Practice Questions / Exam 2 / NUR 113

Calcium

A patient complains of tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the patient's laboratory work has returned? Potassium Magnesium Calcium Phosphorus

Hyponatremia

A patient has a serum osmolality of 250 mOsm/kg. The nurse knows to assess further for: Hyperglycemia. Dehydration. Acidosis. Hyponatremia.

Sodium level of 150 mEq/L

A patient with diabetes insipidus presents to the emergency room for treatment of dehydration. The nurse knows to review serum laboratory results for which of the diagnostic indicators? Potassium level of 6 mEq/L Potassium level of 3.8 mEq/L Sodium level of 137 mEq/L Sodium level of 150 mEq/L

Hypokalemia

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use?

135 mEq/L (135 mmol/L)

Below which serum sodium concentration might convulsions or coma occur? 135 mEq/L (135 mmol/L) 142 mEq/L (142 mmol/L) 145 mEq/L (145 mmol/L) 140 mEq/L (140 mmol/L)

osmotic pressure exerted by proteins.

Oncotic pressure refers to the: amount of pressure needed to stop the flow of water by osmosis. osmotic pressure exerted by proteins. excretion of substances such as glucose through increased urine output. number of dissolved particles contained in a unit of fluid.

Parathyroid hormone (PTH)

The calcium concentration in the blood is regulated by which mechanism? Adrenal gland Thyroid hormone (TH) Parathyroid hormone (PTH) Androgens

Metabolic acidosis

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? Metabolic alkalosis Respiratory alkalosis Respiratory acidosis Metabolic acidosis

Light-headedness or paresthesia

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? Light-headedness or paresthesia Nausea or vomiting Hallucinations or tinnitus Abdominal pain or diarrhea

Metabolic alkalosis

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis

respiratory alkalosis

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: metabolic acidosis. metabolic alkalosis. respiratory alkalosis. respiratory acidosis.

Respiratory alkalosis

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings?

Trousseau's sign

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Goodell's sign. Homans' sign. Hegar's sign. Trousseau's sign.

Presence of Trousseau sign

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? Negative Chvostek sign Muscle weakness Slurred speech Presence of Trousseau sign

Restricting fluids to 800 ml/day

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH? Restricting sodium intake to 1 gm/day Elevating the head of the client's bed to 90 degrees Restricting fluids to 800 ml/day Administering vasopressin as ordered

Serum sodium level of 124 mEq/L

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should anticipate which laboratory test result? Hematocrit of 52% Serum sodium level of 124 mEq/L Serum creatinine level of 0.4 mg/dl Serum blood urea nitrogen (BUN) level of 8.6 mg/dl

electrocardiogram (ECG) results

A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment? bowel sounds respiratory rate electrocardiogram (ECG) results neuromuscular function

Calcium 12.9 mg/dL (3.2 mmol/L)

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation The following are the client's laboratory values. sodium 130 mEq/L (130 mmol/L) potassium 4.6 mEq/L (4.6 mmol/L) chloride 94 mEq/L (94 mmol/L) calcium 12.9 mg/dL (3.2 mmol/L) What laboratory value is consistent with the client's symptoms?

Prepare to assist with ventilation.

A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first?

malignancy is causing the electrolyte imbalance

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the malignancy is causing the electrolyte imbalance. client may be developing hyperaldosteronism. client has a history of alcohol abuse. client's diet is lacking in calcium-rich food products.

chronic respiratory acidosis

A client with emphysema is at a greater risk for developing which acid-base imbalance? chronic respiratory acidosis respiratory alkalosis metabolic alkalosis metabolic acidosis

Respiratory acidosis

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Respiratory alkalosis

Provide oral care every 2-3 hours.

A nurse is caring for a client with acute renal failure and hypernatremia. In this case, which action can be delegated to the nursing assistant? Provide oral care every 2-3 hours. Teach the client about increased fluid intake. Monitor for signs and symptoms of dehydration. Assess the client's weight daily for trends.

Hypercalcemia

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hypokalemia Hypocalcemia Hyperkalemia Hypercalcemia

Urine pH of 3.0 Normal urine pH is 4.5 to 8; therefore, a urine pH of 3.0 is abnormal and requires further investigation. Urine specific gravity normally ranges from 1.010 to 1.025, making this client's value normal. Normally, urine contains no protein, glucose, ketones, bilirubin, bacteria, casts, or crystals. Red blood cells should measure 0 to 3 per high-power field; white blood cells, 0 to 4 per high-power field. Urine should be clear, with color ranging from pale yellow to deep amber.

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? Absence of protein Absence of glucose Specific gravity of 1.02 Urine pH of 3.0

Monitoring respiratory status for signs and symptoms of pulmonary complications.

A priority nursing intervention for a client with hypervolemia involves which of the following?

osmosis

Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? filtration evaporation osmosis active transport

Metabolic acidosis The anion gap is the difference between sodium and potassium cations and the sum of chloride and bicarbonate anions. An anion gap that exceeds 16 mEq/L indicates metabolic acidosis. In this case, the anion gap is (166 + 5) − (115 + 35), yielding 21 mEq/L, which suggests metabolic acidosis. Anion gap is not used to check for respiratory alkalosis, metabolic alkalosis, or respiratory acidosis.

The client's lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap?

Hypocalcemia

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL (1.61 mmol/L). The nurse anticipates that the client will also experience which electrolyte imbalance? Hyponatremia Hyperchloremia Hypermagnesemia Hypocalcemia

155 mEq/L (155 mmol/L)

The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be 125 mEq/L (125 mmol/L) 155 mEq/L (155 mmol/L) 135 mEq/L (135 mmol/L) 145 mEq/L (145 mmol/L)

Magnesium

The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely? Magnesium Potassium Phosphorus Calcium

Confusion

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition?

Send the client for a chest x-ray.

The nurse is participating in the care of a client who had a peripherally inserted central catheter (PICC) placed in the right arm. After catheter placement, the nurse should complete which action?

Compare ABG findings with previous results. Maintain intake and output records. Document presenting signs and symptoms.

The physician has prescribed 0.9% sodium chloride IV for a hospitalized client in metabolic alkalosis. Which nursing actions are required to manage this client? Select all that apply. Compare ABG findings with previous results. Administer IV bicarbonate. Suction the client's airway. Maintain intake and output records. Document presenting signs and symptoms.

0.45% sodium chloride

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? 5% glucose in water 0.45% sodium chloride 5% glucose in normal saline solution 0.9% sodium chloride

1 L

The weight of a client with congestive heart failure is monitored daily and entered into the medical record. In a 24-hour period, the client's weight increased by 2 lb. How much fluid is this client retaining? 500 ml 1500 ml 1 L 1250 ml

Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad.

Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)? Tomato juice, low-fat cottage cheese, and three slices of bacon. Three ounces of sliced ham, beets, and a salad Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad. A frozen, packaged low-fat dinner with a side salad

pH 7.48

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? O2 saturation 95% PaCO 36 pH 7.48 HCO 21 mEq/L

Increased intracranial pressure

Which condition might occur with respiratory acidosis? Decreased pulse Decreased blood pressure Mental alertness Increased intracranial pressure

Potassium

Which electrolyte is a major cation in body fluid? Potassium Chloride Phosphate Bicarbonate

Instruct the client to breathe into a paper bag.

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Administer ordered supplemental oxygen. Administer an ordered decongestant. Offer the client fluids frequently. Instruct the client to breathe into a paper bag.

Breathing

Which is an insensible mechanism of fluid loss? Nausea Bowel elimination Breathing Urination

Generalized

You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema?

Limit sodium and water intake.

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Teach client behaviors that decrease urination. Give medications that promote fluid retention. Limit sodium and water intake. Assess for dehydration.