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Pathophysiology Chapters 8 & 9

Total questions: 20

Worksheet time: 15mins

Name
Class
Date
1.

During the assessment of a client with heart failure, the nurse uses finger pressure to determine if edema is present in the lower extremities. When would the nurse document pitting edema?

a)

Indentation is not present

b)

The skin is thickened and hard.

c)

The area is firm and discolored.

d)

Indentation remains after the finger has been removed.

2.

The effective circulating volume is the major regulator of water balance in the body. What else does it regulate?

a)

Calcium

b)

Sodium

c)

Magnesium

d)

Potassium

3.

Antidiuretic hormone (ADH) helps maintain ppropriate fluid levels in the body. ADH is released when there is a(n):

a)

decreased blood osmolality

b)

increased blood osmolality

c)

ion gap

d)

osmoreceptor decrease

4.

When caring for a client with hyperkalemia, the nurse prioritizes assessment of which body system?

a)

Hepatic

b)

Cerebrovascular

c)

Cardiovascular

d)

Pulmonary

5.

Barbara has increased fluid retention related to her congestive heart failure. Her HCP would like to increase Barbara's fluid excretion. The most common method for increasing fluid excretion includes the use of:

a)

angiotension

b)

aldosterone

c)

diuretics

d)

aquaporins

6.

When caring for a client with hyperkalemia, the nurse prioritizes assessment of which body system?

a)

Hepatic

b)

Cerebrovascular

c)

Cardiovascular

d)

Pulmonary

7.

When caring for the client with portal hypertension and ascites, which dietary intervention does the nurse suggest to prevent the progression of fluid accumulation?

a)

Consume foods high in potassium.

b)

Avoid dairy products.

c)

Reduce protein intake

d)

Limit intake of sodium.

8.

The nurse is reviewing a client’s arterial blood gas (ABG) results. Which pH level would the nurse interpret as normal?

a)

pH of 7.00 to 7.25

b)

pH of 6.55 to 7.12

c)

pH of 7.35 to 7.45

d)

pH of 7.55 to 7.8

9.

The nurse is caring for a client who has developed hypoxemia and tissue hypoxia. Which of these interventions does the nurse set as a priority intervention?

a)

Rebreathing into a paper bag

b)

Alternating deep breathing with holding one’s breath

c)

Administration of supplemental oxygen

d)

Rapid, short, shallow breaths

10.

A potential problem that can occur as the potassium and hydrogen ion exchange attempt to amintain the ph balance is:

a)

hypokalemia

b)

hyperkalemia

c)

hyponatremia

d)

hypernatremia

11.

What is the nurse’s expectation about a client’s ability to compensate for a metabolic blood gas disorder?

a)

The client will not be able to compensate.

b)

The client will compensate with the same system.

c)

The client will compensate with the respiratory system.

d)

The client’s breathing will slow down.

12.

A client's most recent laboratory results suggest the presence of metabolic alkalosis. What action by the nurse best addresses a potential cause of this acid–base imbalance?

a)

Administering an antiemetic to treat the client's frequent vomiting

b)

Repositioning the client frequently to reduce pressure on dependent skin surfaces

c)

Assessing the client's bowel sounds and administering scheduled stool softeners

d)

Assessing the client's level of consciousness using the Glasgow Coma Scale

13.

The nurse is caring for a client who has excessive diarrhea. Which acid–base disturbance does the nurse anticipate uncovering during evaluation of the arterial blood gas?

a)

No change in values from normal

b)

An increase in bicarbonate

c)

Metabolic acidosis

d)

Increased pH value

14.

A client has an increase in her anion gap (AG). What does the nurse determine is the significance of this finding?

a)

It indicates the client has metabolic alkalosis.

b)

It indicates the client has respiratory alkalosis.

c)

It indicates the client has respiratory alkalosis.

d)

It indicates the client has metabolic acidosis.

15.

A nurse is providing care for several clients on an acute medicine unit. Which client should the nurse recognize as being at the highest risk for metabolic alkalosis?

a)

A client on continuous nasogastric suction and whose hypertension is being treated with diuretics

b)

A client in alcohol withdrawal who is being treated with intravenous anticonvulsants

c)

A postoperative client who developed sepsis after the dehiscence of an abdominal wound

d)

A client with acquired immunodeficiency syndrome (AIDS) who has developed tuberculosis and is receiving antibiotics

16.

he nurse is reviewing lab results of a client diagnosed with metabolic acidosis. The most important electrolyte for the nurse to assess would be:

a)

Magnesium (Mg2+)

b)

Sodium (Na+)

c)

Calcium (Ca2+)

d)

Potassium (K+)

17.

A heart failure client has become confused and took too many of his “water pills” (diuretics). On admission, his serum potassium level was 2.6 mEq/L (2.6 mmol/L). Which assessments correlate to this hypokalemia finding? Select all that apply.

a)

Constipation

b)

Polyuria

c)

Bradycardia

d)

Paresthesia with numbness of the lips/mouth

e)

ECG showing short runs of ventricular fibrillation

18.

For several years, a single mother of 2 has been averaging 2 to 3 bottles of wine each night and recently has added several ounces of brandy as well. She now has been diagnosed with cirrhosis. Which physical manifestations of cirrhosis would the nurse expect to find during assessment? Select all that apply.

a)

Ascites

b)

Obesity

c)

Fever

d)

Bleeding tendencies

e)

Epigastric pain

19.

The nurse is assessing a client with fluid volume deficit. Which manifestation of fluid volume deficit may be observed? Select all that apply.

a)

Prolonged capillary refill

b)

Bounding pulse

c)

Sunken eyes

d)

Decreased urine output

e)

Increased blood pressure

20.

A client is suspected of having the onset of alcoholic liver disease. The nurse should be assessing for which manifestation related to the necrosis of liver cells?

a)

Tremors of the hands

b)

Rapid onset of jaundice

c)

Long muscle group atrophy

d)

Development of multiple skin nodules