Missed/good review NCLEX

The nurse is assigned to care for a client with acquired immunodeficiency syndrome (AIDS) suspected of having Kaposi's sarcoma. The nurse should prepare the client for which test to confirm this diagnosis? 1.Biopsy 2.Blood culture 3.Computerized tomography 4.Magnetic resonance imaging

1

While caring for a patient with a protein deficiency, the nurse evaluates that the patient's condition is improving, based upon finding 1) decreased edema 2) decreased blood pressure 3) improved skin turgor 4) decreased hematocrit

1

When reviewing the patient s laboratory test, the health care practitioner notices that the blood urea nitrogen (BUN) level is elevated, the creatinine is normal and the potassium is slightly elevated. The patient is most likely: In early renal failure 1)dehydrated 2)suffering from diabetes 3) overhydrated 4) in early renal failure

1 Rational: An elevated BUN level with a normal creatinine is a classic sign of dehydration. The volume of blood is more concentrated, resulting in a false increase in serum potassium. The hyperkalemia is a result of fluid loss rather than an increase of potassium. With renal failure, the BUN and the creatinine levels are both elevated. The BUN lebel would be normal or low and is not affected with diabetes.

The nurse caring for a client who has undergone kidney transplantation is monitoring the client for organ rejection. Which findings are consistent with acute rejection of the transplanted kidney? Select all that apply. 1.Oliguria 2.Hypotension 3.Fluid retention 4.Temperature of 99.6°F (37.6°C) 5.Serum creatinine of 3.2 mg/dL (282 mcmol/L)

1,3,5

A CD4 T-cell count is measured in a client newly diagnosed with human immunodeficiency virus (HIV). In planning care, the nurse understands that which is accurate regarding the CD4 T-cell count? Select all that apply. 1.Falls in response to a declining viral load 2.Is a primary marker of immunocompetence 3.Plays a role in the cell-mediated immune response 4.Is a direct measure of the magnitude of HIV replication 5.Guides decision making regarding timing of initiation of treatment

2.Is a primary marker of immunocompetence 3.Plays a role in the cell-mediated immune response 5.Guides decision making regarding timing of initiation of treatment

The patient with an ileus has a nasogastric tube to suction. As the health care practitioner assists the patient up to the bedside chair, the patient complains that his legs feel very heavy, and it is difficult to walk. The most appropriate action for the health care practitioner is to: 1) Set the patient in a chair with legs elevated 2) Apply warm compresses to the legs. 3) Put the patient in bed, and check when the last laboratory test for serum potassium was done. 4) Check the laboratory value for hyperkalemia

3

Shelly is brought to the ED with an attempted aspirin overdose. What type of acid-based imbalance is most likely to result from her aspirin ingestion? 1) Respiratory Acidosis 2) Metabolic alkalosis 3) Respiratory Alkalosis 4) Metabolic acidosis

4 rational: Metabolic acidosis is the overproduction of hydrogen ions caused by aspirin toxicity.

An elderly pt with peripheral neuropathy has been taking magnesium supplements. The nurse realizes that which of the following symptoms can indicate hypermagnesaemia? 1. hypotension, warmth, & sweating 2. nausea & vomiting 3. hyperreflexia 4. excessive urination

Answer: 1 Rationale 1: Elevations in magnesium levels are accompanied by hypotension, warmth, & sweating. Rationale 2: Lower levels of magnesium are associated with nausea & vomiting. Rationale 3: Lower levels of magnesium are associated & hyperreflexia. Rationale 4: Urinary changes are not noted.

A pt is diagnosed with hyperphosphatemia. The nurse realizes that this pt might also have an imbalance of which of the following electrolytes? 1. calcium 2. sodium 3. potassium 4. Chloride

Answer: 1 Rationale 1: Excessive serum phosphate levels cause few specific symptoms. The effects of high serum phosphate levels on nerves & muscles are more likely the result of hypocalcemia that develops secondary to an elevated serum phosphorus level. The phosphate in the serum combines with ionized calcium, & the ionized serum calcium level falls.

The pt has a serum phosphate level of 4.7 mg/dL. Which interdisciplinary treatments would the nurse expect for this pt? Select all that apply. 1. IV normal saline 2. calcium containing antacids 3. IV potassium phosphate 4. encouraging milk intake 5. increasing vitamin D intake

Answer: 1,2 Rationale: Serum phosphate level of 4.7 mg/dL indicates hyperphosphatemia. IV normal saline promotes renal excretion of phosphate.

A pt is diagnosed with hypokalemia. After reviewing the pt's current medications, which of the following might have contributed to the pt's health problem? 1. corticosteroid 2. thiazide diuretic 3. narcotic 4. muscle relaxer

Answer: 1Rationale 1: Excess potassium loss through the kidneys is often caused by such meds as corticosteroids, potassium-wasting diuretics, amphotericin B, & large doses of some antibiotics.Rationale 2: Excessive sodium is lost with the use of thiazide diuretics.Rationale 3: Narcotics do not typically affect electrolyte balance.Rationale 4: Muscle relaxants do not typically affect electrolyte balance.

An elderly pt comes into the clinic with the complaint of watery diarrhea for several days with abdominal & muscle cramping. The nurse realizes that this pt is demonstrating which of the following? 1. hypernatremia 2. hyponatremia 3. fluid volume excess 4. Hyperkalemia

Answer: 2 Rationale 1: Hypernatremia is associated with fluid retention & overload. FVE is associated with hypernatremia. Rationale 2: This elderly pt has watery diarrhea, which contributes to the loss of sodium. The abdominal & muscle cramps are manifestations of a low serum sodium level. Rationale 3: This pt is more likely to develop clinical manifestations associated with fluid volume deficit. Rationale 4: Hyperkalemia is associated with cardiac dysrhythmia

The pt, newly diagnosed with diabetes mellitus, is admitted to the emergency department with nausea, vomiting, & abdominal pain. ABG results reveal a pH of 7.2 & a bicarbonate level of 20 mEq/L. Which other assessment findings would the nurse anticipate in this pt? Select all that apply. 1. tachycardia 2. weakness 3. dysrhythmias 4. Kussmaul's respirations 5. cold, clammy skin

Answer: 2,3,4 Rationale: Further assessment findings of this condition are weakness, bradycardia, dysrhythmias, general malaise, decreased level of consciousness, warm flushed skin, & Kussmaul's respirations. Rationale: These ABG results, coupled with the pt's recent diagnosis of diabetes mellitus & history of vomiting would lead the nurse to suspect metabolic acidosis. Further assessment findings of this condition are weakness, bradycardia, dysrhythmias, general malaise, decreased level of consciousness, warm flushed skin, & Kussmaul's respirations.

A 28-year-old male pt is admitted with diabetic ketoacidosis. The nurse realizes that this pt will have a need for which of the following electrolytes? 1. sodium 2. potassium 3. calcium 4. Magnesium

Answer: 4 Rationale 4: One risk factor for hypomagnesaemia is an endocrine disorder, including diabetic ketoacidosis.

A pt is admitted with burns over 50% of his body. The nurse realizes that this pt is at risk for which of the following electrolyte imbalances? 1. hypercalcemia 2. hypophosphatemia 3. hypernatremia 4. Hypermagnesemia

Correct Answer: 2 Rationale 1: Pts who experience burns are not at an increased risk for developing increased blood calcium levels. Rationale 2: Causes of hypophosphatemia include stress responses & extensive burns. Rationale 3: Pts who experience burns are not at an increased risk for developing increased blood sodium levels. Rationale 4: Pts who experience burns are not at an increased risk for developing increased blood magnesium level

When analyzing an arterial blood gas report of a pt with COPD & respiratory acidosis, the nurse anticipates that compensation will develop through which of the following mechanisms? 1. The kidneys retain bicarbonate. 2. The kidneys excrete bicarbonate. 3. The lungs will retain carbon dioxide. 4. The lungs will excrete carbon dioxide.

answer: 1 Rationale 1: The kidneys will compensate for a respiratory disorder by retaining bicarbonate. Rationale 2: Excreting bicarbonate causes acidosis to develop. Rationale 3: Retaining carbon dioxide causes respiratory acidosis. Rationale 4: Excreting carbon dioxide causes respiratory alkalosis