Chapter 11 Select all that apply
What impacts does phosphorus have in the body? (Select all that apply) a. Adds strength/density to bones and teeth b. Activates vitamins and enzymes c. Aids in blood-clotting cascade d. Assist in the formation of ATP e. Assist in cell growth and metabolism
b,d
Plasma is part of which components? a. The intracellular compartment b. the extracellular compartment c. all fluids within the cell d. interstitial fluid e. intravascular fluid
b,d,e
The nurse is caring for a patient with severe hypocalcemia. What safety measures does the nurse put in place for this patient? a. encourage the patient to use a cane when ambulating b. turn on bed alarm when patient is in bed c. obtain an order for Ambien to ensure the patient sleeps at night. d. place the patients bed on low e. ensure the side rales are up when the patient is in bed.
b,d,e
What are common causes of hypophosphatemia? a. increased intake of phosphorus b. hypercalcemia c. immobility d. uncontrolled diabetes e. use of magnesium based antacids
b,d,e
What are the functions of potassium in the body? a. regulates hydration status b. intracellular osmolarity and volume c. stimulates the secretion of ADH d. regulates glucose use and storage e. helps maintain normal cardiac rhythm
b,d,e
A patient with hypocalcemia is in need of supplemental dietary therapy. Which foods does the nurse recommend to provide both calcium and Vit D? a. Tofu b. cheese c. eggs d. broccoli e. milk
b,e
The nurse is caring for an older adult patient whose serum sodium level is 150 mEq/L. The nurses assesses the patient for which common manifestations associated with this sodium level? a. intake recall of recent events b. increased pulse rate c. rigidity of extremities d. hyperactivity e. muscle weakness
b,e
Patients with which conditions are at risk for developing hypernatremia? (Select all that apply) a. Chronic constipation b. Heart failure c. Severe diarrhea d. Poor kidney function e. Profound diaphoresis
c,d,e
Which factors affect the amount and distribution of body fluids? (Select all that apply) a. Race b. Age c. Gender d. Height e. Body fat
b,c,e
Which foods will the nurse instruct the patient with kidney disease and hyperkalemia to avoid? a. canned apricots b. dried beans c. potatoes d. cabbage e. cantaloupe
b,c,e
A patient with hyponatremia would have which gastrointestinal findings upon assessment? a. hyperactive bowel sounds on auscultation, mostly in the left lower quadrant. b. hard, dark brown stools c. hypoactive bowel sounds on auscultation. d. bowel movements that are frequent and watery e. abdominal cramping
A,D,E
which statements are true about the electrolyte chloride and its role in the cellular environment of the body? a. it is a major cation in extracellular fluid b. it maintains plasma acid base balance c. it provides electroneutrality in relation to sodium d. chloride imbalances occur with alterations in body water volume e. chloride concentration varies inversely with changes in bicarbonate concentration.
b,c,d
A patient with CHF is receiving a loop diuretic. The nurse monitors for which electrolyte imbalances? a. hypocalcemia b. hypokalemia c. hyponatremia d. hypercalcemia e. hyperkalemia f. hypernatremia
a,b,c
Which conditions cause a patient to be at risk for hypocalcemia? a. crowns disease b. acute pancreatitis c. removal or destruction of parathyroid glands. d. immobility e. use of digitalis
a,b,c,d
Patients with which conditions are at greatest risk for deficit fluid volume? (Select all that apply) a. Fever of 103 degrees F b. Extensive burns c. Thyroid crisis d. Water intoxication e. Continuous fistula drainage f. Diabetes insidious
a,b,c,e,f
A patient with renal failure that results in hypernatremia will require which interventions? a. administration of Lasix b. hemodialysis c. IV infusion of 0.9% sodium chloride d. dietary sodium restrictions e. administration of Bumex
a,b,d
Which findings indicate that a patient may have hypervolemia? a. Increased, bounding pulse b. Jugular venous distention c. Diminished peripheral pulses d. Presence of crackles e. Excessive thirst f. Elevated blood pressure g. Orthostatic hypotension h. Skin pale and cool to the touch
a,b,d,f,h
The nurse is teaching a patient with hypokalemia about foods high in potassium. Which food items does the nurse recommend to this patient? a. soybeans b. lettuce c. cantaloupe d. potatoes e. peaches
a,c,d
Which are typical nursing findings for a patient with hypocalcemia? a. positive chvosteks sign b. hypertension c. diarrhea d. prolonged ST interval e. elevated T wave
a,c,d
Which factors can cause hyperphophatemia? a. tumor lysis syndrome b. decreased intake of phosphorus c. hypoparathyroidism d. decreased renal excretion e. hyperthyroidism
a,c,d
Which patients are at risk for developing hyponatremia? a. postoperative patient who has been NPO for 24 hours with no IV infusing. b. patient with decreased fluid intake for several days c. patient receiving excess intravenous fluid with 5% dextrose. d. diabetic patient with blood glucose of 250 mg/dL e. patient with over active adrenal glands f. tennis player in 100 degree F weather who has been drinking water.
a,c,d,f
The patients potassium level is 2.5 mEq/L. Which clinical findings does the nurse expect to see when assessing this patient? a. general skeletal muscle weakness b. moist crackles and tachypnea c. lethargy d. increased specific gravity and decreased urine output e. weak hand grasps
a,c,e
Which are preventative nursing interventions for a patient at risk of developing hypercalcemia? a. administer D5W b. administer Lasix c. ensure adequate hydration d. administer plicamycin( Mithracin) e. discourage weight bearing activity such as walking
a,c,e
Which nursing interventions apply to patients with hypercalcemia? a. administer IV normal saline (0.9% sodium chloride) b. assess the patient for a positive Homans sign c. measure the abdominal girth d. massage calves to encourage blood flow return to the heart e. monitor for ECG changes f. provide adequate intake of Vit D g. During treatment, monitor for tetany
a,c,e
What are consequences for a patient who does not meet the obligatory urine output? a. lethal electrolyte balance b. alkalosis c. urine becomes diluted d. toxic buildup of nitrogen e. acidosis
a,d,e
What impacts does sodium have on body function? (Select all that apply) a. Maintains electroneutrality b. Maintains electrical membrane excitability c. Aids in carbohydrate and lipid metabolism d. Regulates water balance e. Regulates plasma osmolarity
a,d,e
What manifestations reflect severe hypophosphatemia? a. profound muscle weakness b. decreased peristalsis c. elevated T wave d. irritability e. cardiac muscle damage
a,d,e
The nurse is teaching a patient to recognize foods that are high in sodium. Which food items does the nurse use as an example? a. egg roll with soy sauce b. white rice c. salad with oil and vinegar dressing d. bacon and eggs e. steak f. soup with saltine crackers. g. steamed vegetables
a,d,f
What interventions are appropriate for a patient with mild hypernatremia caused by excessive fluid loss? a. hypotonic intravenous infusion b. 0.45% sodium chloride intravenous infusion c. D5W intravenous infusion d. administration of Bumex e. ensure adequate water intake.
a,e
Which assessment findings are related to prolonged hypercalcemia? a. prolonged bradycardia b. paresthesia c. leg cramping d. hyperactive bowel sounds e. shorten QT interval f. impaired blood flow g. profound muscle weakness
a,e,f,g
A newly admitted patient with CHF has a potassium level of 5.7 mEq/L. How does the nurse identify contributing factors for the electrolyte imbalance? a. assess the patient for hypokalemia b. obtain a list of the patients home medications c. assess the patient for hyperkalemia d. ask about the patients method of taking medications at home e. evaluate the patients appetite.
b,c,d
A patient has an elevated potassium level. Which assessment findings are associated with hyperkalemia? a. wheezing on exhalation b. numbness in hands, feet, and around the mouth c. frequent, explosive diarrhea stools d. irregular heart rate and hypotension e. circumoral cyanosis
b,c,d
Which potassium levels are within normal limits? a. 2.0 mmol/L b. 3.5 ,,ol/L c. 4.5 mmol/L d. 5.0 mmol/L e. 6.0 mmol/L
b,c,d
A patient with hypokalemia is likely to have which condition? a. liver failure b. metabolic alkalosis c. COPD d. hypothyroidism e. paralytic ileus
b,c,e
