Font size
WorksheetsEXAM 4
Total questions: 50
Worksheet time: 2hrs 40mins
We've made it this far and I'm so proud of you! Hopefully we keep in touch throughout the next quarter! If you have any questions, comments, or concerns, please leave it down below! Thank you!! Hope this helps :) -kaitlyn
Endurance athletes who exercise for long periods of time and consume only water may experience a sodium deficit in their extracellular fluid. What is this electrolyte imbalance known as?
hyponatremia
hyperkalemia
hypernatremia
hypokalemia
The primary care provider writes prescriptions for a client who is admitted with a serum potassium level of 6.9 mEq/L. What does the nurse implement first?
Ensure that a potassium-restricted diet is ordered.
Administer sodium polystyrene sulfonate (Kayexalate) orally.
Teach the client about foods that are high in potassium.
Place the client on a cardiac monitor.
A client is receiving an intravenous infusion of 1000 mL of normal saline with 40 mEq of potassium chloride. The care unit nurse is monitoring the client for signs of hyperkalemia. Which finding initially will be noted in the client if hyperkalemia is present?
confusion
muscle weakness
mental status changes
depressed deep tendon reflexes
A patient is given: 3 oz apple juice, 1 oz of bread, 2 oz of gelatin and 4 oz of fruity pebbles. What is the patient's fluid intake in mL?
300 mL
90 mL
150 mL
100 mL
Hypotonic solutions shift from where?
intracellular to extracellular
extraceullar to intracellular
it is equal inside and outside
The nurse is caring for a client with a nasogastric tube that is attached to low suction. The nurse monitors the client for manifestations of which disorder that the client is at risk for?
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
A patient who has renal failure has what acid-base imbalance?
(a)
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?
weight loss and dry skin
flat neck and hand veins and decreased urinary output
increased blood pressure and respirations
weakness and decreased central venous pressure
A client with hypermagnesemia is seen in the emergency department (ED). Which of these interventions is most appropriate?
monitor for hyperactive reflexes
prepare for endotracheal intubation
do patient teachings on avoiding magnesium rich foods
place the client on a cardiac monitor
The nurse is caring for an older adult with hypernatremia. Which of these interventions does the nurse perform first?
restrict the client intake of sodium
administer a diuretic
monitor the serum osmolarity
encourage fluid intake
The nurse is caring for a client with a diagnosis of dehydration, and the client is receiving IV fluids. Which assessment data would indicate to the nurse that the dehydration remains unresolved?
oral temp of 98.8
urine specific gravity of 1.043
urine output that is pale yellow
a blood pressure of 120/80
The nurse is monitoring the fluid balance of a client with a burn injury. The nurse determines that the client is less than adequately hydrated if which information is noted during assessment?
urine ph = 6
urine is pale yellow
urine output is 40 mL/hr
urine specific gravity = 1.032
The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which cardiovascular manifestation would the nurse expect to note?
hypotension
increased heart rate
bounding peripheral pulses
constipation
A nurse is caring for a client with a diagnosis of COPD. The nurse monitors the client for which acid-base imbalance that most likely occurs in clients with this condition?
metabolic acidosis
respiratory acidosis
metabolic alkalosis
respiratory alkalosis
If you are vomiting, you are losing _____ and your acid-base imbalance will be ______
acid, respiratory alkalosis
acid, metabolic alkalosis
base, metabolic acidosis
base, metabolic alkalosis
A patient recovering from major abdominal surgery is to be progressed from a clear liquid diet to the next diet level. Which statement by the nurse would be most appropriate in this circumstance?
“you will progress from a clear liquid diet to a mechanical soft diet.”
“if you can tolerate the clear liquid diet, your next meal will be a full liquid.”
“you will receive a regular diet tray with anything you want at the next meal.”
“it is important that you eat a puréed diet after you are able to tolerate the clear liquids.”
A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which priority problem?
metabolic alkalosis
metabolic acidosis
diarrhea
hyperactive bowel sounds
A patient was involved in a motor vehicle crash. How should the nurse interpret the following arterial blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L?
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
The nurse has a prescription to give 30 mL of an antacid to a client through a feeding tube. Which is the priority nursing action?
assess tube placement
Flush with 30 mL of sterile saline.
Aspirate to determine residual volume.
Administer the antacid by gravity flow.
The nurse is administering a bolus feeding through a NG tube. Which position should the nurse use for the client after the tube feeding?
supine
flat on the left side
fowler's on the right side
semi fowlers on the left side
A client is 6-days postoperative surgery and has been on bedrest and is now presenting with a serum calcium level of 11.2 mg/dL. Which of the following interventions should the nurse implement?
Administer IV calcium gluconate
Compare their intake and output from the previous shift
Encourage intake of milk, broccoli, and dried figs
Assist the client with frequent ambulation throughout the day
The nurse is providing dietary teaching to a client who is receiving a potassium-retaining diuretic about foods that are low in potassium. Which foods should the nurse include on a list of foods with low potassium content?
apple
carrots
spinach
avocado
The nurse is monitoring the nutritional status of a client receiving enteral nutrition. Which intervention should the nurse implement to determine the effectiveness of the tube feedings?
use a calorie count
obtain daily weight
evaluate intake and output
monitor serum protein level
The nurse should include which item in a list of the most helpful foods for a vegan client wishing to increase foods high in vitamin A?
peas
carrots
potatoes
green beans
The nurse provides dietary instructions to a client at risk for hypokalemia about which foods are high in potassium and should be included in the daily diet. The nurse should tell the client that which fruit is highest in potassium?
kiwi
apples
pineapples
peaches
The nurse is providing instructions to a client regarding food items that are high in vitamin D. The client demonstrates understanding of the instructions by stating the need to include which food item in the diet?
milk
meat
oranges
cheese
During an assessment of a newly admitted client, the nurse notes that the client's heart rate is 110 beats/min, his blood pressure shows orthostatic changes when he stands up, and his tongue has a sticky, paste-like coating. The client's spouse tells the nurse that he seems a little confused and unsteady on his feet. Based on these assessment findings, the nurse suspects that the client has which condition?
dehydration
hypokalemia
fluid overload
hypernatremia
During an assessment of skin turgor in an older client, the nurse discovers that skin tenting occurs when the skin is pinched on the client's forearm. What should the nurse do next?
document the finding
call another nurse to verify the finding
call the physician to order a fluid replacement
check skin turgor over the patient's sternum
A school nurse is teaching an athletic coach how to prevent dehydration in athletes during football practice. Which action by the coach during football practice would indicate that further teaching is needed?
Weighs athletes before, during, and after football practice
Asks the athletes to take a salt tablet before football practice
Schedules fluid breaks every 30 minutes throughout practice
Tells the athletes to drink 16 oz of fluid per pound lost during practice
The nurse caring for a client with heart failure is notified by the hospital laboratory that the client's serum magnesium level is 1.0 mEq/L. Which would be the most appropriate nursing action for this client?
Monitor the client for dysrhythmias.
Encourage increased intake of phosphate antacids.
Discontinue any magnesium-containing medications.
Encourage intake of foods such as ground beef, eggs, or chicken breast.
What is magnesium and sodium associated with?
bones + heart
breathing + bones
breathing + fluids
breathing + heart
What percent of daily fats should you intake?
20%
25%
30%
35%
A client treated for an episode of hyperthermia is being discharged to home. The nurse determines that the client needs clarification of discharge instructions if the client states a need to perform which action?
increase fluid intake
resume full activity level
stay in a cool environment
monitor voiding for adequacy of urine output
The nurse is caring for a client with a phosphorus level of 1.9 mg/dL. Which of the following interventions should the nurse implement?
restrict fluid intake
place patient on a cardiac monitor
Encourage intake of phosphorus rich foods
Call the physician and recommend an order of a phosphorus IV infusion
A nurse is teaching a client about the importance of a balanced diet. The nurse determines that the education was successful when the client identifies which of the following as a rich source of potassium?
bread items
processed meats
dairy products
apricots
What is a sign and symptom of hypovolemia?
hypertension
strong and bounding pulse
moist crackles in the lungs
dry mucous membranes
The client tells the nurse that he ingests large amounts of oral antacids on a daily basis. The nurse plans care knowing that the excessive use of oral antacids containing bicarbonate can result in which acid-base disturbance?
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
The nurse assess that her client who is 3 days postoperative following abdominal surgery. Which of the following items can the nurse include in the clients tray?
fish and chips
chocolate pudding
a small muffin
cheese crackers
The nurse is performing an assessment on a client admitted to the hospital with a diagnosis of dehydration. Which assessment finding should the nurse expect to note?
bradycardia
elevated blood pressure
changes in mental status
bilateral crackles in the lungs
The nurse reviews a client's laboratory report and notes that the client's serum phosphate level is 1.8 mg/dL. Which condition most likely caused this serum phosphorus level?
malnutrition
renal insufficiency
Hypoparathyroidism
tumor lysis syndrome
The nurse is caring for a client who is experiencing metabolic alkalosis. Knowing the risks of this imbalance, the nurse plans to protect the client's safety by carefully implementing which prescribed precaution?
neutropenic precautions
bleeding precautions
seizure precautions
contact isolation
A client is determined by blood gas analysis to be in respiratory alkalosis. Which electrolyte disorder should the nurse monitor for that could accompany the acid-base imbalance?
hypokalemia
hypercalcemia
hypochloremia
hypernatremia
A client with asthma is most likely to experience which type of acid-base imbalance as a complication of the disorder?
respiratory alkalosis
respiratory acidosis
metabolic acidosis
metabolic alkalosis
If you are hyponatremia, you have low sodium which means your body doesn't have enough water
true
false
The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance?
Respiratory acidosis from inadequate ventilation
Respiratory alkalosis from anxiety and hyperventilation
Metabolic acidosis from calcium loss due to broken bones
Metabolic alkalosis from taking analgesics containing base products
What is not a sign of malnourishment?
low albumin levels
thin/dry hair
small tongue
poor dentition
The nurse reviews the arterial blood gas results of an assigned client and notes that the laboratory report indicates a pH 7.30, Pco2 58 mm Hg, Po2 80 mm Hg, and HCO3 26 mEq/L. The nurse should interpret this to mean that the client has which acid-base disturbance?
metabolic acidosis
metabolic alkalosis
respiratory acidosis
respiratory alkalosis
The nurse is preparing to administer a bolus enteral feeding through her clients PEG tube. Upon assessment of the client's residual the nurse notes about 320 mLs of residual. Which of the following actions should the nurse take?
Administer the feeding per the physician’s order
Hold the bolus feeding and then call the charge nurse
Wait 1 hour and recheck the residual again
Slow down the rate at which the bolus feeding is administered
What is Vitamin E and Vitamin K good for?
immune system, blood clotting
immune system, bones
blood clotting, vision
bones, immune system
