deep tendon reflexes

Loss of deep tendon reflexes

The client is suspected of having a skeletal muscle disorder. Which isoenzyme value reported with the creatine kinase (CK) level should the nurse assess for elevation? MM MB BB MS

MM

The nurse receives a telephone laboratory report indicating that a client with diabetes mellitus has a glycosylated hemoglobin (HgbA1c) level of 7.6%. In which priority area should the nurse plan to provide diabetic teaching? Avoidance of infection Rotation of insulin injection sites Measures to prevent hyperglycemia Avoidance of hypoglycemic episodes

Measures to prevent hyperglycemia

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which priority problem? Diarrhea Metabolic acidosis Metabolic alkalosis Hyperactive bowel sounds

Metabolic alkalosis

The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Metabolic alkalosis

The nurse caring for a client with heart failure is notified by the hospital laboratory that the client's serum magnesium level is 1.0 mEq/L (0.5 mmol/L). Which would be the most appropriate nursing action for this client? Monitor the client for dysrhythmias. Encourage increased intake of phosphate antacids. Discontinue any magnesium-containing medications. Encourage intake of foods such as ground beef, eggs, or chicken breast.

Monitor the client for dysrhythmias

A client with a history of gastrointestinal bleeding has a platelet count of 300,000 mm3 (300 × 109/L). The nurse should take which action after seeing the laboratory results? Report the abnormally low count. Report the abnormally high count. Place the client on bleeding precautions. Place the normal report in the client's medical record.

Place the normal report in the client's medical record

The nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50 and a Paco2 of 30 mm Hg (30 mm Hg). The nurse has determined that the client is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? Sodium level of 145 mEq/L (145 mmol/L) Potassium level of 3.0 mEq/L (3.0 mmol/L) Magnesium level of 1.3 mEq/L (0.65 mmol/L) Phosphorus level of 3.0 mg/dL (0.97 mmol/L)

Potassium level of 3.0

A client with diabetes mellitus has a glycosylated hemoglobin A1c level of 9%. On the basis of this test result, the nurse plans to teach the client about the need for which measure? Avoiding infection Taking in adequate fluids Preventing and recognizing hypoglycemia Preventing and recognizing hyperglycemia

Preventing and recognizing hyperglycemia

The nurse is reviewing a client's laboratory report and notes that the total serum calcium level is 6.0 mg/dL (1.66 mmol/L). 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 normal serum calcium level is 9.0 to 10.5 mg/dL (2.25 to 2.75 mmol/L). A client with a serum calcium level of 6.0 mg/dL (1.66 mmol/L) is experiencing hypocalcemia. Prolonged bed rest is a cause of hypocalcemia. Although immobilization initially can cause hypercalcemia, the long-term effect of prolonged bed rest is hypocalcemia. End-stage renal disease, rather than renal insufficiency, is a cause of hypocalcemia. Hyperparathyroidism and excessive ingestion of vitamin D are causative factors associated with hypercalcemia.

The nurse is reviewing the laboratory test results for a client who takes 325 mg of acetylsalicylic acid, or aspirin, daily and has been having frequent nosebleed episodes. What blood level should the nurse review? Hemoglobin (Hgb) Prothrombin time (PT) Red blood cell (RBC) level Partial thromboplastin time (PTT)

Prothrombin time (PT)

An anxious client is experiencing respiratory alkalosis from hyperventilation caused by anxiety. The nurse should take which action to help the client experiencing this acid-base disorder? Put the client in a supine position. Provide emotional support and reassurance. Withhold all sedative or antianxiety medications. Tell the client to breathe very deeply but more slowly.

Provide emotional support and reassurance

The clinic nurse has obtained a throat culture specimen from a client in whom a throat infection is suspected. The nurse calls the laboratory to have the specimen picked up and is told that the laboratory is short staffed and the laboratory assistant will pick up the specimen in 2 hours. Which is the appropriate nursing action? Refrigerate the specimen. Tell the client to return in 1 hour for a repeat throat culture. Contact the primary health care provider (PHCP) who prescribed the specimen. Tell the laboratory that someone needs to pick up the specimen immediately.

Refrigerate the specimen

A client has a prescription for a set of arterial blood gas (ABG) samples to be drawn on room air. The client currently is receiving oxygen by nasal cannula at a delivery rate of 3 L/min. After reading the prescription, the nurse should take which action? Remove the nasal cannula for 15 minutes; then have the ABG samples drawn. Change the nasal cannula to a shovel face mask; then have the ABG samples drawn. Leave the nasal cannula in place and have the ABG samples drawn. Change the nasal cannula to a Venturi face mask; then have the ABG samples drawn.

Remove the nasal cannula for 15 minutes

The nurse caring for a client with a diagnosis of gastrointestinal (GI) bleeding reviews the client's laboratory results and notes a hematocrit level of 30% (0.30). Which action should the nurse take? Report the abnormally low level. Report the abnormally high level. Inform the client that the laboratory result is normal. Place the normal report in the client's medical record.

Report the abnormally low level

The nurse is admitting to the hospital a client with a diagnosis of Guillain-Barré syndrome. The nurse knows that if the disease is severe, the client will be at risk for which acid-base imbalance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis

The nurse is reviewing the arterial blood gas values of a client and notes that the pH is 7.31 (7.31), Paco2 is 50 mm Hg (50 mm Hg), and the bicarbonate (HCO3) level is 26 mEq/L (26 mmol/L). The nurse concludes that which acid-base disturbance is present in this client? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis

The nurse reviews the arterial blood gas results of an assigned client and notes that the laboratory report indicates a pH of 7.30 (7.30), a Paco2 of 58 mm Hg (58 mm Hg), a Pao2 of 80 mm Hg (80 mm Hg), and an HCO3 of 26 mEq/L (26 mmol/L). The nurse should interpret this to mean that the client has which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory acidosis

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg (90 mm Hg), and HCO3- is 22 mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition? Metabolic acidosis with compensation Respiratory acidosis with compensation Metabolic acidosis without compensation Respiratory acidosis without compensation

Respiratory acidosis without compensation

A client who is found unresponsive has arterial blood gases drawn and the results indicate the following: pH is 7.12, Paco2 is 90 mm Hg (90 mmol/L), and HCO3- is 22 mEq/L (22 mmol/L). The nurse interprets the results as indicating which condition? Metabolic acidosis with compensation Respiratory acidosis with compensation Metabolic acidosis without compensation Respiratory acidosis without compensation

Respiratory acidosis without compensation

Arterial blood gas analysis yields the following results: pH 7.48 (7.48), Paco2 32 mm Hg (32 mm Hg), Pao2 94 mm Hg (94 mm Hg), HCO3 level 24 mEq/L (24 mmol/L) for a client seen in the health care clinic. The nurse interprets that the client has which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Respiratory alkalosis

The nurse reviews the arterial blood gas results of a client and notes the following: pH 7.45, Paco2 of 30 mm Hg (30 mmol/L), and HCO3- of 20 mEq/L (20 mmol/L). The nurse analyzes these results as indicating which condition? Metabolic acidosis, compensated Respiratory alkalosis, compensated Metabolic alkalosis, uncompensated Respiratory acidosis, uncompensated

Respiratory alkalosis, compensated

A client treated for an episode of hyperthermia is being discharged to home. The nurse determines that the client needs clarification of discharge instructions if the client states a need to perform which action? Increase fluid intake. Resume full activity level. Stay in a cool environment when possible. Monitor voiding for adequacy of urine output.

Resume full activity level

A client with cirrhosis is being treated for hypernatremia. On reviewing the laboratory values for the client, the nurse determines that treatment is effective if which laboratory result is noted? Urine specific gravity of 1.040 Serum sodium value of 150 mEq/L (150 mmol/L) Serum sodium value of 145 mEq/L (145 mmol/L) Serum osmolality of 300 mOsm/kg (300 mmol/kg)

Serium sodium value of 145

The nurse is reviewing the laboratory blood test results for a client and notes that the hemoglobin S (Hgb S) value is elevated. The nurse determines that this laboratory finding is associated with which condition? Aplastic anemia Sickle cell anemia Infectious mononucleosis Acute lymphocytic leukemia

Sickle Cell Anemia

The 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 result indicates a potassium level of 4.5 mEq/L (4.5 mmol/L) and a sodium level of 132 mEq/L (132 mmol/L). Based on these laboratory findings, the nurse should select which solution to use for the nasogastric tube irrigation? Tap water Sterile water Distilled water Sodium chloride

Sodium Chloride

A registered nurse (RN) has instructed an assistive personnel (AP) to administer soap suds enemas until clear to a client. The AP reports that 3 enemas have been administered and the client is still passing brown, liquid stool. What should the RN instruct the AP to do? Administer a Fleet enema. Administer an oil retention enema. Wait 30 minutes and then administer another enema. Stop administering the enemas until the primary health care provider (PHCP) is notified.

Stop administering the enemas

A child is receiving edetate calcium disodium (calcium ethylenediaminetetraacetic acid [EDTA]) by intravenous (IV) infusion for the treatment of lead poisoning. The primary health care provider (PHCP) prescribes a blood level lead concentration measurement. Which action should the nurse take to obtain the blood specimen? Stop the IV infusion for 1 hour before obtaining the blood. Irrigate the IV line with normal saline before drawing the blood. Obtain the blood specimen on the extremity that is not receiving the IV infusion. Maintain the client on NPO (nothing by mouth) status 12 hours before obtaining the blood specimen.

Stop the IV infusion for 1 hour before obtaining the blood

A client with trigeminal neuralgia who is receiving carbamazepine 400 mg orally daily has a white blood cell (WBC) count of 2800 mm3 (2.8 × 109/L), blood urea nitrogen (BUN) of 17 mg/dL (6.12 mmol/L), sodium of 141 mEq/L (141 mmol/L), and uric acid of 5 mg/dL (0.3 mmol/L). On the basis of these laboratory values, the nurse should make which interpretation? The WBC count is low, indicating a blood dyscrasia. The BUN level is elevated, indicating nephrotoxicity. The sodium level is low, indicating an electrolyte imbalance. The uric acid level is elevated, indicating the risk for renal calculi.

The WBC count is low

The nurse is caring for a client having respiratory distress related to an anxiety attack. Recent arterial blood gas values are pH = 7.53, Pao2 = 72 mm (72 mmol/L), and HCO3− = 28 mEq/L (28 mmol/L). Which conclusion about the client should the nurse make? The client has acidotic blood. The client is probably overreacting. The client is fluid volume overloaded. The client is probably hyperventilating.

The client is probably hyperventilating

A client with heart failure who has a serum potassium (K+) level of 2.9 mEq/L (2.9 mmol/L) tells the nurse that he does not feel like eating lunch. The nurse checks his serum digoxin level from that morning and notes that it is 1.0 ng/mL (1.2 nmol/L). What should the nurse determine about this digoxin level? Low Extremely toxic Within the therapeutic range Just above the high end of the therapeutic range

Whithin the therapeutic range Digoxin is a cardiac glycoside that is used to treat dysrhythmias such as atrial fibrillation in clients with heart failure. Digoxin blood levels need to be checked while the client is taking this medication to monitor for toxicity. The therapeutic range for digoxin is 0.5 to 2.0 ng/mL (0.6 to 2.4 nmol/L). Therefore, a blood level of 1.0 ng/mL (1.2 nmol/L) is within the therapeutic range. It is important to be aware that a low K+ level has an additive effect in increasing the risk of digoxin toxicity. The normal K+ level is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L).

The nurse reviews the blood gas results of a client with atelectasis. The nurse analyzes the results and determines that the client is experiencing respiratory acidosis. Which result validates the nurse's findings? pH 7.25, Paco2 50 mm Hg (50 mm Hg) pH 7.35, Paco2 40 mm Hg (40 mm Hg) pH 7.50, Paco2 52 mm Hg (52 mm Hg) pH 7.52, Paco2 28 mm Hg (28 mm Hg)

pH 7.25, Paco2 50 mm Hg