Adult Health Final Exam PrepU Questions
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:
"As the disease progresses, you will most likely require renal replacement therapy."
The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer?
0.45% sodium chloride
Which is considered an isotonic solution?
0.9% normal saline
The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of:
1,500 mL of fluid
A patient has missed 2 doses of digitalis. What laboratory results would indicate to the nurse that the patient is within therapeutic range?
2.0 mg/mL
1. A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of:
280 mOsm/kg.
A client has been diagnosed with systolic heart failure. What percentage will the nurse expect the patient's ejection fraction to be?
30%
Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?
6
The following clients are in need of exercise electrocardiography. Which client would the nurse indicate as most appropriate for a drug-induced stress test?
A 55-year-old recovering from a fall and broken femur
The nurse is assessing a patient who reports feeling "light-headed." When obtaining orthostatic vital signs, what does the nurse determine is a significant finding?
A heart rate of more than 20 bpm above the resting rate
The nurse is administering sublingual nitroglycerin to a client with chest pain. What action will the nurse take after administering two sublingual tablets if the client continues with chest pain and has a blood pressure of 120/82 mm Hg?
Administer the third sublingual nitroglycerin tablet.
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?
Administration of sodium polystyrene sulfonate [Kayexalate])
A nurse is caring for a diabetic patient with a diagnosis of nephropathy. What would the nurse expect the urinalysis report to indicate?
Albumin
1. Which is the most common cause of symptomatic hypomagnesemia?
Alcoholism
Which of the following is the most common cause of symptomatic hypomagnesemia in the United States?
Alcoholism
A client has been experiencing increasing shortness of breath and fatigue. The health care provider has ordered a diagnostic test in order to determine what type of heart failure the client is having. What diagnostic test does the nurse anticipate being ordered?
An echocardiogram
The nurse is caring for a client with heart failure. What sign will lead the nurse to suspect right-sided and left-sided heart failure?
Ascites
Which of the following is the leading cause of death among patients undergoing maintenance hemodialysis?
Atherosclerotic cardiovascular disease
The nurse is providing discharge education for a client going home after cardiac catheterization. What information is a priority to include when providing discharge education?
Avoid tub baths, but shower as desired.
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?
Azotemia
Which is an insensible mechanism of fluid loss?
Breathing
A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?
Calcium
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?
Instruct the client to breathe into a paper bag.
Which feature is the hallmark of systolic heart failure?
Low ejection fraction (EF)
Which describes difficulty breathing when a client is lying flat?
Orthopnea
The calcium concentration in the blood is regulated by which mechanism?
Parathyroid hormone (PTH)
What is a hallmark of the diagnosis of nephrotic syndrome?
Proteinuria
A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?
Risk for infection
Which of the following arterial blood gas results would be consistent with metabolic alkalosis?
Serum bicarbonate of 28 mEq/L
What does the nurse recognize as one of the best indicators of the patient's renal function?
Serum creatinine
A nurse providing education about hypertension to a community group is discussing the high risk for cardiovascular complications. What are risk factors for cardiovascular problems in clients with hypertension? Select all that apply.
Smoking Diabetes mellitus Physical inactivity
To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body?
Tachycardia
Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.
Tall, peaked T waves
A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis?
The client had a liver transplant 2 years ago.
The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?
The kidneys can improve over a period of months.
A patient recently diagnosed with pericarditis asks the nurse to explain what area of the heart is involved. How does the nurse best describe the pericardium to the client?
Thin fibrous sac that encases the heart.
Which clinical finding should a nurse look for in a client with chronic renal failure?
Uremia
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?
Urine output of 20 ml/hour
A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?
Urine output of 250 ml/24 hours
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation?
Urine pH of 3.0
A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?:
Wear a mask when performing exchanges.
A nurse caring for a client recently admitted to the ICU observes the client coughing up large amounts of pink, frothy sputum. Lung auscultation reveals course crackles to lower lobes bilaterally. Based on this assessment, the nurse recognizes this client is developing
decompensated heart failure with pulmonary edema.
The nurse is teaching a client with heart failure about the ability for the heart to pump out blood. What diagnostic test will measure the ejection fraction of the heart?
echocardiogram
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
fatigue and weakness.
A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed?
furosemide
The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder?
pH 7.20, PaCO2 36, HCO3 14-
The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis?
pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L
The nurse is caring for a patient with systolic blood pressure of 135 mm Hg. This finding would be classified as
prehypertension.
The nurse is caring for a geriatric client. The client is ordered Lanoxin (digoxin) tablets 0.125mg daily for a cardiac dysrhythmias. Which of the following assessment considerations is essential when caring for this age-group?
Digoxin level
Which is a cerebrovascular manifestation of heart failure?
Dizziness
A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply.
Drink at least eight glasses of fluid each day. Drink water as an inexpensive way to meet fluid needs. Respond to thirst
A client has been having cardiac symptoms for several months and is seeing a cardiologist for diagnostics to determine the cause. How will the client's ejection fraction be measured?
Echocardiogram
The nurse is caring for a client with heart failure. What procedure should the nurse prepare the client for in order to determine the ejection fraction to measure the efficiency of the heart as a pump?
Echocardiogram
Which diagnostic study is usually performed to confirm the diagnosis of heart failure?
Echocardiogram
A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?
Encourage use of incentive spirometer every 2 hours.
A client has a significant history of congestive heart failure. What should the nurse specifically assess during the client's semiannual cardiology examination? Select all that apply.
Examine the client's neck for distended veins. Monitor the client for signs of lethargy or confusion.
A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, bradycardia, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence?
Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.
A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, bradycardia, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence? =
Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?
Fever
The nurse is teaching a client about medications prescribed for severe volume overload from heart failure. What diuretic is the first-line treatment for clients diagnosed with heart failure?
Furosemide
Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure?
Glomerulonephritis
A client with congestive heart failure is admitted to the hospital after reporting shortness of breath. How should the nurse position the client in order to decrease preload?
Head of the bed elevated 45 degrees and lower arms supported by pillows
In which of the following medical conditions would administering IV normal saline solution be inappropriate? Select all that apply.
Heart failure Pulmonary edema Renal impairment
A client diagnosed with chronic renal failure is receives continuous peritoneal dialysis (PD). The nurse instructs the client about which diet plan?
High-protein diet
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?
Hypercalcemia
Based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. Select all that apply.
Hyperkalemia Anemia Hypocalcemia
A client is already being treated for hypertension. The doctor is concerned about the potential for heart failure, and has the client return for regular check-ups. What does hypertension have to do with heart failure? .
Hypertension causes the heart's chambers to enlarge and weaken
An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use?
Hypokalemia
Oral intake is controlled by the thirst center, located in which of the following cerebral areas?
Hypothalamus
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
Hypovolemic shock caused by hemorrhage
A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia?
Increase carbohydrates and limit protein intake.
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
Increased BUN
What is a characteristic of the intrarenal category of acute renal failure?
Increased BUN
When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up?
Irregular heart rate
The nurse identifies which symptom as a characteristic of right-sided heart failure?
Jugular vein distention (JVD)
A new client has been admitted with right-sided heart failure. When assessing this client, the nurse knows to look for which finding?
Jugular venous distention
The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output?
Less than 400 mL
A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?
Light-headedness or paresthesia
The nurse is providing discharge instructions to a client with heart failure preparing to leave the following day. What type of diet should the nurse request the dietitian to discuss with the client?
Low-sodium diet
A client has been rushed to the ED with pulmonary edema and is going to need oxygen immediately. Which oxygen delivery system should be used first?:
Mask
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 alkalosis
Which action will the nurse include in the plan of care for a client admitted with acute decompensated heart failure (ADHF) who is receiving milrinone?
Monitor blood pressure frequently
A client develops cardiogenic pulmonary edema and is extremely apprehensive. What medication can the nurse administer with physician orders that will relieve anxiety and slow respiratory rate?
Morphine sulfate
The nurse is working in a long-term care facility with a group of older adults with cardiac disorders. Why would it be important for the nurse to closely monitor an older adult receiving digitalis preparations for cardiac disorders?
Older adults are at increased risk for toxicity.
The client with cardiac failure is taught to report which symptom to the physician or clinic immediately?
Persistent cough
A nurse in the emergency department is caring for a client with acute heart failure. Which laboratory value is most important for the nurse to check before administering medications to treat heart failure?
Potassium
Which electrolyte is a major cation in body fluid?
Potassium
The nurse is preparing to administer furosemide to a client with severe heart failure. What lab study should be of most concern for this client while taking furosemide?
Potassium level of 3.1
Which term describes the degree of stretch of the ventricular cardiac muscle fibers at the end of diastole?
Preload
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?
Prepare to assist with ventilation.
A patient is admitted to the intensive care unit (ICU) with left-sided heart failure. What clinical manifestations does the nurse anticipate finding when performing an assessment? (Select all that apply.)
Pulmonary crackles Dyspnea Cough
Which term is refers to hypertension in which blood pressure that is controlled with therapy becomes uncontrolled (abnormally high) when the therapy is discontinued?
Rebound
A patient is flying overseas for 1 week for business and packed antihypertensive medications in a suitcase. After arriving at the intended destination, the patient found that the luggage had been stolen. If the patient cannot take the medication, what condition becomes a concern?
Rebound hypertension
A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?
Recent history of streptococcal infection
A client is brought to the emergency department with reports of a bad headache and an increase in blood pressure. The blood pressure reading obtained by the nurse is 260/180 mm Hg. What is the therapeutic goal for reduction of the mean blood pressure?
Reduce the blood pressure by 20% to 25% within the first hour of treatment.
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?
Respiratory acidosis
The nurse recognizes which symptom as a classic sign of cardiogenic shock?
Restlessness and confusion
A client, newly admitted to the nursing unit, has a primary diagnosis of renal failure. When assessing the client, the nurse notes a blood pressure (BP) of 180/100. The nurse knows that this is what kind of hypertension?
Secondary
Based on her knowledge of the primary cause of end-stage renal disease, the nurse knows to assess the most important indicator. What is that indicator?
Serum glucose
What is used to decrease potassium level seen in acute renal failure?
Sodium polystyrene sulfonate
Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?
SpO2 at 90% with fine crackles in the lung bases
A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?
Start IV fluids with a normal saline solution bolus followed by a maintenance dose.
When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?
Tea-colored urine
A client has a myocardial infarction in the left ventricle and develops crackles bilaterally; 3-pillow orthopnea; an S3 heart sound; and a cough with pink, frothy sputum. The nurse obtains a pulse oximetry reading of 88%. What do these signs and symptoms indicate for this client?
The development of left-sided heart failure
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)?
Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad
Which is a classic sign of cardiogenic shock?
Tissue hypoperfusion
1A client with a history of heart failure is returning from the operating room after inguinal hernia repair and the nurse assesses a low pulse oximetry reading. What is the most important nursing intervention?
Titrate oxygen therapy.
The nurse cares for a client with an intra-arterial blood pressure monitoring device. The nurse recognizes the most preventable complication associated with hemodynamic monitoring includes which condition?
catheter-related bloodstream infections
A client with emphysema is at a greater risk for developing which acid-base imbalance?
chronic respiratory acidosis
The nurse is assessing a newly admitted client with chest pain. What medical disorder is most likely causing the client to have jugular vein distention?
heart failure
The nurse is performing an assessment for an older adult client and auscultates an S3 heart sound. What condition does the nurse determine may correlate with this finding?
heart failure
A nurse is administering digoxin. What client parameter would cause the nurse to hold the digoxin and notify the health care prescriber?
heart rate of 55 beats per minute
A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values: Sodium 134 mEq/L (134 mmol/L) Potassium 3.2 mEq/L (3.2 mmol/L) 111 mEq/L (111 mmol/L) Magnesium 1.1 mg/dL (0.45 mmol/L) Calcium 8.4 mg/dL (2.1 mmol/L) What fluid and electrolyte imbalance would the nurse relate to the client's findings?
hypomagnesemia
The nurse is asssessing a client with crackling breath sounds or pulmonary congestion. What is the cause of the congestion?
inadequate cardiac output
Clients diagnosed with hypervolemia should avoid sweet or dry food because it
increases the client's desire to consume fluid.
It is appropriate for the nurse to recommend smoking cessation for clients with hypertension because nicotine
increases the heart rate, constricts arterioles, and reduces the heart's ability to eject blood.
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.
The nurse is caring for a client with heart failure who is receiving torsemide. What implementation will help the nurse evaluate the client's response of the medication?
measuring intake and output
A client is receiving captopril for heart failure. During the nurse's assessment, what sign indicates that the medication therapy is ineffective?
peripheral edema
The nurse completes an assessment of a client admitted with a diagnosis of right-sided heart failure. What will be a significant clinical finding related to right-sided heart failure?
pitting edema
The nurse is administering digoxin to a client with heart failure. What laboratory value may predispose the client to digoxin toxicity?
potassium level of 2.8 mEq/L
A client has been diagnosed with acute glomerulonephritis. This condition causes:
proteinuria.
A client with a history of an anterior wall myocardial infarction is being transferred from the coronary care unit (CCU) to the cardiac step-down unit (CSU). While giving a report to the CSU nurse, the CCU nurse says, "His pulmonary artery wedge pressures have been in the high normal range." What additional assessment information would be important for the CSU nurse to obtain?
pulmonary crackles
One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include:
restricting sources of potassium usually found in fresh fruits and vegetables.
According to the classification of hypertension diagnosed in older adults, hypertension that can be attributed to an underlying cause is termed
secondary.
A client has been admitted to the hospital unit with signs and symptoms of hypovolemia; however, the client has not lost weight. The client exhibits a localized enlargement of her abdomen. What condition could the client be presenting?
third-spacing
A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching?
tingling sensation in the fingers
A nurse suspects that a client has digoxin toxicity. The nurse should assess for:
vision changes.
A client with chronic heart failure is receiving digoxin 0.25 mg by mouth daily and furosemide 20 mg by mouth twice daily. The nurse should assess the client for what sign of digoxin toxicity?
visual disturbances
A nurse receives her client care assignment. Following the report, she should give priority assessment to the client:
who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.
Which findings indicate that a client has developed water intoxication secondary to treatment for diabetes insipidus?
Confusion and seizures
The nurse identifies which symptom as a manifestation of right-sided heart failure (HF)?
Congestion in the peripheral tissues
The nurse is performing an assessment of a clients peripheral pulses and indicates that the pulse quality is +1 on a scale of 0-4. What does this documented finding indicate?
Difficult to palpate and is obliterated with pressure.
When preparing a client for hemodialysis, which of the following would be most important for the nurse to do?
Check for thrill or bruit over the access site.
Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism?
Chest pain
A client is experiencing an irregular heartbeat. The client asks the nurse how a heartbeat occurs. The nurse explains the conduction system of the heart beginning with the sinoatrial node (SA node). Place the conduction sequence of the heart in order beginning with the SA node. Use all options.
Atrial cell stimulation AV node Bundle of His Bundle branches Purkinje fibers
Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted.
Citrus fruits
The nurse is teaching a group of clients with heart failure about how to decrease leg edema. What dietary advice will the nurse give to clients with severe heart failure?
Avoid the intake of processed and commercially prepared foods.
The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?
Cola-colored urine
Upon shift report, the nurse states the following laboratory values: pH, 7.44; PCO2, 30mmHg; and HCO3,21 mEq/L for a client with noted acid-base disturbances. Which acid-base imbalance do both nurses agree is the client's current state?
Compensated respiratory alkalosis
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?
Confusion
The client is being prepared for echocardiography when he asks the nurse why he needs to have this test. What would be the nurse's best response?
"Echocardiography is a way of determining the functioning of the left ventricle of your heart."
A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse?
"Even a perfect match does not guarantee organ success."
The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L (2.9 mmol/L). Which statement made by the client indicates the need for further teaching?
"I can use laxatives and enemas but only once a week."
A nurse is caring for a client with heart failure. The nurse knows that the client has left-sided heart failure when the client makes which statement?
"I sleep on three pillows each night."
After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?
"It is appropriate to warm the dialysate in a microwave."
An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?
"This type of dialysis will provide more independence."
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?
1 L
A client has chronic hyponatremia, which requires weekly laboratory monitoring to prevent the client lapsing into convulsions or a coma. What is the level of serum sodium at which a client can experience these side effects?
114 mEq/L
Below which serum sodium concentration might convulsions or coma occur?
135 mEq/L (135 mmol/L)
A client weighing 160 pounds (72.6 kg), who has been diagnosed with hypovolemia, is weighed every day. The health care provider asked to be notified if the client loses 1,000 mL of fluid in 24 hours. What weight would be consistent with this amount of fluid loss? 158 lbs (71.7 kg)
158 lbs (71.7 kg)
The nurse is explaining the DASH diet to a client diagnosed with hypertension. The client inquires about how many servings of fruit per day can be consumed on the diet. What is the nurse's best response?
4 or 5 servings per day
A client has had an echocardiogram to measure ejection fracton. The nurse explains that ejection fraction is the percentage of blood the left ventricle ejects upon contraction. What is the typical percentage of blood a healthy heart ejects?
55%
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?
A GFR of 30-59 mL/min/1.73 m2
A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution?
Acidic
A client in the emergency room is in cardiac arrest and exhibiting pulseless electrical activity (PEA) on the cardiac monitor. What will be the nurse's next action?
Administer epinephrine.
A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. What outcome will the decrease in erythropoietin have?
Anemia from the decrease in maturation of red blood cells
A nurse is checking laboratory values on a client who has crackles in the lower lobes, 2+ pitting edema, and dyspnea with minimal exertion. Which laboratory value does the nurse expect to be abnormal?
B-type natriuretic peptide (BNP)
A health care provider in the outpatient department examines a client with chronic heart failure to investigate recent-onset peripheral edema and increased shortness of breath. The nurse documents the severity of pitting edema as +1. What is the best description of this type of edema?
Barely detectable depression when the thumb is released from the swollen area; normal foot and leg contours
A client with heart failure is having a decrease in cardiac output. What indication does the nurse have that this is occurring?
Blood pressure 80/46 mm Hg
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL
A 54-year-old male patient is admitted to the hospital with a case of severe dehydration. The nurse reviews the patient's laboratory results. Which of the following results are consistent with the diagnosis? Select all that apply.
Blood urea nitrogen (BUN) of 23 mg/dL Serum osmolality of 310 mOsm/kg Serum sodium of 148 mEq/L Urine specific gravity of 1.03
Which assessment finding is most important in determining nursing care for a client with acute glomerulonephritis?
Blurred vision
The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?
Brief, hot daily showers
The nursing instructor is teaching their clinical group how to assess a client for congestive heart failure. How would the instructor teach the students to assess a client with congestive heart failure for nocturnal dyspnea?
By questioning how many pillows the client normally uses for sleep
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?
Calcium
The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?
Dehydration
A client with left-sided heart failure reports increasing shortness of breath and is agitated and coughing up pink-tinged, foamy sputum. The nurse should recognize these findings as signs and symptoms of what condition?
acute pulmonary edema.
A change that occurs during chronic glomerulonephritis is termed
anemia.
A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse?
bicarbonate-carbonic acid buffer system
