patho 1 exam 1 EAQs

Which response would the nurse make to a 30-year-old client diagnoses with hyperlipidemia and hypertension who asks the nurse to explain why treatment is important, stating "I feel fine, so I don't really see the need to make any changes."? - "Both high blood pressure and high cholesterol contribute to development of heart disease." - "Lifestyle adaptations alone will be adequate as long as you continue to be asymptomatic." - "Usually someone with these diagnoses will have symptoms of heart disease already." - "You should discuss your questions about medical problems with the health care provider."

"Both high blood pressure and high cholesterol contribute to development of heart disease."

Which instruction would the nurse use when preparing a client who successfully passed his or her renal calculus for discharge home? - "Continue to strain all urine" - "Increase your fluid intake" - "Limit dietary potassium" - "Maintain bed rest for 24 hours"

"Increase your fluid intake"

Which physiological factor helps maintain blood pressure in the client with hypovolemia? (select all that apply) - Arteriolar dilation - Release of aldosterone - Activation of angiotensin II - Sympathetic nervous system activation - Stimulation of the vagus nerve

- Arteriolar dilation - Activation of angiotensin II - Sympathetic nervous system activation

Which action would the nurse include in the plan of care for a client admitted with heart failure who has gained 20 pounds in 3 weeks? (select all that apply) - Diuretics - Low-salt diet - Daily weight checks - Fluid restriction - Intake and output - Oxygen administration

- Diuretics - Low-salt diet - Daily weight checks - Fluid restriction - Intake and output

Which signs of hypokalemia would the nurse monitor in the postoperative surgical client with a nasogastric tube attached to continuous low suction? (select all that apply) - Irritability - Dysrhythmias - Muscle weakness - Abdominal cramps - Acidosis

- Dysrhythmias - Abdominal cramps

Which clinical manifestation would the nurse include when teaching a client with heart failure about signs and symptoms that indicate a need to contact the primary health care provider? (select all that apply) - Weight loss - Extreme fatigue - Coughing at night - Excessive urination - Difficulty breathing

- Extreme fatigue - Coughing at night - Difficulty breathing

The nurse is teaching a client about a sodium-restricted diet. Which foods should the nurse encourage the client to consume? (select all that apply) - Fruits - Sliced deli meats - Condiments - Fresh vegetables - Processed cheese

- Fruits - Fresh vegetables

For which clinical manifestation will the nurse monitor for when caring for a client admitted with heart failure? (select all that apply) - Weight loss - Unusual fatigue - Dependent edema - Nocturnal dyspnea - Increased urinary output

- Unusual fatigue - Dependent edema - Nocturnal dyspnea

How would the nurse describe heart failure to a client? - A cardiac condition caused by inadequate circulating blood volume - An acute state in which the pulmonary circulation pressure decreases - An inability of the heart to pump blood in proportion to metabolic needs - A chronic state in which the systolic blood pressure drops below 90 mmHg

An inability of the heart to pump blood in proportion to metabolic needs

Which symptom would the nurse monitor for when caring for a client who has hyponatremia? - Increased urine output - Deep rapid respirations - Change in level of consciousness - Distended neck veins

Change in level of consciousness

Which condition unrelated to cardiac disease is the major cause of right ventricular failure? - Hypovolemic shock - Chronic kidney disease - Chronic obstructive pulmonary disease (COPD) - Systemic inflammatory response syndrome (SIRS)

Chronic obstructive pulmonary disease (COPD)

Which findings by the nurse when assessing a client who is receiving intravenous (IV) fluids indicates need for a change in the fluid infusion rate? - Crackles in lungs - Supple skin turgor - Urine output of 480 mL over 8 hours - Heart rate decrease from 126 beats/minute to 96 beats/minute

Crackles in lungs

Which explanation would the nurse include when teaching a client with heart failure about the reason for a low-sodium diet? - Body weight control - Decreased fluid retention - Lowering of blood pressure - Prevention of hypernatremia

Decreased fluid retention

Which action would the nurse take first when a client with heart failure reports sudden dyspnea and has bilateral crackles throughout the lungs with a respiratory rate of 32 breaths/minute? - Elevate the head of the bed to 75 degrees - Obtain the apical pulse and blood pressure - Notify the hospital Rapid Response Team - Check oxygen saturation with the pulse oximeter

Elevate the head of the bed to 75 degrees

Which electrolyte disorder would the nurse consider when a client's telemetry monitor shows flattening T waves and peaked P waves? - Hypokalemia - Hypocalcemia - Hyponatremia - Hypomagnesemia

Hypokalemia

Which type of collaborative action would the nurse anticipate the need to rapidly implement when caring for a client who has a blood pressure of 80/60 mmHg and a heart rate of 120 beats/minute after a motor vehicle accident? - Increase circulating blood volume - Administer arterial vasopressors - Stimulate increased heart rate - Correct electrolyte disturbances

Increase circulating blood volume

While in the postanesthesia care unit, a client reports shortness of breath and chest pain. Which is the most appropriate initial response by the nurse? - Initiate oxygen via a nasal cannula - Administer the prescribed morphine - Prepare the client for endotracheal intubation - Place a nitroglycerin tablet under the client's tongue

Initiate oxygen via a nasal cannula

Which element would the nurse conclude is likely to have contributed to the development of hyponatremia in an older client found unconscious at home and admitted to the hospital with the fractured hip, renal failure, and dehydration who received 3 L of intravenous fluid in the 24 hours since admission? - Reduced dietary salt intake - Intravenous fluid infusion - Potassium reabsorption rate - Increased glomerular filtration

Intravenous fluid infusion

Which meal on the client's dietary record provides the most calcium? (Breakfast: two eggs, toast, coffee; Lunch: grilled cheddar cheese sandwich, spinach salad, milk; Dinner: half breast of grilled chicken, carrots, baked potato, apple juice; Snack: strawberry yogurt, apple) - Breakfast - Lunch - Dinner - Snack

Lunch

What physiological response occurs first when a client experiences sudden hypovolemia caused by hemorrhage? - Peripheral vasoconstriction - Elevation of serum cortisol level - Release of immature erythrocytes - Increased antidiuretic hormone (ADH)

Peripheral vasoconstriction

The nurse's physical assessment of a client with heart failure reveals tachypnea and bilateral crackles. Which is the priority nursing intervention? - Obtain chest x-ray film immediately - Notify the primary health care provider - Place client in a high-Fowler position - Assess the client's oxygen saturation level

Place client in a high-Fowler position

Which laboratory result is important to communicate quickly to the health care provider? - Blood glucose 98 mg/dL (5.44 mmol/L) - Hemoglobin 14.1 g/dL (141 mmol/L) - Potassium 3.0 mEq/L (3.0 mmol/L) - White blood cell 9200/mm^3 (9.2 x 10^9 / L)

Potassium 3.0 mEq/L (3.0 mmol/L)

Which test result would the nurse anticipate in the laboratory reports of a client with a diagnosis of end-stage renal disease? - Arterial pH of 7.5 - Hematocrit of 54% - Potassium of 6.3 mEq/L (6.3 mmol/L) - Creatinine of 1.2 mg/dL (106 mcmol/L)

Potassium of 6.3 mEq/L (6.3 mmol/L)

Which prescription would the nursing questions when a client's serum sodium is 123 mEq/L (123 mmol/L)? - Add table salt to each meal - Fluid restriction of 1000 mL per day - Assess neurological status every 2 hours - Provide 0.45% sodium chloride (NaCl) intravenously at 125 mL/hr

Provide 0.45% sodium chloride (NaCl) intravenously at 125 mL/hr

Which likely cause would a nurse suspect is responsible for a drop in blood pressure after a client sustains multiple internal injuries in a motor vehicle accident and the blood pressure suddenly drops from 134/90 to 80/60 mmHg? - Reduction in the circulating blood volume - Diminished vasomotor stimulation to the arterial wall - Vasodilation resulting from diminished vasoconstrictor tone - Cardiac decompression resulting from electrolyte imbalance

Reduction in the circulating blood volume

Which nursing action is a priority before administering prescribed furosemide? - Weight the client - Assess skin turgor - Review the potassium level results - Check the 24-hour intake and output

Review the potassium level results

Which rationale supports the nurse's instruction that a client with chronic kidney disease is to avoid all salt substitutes? - A person's body tends to retain fluid when a salt substitute is included in the diet - Limiting salt substitutes in the diet prevents a buildup of waste products in the blood - Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats - The salt substitute substances interfere with capillary membrane transfer, resulting in anasarca

Salt substitutes contain potassium, which must be limited to prevent abnormal heartbeats

Which diagnostic test will the nurse use to confirm the diagnosis when hypokalemia is suspected? - Complete blood cell count - Serum potassium level - X-ray film of long bones - Blood cultures x3

Serum potassium level

Which electrolyte concentration has the potential to precipitate dysrhythmias and cardiac arrest in a client? - Serum sodium of 139 mEq/L (139 mmol/L) - Serum chloride of 100 mEq/L (100 mmol/L) - Serum calcium of 10.2 mg/dL (2.55 mmol/L) - Serum potassium of 7.2 mEq/L (7.2 mmol/L)

Serum potassium of 7.2 mEq/L (7.2 mmol/L)

Which dietary restriction will the nurse expect to be included in the plan for a client with left ventricular failure? - Sodium - Calcium - Potassium - Magnesium

Sodium

A client is experiencing persistent vomiting, and serum electrolytes have been prescribed. The nurse would monitor which laboratory results? - Sodium and chloride levels - Bicarbonate and sulfate levels - Magnesium and protein levels - Calcium and phosphate levels

Sodium and chloride levels

Which prescribed action will the nurse take first when a client is admitted to the emergency department with reports of frequent loose, watery stools and anorexia during the past week with a blood pressure of 90/68 mmHg and a pulse of 124? - Obtain blood and urine cultures - Start infusion of normal saline - Insert retention catheter - Transfer the client to intensive care unit

Start infusion of normal saline

A client with a coronary occlusion is experiencing chest pain and distress. Which is the primary reason that the nurse administers oxygen? - To prevent dyspnea - To prevent cyanosis - To increase oxygen concentration to heart cells - To increase oxygen tension in the circulating blood

To increase oxygen concentration to the heart cells

Which recommendation is important for the nurse to include in a teaching program for a client who has been placed on a 2-gram sodium diet? - Use lemon juice to season meat - Put condiments on food to add flavor - Include canned vegetables in meal preparation - Drink carbonated beverages instead of decaffeinated coffee

Use lemon juice to season meat

Which action by the nurse will be most effective in determining whether fluid overload is improving when caring for a client who was admitted with heart failure? - Weighing the client - Monitoring the intake and output - Assessing the extent of pitting edema - Asking the client about subjective symptoms

Weighing the client