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EXAM 4

Total questions: 50

Worksheet time: 2hrs 40mins

Name
Class
Date
1.

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

4 lines
2.

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?

a)

hyponatremia

b)

hyperkalemia

c)

hypernatremia

d)

hypokalemia

3.

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?

a)

Ensure that a potassium-restricted diet is ordered.

b)

Administer sodium polystyrene sulfonate (Kayexalate) orally.

c)

Teach the client about foods that are high in potassium.

d)

Place the client on a cardiac monitor.

4.

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?

a)

confusion

b)

muscle weakness

c)

mental status changes

d)

depressed deep tendon reflexes

5.

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?

a)

300 mL

b)

90 mL

c)

150 mL

d)

100 mL

6.

Hypotonic solutions shift from where?

a)

intracellular to extracellular

b)

extraceullar to intracellular

c)

it is equal inside and outside

7.

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?

a)

metabolic acidosis

b)

metabolic alkalosis

c)

respiratory acidosis

d)

respiratory alkalosis

8.

A patient who has renal failure has what acid-base imbalance?

(a)  

9.

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?

a)

weight loss and dry skin

b)

flat neck and hand veins and decreased urinary output

c)

increased blood pressure and respirations

d)

weakness and decreased central venous pressure

10.

A client with hypermagnesemia is seen in the emergency department (ED). Which of these interventions is most appropriate?

a)

monitor for hyperactive reflexes

b)

prepare for endotracheal intubation

c)

do patient teachings on avoiding magnesium rich foods

d)

place the client on a cardiac monitor

11.

The nurse is caring for an older adult with hypernatremia. Which of these interventions does the nurse perform first?

a)

restrict the client intake of sodium

b)

administer a diuretic

c)

monitor the serum osmolarity

d)

encourage fluid intake

12.

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?

a)

oral temp of 98.8

b)

urine specific gravity of 1.043

c)

urine output that is pale yellow

d)

a blood pressure of 120/80

13.

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?

a)

urine ph = 6

b)

urine is pale yellow

c)

urine output is 40 mL/hr

d)

urine specific gravity = 1.032

14.

The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which cardiovascular manifestation would the nurse expect to note?

a)

hypotension

b)

increased heart rate

c)

bounding peripheral pulses

d)

constipation

15.

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?

a)

metabolic acidosis

b)

respiratory acidosis

c)

metabolic alkalosis

d)

respiratory alkalosis

16.

If you are vomiting, you are losing _____ and your acid-base imbalance will be ______

a)

acid, respiratory alkalosis

b)

acid, metabolic alkalosis

c)

base, metabolic acidosis

d)

base, metabolic alkalosis

17.

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?

a)

“you will progress from a clear liquid diet to a mechanical soft diet.”

b)

“if you can tolerate the clear liquid diet, your next meal will be a full liquid.”

c)

“you will receive a regular diet tray with anything you want at the next meal.”

d)

“it is important that you eat a puréed diet after you are able to tolerate the clear liquids.”

18.

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which priority problem?

a)

metabolic alkalosis

b)

metabolic acidosis

c)

diarrhea

d)

hyperactive bowel sounds

19.

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?

a)

metabolic acidosis

b)

metabolic alkalosis

c)

respiratory acidosis

d)

respiratory alkalosis

20.

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?

a)

assess tube placement

b)

Flush with 30 mL of sterile saline.

c)

Aspirate to determine residual volume.

d)

Administer the antacid by gravity flow.

21.

The nurse is administering a bolus feeding through a NG tube. Which position should the nurse use for the client after the tube feeding?

a)

supine

b)

flat on the left side

c)

fowler's on the right side

d)

semi fowlers on the left side

22.

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?

a)

Administer IV calcium gluconate

b)

Compare their intake and output from the previous shift

c)

Encourage intake of milk, broccoli, and dried figs

d)

Assist the client with frequent ambulation throughout the day

23.

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?

a)

apple

b)

carrots

c)

spinach

d)

avocado

24.

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?

a)

use a calorie count

b)

obtain daily weight

c)

evaluate intake and output

d)

monitor serum protein level

25.

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?

a)

peas

b)

carrots

c)

potatoes

d)

green beans

26.

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?

a)

kiwi

b)

apples

c)

pineapples

d)

peaches

27.

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?

a)

milk

b)

meat

c)

oranges

d)

cheese

28.

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?

a)

dehydration

b)

hypokalemia

c)

fluid overload

d)

hypernatremia

29.

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?

a)

document the finding

b)

call another nurse to verify the finding

c)

call the physician to order a fluid replacement

d)

check skin turgor over the patient's sternum

30.

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?

a)

Weighs athletes before, during, and after football practice

b)

Asks the athletes to take a salt tablet before football practice

c)

Schedules fluid breaks every 30 minutes throughout practice

d)

Tells the athletes to drink 16 oz of fluid per pound lost during practice

31.

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?

a)

Monitor the client for dysrhythmias.

b)

Encourage increased intake of phosphate antacids.

c)

Discontinue any magnesium-containing medications.

d)

Encourage intake of foods such as ground beef, eggs, or chicken breast.

32.

What is magnesium and sodium associated with?

a)

bones + heart

b)

breathing + bones

c)

breathing + fluids

d)

breathing + heart

33.

What percent of daily fats should you intake?

a)

20%

b)

25%

c)

30%

d)

35%

34.

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?

a)

increase fluid intake

b)

resume full activity level

c)

stay in a cool environment

d)

monitor voiding for adequacy of urine output

35.

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?

a)

restrict fluid intake

b)

place patient on a cardiac monitor

c)

Encourage intake of phosphorus rich foods

d)

Call the physician and recommend an order of a phosphorus IV infusion

36.

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?

a)

bread items

b)

processed meats

c)

dairy products

d)

apricots

37.

What is a sign and symptom of hypovolemia?

a)

hypertension

b)

strong and bounding pulse

c)

moist crackles in the lungs

d)

dry mucous membranes

38.

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?

a)

metabolic acidosis

b)

metabolic alkalosis

c)

respiratory acidosis

d)

respiratory alkalosis

39.

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?

a)

fish and chips

b)

chocolate pudding

c)

a small muffin

d)

cheese crackers

40.

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?

a)

bradycardia

b)

elevated blood pressure

c)

changes in mental status

d)

bilateral crackles in the lungs

41.

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?

a)

malnutrition

b)

renal insufficiency

c)

Hypoparathyroidism

d)

tumor lysis syndrome

42.

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?

a)

neutropenic precautions

b)

bleeding precautions

c)

seizure precautions

d)

contact isolation

43.

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?

a)

hypokalemia

b)

hypercalcemia

c)

hypochloremia

d)

hypernatremia

44.

A client with asthma is most likely to experience which type of acid-base imbalance as a complication of the disorder?

a)

respiratory alkalosis

b)

respiratory acidosis

c)

metabolic acidosis

d)

metabolic alkalosis

45.

If you are hyponatremia, you have low sodium which means your body doesn't have enough water

a)

true

b)

false

46.

The nurse is caring for a client with several broken ribs. The client is most likely to experience what type of acid-base imbalance?

a)

Respiratory acidosis from inadequate ventilation

b)

Respiratory alkalosis from anxiety and hyperventilation

c)

Metabolic acidosis from calcium loss due to broken bones

d)

Metabolic alkalosis from taking analgesics containing base products

47.

What is not a sign of malnourishment?

a)

low albumin levels

b)

thin/dry hair

c)

small tongue

d)

poor dentition

48.

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?

a)

metabolic acidosis

b)

metabolic alkalosis

c)

respiratory acidosis

d)

respiratory alkalosis

49.

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?

a)

Administer the feeding per the physician’s order

b)

Hold the bolus feeding and then call the charge nurse

c)

Wait 1 hour and recheck the residual again

d)

Slow down the rate at which the bolus feeding is administered

50.

What is Vitamin E and Vitamin K good for?

a)

immune system, blood clotting

b)

immune system, bones

c)

blood clotting, vision

d)

bones, immune system