Exam 4: Fluid & Electrolyte Imbalances (NCLEX)
D
During the shift report, the nurse discovers that the patient has low sodium. What gastrointestinal change does the nurse expect to find during the physical assessment? a. Minimal bowel sounds with frequent episodes of vomitting. b. Absent bowel sounds with pronounced abdominal distention. c. Hypoactive bowel sounds and complaints of constipation. d. Hyperactive bowel sounds and abdominal cramps.
B
Hyperkalemia can cause severe problems in which body system? a. Neuromuscular b. Cardiovascular c. Intestinal d. Respiratory
B
On admission, the patient with pulmonary edema weighed 151 lbs; now the patient's weight is 149 lbs. Assuming the patient was weighed both times with the same clothing, same scale, and same time of day, how many milliliters of fluid does the nurse estimate the patient has lost? a. 500 b. 1000 c. 2000 d. 2500
C
The UAP reports to the nurse that the patient being evaluated for kidney problems has produced a large amount of pale yellow urine. What does the nurse do next? a. Instruct the UAP to measure the amount carefully and then discard the urine. b. Instruct the UAP to save the urine in a large bottle for a 24-hour urine specimen. c. Assess the patient for signs of fluid imbalance and check the specific gravity of the urine. d. Compare the amount of urine output to the fluid intake for the previous 8 hours.
C
The advanced practice nurse is assessing the patient with a risk for hypocalcemia. What is the correct technique to test for Chvostek's sign? a. Patient flexes arms against the chest and examiner attempts to pull the arms away from the chest. b. Place a blood pressure cuff around the upper arm and inflate the cuff to greater than the patient's systolic pressure c. Tap the face just below and in front of the ear to trigger facial twitching of one side of the mouth, nose, and cheek d. Lightly tap the patellar and Achilles tendons with a reflex hammer and measure the movement.
C
The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition is a cause for these findings? a. Overhydration b. Anemia c. Dehydration d. Renal failure
C
The client who has undergone an exploratory laparotomy and subsequent removal of a large intestinal tumor has a nasogastric tube (NGT) in place an an IV running at 150 mL/hr via an IV pump. Which data should be reported to the HCP? a. The pump keeps sounding an alarm indicating the high pressure has been reached. b. Intake is 1800 mL, NGT output is 550 mL, and Foley output is 950 mL c. On auscultation, crackles and rhonchi in all lung fields are noted d. Client has negative pedal edema and an increasing level of consciousness
A
The emergency department (ED) nurse is caring for the patient who was brought in for significant alcohol intoxication and minor trauma to the wrist. What will serial hematocrits for this patient likely show? a. Hemoconcentration b. Normal and stable hematocrits c. Progressively lower hematocrits d. Decreasing osmolality
B
The nurse administering potassium to the patient carefully monitors the infusion because of the risk for which condition? a. Pulmonary edema b. Cardiac dysrhythmia c. Postural hypotension d. Renal failure
A
The nurse assessing the patient notes a bounding pulse quality, neck vein distention when supine, presence of crackles in the lungs, and increasing peripheral edema. What condition does the nurse suspect? a. Fluid excess b. Fluid deficit c. Electrolyte imbalance d. Serum protein increase
BCD
The nurse caring for the patient with hypercalcemia anticipates orders for which medications? (Select all that apply) a. Magnesium sulfate b. Calcitonin (Calcimar) c. Furosemide (Lasix) d. Plicamycin (Mithracin) e. Calcium gluconate f. Aluminum hydroxide
A
The nurse identifies the nursing diagnosis of Risk for Injury for the patient with hyponatremia. What is the etiology of this diagnosis? a. Altered mental capabilities b. Fragility of bones c. Immobility d. Altered senses
C
The nurse instructs the UAP to use precautions with moving and use of a lifting sheet for which patient with an electrolyte imbalance? a. Young diabetic woman with hyperkalemia b. Psychiatric patient with hyponatremia c. Older woman with hypocalcemia d. Child with severe diarrhea and hypomagnesemia
A
The nurse is assessing skin turgor in the 65-year-old patient. What is the correct technique to use with this patient? a. Pinch the skin over the sternum and observe for tenting and resumption of skin to its normal position after release. b. Observe the skin for a dry, scaly appearance and compare it to a previous assessment. c. Pinch the skin over the back of the hand and observe for tenting; count the number of seconds for the skin to recover position. d. Observe the mucous membranes and tongue for cracks, fissures, or a pasty coating.
A
The nurse is assessing the patient with a mild increase in sodium level. What early manifestation does the nurse observe in this patient? a. Muscle twitching and irregular muscle contractions. b. Inability of muscles and nerves to respond to a stimulus c. Muscle weakness occurring bilaterally with no specific pattern. d. Reduced or absent deep tendon reflexes.
A
The nurse is assessing the patient with severe hypermagnesemia. Which assessment findings are associated with this electrolyte imbalance? a. Bradycardia and hypotension b. Tachycardia and weak palpable pulse c. Hypertension and irritability d. Irregular pulse and deep respirations
A
The nurse is assessing the patient's neuromuscular status to obtain a baseline because the patient is at risk for electrolyte imbalances. What technique does the nurse use to assess muscle strength in the legs? a. Ask the patient to push the feet against a flat surface and apply resistance to the opposite side of the flat surface. b. Ask the patient to walk around the room and observe for stride, gait, balance, and endurance. c. Instruct the patient to stand at the side of the bed and abduct each leg as high as possible. d. Support the patient's lower leg with the palm and move the knee through flexion and extension.
B
The nurse is assessing the patient's urine specific gravity. The value is 1.035. How does the nurse interpret this result? a. Overhydration b. Dehydration c. Normal value for an adult d. Renal disease
C
The nurse is assessing the weight of the patient with chronic renal failure. The patient shows a 2 kg weight gain since the last clinic appointment. This is equivalent to how many liters of fluid? a. 0.5 b. 1 c. 2 d. 3
D
The nurse is assisting a community group to plan a family sports day. In order to prevent dehydration, what beverage does the nurse suggest be supplied? a. Iced tea b. Light beer c. Diet soda d. Bottled water
B
The nurse is caring for a patient who takes potassium and digoxin. For what reason does the nurse monitor both laboratory results? a. Digoxin increases potassium loss through the kidneys. b. Digoxin toxicity can result if hypokalemia is present. c. Digoxin may cause potassium levels to rise to toxic levels d. Hypokalemia causes the cardiac muscle to be less sensitive to digoxin
C
The nurse is caring for several patients at risk for falls because of fluid and electrolyte imbalances. Which task related to patient safety and fall prevention does the nurse delegate to the UAP? a. Assess for orthostatic hypotension b. Orient the patient to the environment. c. Help the incontinent patient to toilet every 1 to 2 hours. d. Encourage family members or significant other to stay with the patient.
C
The nurse is caring for several patients with electrolyte imbalances. Which condition may require the patient to be put on seizure precautions? a. Hypercalcemia b. Hyperphosphatemia c. Hypocalcemia d. Hypokalemia
B
The nurse is caring for the child at risk for dehydration secondary to diarrhea, vomiting, and fever. The child is alert, quiet, and clinging to the parent. What is the best nursing intervention to rehydrate this patient? a. Give an oral rehydration solution such as oralyte or rehydralyte. b. Have the parent give small sips of preferred diluted fluids every 5 to 10 minutes. c. Obtain an order for IV access and an isotonic solution such as normal saline. d. Encourage the child to take as much water as possible and offer popsicles.
D
The nurse is caring for the older adult patient whose serum sodium level is 150 mEq/L. The nurse assesses the patient for which common manifestation associated with this sodium result? a. Gastrointestinal disorders b. Altered urinary elimination c. Impaired skin integrity d. Altered cerebral functioning
C
The nurse is caring for the patient with hypernatremia caused by fluid and sodium losses. What type of IV solution is best for treating this patient? a. Hypotonic 0.225% sodium chloride. b. Small-volume infusions of hypertonic (2% to 3%) saline. c. Isotonic sodium chloride (NaCl) d. Isotonic Ringer's lactate
C
The nurse is caring for the patient with hypovolemia secondary to severe diarrhea and vomiting. In evaluating the respiratory system for this patient, what does the nurse expect to assess? a. No changes, because the respiratory system is not involved. b. Hypoventilation, because the respiratory system is trying to compensate for low pH c. Increased respiratory rate, because the body perceives hypovolemia as hypoxia d. Normal respiratory rate, but a decreased oxygen saturation
B
The nurse is caring for the psychiatric patient who is continuously drinking water. The nurse monitors for which complication related to potential hyponatremia? a. Proteinuria/prerenal failure b. Change in mental status/increased intracranial pressure c. Pitting edema/circulatory failure d. Possible stool for occult blood/gastrointestinal bleeding
B
The nurse is evaluating the hydration status of the older adult patient. If the patient is dehydrated, the nurse expects to observe which type of cardiovascular change? a. Hypertension with bounding peripheral pulses b. Tachycardia with weak peripheral pulses c. Bradycardia and distended neck veins d. Increase in pulse pressure and systolic pressure
A
The nurse is giving discharge instructions to the patient with advanced congestive heart failure who is at continued risk for fluid volume excess. For which physical change does the nurse instruct the patient to call the health care provider? a. Greater than 3 lbs gained in a week or greater than 1 to 2 lbs gained in a 24-hour period. b. Greater than 5 lbs gained in a week or greater than 1 to 2 lbs gained in a 24-hour period. c. Greater than 15 lbs gained in a month or greater than 5 lbs gained in a week. d. Greater than 20 lbs gained in a month or greater than 5 lbs gained in a week.
C
The nurse is reviewing orders for several patients who have risk for fluid volume excess. For which patient condition does the nurse question an order for diuretics? a. Pulmonary edema b. Congestive heart failure c. End-stage renal disease d. Ascites
B
The nurse is reviewing the laboratory calcium level results for the patient. Which value indicates mild hypocalcemia? a. 5.0 mg/dL b. 8.0 mg/dL c. 10.0 mg/dL d. 12.0 mg/dL
D
The nurse is teaching the patient about foods high in potassium. Which food item does the nurse use as the best example? a. Bread b. Eggs c. Cereal grains d. Meat
B
The nurse is teaching the patient about hypokalemia. Which statement by the patient indicates a correct understanding of the treatment of hypokalemia? a. "My wife does all the cooking. She shops for food high in calcium." b. "When I take the liquid potassium in the evening, I'll eat a snack beforehand." c. "I will avoid bananas, orange juice, and salt substitutes." d. "I hate being stuck with needles all the time to monitor how much sugar I can eat."
ADEG
The nurse is teaching the patient to recognize food sthat are high in sodium. Which food items does the nurse use as examples? (Select all that apply) a. Egg roll with soy sauce b. Whate rice c. Salad with oil and vinegar dressing d. Bacon and eggs e. Cottage cheese and tomato f. Steak g. Soup with saltine crackers h. Steamed vegetable
A
The nurse is working in a long-term care facility where there are numerous patients who are immobile and at risk for dehydration. Which task is best to delegate to the unlicensed assistive personnel (UAP)? a. Offer patients a choice of fluids every 1 to 2 hours. b. Check patients at the beginning of the shift to see who is thirsty. c. Give patients extra fluids around medication times. d. Evaluate oral intake and urinary output.
A
The nurse monitors the effectiveness of magnesium sulfate by assessing which factor every hour? a. Deep tendon reflexes b. Vital signs c. Serum laboratory values d. Urine output
B
The older adult patient at risk for fluid and electrolyte problems is vigilantly monitored by the nurse for the first indication of a fluid balance problem. What is this indication? a. Fever b. Mental status change c. Poor skin turgor d. Dry mucous membranes
B
The older adult patient needs an oral potassium solution, but is refusing it because it has a strong and unpleasant taste. What is the best strategy the nurse uses to administer the drug? a. Tell the patient that failure to take the drug could result in serious heart problem b. Ask the patient's preference of juice and mix the drug with a small amount c. Mix the solution into food on the patient's meal tray and encourage the patient to eat everything d. Offer the drug to the patient several times and then document the patient's refusal.
A
The patient has a low potassium level and the physician has ordered an IV infusion. Before starting an IV potassium infusion, what does the nurse assess? a. Adequate urine output b. Oxygen saturation level c. Baseline mental status d. Apical pulse
D
The patient has a magnesium level of 0.8 mg/dL. Which treatment does the nurse expect to be ordered for this patient? a. Intramuscular magnesium sulfate b. Increased intake of fruits and vegetables c. Oral preparations of magnesium sulfate d. IV magnesium sulfate and discontinuation of diuretic therapy
B
The patient has a serum sodium level of 126 mEq/L. What assessment findings does the nurse expect to see in this patient? a. Constipation and paralytic ileus b. Watery diarrhea with abdominal cramping c. Muscle cramping and spasticity d. Tachypnea and diminished breath sounds
BCD
The patient has an elevated potassium level. Which assessment findings are associated with hyperkalemia? (Select all that apply) 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
The patient has chronic renal failure (CRF). Which electrolyte imbalance often associated with hypocalcemia and CRF does the nurse monitor for? a. Hypophosphatemia b. Hyperphosphatemia c. Hyperkalemia d. Hyponatremia
A
The patient has hyperkalemia resulting from dehydration. Which additional laboratory findings does the nurse anticipate for this patient? a. Increased hematocrit and hemoglobin levels b. Decreased serum electrolyte levels c. Increased urine potassium levels d. Decreased serum creatinine
B
The patient has hyperphosphatemia. Which accompanying and potentially life-threatening electrolyte imbalance does the nurse monitor for? a. Hypercalcemia b. Hypocalcemia c. Hyponatremia d. Hyperkalemia
D
The patient is at risk for fluid volume excess and dependent edema. Which task does the nurse delegate to the UAP? a. Massage the legs and heels to stimulate circulation. b. Evaluate the effectiveness of a pressure-reducing-mattress. c. Assess the coccyx, elbows, and hips daily for signs of redness. d. Assist the patient to change position every 2 hours.
D
The patient is at risk for fluid volume excess. For self-management at home, what does the nurse teach the patient to do? a. Increase diuretic dose if swelling occurs. b. Limit the amount of free water in relation to sodium intake. c. Monitor his or her skin turgor. d. Weigh self each day on the same scale.
C
The patient is talking to the nurse about sodium intake. Which statement by the patient indicates an understanding of high sodium food sources? a. "I have bacon and eggs every morning for breakfast." b. "We never eat seafood because of the salt water." c. "I love Chinese food, but I gave it up because of the soy sauce." d. "Pickled herring is a fish and my doctor told me to eat alot of fish.
A
The patient on the medical-surgical unit suddenly has a severely elevated magnesium level. What does the nurse anticipate will happen next with the patient's care? a. Immediate transfer to the intensive care unit b. Discontinuation of magnesium sources so the patient can recover c. Administration of diuretics such as furosemide d. Administration of IV magnesium binder
A
The patient who has undergone which surgical procedure is at risk for hypocalcemia? a. Thyroidectomy b. Adrenalectomy c. Pancreatectomy d. Gastrectomy
A
The patient with a recent history of anterior neck injury reports muscle twitching and spasms with tingling in the lips, nose, and ears. The nurse suspects these symptoms may be caused by which condition? a. Hypocalcemia b. Hypokalemia c. Hyponatremia d. Hypomagnesemia
ABC
The patient with congestive heart failure is receiving a loop diuretic. The nurse monitors for which electrolyte imbalances? (Select all that apply) a. Hypocalcemia b. Hypokalemia c. Hyponatremia d. Hypercalcemia e. Hyperkalemia f. Hypernatremia
B
The patient with low potassium must have an IV potassium infusion. The pharmacy sends a 250 mL IV bag of dextrose in water with 40 mEq of potassium. The label is marked "to infuse over 1 hour." What does the nurse do? a. Obtain a pump and administer the solution b. Double-check the physician's order and call the pharmacy c. Hold the infusion because there is an error in labeling d. Recalculate the rate so that it is safe for the patient
A
The patient's laboratory results show a decrease in serum phosphorus level. The nurse expects to see a reciprocal increased change in which serum level? a. Calcium b. Potassium c. Sodium d. Magnesium
C
The patient's potassium level is 2.5 mEq/L. Which clinical findings does the nurse expect to see when assessing this patient? a. Hypertension, bounding pulses, and bradycardia b. Moist crackles, tachypnea, and diminished breath sounds c. General skeletal muscle weakness, lethargy, and weak hand grasps d. Increased specific gravity and decreased urine output
B
The patient's serum potassium value is below 2.8 mEq/L. The patient is also on digoxin. The nurse quickly assesses the patient for which cardiac problem before notifying the physician? a. Cardiac murmur b. Cardiac dysrhythmia c. Congestive heart failure d. Cardiac tamponade
ABDEF
The patients with which conditions are at great risk for deficient 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 insipidus
A
The physician has ordered therapy for the patient with low sodium and signs of fluid volume excess. Which diuretic is best for this patient? a. Conivaptan (Vaprisol) b. Furosemide (Lasix) c. Hydrochlorothiazide (HydroDiuril) d. Bumetanide (Bumex)
A
What is a typical nursing assessment finding for the patient with hypocalcemia? a. Paresthesias and tingling followed by numbness b. Shortened ST segment, tachycardia, and hypertension c. Constipation and hypoactive bowel sounds d. Severe muscle weakness
C
What is the consequence and clinical manifestation for the patient who does not meet the obligatory urine output? a. Increased salivation and alkalosis b. Increased thirst with dry mucous membranes c. Lethal electrolyte imbalance and acidosis d. Bradycardia and decreased nitrogen level.
D
What is the intervention of choice for the patient with mild hypernatremia caused by excessive fluid loss? a. IV infusion of 10 units of insulin in 50 mL of 10% dextrose. b. Replacement of table salt with salt substitute c. Furosemide (Lasix) 20 mg IV d. Increased oral water intake
B
What is the minimum amount of urine per day needed to excrete toxic waste products? a. 200 to 300 mL b. 400 to 600 mL c. 500 to 1000 mL d. 1000 to 1500 mL
A
Which analogy best approximates the principles of diffusion and concentration gradient? a. Game with four players on one side and eight on the other; two move over to create six per side b. Community fun run where 2000 participants move across the line in a mass start. c. Basketball game of five players per side; all players move across the court. d. Concert where 1000 people are trying to enter through a single gate.
AEFGH
Which assessment findings are related to hypercalcemia? (Select all that apply) a. Bradycardia b. Paresthesia c. Leg cramping d. Hyperactive bowel sounds e. Ineffective respiratory movements f. Shortened QT interval g. Impaired blood flow h. Profound muscle weakness
A
Which changes on the patient's electrocardiogram (ECG) reflect hyperkalemia? a. Tall peaked T waves b. Narrow QRS complex c. Tall P waves d. Normal P-R interval
B
Which clinical condition can result from hypocalcemia? a. Stimulated cardiac muscle contraction b. Increased intestinal and gastric motility c. Decreased peripheral nerve excitability d. Increased bone density
ACDE
Which conditions cause the patient to be at risk for hypernatremia? (Select all that apply) a. Renal failure b. Immobility c. Use of corticosteroids d. Watery diarrhea e. Cushing's syndrome
C
Which food provides both calcium and vitamin D for the patient in need of supplemental diet therapy for hypocalcemia? a. Eggs b. Broccoli c. Milk d. Tofu
B
Which intake-output record represents the norm for the average adult? a. 500 mL of fluid per day, ingesting an additional 200 mL of fluid from food. b. 1500 mL of fluid per day, ingesting an additional 800 mL of fluid from food. c. 3000 mL of fluid per day, ingesting an additional 500 mL of fluid from food. d. 5000 mL of fluid per day, ingesting an additional 100 mL of fluid from food.
D
Which intervention does the nurse implement for the patient with hypocalcemia? a. Encourage activitiy by thepatient as tolerated, including weight-lifting b. Encourage socialization and active participation in stimulating activities c. Include a tracheostomy tray at the bedside for emergency use d. Provide adequate intake of vitamin D and calcium rich foods
A
Which is a preventive measure for patients at risk for developing hypocalcemia? a. Increase daily dietary calcium intake to 1000 mg b. Increase intake of phosphorus c. Apply sunblock and wear protective clothing whenever outdoors d. Administer calcium-containing IV fluids to patients receiving multiple blood transfusions
A
Which is a preventive nursing intervention for patients at risk for developing hypercalcemia? a. Ensure adequate hydration b. Discourage weight-bearing activity such as walking c. Monitor the patient for fluid volume excess d. Administer multivitamin tablets twice per day
A
Which medication order does the nurse clarify before administering the drug to the patient with hypocalcemia? a. Magnesium sulfate 1 g IM every 6 hours for four doses b. Aluminum hydroxide (AlternaGEL) 15 mL orally three times a day and at bedtime c. Calcium carbonate 1000 mg orally after meals and at bedtime d. Calcium gluconate 5 mEq IV PRN for tetany
ACEG
Which nursing interventions apply to patients with hypercalcemia? (Select all that apply) a. Administer IV normal saline (0.9% sodium chloride) b. Assess the patient for a positive Homan's sign. c. Measure the abdominal girth. d. Massage calves to encourage blood return to the heart. e. Monitor for ECG changes f. Provide adequate intake of vitamin D g. During treatment, monitor for tetany
B
Which nursing interventions does the nurse include for the patient with hypophosphatemia? a. Aggressive treatment with parenteral p;hosphorous b. Administration of oral vitamin D and phosphorus supplements c. Concurrent administration of calcium supplements d. Elimination of beef, pork, and legumes from the diet
C
Which patient condition places the patient at risk for hypocalcemia, hyperkalemia, and hypernatremia? a. Hypothyroidism b. Diabetes mellitus c. Chronic renal failure d. Adrenal insufficiency
ABCD
Which patient conditions cause the patient to be at risk for hypocalcemia? (Select all that apply) a. Crohn's disease b. Acute pancreatitis c. Removal or destruction of parathyroid glands d. Immobility e. Use of digitalis
C
Which patient in the medical surgical unit is most likely to have increased aldosterone secretion? a. Patient who has excessive salt ingestion b. Patient who drinks a lot of water c. Patient who loses a lot of fluid and sodium d. Patient who loses potassium and water
C
Which patient is at greatest risk of developing hypocalcemia? a. 30-year-old Asian woman with breast cancer b. 45-year-old Caucasian man with hypertension and diuretic therapy c. 60-year-old Aftrican American woman with a recent ileostomy d. 70-year-old Caucasian man on long-term lithium therapy
D
Which patient is most at risk for developing hypernatremia? a. Patient who dislikes drinking milk and lacks calcium in the diet. b. Patient who is receiving total parenteral nutrition related to gastrointestinal surgery c. Patient with excessive diarrhea and vomiting from food poisoning d. Older adult patient with decreased sensitivity to thirst
ACDF
Which patients are at risk for developing hyponatremia? (Select all that apply) a. Postoperative patient who has been NPO for 24 hours. b. Patient with decreased fluid intake for several days c. Patient with excessive intake of 5% dextrose solution d. Diabetic patient with blood glucose of 250 mg/dL e. Patient with overactive adrenal glands f. Tennis player in 100 degree F weather
D
Which person is most likely to have symptoms related to poor lymph circulation? a. Person with carpal tunnel syndrome b. Marathon runner c. Person with a history of myocardial infarction d. Frequent overseas flyer
BCD
Which potassium levels are within normal limits? (Select all that apply) a. 2.0 mmol/L b. 3.5 mmol/L c. 4.5 mmol/L d. 5.0 mmol/L e. 6.0 mmol/L
C
Which precaution or intervention does the nurse teach the patient at continued risk for hypernatremia? a. Avoid salt substitutes b. Avoid aspirin and aspirin-containing products c. Read labels on canned or packaged foods to determine sodium content d. Increase daily intake of caffeine-containing foods and beverages
D
Which serum laboratory value does the nurse expect to see in the patient with hyperkalemia? a. Calcium greater than 8.0 mg/dL b. Potassium greater than 3.5 mEq/L c. Calcium greater than 11.0 mg/dL d. Potassium greater than 5.0 mEq/L
D
Which serum laboratory value does the nurse expect to see in the patient with hypokalemia? a. Calcium less than 8.0 mg/dL b. Potassium less than 5.0 mEq/L c. Calcium less than 11.0 mg/dL d. Potassium less than 3.5 mEq/L
D
Which serum laboratory value indicates the patient has hypernatremia? a. Chloride greater than 95 mEq/L b. Sodium greater than 135 mEq/L c. Chloride greater than 103 mEq/L d. Sodium greater than 145 mEq/L
A
Which serum level of phosphorus represents hypophosphatemia? a. 2.5 mg/dL b. 3.5 mg/dL c. 4.5 mg/dL d. 5.5 mg/dL
A
Which serum value does the nurse expect to see in the patient with hyponatremia? a. Sodium less than 136 mEq/L b. Chloride less than 95 mEq/L c. Sodium less than 145 mEq/L d. Chloride less than 103 mEq/L
D
the nurse is caring for several patients at risk for fluid and electrolyte imbalances. Which patient problem or condition can result in a relative hypernatremia? a. Use of salt substitute b. Diarrhea c. Drinking too much water d. NPO status for a prolonged period
A
the patient shows a positive Trousseau's or Chvostek's sign. The nurse prepares to give the patient which urgent treatment? a. IV calcium b. Calcitonin (Calcimar) c. IV potassium chloride d. Large doses of oral calcium
B
the patient's potassium level is low. What change in the cardiovascular system does the nurse expect to see related to hypokalemia? a. Tall, peaked T waves b. Weak, thready pulse c. Malignant hypertension d. Distended neck veins
C
The 65-year-old patient has a potassium laboratory value of 5.0 mEq/L. How does the nurse interpret this value? a. High for the patient's age b. Low for the patient's age c. Normal for the patient's age d. Dependent upon the medical diagnosis
ABDFH
The nurse is assessing the patient at risk for fluid volume excess. Which findings indicate that the patient has fluid volume excess? (Select all that apply) 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 touch
B
The patient's blood osmolality is 302 mOsm/L. What manifestation does the nurse expect to see in the patient? a. Increased urine output b. Thirst c. Peripheral edema d. Nausea
D
The physician orders magnesium sulfate (MgSO4) for the patient with severe hypomagnesemia. What is the preferred route of administration for this drug? a. Oral b. Subcutaneous c. Intramuscular d. Intravenous
BDE
Which statements about the function of the lymphatic system are true? (Select all that apply) a. Lymph fluid contains more protein than plasma. b. Lymph flow is slower than blood flow c. Lymph flow is enhanced by a pump system d. Lymphatic vessels carry lymph fluid toward the heart e. Lymph fluid is filtered by lymph nodes. f. The lymphatic system takes lymph to the kidneys for excretion.
A
Whish statement best explains how antidiuretic hormone (ADH) affects urine output? a. It increases permeability to water in the tubules causing a decrease in urine output. b. It increases urine output as a result of water being absorbed by the tubules. c. Urine output is reduced as the posterior pituitary decreases ADH production. d. Increased urine output results from increased osmolarity and fluid in the extracellular space.
D
Based on the factors of age, gender, and body type, which patient has the smallest percentage of total body water? a. Thin 78-year-old adult man b. Obese 35-year-old man c. Thin 25-year-old woman d. Obese 68-year-old woman