Exam 4

What clinical indication of hypophosphateria does the nurse assess in a patient? a. Bone pain b. Paresthesia c. Seizures d. Tetany

D

'The nurse is caring for a client with several broken ribs.The client is most likely to experience what type of acidbase imbalance? 1. Respiratory acidosis from inadequate ventilation 2. Respiratory alkalosis from anxiety and hyperven- tilation 3. Metabolic acidosis from calcium loss due to bro- ken bones 4. Metabolic alkalosis from taking analgesics contain- ing base products

1

19. The patient with respiratory failure is receiving me- chanical ventilation and continues to produce arte- rial blood gas results indicating respiratory acidosis.Which change in ventilator setting should the nurse 1. Increase 6-10 2. Decrease in ventilator rate from 10 to 6 breaths/min 3. Increase in oxygen concentration from 30% to 40% 4. Decrease in oxygen concentration from 40% to 30%

1

26. The patient has an order for hydrochlorothiazide HCTZ) 10 mg orally every day. What should the nurse be sure to include in a teaching plan for this 1. Take in the morning 2. "This medication should be taken in two divided doses: half when you get up and half when you go to bed.» 3. Eat foods with extra sodium every day." 4. "Inform your health care provider (HCP) if you notice weight gain or increased swelling. 5. You should expect your urine output to increase." 6. "Your HCP may also prescribe a potassium supplement."

1

30. The nurse is providing care for several patients who are at risk for acid-base imbalance. Which patient is most at risk for respiratory acidosis? 1. A 68-year-old patient with chronic emphysema 2. A 58-year-old patient who uses antacids every day 3. A 48-year-old patient with an anxiety disorder 4. A 28-year-old patient with salicylate intoxication

1

43. The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of hypocalcemia. Which clinical manifestation would the nurse expect to note in the client? 1. Twitching 2. Hypoactive bowel sounds 3. Negative Trousseau's sign 4. Hypoactive deep tendon reflexes

1

46. Which dient is at risk for the development of a sodium level at 130 mEg/L (130 mmol/L)? 1. The dient who is taking diuretics 2. The client with hyperaldosteronism 3. The client with Cushing's syndrome 4. The dient who is taking corticosteroids

1

50. The nurse is assigned to care for a group of cliens On review of the clients' medical records, the nurse determines that which dient is most likely at rist for a fluid volume deficit? 1. A dient with an ileostomy 2. A client with heart failure 3. A client on long-term corticosteroid therapy 4. A client receiving frequent wound irrigations

1

51. The nurse caring for a client who has been receiving intravenous (IV) diuretics suspects that the client is experiencing a fluid volume deficit. Which assess- ment finding would the nurse note in a client with this condition? 1. Weight loss and poor skin turgor 2. Lung congestion and increased heart rate 3. Decreased hematocrit and increased urine output 4. Increased respirations and increased blood pressure

1

A patient is admitted to the oncology unit for chemo- therapy. To prevent an acid-base problem, which find- ing would the nurse instruct the assistive personnel to report? 1. Repeated episodes of nausea and vomiting 2. Reports of pain associated with exertion 3. Failure to eat all the food on the breakfast tray 4. Patient hair loss during the morning bath

1

A patient with lung cancer has received oxycodone 10 mg orally for pain. When the student nurse assesses the patient, which finding would the nurse instruct the student nurse to report immediately? 1. Respiratory rate of 8 to 10 breaths/min 2. Decrease in pain level from 6 to 2 (on a scale of 1 to 10) 3. Request by the patient that the room door be closed 4. Heart rate of 90 to 100 beats/min

1

A patient's potassium level is 6.7 mEg/L (6.7 mmol/L). Which intervention should the nurse del- egate to the first-year student purse under his or her supervision? (1. )Administer sodium polystyrene sulfonate 15 g orally. 2. Administer spironolactone 25 mg orally. 3. Assess the electrocardiogram (ECG) strip for tall Twaves. 4. Administer potassium 10 mEq (10 mmol/I) orally.

1

The patient is at risk for poor perfusion related to de- creased plasma volume. Which assessment finding supports this risk? 1. Flattened neck veins when the patient is in the su- pine position 2. Full and bounding pedal and post-tibial pulses 3. Pitting edema located in the feet, ankles, and calves 4. Shallow respirations with crackles on auscultation

1

The student nurse, under the supervision of an RN, is reviewing a patient's arterial blood gas results and notes an acute increase in arterial partial pressure of carbon dioxide (Pac0) to 51 mm Hg compared with the previous results. Which statement by the student nurse indicates an accurate understanding of the acid-base balance for this patient? 1. When the Paco, is acutely elevated, the blood pH should be lower than normal." 2.This patient should be taught to breathe and re breathe in a paper bag. 3. *An elevated Paco, always means that a patient has an acidosis. 4. "When a patient's Paco2 is increased, the respira- tory rate should decrease to compensate.

1

IVPB antibiotic needs to infusé over 30 minutes. The IVPB bag contains 50 mL. Calculate the setting for the infusion pump.

100

1. The nurse should assess the patient for signs of lethargy, increasing intracranial pressure, and seizures when the serum sodium reaches what level? a)115 mEg/L b. 130 mEg/L c. 145 mEg/L d. 160 mEg/L

115

nursing plan of care for an older patient with dehydration includes interventions for oral health. Which interventions are within the scope of practice for an LP/LVN being supervised by an RN? Select all that apply. 1JReminding the patient to avoid commercial mouthwashes (2) Encouraging mouth rinsing with warm saline 3. Assessing skin turgor by pinching the skin over the back of the hand (4 Observing the lips, tongue, and mucous membranes 5. Providing mouth care every 2 hours while the pa- tient is awake 6. Seeking a dietary consult to increase fluids on meal trays

1245

Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia. Which actions should the nurse take to plan for preparation and administration of the potassium?SATA 1.Obtain an intravenous (IV) infusion pump. 2. Monitor urine output during administration. 3. Prepare the medication for bolus administration. 4. Monitor the IV site for signs of infiltration or phlebitis. 5. Ensure that the medication is diluted in the appropriate volume of fluid. 6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.

12456

32. The nurse is completing a history for an older patient at risk for an acidosis imbalance. Which questions would the nurse be sure to ask? Select all that apply. 1.Which drugs do you take on a daily basis?" 2.Do you have any problems with breathing?" .3. When was your last bowel movement?" 4. "Have you experienced any activity intolerance or fatigue in the past 24 hours?" 5. "Over the past month have you had any dizziness or tinnitus?" 6. "Do you have episodes of drowsiness or decreased alertness?"

1246

nurse notes that a client's arterial blood gas (ABG) results reveal a pH of 7.50 and a Paco, of 30 mm Hg (30 mm Hg). The nurse monitors the client for which clinical manifestations associated with these ABG SATA 1. Nausea I 2. Confusion a 3. Bradvonea 4. Tachycardia 5. Hyperkalemia 6. Lightheadedness

1246

41. The nurse reviews a client's electrolyte labora- tory report and notes that the potassium level is 2.5 mEg/L (2.5mmol/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

134

12. The charge nurse assigned the care of a patient with acute kidney failure and hypernatremia to a newly grad- uated R. Which actions can the new RN delegate to the assistive personnel (AP)? Select all that apply. (1) Providing oral care every 3 tò 4 hours 2. Monitoring for indications of dehydration 3. Administering 0.45% saline by IV line 4. Recording urine output when patient voids 5. Assessing daily weights for trends 6. Helping the patient change position every 2 hours

146

3. A patient who is semiconscious presents with restlessness and weakness. The nurse assesses a dry, swollen tongue and a body temperature of 99.3°F. The urine specific gravity is 1.020. What is the most likely serum sodium value for this patient? a. 110 mEq/L b. 140 mEq/L c. 155 mEq/L d. 165 mEq/L

155

Nurse caring for patient with tonic clinic seizure with periods of apnea. The nurse must be alert for which acid-base imbalance? 1. Respiratory alkalosis 2. Respiratory acidosis 3. Metabolic alkalosis 4. Metabolic acidosis

4

13. An experienced LP/LVN reports to the RN that a patient's blood pressure and heart rate have de- creased and that when his face was assessed, one side twitched. What action should the RN take at this time? 1Reassess the patiant's blood pressure and heart rate. 2.Review the patient's morning calcium level. 3. Request a neurologic consult today. 4. Check the patient's pupillary reaction to light.

2

25. The patient has a nasogastric (NG) tube connected to intermittent wall suction. The student nurse asks why the patient's respiratory rate and depth has decreased. What is the nurse's best response? 1. "It's common for patients with uncomfortable Common Health scenarios equipment such as NG tubes to have a lower rate of breathing." 2. "The patient may have a metabolic alkalosis because of the NG suctioning, and the decreased respira- tory rate is a compensatory mechanism. 3. Whenever a patient develops a respiratory acid- base problem, decreasing the respiratory rate helps correct the problem. 4. "The patient is hypoventilating because of anxiety, and we will have to stay alert for the development of respiratory acidosis."

2

27. Which blood test result would the nurse be sure to monitor for the patient taking hydrochlorothiazide (HCTZ)? 1. Sodium level 2. Potassium level 3. Chloride level 4. Calcium level

2

33. Which specific instruction does the charge nurse give the assistive personnel helping to provide care for a patient who is at risk for metabolic acidosis? 1. Check to see that the patient keeps his oxygen in place at all times. 2. Inform the nurse immediately if the patient's respi- ratory rate and depth increases. 3. Record any episodes of reflux or constipation. 4. Keep the patient's ice water pitcher filled at all times.

2

40. The nurse reviews a client's record and determines that the dient is at risk for developing a potassium deficit if which situation is documented? 1 Sustained tissue damage 2. Requires nasogastric suction 3. Has a history of Addison's disease 4. Uric acid level of 9.4 mg/dL (557 mcmol/L)

2

The assistive personnel (AP) reports to the nurse that a patient seems very anxious, and vital sign measurement included a respiratory rate of 38 breaths/min. Which acid-base imbalance should the nurse suspect? 1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis

2

The nurse has been floated to the telemetry unit for the day. The monitor technician informs the nurse that. the patient has developed prominent U waves. Which laboratory value should be checked immediately? 1. Sodium 2. Potassium 3. Magnesium 4. Calcium

2

The nurse is caring for a client who is on a mechanical ventilator. Blood gas results indicate a pH of 7.50and a Paco, of 30 mm Hg (30 mm Hg). The nurse has determined that the dient is experiencing respiratory alkalosis. Which laboratory value would most likely be noted in this condition? 1. Sodium level of 145 mEg/L (145 mmol/L) Potassium level of 3.0 mEg/L (3.0 mmol/L) 3. Magnesium level of 1.8 (0.74 mmol/L) 4. Phosphorus level of 3.0 mg/dL (0.97 mmol/L)

2

The nurse reviews blood gas results PH7.45, PacO2 30mhgHCO3 20 these results as indicating whil) condition? 1. Metabolic acidosis, compensated 2. Respiratory alkalosis, compensated 3. Metabolic alkalosis, uncompensated 4. Respiratory acidosis, uncompensated

2

The patient has fuid volume deficit related to excessive Quid loss. Which action related to fuid management hould be delegated by the RN to the assistive person- el (AP)? 1. Administering IV Auids as prescribed by the health care provider 2 Providing straws and offering fluids between meals 3. Developing a plan for added fluid intake over 24 hours 4. Teaching family members to assist the patient with Auid

2

Which patient would the charge nurse assign to the step-down unit nurse who was floated to the intensive care unit for the day? 1. A 68-year-old patient on a ventilator with acute resp failure and respiratory acidosis 2. 72-year-old patient with chronic obstructive pulmonary discase (COPD) and normal blood gas values who is ventilator dependent 3. A newly admitted 56-year-old patient with dia- betic ketoacidosis receiving an insulin drip 4. A 38-year-old patient on a ventilator with narcotic overdose and respiratory alkalosis

2

is. The muse is caring for a client with a ng tube That is altached to low suction. The nurse monitors for manifestations of which disorder that the clent is at risk for? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2

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

2 4

20. Which actions should the nurse delegate to an assis- tive personnel (AP) for the patient with diabetic keto- acidosis? Select all that apply. 1 Checking fingerstick glucose results every hour 2. Recording intake and output every hour 3 Measuring vital signs every 15 minutes 4. Assessing for indicators of Auid imbalance 5. Notifying the health care provider of changes in glucose level 6) Assisting the patient to reposition every 2 hours

236

A patient's serum sodium concentration is within the normal range. What should the nurse estimate the serum osmolality to be? a. <136 mOsm/kg b. 275 to 300 mOsm/kg c. >408 mOsm/kg d. 350 to 544 mOsm/kg

275-300

39. 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? 1. Weight loss and dry skin 2. Flat neck and hand veins and decreased urinary output 3. An increase in blood pressure and increased respirations 4. Weakness and decreased central venous pressure (CVP)

3

M. A patient is admitted to the unit with a diagnosis of syndrome of inappropriate antidiuretic hormone se- cretion (SIADHI). For which electrolyte abnormality would the nurse be sure to monitor? 1. Hypokalemia 2 Hyperkalemia (3) Hyponatremia 4. Hypernatremia

3

The RN is admitting a patient with benign prostatic hyperplasia to an acute care unit. The patient describes an oral intake of about 1400 mL/day. What is the RN's priority concern? 1. Ask the patient about his bowel movements. 2. Have the patient complete a diet diary for the past 2 days. (3.) Instruct the patient to increase oral intake to 2 to 3 L/day. 4. Ask the patient to describe his urine output.

3

The nurse is caring for a client with heart failure whois receiving high doses of a diuretic. On assessment,the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deeptendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in a client with hyponatremia? 1. Muscle twitches 2. Decreased urinary output 3. Hyperactive Dowel sounds 4. Increased specitic gravity of the urine

3

The nurse is reading a primary health care provider) progress notes in the clients record and reads that the PHCP has documented "insensible LiQuid loss of approximately 800 mL daily.The nurse makes a notation that insensible fluid loss occurs through which type of excretion? 1. Urinary output 2. Wound drainage 3. Integumentary output 4. The gastrointestinal tract

3

Which statement related to dehydration made by a patient with hypovolemia is the best indicator to the nurse of the need for additional teaching? 1. "I will drink 2 to 3 L of fluids every day." 2. "I will drink a glass of water whenever I feel thirsty." (3. I will drink coffee and cola drinks throughout the day." 4. "I will avoid drinks containing alcohol."

3

45. The nurse reviews the electrolyte results of a client with chronic kidney disease 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

35

15. Which prescription for a patient with hypercalcemia would the nurse question? 1. 0.9% saline at 50 mL/hr IV 2. Furosemide 20 mg orally each morning 3. Apply cardiac telemetry monitoring. (4. Hydrochlorothiazide (HCTZ) 25 mg orally each morning

4

21. The nurse is admitting an older adult patient to the acute care medical unit. Which assessment factor alerts the nurse that this patient has a risk for acid- base imbalances? 1. History of myocardial infarction (MI) 1 year ago 2. Antacid use for occasional indigestion 3.Shortness of breath with extreme exertion (4. )Chronic renal insufficiency

4

52. On review of the clients' medical records, the nursedetermines that which client is at risk for fluid volume excess? 1. The client taking diuretics who has tenting of the skin 2. The client with an ileostomy from a recent abdomi- nal surgery 3. The client who requires intermittent gastrointestinal suctioning 4. The client with kidney disease and a 12-year history of diabetes mellitus

4

53. Which client is at risk for the development of a potassium level of 5.5 mEg/L (5.5 mmol/L)? 1. The client with colitis 2. The dient with Cushing's syndrome 3. The dient who has been overusing laxatives 4. The dient who has sustained a traumatic burn

4

7. The health care provider has written these orders for a patient with a diagmosis of pulmonary edema. The paitent's morning assessment reveals bounding peripheral pulses, a weight gain of 2 lb, pitting ankle edema, moist crackles bilaterally. Which order takes priority at this time? 1. Weigh the patient every morning. 2. Maintain accurate intake and output records. 3. Restrict fluids. to 1500 mL/day. 4. Administer furosemide 40 mg IV push.

4

A client with a 3-day history of nausea and vomiting presents to the emergency department. The dienti 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 nure reviews the results, expecting to note which finding 1. A decreased pH and an increased Paco2 2. An increased pHI and a decreased Paco2 3. A decreased pH and a decreased HCO3 4. An increased pH and an increased HCO3

4

The RN is providing care for a patient diagnosed with dehydration and hypovolemic shock. Which prescribed intervention from the health care provider should the R question? 1. Blood pressure every 15 minutes 2. Place two 18-gauge IV lines. 3.Oxygen at 3 L via nasal cannula 4. IV 5% dextrose in water (DaW) to run at 250 mU/hr

4

The RN is reviewing the patient's morning laboratory results. Which of these results is of most concern? 1. Serum potassium level of 5.2 mEg/L (5.2 mmol/L) 2. Serum sodium level of 134 mEq/L (134 mmolL) 3. Serum calcium level of 10.6 mg/dL (2.65 mmolL) (4) Serum magnesium level of 0.8 mEg/L (0.4 mmo/L)

4

The assistive personnel (AP) reports to the nurse that a patient's urine output for the past 24 hours has been only 360 mL. What is the nurse's priority action at

4. Contact and notify the health care provider immediately.

44. The nurse is caring for a client with Crohn's disease who has a calcium level of 8 mg/dL (2mmol/L). Which patterns would the nurse watch for on the electrocardio- gram? Select all that apply. 1. U waves 2. Widened T wave 3. Prominent U wave 4. Prolonged QT interval 5. Prolonged ST segment

45

The nurse is preparing to discharge a patient whose calcium level was low but is now just barely within normal range (9 to 10.5 mg/dL [2.25 to 2.63 mmol/L]). Which statement by the patient indicates the need for additional teaching? 1. "I will call my doctor if I experience muscle twitching or seizures." 2. "I will make sure to take my vitamin D with my calcium each day." 3. "I will take my calcium citrate pill every morning before breakfast." 5. VI will avoid dairy products, broccoli, and spinach when I eat."

5

In a patient with excess fluid volume, hyponatremia is treated by restricting fluids to how many milliliters in 24 hours? a. 400 b. 600 (c.) 800 d. 1200

800

14. The healthcare provider has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? a. 0.45% sodium chloride b. 0.90% sodium chloride c. 5% dextrose in water d. 5%6 dextrose in normal saline solution

A

6. The nurse notes that a patient's urine osmolality is 980 mOsm/kg. What should the nurse assess as a possible cause of this finding? a. Acidosis b. Fluid volume excess c. Diabetes insipidus d. Hyponatremia

A

A charge nurse is teaching a group of nurses about conditions related to metabolic acidosis Which of the following statements by a unit nurse indicates the teaching has been effective? "Metabolic acidosis can occur due to diabetic ketoacidosis: *Metabolic acidosis can occur in a client who has myasthenia gravis "Metabolic acidosis can occur in a client who has asthma. "Metabolic acidosis can occur due to cancer;

A

A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the following conditions as being associated with this electrolyte imbalance? A. Diabetic ketoacidosis B. Heart failure C. Cushing's syndrome D. Thyroidectomy

A

A nurse is caring for a client who has a blood potassium 5.4 mEg/L. The nurse should assess for which of the following manifestations? A. ECG changes B. Constipation C. Polyuria D. Paresthesia

A

A nurse is caring for a client who was in a motor-vehicle accident. The client reports chest pain and difficulty breathing. A chest x-ray reveals the client has a pneumothorax. Which of the following arterial blood gas findings should the nurse expect? A. pH 7.06 PaO86 mm Hg PaCO: 52 mm Hg HCO-24 mEq/L B. pH 7.42 Pa©a 100 mm Hg PaCO, 38 mm Hg HCO, 23 mEq/L C. pH. 6,98 Pa©: 100 mm Hg PaCO, 30 mm Hg HCO, 18 mEq/L D. pH 7.58 PaO, 96 mm Hg PaCO, 38 mm Hg HO, 29 mEQ/L

A

Administration of a hypertonic intravenous fluid would result in which of the following? (a) Cellular shrinkage b. Cellular swelling c. Dependent edema d. Dehydration

A

What foods would you recommend for a patient with hypokalemia a. Fruits such as bananas and apricots b. Green, leafy vegetables c. Milk and yogurt d. Nuts and legumes

A

patient with abnormal sodium losses is receiving a regular diet. How can the nurse supplement the patient's diet to provide 1600 mg of sodium daily? a. One beef cube and 8 oz of tomato juice b. Four beef cubes and 8 oz of tomato juice c. One beef cube and 16 oz of tomato juice d. One beef cube and 12 oz of tomato juice

A

11. The following IV is to be given: 1000 mL D,W with 20 mEq potassium chloride (KCI) over the next 24 hours. The tubing drop factor is 15. a. At what rate will the KC1 be administered? b. What will the gtt/min be?

A 42 B 11

A nurse is caring for a patient with a diagnosis of hyponatremia what nursing intervention is appropriate select all that apply A Assessing for nausea and Mallies b innuraging the intake of low-sodium liquid c. Monitoring neurologic status d. Restricting tap water intake e Encouraging the use of salt substitute instead of salt

A C D

What laboratory findings does the nurse determine are consistent with hypovolemia in a female patient? (Select all that apply.) a. Hematocrit level of >47% b. BUN: serum creatìnine ratio of >12.1 c. Urine specific gravity of 1.027 d. Urine osmolality of >450 mOsm/kg e. Urine positive for blood

A,C,D

A nurse is admitting a client reporting , nause, vomiting, and weakness: The client has dry oral mucous membranes, and blood pressure 902/64 mm Hg. Which of the following findings should the nurse identily as manifestations p9* Nuid volume deficit? (Select all that apply) A. Decreased skin turgor B. Concentrated urine D. Low-grade fever E. Tachypnea

ABDE

A nurse is admitting an older adult client who repos a weight gain of 2.3 kg (5 b) in 48 hr. Which of the following manifestations of fluid volume excess should the nurse expect? (Select all that apply) A. Dyspnea B. Edema C. Bradycardia D. Hypertension E. Weakness

ABDE

Which are common uses of crystalloids? (Select all that apply.) a. Fluid replacement b. Promotion of urinary flow C. Transport of oxygen to cells d. Replacement of electrolytes e. As maintenance fluids f. Replacement of clotting factors

ABDE

3. A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning. The nurse should monitor for which of the following electrolyte imbalances? A. Hypercalcemia B. Hyponatremia C. Hyperphosphatemia D. Hyperkalemia

B

7. A patient is receiving conivaptan. Which action by the nurse is appropriate? a. Administer the drug by slow IV push over 10 minutes. b. Report serum sodium levels of 149 mEg/L (c.) Monitor for hyperkalemia. d. Implement measures to prevent constipation.

B

7. The nurse is reviewing the laboratory studies for a patient suspected of acute kidney injury: What test would be the best indicator of the patient's renal function? a. Blood urea nitrogen b. Serum creatinine c. Specific gravity d. Urine osmolality

B

A nurse is caring for a client admitted with confusion and lethargy, The client was found at home unresponsive with an empty bottle of aspirin vina next to the bed. Vital sins reveal biood pressure 104/72 mm Ha, heart rate 116/min with reqular rhythm, and respiratory rate 44/min and deep. Which of the following arterial blood gas findings should the nurse expect? A pH 7.68 PaO: 96 mm Hg PaCO; 38 mm Hg HCO, 28 mEq/L B pH 7.48 PaO; 100 mm Hg PaCO; 28 mm Hg HO,- 23 mEq/L C. pH 6.98 PaO: 100 mm Hg PaCO: 30 mm Hg HCO, 18 mEq/L D. pH 7.58 PaO, 96 mm Hg PaCO, 38 mm Hg HCO, 29 mEq/L

B

Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis a. Sodium bicarbonate b. Magnesium sulfate c. Furosemide (Lasix) d. Calcium gluconate

B

Which of the following outcomes would be appropriate for the patient receiving patiromer? a. Increased serum sodium b. Decreased serum potassium c. Increased serum magnesium d. Decreased serum calcium

B

nurse monitors for which signs of a possible transfusion reaction when a patient is receiving blood products? a. Subnormal temperature and hypertension b. Apprehension, restlessness, fever, and chills c. Decreased pulse and respirations and fever d. Headache, nausea, and lethargy

B

patient is admitted with a diagnosis of kidney injury. The patient reports "stomach distress" and describes ingesting several antacid tablets over the past 2 days. Blood pressure is 110/70 mm Hg, face is flushed, and the patient is experiencing generalized Weakness. Which is the most likely magne- sium level associated with the symptoms the patient has a. 11 mEq/L b. 5 mEq/L c. 2 mEq/L d. 1 mEq/L

B

patient with a blood disorder needs a replacement product that contains clotting factors. The nurse expects which product to be given? a. Albumin b. Fresh frozen plasma C packed RBC D 0.9 NS

B

A patient has been involved in a traumatic accident and is hemorrhaging from multiple sites. The nurse expects that the compensa- tory mechanisms associated with hypovole- mia would cause what clinical manifestations? (Select all that apply.) (a.) Hypertension b. Oliguria c. Tachycardia d. Bradycardia e. Tachypnea

B c E

13. The nurse is caring for a patient with hyper- natremia, What complication of hypernatre- mi should the nurse continuously monitor for? a. Red blood cell crenation b. Red blood cell hydrolysis c. Cerebral edema d. Kidney injury

C

2. The intravenous order for a newly admitted patient calls for "Normal saline to run at 100 mL/hr." The nurse will choose which concentration of normal saline? a. 0.33% b. 0.45% C. 0.9% d. 3.0%

C

21. The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicar- bonate concentration should the nurse assess for? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis

C

5. The nurse is reviewing the laboratory studies for a group of patients. Which patient is most likely to experience a decrease in serum osmolality? a. A patient with diabetes insipidus b. A patient with a glucose level of 360 mg/dL c. A patient with kidney failure d. A patient with uremia

C

9. The nurse would anticipate the administration of which of the following in the patient with a potassium level of 5.9 mEg? a. Furosemide b. Sodium chloride C Magnesium sulfate D sodium polystyrene sulfonate

C

A nurse is assessing a client for Chvostek's sign. Which of the following techniques should the nurse use to perform this test? A. Apply a blood pressure cuff to the client's arm. B. Place the stethoscope bell over the client's carotid artery. C. Tap lightly on the client's cheek D. Ask the client to lower their chin to their chest.

C

A patient with mild fluid volume excess is prescribed a diuretic that blocks sodium reab sorption in the distal tubule, Which diuretic does the nurse anticipate administering to this patient? a. Bumetanide b. Torasemide c. Hydrochlorothiazide d. Furosemide

C

The patient has had severe vomiting for 24 hours The nurse observes flat tea waves and ST segment depression. Which potassium level a. 4.0 mEq/t b. 8.0 mEq/L c. 2.0 mEq/L d. 2.6 mEq/L

C

When giving intravenous potassium, which is important for the nurse to remember? a. Intravenous doses are preferred over oral dosage forms. b. Intravenous solutions should contain at least 50 mEq/L. (c) Potassium must always be given in diluted form. d. It is given by slow intravenous bolus.

C

3. A nurse is assessing a client who is dehydrated. Which of the following findings should the nurse expect? A. Moist skin B. Distended neck veins C. Increased urinary output D. Tachycardia

D

3. A patient has been admitted with severe dehydration after working outside on a very hot day. The nurse expects which intravenous product to be ordered? a. Albumin b. Hetastarch c. Fresh frozen plasma d 0.9% sodium chloride

D

4. A nurse is caring for a client in a long-term care facility who has become weak, confused, and experienced dizziness when standing. The client's temperature is 38.3° C (100.9° F), pulse 92/min, respirations 20/min, and blood pressure 108/60 mm Hg. Which of the following actions should the nurse take? A. Initiate fluid restrictions to limit intake. B. Check for peripheral edema. C. Encourage the client to ambulate to promote oxygenation, D. Monitor for orthostatic hypotension.

D

A nurso is obtaining arterial blood gas to a client who has vomited for 24 hr The nurse should exprect which the following acid base imbalances to result in vomiting for 24hr A Respiratory acidosis B. Respiratory alkalosis C Metabolic acidosis D. Metabolic alkalosis

D

5. A nurse is assessing a client who has pancreatitis The client's arterial blood gases reveal metabolic acidosis. Which of the following are expected findings? (Select all that apply) A. Tachycardia B. Hypertension C. Bounding pulses D. Hyperreflexia E. Dysrhythmia F. Tachypnea

E F