PN2 Exam 1 Part 2

1. Which of these conditions results from a decreased level of carbonic acid from hyperventilation?

a. Respiratory alkalosis

1. pH 7.18, PaO2 98 mm Hg, PaCO2 45 mm Hg, and HCO3- 16 mEq/L What order will you give

a. Sodium bicarbonate 100mEq diluted in 1L of D5W

1. Who has a serum calcium level of 14 mg/dL. Which provider order does the nurse implement first?

a. This patient on a cardiac monitor

1. Cause of hypermagnesemia

a. Uncontrolled diabetes mellitus DM

1. A patient exhibits dehydration-induced confusion. Which intervention does the nurse implement first?

a. apply oxygen by mask or nasal cannula

1. If a client is retaining too much hydrogen or losing too much bicarbonate

a. metabolic acidosis

1. Respiratory acidosis

a. pH 7.25 pCO2 58mmHg

1. A cause of hypernatremia

a. Excessive intake of antacids

1. A nurse assesses patients on the medical-surgical unit. Which patient is at greatest risk for bladder cancer?

An 86-year-old male with a 50-pack-a-year cigarette smoking history

1. K+ 7.5. What should you implement first?

a. Prepare to administer dextrose 20% and 10 units of regular insulin

1. A nurse finds the patient vomiting large amounts of bright red blood on the floor, what do you do first?

a. Put on gloves

1. Which patient is at highest risk for the development of colorectal cancer?

a. A 44-year-old with IBS b. A 72-year-old who eats fast food frequently

1. Patient has a potassium level 7.5mEq/L, which prescription will the nurse implement first?

a. Administer dextrose 20% and 10 units of regular insulin

1. Which drug-lab value combination should the nurse report immediately to the healthcare provider?

a. Furosemide (Lasix)/potassium: 2.1mEq/L

1. Most common symptoms of a hiatal hernia

a. Heartburn

1. Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)?

a. Hyperkalemia

1. Chronic renal failure is experiencing muscle weakness, paresthesia, and depression

a. Hypermagnesemia

1. pH 7.50; PaCO2 30; HCO3: 24; and PaO2 68. Cause? (respiratory alkalosis)

a. Hyperventilation due to poor oxygenation

1. An older female patient has been prescribed esomeprazole for Tx of chronic gastric ulcers. What teaching is important?

a. Increase intake of calcium and vitamin D

1. pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3- 18 mEq/L what might you see (metabolic acidosis)

a. Increased rate and depth of respirations

1. To prevent aspiration during the administration of an enteral tube feeding, a nurse should...

a. Keep in an upright position

Patient is having oliguria after an acute kidney injury, what would be an appropriate nursing intervention?

a. Limit fluids based on the client's output for the day

1. What is a major function of potassium within the body?

a. Maintaining normal nerve and muscle activity

1. A patient is prescribed Furosemide (Lasix) for hypertension. Which acid-base imbalance does the nurse assess for

a. Metabolic alkalosis

1. Which category best describes the mechanism of action of sucralfate (Carafate)?

a. Mucosal barrier fortifier

1. Patient has a peptic ulcer. If patient has sudden horrible pain and rigid abdomen what do you do?

a. Notify doctor immediately

1. Which patient is at risk for hypokalemia?

a. Patient with continuous nasogastric (NG) suctioning

1. Cause of respiratory acidosis

a. Pneumothorax

1. Cause of hyponatremia

a. Prolonged vomiting and diarrhea

1. The nurse is caring for a client with hyponatremia. The nurse can identify the condition is a result of

a. Prolonged vomiting or diarrhea

1. Kussmaul's respirations. Which of the following would the nurse MOST likely have observed?

a. Respirations that are abnormally deep, regular, and fast/increased in rate

1. A patient who has gastroesophageal reflux disease (GERD) is experiencing increasing discomfort. Which patient statement to the nurse indicates that additional teaching about GERD is needed?

· "I eat small meals during the day and have a bedtime snack."

1. When do clients who have gastric ulcers MOST often complain of pain?

· 1 to 2 hours after eating

1. When teaching the client with gastritis, the nurse should include which of these instructions?

· Avoid eating at bedtime

1. A 68-yr-old male patient with a stroke is unconscious and unresponsive to stimuli. After learning that the patient has a history of gastroesophageal reflux disease (GERD), the nurse will plan to do frequent assessments of the patient's

· Breath sounds

1. A nurse cares for a patient newly diagnosed with colon cancer who has become withdrawn from family members. Which action would the nurse take?

· Encourage the patient to verbalize feelings about the diagnosis.

1. A 37-yr-old female patient is hospitalized with acute kidney injury (AKI). Which information will be most useful to the nurse in evaluating improvement in kidney function?

· Glomerular filtration rate (GFR)

1. Clients with diverticulitis will frequently complain of abdominal pain located in which area of the abdomen?

· Left lower side

1. In GERD, gastric secretions flow upward into the esophagus, damaging the tissues. This is caused by the inability of which of the below to fully close?

· Lower esophagus sphincter (LES)

1. A client is admitted with diverticulitis of 1 day's duration. Which of these nursing interventions should be included in the client's plan of care?

· Maintain NPO

1. An example of a proton pump inhibitor is

· Omeprazole

1. When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an assessment finding of

· Rapid, deep respirations

1. A client is admitted with the diagnosis Rule out appendicitis. Which nursing action is MOST important?

· avoiding administering analgesics

1. Which of these factors contributes to a client developing gastritis?

· exposure to irritating substances, i.e., ibuprofen

1. A client who has diverticulitis should be instructed to follow which of these prescribed diets when the acute episode is resolved?

· high fiber

1. Which food should the nurse encourage a client with diverticulitis to incorporate into the diet?

Broccoli

1. Which of the following laboratory findings would the nurse expect to find in a client with diverticulitis?

a. Elevated WBC

1. A patient is receiving TPN in the hospital. How often should the glucose be checked?

a. Every 4 to 6 hours

1. Cause of hypomagnesemia

a. Alcoholism

1. pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm Hg, and HCO3- 22 mEq/L. What is cause? (Respiratory alkalosis)

a. Anxiety-induced hyperventilation

1. Cause of respiratory alkalosis

a. Anxiety/hyperventilation

1. pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3- 16 mEq/L What do you do next?

a. Assess patient's rate, rhythm, and depth of respirations

1. A nurse if assessing a patient with hypokalemia, what should be assessed?

a. Assess the patient's respiratory rate, rhythm, and depth

What should you do first to assess a peptic ulcer?

a. Auscultate the client's bowel sounds in all four quadrants

1. How can you teach a patient with a hiatal hernia to reduce their symptoms?

a. Avoid lying down after meals

1. pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3- 22 mEq/L . What might cause this? (Respiratory acidosis)

a. Bronchial obstruction related to aspiration of a hotdog

1. Which information in a medical history would strongly suggest colorectal cancer?

a. Change in bowel habits

1. When a client's sodium level is low, which of the following occurs?

a. Chloride level is low

1. Which assessment data supports the client's diagnosis of gastric ulcer?

a. Complaints of pain with food and when trying to sleep

1. Laboratory results: K+ 3.4 mEq/L, Mg 1.8 mEq/L , Ca 8.5 mEq/L, what do you assess first?

a. Depth of respirations

1. The client is at risk for dumping syndrome after a partial gastrectomy. Which intervention will prevent this?

a. Eat in an upright position

1. A client is diagnosed with appendicitis. Which lab result would be abnormal?

wbc

1. A nurse prepares a patient for a colonoscopy scheduled for tomorrow. The patient states, "My provider told me that the fecal occult blood test was negative for colon cancer. I don't think I need the colonoscopy and would like to cancel it." How would the nurse respond?

· "A negative fecal occult blood test does not rule out the possibility of colon cancer."