NUR 113 Test 1

Which urine specific gravity level is abnormal? A. 1.006 B. 1.012 C. 1.028 D. 1.041

D Rationale: The normal specific gravity of urine lies between 1.005 and 1.030. A specific gravity value of 1.041 is higher than the normal range; therefore it's abnormal.

Which clinical manifestations would the nurse identify when assessing a client with hypercalcemia? SATA A. Muscle tremors B. Abdominal cramps C. Increased peristalsis D. Cardiac dysrhythmias E. Hypoactive bowel sounds

D, E Rationale: When the serum calcium level is increased, initially it causes tachycardia; as it progresses, it depressed electrical conduction in the heart, causing bradycardia. Hypercalcemia causes decreased peristalsis identified by constipation and hypoactive or absent bowel sounds. Muscle tremors, abdominal cramps, and increased intestinal peristalsis occur with hypocalcemia, not hypercalcemia.

When a client's telemetry monitor shows flattening T-waves and pealed P-waves, which electrolyte disorder would the nurse consider based on these ECG changes? A. Hypokalemia B. Hypocalcemia C. Hyponatremia D. Hypomagnesemia

A Rationale: Flattened or inverted T waves, peaked P waves, depressed ST segments, and elevated U waves are associated with hypokalemia. Prolongation of the QT interval may indicate hypocalcemia. Hyponatremia is not reflected in the heart's electrical conduction. Although flattening of T waves may occur with hypomagnesemia, the ST segment may be shortened, and the PR and QRS intervals may be prolonged.

A client with the diagnosis of Cushing syndrome has the following lab results: Na+ 149mEq/L; K+ 3.2 mEq/L, Hb 17 g/dL, and glucose 90 mg/dL. Based on these lab results, which instructions would the nurse include in the teaching plan for this client? SATA A. Avoid foods high in salt B. Restrict your fluid intake C. Eat foods high in potassium D. Limit your carb intake E. Continue your regular diet as before

A, C Rationale: Based on the lab results and not directly related to the client's chronic medical condition, dietary recommendations are as follows: A sodium level of more than 145 mEq is considered hypernatremia; the client should be taught to avoid foods high in sodium. A potassium level less than 3.5 mEq/L is considered hypokalemia. The client should be encouraged to eat foods high in potassium. Restricting fluid intake will increase the serum sodium level and is contraindicated. A glucose level of 90 mg/dL is within the expected range of less than 110 mg/dL and is not a concern. The lab results for serum sodium and serum potassium are not within the expected. agues, and the client should be taught how to alter the diet.

A client has been admitted with a diagnosis of intractable vomiting and can tolerate only sips of water. The initial blood work shows a sodium level if 122 mEq/L and a potassium level of 3.6 mEq/L. The client is likely experiencing which condition? A. Hypernatremia B. Hyponatremia C. Hyperkalemia D. Hypokalemia

B Rationale: The normal range for serum sodium is 135 to 145 mEq/L and for serum potassium it is 3.5 to 5 mEq/L. Vominitng and the use of diuretics, such as furosemide, deplete the body of sodium. W/o intervention, symptoms of hyponatremia may progress to include neurologic symptoms such as confusion, lethargy, seizures, and coma.

Which clinical indicator(s) would the nurse expect a client with hyperkalemia to exhibit? SATA A. Tetany B. Seizures C. Confusion D. Weakness E. Dysrhythmias

C, D, E Rationale: Tetany is caused by hypocalcemia. Seizures caused by electrolyte imbalances are associated with low calcium or low sodium levels. Because of potassium's role in the Na/K pump, hyperkalemia will cause confusion, weakness, and cardiac dysrhythmias.

Which assessment finding in a client signifies a mild form of hypocalcemia? A. Seizures B. Hand spasms C. Sever muscle cramps D. Numbness around the mouth

D Rationale: A numbness or tingling sensation around the mouth or in the hands and feet indicates mild to moderate hypocalcemia. Seizures, hand spasms, and severe muscle cramps are associated with sever hypocalcemia.

Which clinical finding would the nurse associate with hypokalemia? A. Edema B. Muscle spasms C. Kussmaul respirations D. Muscle weakness

D Rationale: Serum hypokalemia diminishes the magnitude of neuronal and muscle cell resting potentials. This can result in observable muscle weakness. Edema is associated with electrolyte imbalances, including hypernatremia. Muscle spasms and twitching are often seen in the setting of hypocalcemia. Kussmaul respiration is a breathing pattern characterized by deep and labored breaths in response to metabolic acidosis, especially diabetic ketoacidosis.

When the clinic nurse is teaching a group of clients with heart failure about dietary interventions to prevent fluid overload, which topic will be included? A. Fluid intake restrictions B. Low-calorie diet for weight loss C. Avoidance of high-fat, high-cholesterol foods D. Use of fresh or frozen veggies instead of canned ones

D Rationale: The key principle to teach HF clients is the importance of decreasing sodium in their diet and which foods contain sodium. If sodium is decreased, water retention will decrease also. Fresh or frozen veggies have less sodium than canned ones. Most HF clients do not need to restrict fluid intake. A low-calorie diet is needed for overweight clients but does not improve volume status. Avoidance of high-fat and high-cholesterol foods is important to prevent coronary artery disease but will not prevent fluid overload.