NRS 203 FLUID AND ELECTROLYTES
25. A nurse reviews electrolyte values and notes a sodium level of 130 mEq / L . the nurse understands that this sodium level would be noted in a client with which condition ?
4. The client with the SIADH
70. What foods would you recommend for a patient with hypokalemia
a . Fruits such as bananas and apricots
27. A nurse is caring for a client with a diagnosis of hyperparathyroidism . Lab studies are performed , and the serum calcium level is 12.0 mg / dL . On the basis of this lab value , the nurse takes which action ?
2. Informs the RN of the lab value
35. A nurse is instructing a client regarding how to decrease the intake of phosphorus in the diet The nurse tells the client that which food item contains the least amount of phosphorus ?
2. Oranges
28. A nurse reviews the client's serum calcium level and notes the level is 8.0 mg / dL . The nurse understands that which condition would cause this serum calcium level ?
2. Prolonged bedrest
The nurse is preparing to care for a client with a potassium deficit . The nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation ?
2. Requires nasogastric suction
36. The nurse is told in report that the client has a positive Chvostek's sign . What data would the nurse expect to note during assessment ? ( select all that apply )
2. Tetany 3. Diarrhea 4. Possible seizure activity 6. Positive Trousseau's sign
23. The nurse is reviewing the health records of assigned clients . The nurse plans care knowing that which client is at risk for fluid volume deficit ?
2. The client with a colostomy
59. What laboratory findings does the nurse determine are consistent with hypovolemia in a female patient ? ( Select all that apply . )
a . Hematocrit level of > 47 %, urine specific gravity of 1.027, urine osmolality of > 450 mOsm/kg
The nurse is assigned to care for a group of clients . On review of the clients ' medical records , the nurse determines that which client is most likely at risk for a fluid volume deficit ?
1. A client with an ileostomy
34. The nurse reviews the client's serum phosphorus level and notes that the level is 2.0 mg / dL . The nurse understands that which condition caused this serum phosphorus level ?
1. Alcoholism
32. A nurse is instructing a client on how to decrease the intake of potassium in the diet . The nurse tells the client that which food contains the least amount of potassium ?
1. Lettuce
12. The nurse reviews a client's laboratory report and notes that the client's serum phosphorus ( phosphate ) level is 1,8 mg / dL ( 0.45 mmol / L ) . Which condition most likely caused this serum phosphorus level ?
1. Malnutrition
Potassium chloride intravenously is prescribed for a client with hypokalemia Which actions should the nurse take to plan for preparation and administration of the potassium ? Select all that apply
1. Obtain an intravenous ( IV ) infusion pump 2. Monitor urine output during administration 4. Monitor the IV site for signs of infiltration or phlebitis 5. Ensure that the medication is diluted in the appropriate volume of fluid 6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution
The nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq / L ( 150 mmol / L ) . The nurse reports the serum sodium level to the health care provider ( HCP ) and the HCP prescribes dietary instructions based on the sodium level . Which acceptable food items does the nurse instruct the client to consume ? Select all that apply .
1. Peas 2. Nuts 4. Cauliflower
Which client is at risk for the development of a sodium level at 130 mEq / L ( 130 mmol / L ) ?
1. The client who is taking diuretics
21. A nurse is reading the physician's progress notes in the client's record and sees that the physician has documented " insensible fluid loss of approximately 800 mL daily . " The nurse understands that this type of fluid loss can occur through :
1. The skin
The nurse is assessing a client with a suspected diagnosis of hypocalcemia Which clinical manifestation would the nurse expect to note in the client ?
1. Twitching
The nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 2.5 mEq / L ( 2.5 mmol / L ) . Which patterns should the nurse watch for on the electrocardiogram ( ECG ) as a result of the laboratory value ? Select all that apply
1. U waves 3. Inverted T waves 4. Depressed ST segment
The nurse caring for a client who has been receiving intravenous ( IV ) diuretics suspects that the client is experiencing a fluid volume deficit . Which assessment finding would the nurse note in a client with this condition ?
1. Weight loss and poor skin turgor
30. A nurse is instructing a client on how to decrease the intake of calcium in the diet . The nurse tells the client that which food item contains the least amount of calcium ?
2. Butter
The nurse is caring for a client with heart failure . On assessment the nurse notes that the client is dyspneic and crackles are audible on auscultation What additional manifestations would the nurse expect to note in this client if excess fluid volume is present ?
3. An increase in blood pressure and increased respirations
31. A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg / dL . Which medication would the nurse prepare to administer as prescribed to the client ?
3. Calcitonin ( Miacalcin )
The nurse is caring for a client with heart failure who is receiving high doses of a diuretic . On assessment , the nurse notes that the client has flat neck veins . generalized muscle weakness , and c inished deep reflexes . The nurse suspects hyponatremia . What additional signs would the nurse expect to note in a client with hyponatremia ?
3. Hyperactive bowel sounds
13. The nurse is reading a health care provider's ( HCP's ) progress notes in the client's record and reads that the HCP has documented " insensible fluid loss of approximately 800 mL daily . " The nurse makes a notation that insensible fluid loss occurs through which type of excretion ?
3. Integumentary output
The nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.7 mEq / L ( 5.7 mmol / L ) . Which patterns would the nurse watch for on the cardiac monitor as a result of the laboratory value ? Select all that apply
3. Tall peaked T waves 5. Widened QRS complexes
A nurse is caring for a client with cirrhosis . The nurse notes that the client is dyspneic and that crackles are heard on auscultation of the lunas : fluid volume excess is suspected What additional signs would the nurse expect to note in this client if a fluid volume excess is present ?
4. An increased blood pressure
29. A nurse is caring for a client with a suspected diagnosis of hypercalcemia . Which of the following signs would be an indication of this diagnosis ?
4. Generalized muscle weakness
24. A nurse is caring for a client who has ben taking diuretics on a long - term basis . A fluid volume deficit is suspected . Which finding would be noted in the client with this condition ?
4. Increased specific gravity of the urine
33. The nurse is caring for a client with renal failure . The lab results reveal a magnesium level of 3.6 mg / dL . Which of the following signs would the nurse expect to note in the client based on this level ?
4. Loss of deep tendon reflexes
20. A nurse reviews a client's electrolyte results anld notes that the potassium level is 5.4 mEq / L . Which of the following would the nurse note on the cardiac monitor as a result of this lab value ?
4. Narrow , peaked T waves
26. A nurse is caring for a client with leukemia and notes that the client has poor skin turgor and flat neck and hand veins . The nurse suspects hyponatremia . What additional signs would the nurse expect to note in this client if hyponatremia is present ?
4. Postural blood pressure changes
The nurse is caring for a client with hypocalcemia . Which patterns would the nurse watch for on the electrocardiogram as a result of the laboratory value ? Select all that apply .
4. Prolonged QT interval 5. Prolonged ST segment
19. The nurse is reviewing the health records of assigned clients . The nurse plans care knowing that which client is at risk for a potassium deficit ?
4. The client receiving nasogastric suction
17. Which client is at risk for the development of a potassium level of 5.5 mEq / L ( 5.5 mmol / L ) ?
4. The client who has sustained a traumatic burn
22. The nurse is reviewing the health records of assigned clients . The nurse plans care knowing that which client is at the lowest risk for the development of third - spacing ?
4. The client with diabetes mellitus
On review of the clients ' medical records , the nurse determines that which client is at risk for fluid volume excess ?
4. The client with kidney disease and a 12 - year history of diabetes mellitus
49. During diuretic therapy , the nurse monitors the fluid and electrolyte status of the patient . Which assessment findings are symptoms of hyponatremia ? ( Select all that apply . )
a . Red b . Lethargy d . Hypotension e . Stomach cramps
54. The nurse should assess the patient for signs of lethargy , increasing intracranial pressure , and seizures when the serum sodium reaches what level ?
a 115 mEq / l
52. A nurse is admitting an older adult client who is experiencing dyspnea , weakness weight gain of 2lb , and 1+ bilateral edema of the lower extremities . The client has temp 99F . pulse 96 / min . rep 26 / min . 02 94 % on 3L 02. BP 152/96 . Which of the following manifestations of fluid volume excess should the nurse expect ?
Dyspnea Weakness Hypertension Edema
67. A nurse is assessing a client who has pancreatitis The client's arterial blood gases reveal metabolic acidosis . Which of the following are expected findings ? ( Select all that apply )
E. Dysrhythmia F. Tachypnea
The nurse provides instructions to a client with a low potassium level about the foods that are high in potassium and tells the client to consume which foods ? Select all that apply .
Fruits such as apricots and bananas
50. A nurse is caring for an older adult client in a ling - term care facility . The client has become weak and confused . He ate 40 % breakfast and lunch . Temp 100.9 . pulse 93 / min . resp 20 / min . BP 108/60 . He has lost 3/4 lb and reports dizziness when assisted to the bathroom He also has a nonproductive cough with diminished breath sounds in the right lower lobe . Which of the following actions should the nurse take ?
Monitor for orthostatic hypotension
51. A nurse is assessing a client who is dehydrated for fluid volume deficit . Which of the following findings should the nurse expect the client ?
Tachycardia
64. The healthcare provider has prescribed a hypotonic IV solution for a patient . Which IV solution should the nurse administer ?
a . 0.45 % sodium chloride
63. The nurse notes that a patient's urine osmolality is 980 mOsm / kg . What should the nurse assess as a possible cause of this finding ?
a . Acidosis
44. The nurse is preparing to transfuse a patient with a unit of packed red blood cells ( PRBCs ) . Which intravenous solution is correct for use with the PRBC transfusion ?
b . 0.9 % sodium chloride ( NS ) sodium chloride
57. A patient's serum sodium concentration is within the normal range . The nurse estimates that the serum osmolality should be :
b . 275 to 300 mOsm / kg
72. patient is admitted with a diagnosis of kidney injury . The patient reports " stomach distress " and describes ingesting several antacid tablets over the past 2 days . Blood pressure is 110/70 mm Hg . face is flushed , and the patient is experiencing generalized Weakness . Which is the most likely magnesium level associated with the symptoms the patient has
b . 5 mEq / L
45. The nurse is preparing to transfuse a patient with a unit of packed red blood cells ( PRBCS ) . Which patient would be best treated with this transfusion ?
b . A patient with severe anemia
62. A patient has been involved in a traumaticaccident and is hemorrhaging from multiple sites . The nurse expects that the compensatory mechanisms associated with hypovolemia would cause what clinical manifestations ? ( Select all that apply . )
b . Oliguria d . Bradycardia e . Tachypnea
48. The nurse is preparing to give a potassium supplement . Which laboratory test should be checked before the patient receives a dose of potassium ?
b . Serum potassium level
46. After a severe auto accident , a patient has been taken to the trauma unit and has an estimated blood loss of more than 30 % of his blood volume The nurse prepares to administer which product ?
b . Whole blood
71. Which medication does the nurse anticipate administering to antagonize the effects of potassium on the heart for a patient in severe metabolic acidosis
b Magnesium sulfate
68. The nurse is reviewing the laboratory studies for a patient suspected of acute kidney injury : What test would be the best indicator of the patient's renal function ?
b Serum creatinine
69. The patient has had severe vomiting for 24 hours The nurse observes flat tea waves and ST segment depression . Which potassium level
c . 2.0 mEq / L
55. In a patient with excess fluid volume . hyponatremia is treated by restricting fluids to how many mL in 24 hours ?
c . 800
65. The nurse is caring for a patient with hypernatremia . What complication of hypernatremia should the nurse continuously monitor for ?
c . Cerebral edema
43. A patient is receiving an infusion of fresh frozen plasma . Based on this order , the nurse interprets that this patient has which condition ?
c . Coagulation disorder
38. During a blood transfusion , the patient begins to have chills and back pain . What is the nurse's priority action ?
c . Discontinue the infusion immediately and notify the prescriber
42. During an infusion of albumin , the nurse monitors the patient closely for the development of which adverse effect ?
c . Fluid volume overload
61. A patient with mild fluid volume excess is prescribed a diuretic that blocks sodium reab sorption in the distal tubule Which diuretic does the nurse anticipate administering to this patient ?
c . Hydrochlorothiazide
66. The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea . What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for ?
c . Metabolic acidosis
47. A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload . The prescriber wants to raise the patient's hemoglobin and hematocrit levels . The nurse anticipates that the patient will receive which blood product ?
c . Packed red blood cells ( PRBCS )
58. The nurse expects that a decrease in serum osmolality would occur with :
c . renal failure
60. The nurse is reviewing the laboratory studies for a group of patients . Which patient is most likely to experience a decrease in serum osmolality ?
c A patient with kidney failure
56. A patient who is semiconscious presents with restlessness and weakness . The nurse assesses a dry , swollen tongue and a body temperature of 99.3 F. The urine specific gravity 1.020 . What is the most likely serum sodium value for this patient ?
c.155 mEq / L
41. When monitoring patient for signs of hypokalemia , the nurse looks for what early sign ?
d . Muscle weakness
39. The nurse is working with a graduate nurse to prepare an intravenous dose of potassium Which statement by the graduate nurse reflects a need for further teaching ?
d . The intravenous potassium dose will be given undiluted
40. A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending several hours doing gardening work in the heat of the day . The nurse expects that which drug therapy will be used to treat this condition ?
d Oral administration of sodium chloride tablets
73. What clinical indication of hypophosphatemia does the nurse assess in a patient ?
d Tetany
53. A nurse is admitting a client who reports nausea , vomiting , and weakness . The client has dry oral mucous membranes . Which of the following findings should the nurse identify as manifestations of fluid volume deficit ?
decreased skin turgor Concentrated urine Low - grade fever Tachypnea
37. When reviewing the health history of a patient , the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem ?
has a ( select c . Renal disease
