acid base/fluid and electrolytes

Front

A patient with renal failure is in metabolic acidosis. Which compensatory mechanism would the nurse expect to occur?

Back

Increase in respiratory rate

Answer explanation

Answer: B. Increase in respiratory rate. Rationale: The body compensates for metabolic acidosis by increasing the respiratory rate to expel CO2, which in turn reduces the acidity in the blood. The kidneys al attempt to excrete excess hydrogen ions, but respiratory compensation is the more immediate response.

Front

A nurse is caring for a patient who is hyperventilating due to anxiety. Which intervention should the nurse implement first?

Back

Instruct the patient to breathe slowly into a paper bag.

Answer explanation

Answer: B. Rationale: Breathing into a paper bag helps the patient re-inhale CO2, which can help correct respiratory alkalosis caused by hyperventilation.

Front

A patient with a history of prolonged vomiting presents with confusion and lethargy. The nurse reviews the laboratory results and finds a pH of 7.50 and a bicarbonate level of 34 mEq/L. What condition is most likely present?

Back

Metabolic alkalosis

Answer explanation

Answer: B Metabolic alkalosis. Metabolic alkalosis is characterized by an elevated pH (>7.45) and an increased bicarbonate level, which is consistent with the patient's laboratory results. Prolonged vomiting can lead to the loss of gastric acid, causing an alkalotic state.

Front

A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital with respiratory distress. The nurse expects which of the following to be true regarding the patient's acid-base status? Options: Increased pH and decreased PaCO2, Decreased pH and increased PaCO2, Decreased pH and decreased PaCO2, Increased pH and increased PaCO2

Back

Decreased pH and increased PaCO2

Answer explanation

Answer: B. Decreased pH and increased PaCO₂ Rationale: Respiratory acidosis occurs when the lungs cannot remove enough CO₂, leading to an increase in PaCO₂ and a decrease in pH. COPD often causes impaired gas exchange, leading to respiratory acidosis.

Front

A patient with hypertension is prescribed a thiazide diuretic. Which of the following side effects should the nurse monitor for in this patient? Hyperkalemia, Hyponatremia, Hypokalemia, Hypercalcemia

Back

Hypokalemia

Answer explanation

Answer: C. Hypokalemia Rationale: Thiazide diuretics can cause potassium loss, leading to hypokalemia. The nurse should monitor the patient's potassium levels and educate them about potassium-rich foods or supplementation if needed.

Front

A patient with kidney disease has a potassium level of 6.2 mEq/L. The nurse should monitor the patient for which of the following complications? Hypotension, Hypoglycemia, Cardiac dysrhythmias, Muscle weakness

Back

Cardiac dysrhythmias

Answer explanation

Answer: C. Cardiac dysrhythmias Rationale: A potassium level of 6.2 mEq/L indicates hyperkalemia. High potassium levels can lead to life-threatening cardiac dysrhythmias, including bradycardia and arrhythmias. Monitoring the heart rhythm is critical in this situation.

Front

A nurse is caring for a patient who is receiving an intravenous (IV) infusion of 0.9% saline solution. What is the primary purpose of administering isotonic fluids like 0.9% saline?

Back

To maintain or restore fluid balance in the extracellular space

Answer explanation

Answer: C. To maintain or restore fluid balance in the extracellular space Rationale: Isotonic solutions, like 0.9% saline, have the same osmolarity as blood plasma and are primarily used to maintain or restore fluid balance in the extracellular space without causing shifts into or out of cells.

Front

A nurse is assessing a patient with severe dehydration. Which of the following signs would the nurse expect to find in this patient? Hypertension, Edema, Decreased skin turgor, Weight gain

Back

Decreased skin turgor

Answer explanation

Answer: C. Decreased skin turgor Rationale: Decreased skin turgor is a common sign of dehydration, reflecting a loss of body fluids. The skin may appear dry, and when pinched, it takes longer to return to normal. Edema and weight gain are signs of fluid overload, not dehydration.

Front

A patient has a sodium level of 128 mEq/L. Which of the following symptoms is most likely to be observed in this patient?

Back

Muscle weakness and confusion

Answer explanation

Answer: B. Muscle weakness and confusion Rationale: A sodium level of 128 mEq/L indicates hyponatremia, which can cause symptoms such as muscle weakness, confusion, headache, and seizures due to the shift of water into cells.

Front

A nurse is caring for a patient with hypernatremia. Which of the following interventions would be most appropriate for this patient? Restricting fluid intake, Administering hypotonic fluids as prescribed, Encouraging the patient to increase sodium intake, Administering a diuretic

Back

Administering hypotonic fluids as prescribed

Answer explanation

Answer: B. Administering hypotonic fluids as prescribed Rationale: Hypernatremia is characterized by a high sodium level in the blood. Hypotonic fluids (like 0.45% saline) are often used to help dilute the sodium in the bloodstream and promote fluid balance.