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NSG 3100 Exam 4 Review

Total questions: 73

Worksheet time: 37mins

Name
Class
Date
1.

The patient is on a low potassium diet that includes food such as applesauce, green beans, cabbage, lettuce, grapes, and raspberries. What type of patient would you expect to be on this type of diet?

a)

A patient who recently had gastric bypass surgery

b)

A patient with Addison’s disease

c)

A patient with osteoporosis

d)

A patient with heart disease

2.

A patient is to be started on enteral feedings. What important step should the nurse take before the patient is started on enteral feedings?

a)

Assess patient allergies to lactose

b)

Evaluate the families perception of the enteral feedings

c)

Make sure the patient stays nothing by mouth while enteral feedings are being administered

d)

Assess the patient’s understanding about enteral feedings

3.

A patient asks you what vitamin is best for eye sight. Your response is:

a)

Vitamin A

b)

Vitamin B12

c)

Vitamin C

d)

Vitamin B6

4.

A patient has a low magnesium level. Which food of the selection below is the highest in magnesium?

a)

Mushrooms

b)

Rhubarb

c)

Avocado

d)

Liver

5.

A patient with anemia would benefit from which diet?

a)

Legumes, organ meat, and dark green leafy vegetables

b)

Nuts and seeds, fruits, and soy products

c)

Vegetables, fish, and pasta

d)

Grains, berries, and organic vegetables

6.

You have a patient who just had a stroke and has garbled speech. What type of diet do you expect the patient to be prescribed after a speech evaluation?

a)

Mechanically altered diet with nectar thick liquids

b)

Mechanically altered diet with thin liquids

c)

Soft diet

d)

Full liquid diet

7.

A patient is started on the diuretic Spironolactone. Which foods should the patient be careful to avoid eating too much of?

a)

Bananas

b)

Eggs

c)

Hot Dogs

d)

Green leafy vegetables

8.

A patient has a stage 4 pressure ulcer on their sacral area. What type of foods would the patient most benefit from?

a)

Dried beans, eggs, meats

b)

Peanuts, tomatoes, and cabbage

c)

Liver, spinach, corn

d)

Oats, fruits, and vegetables

9.

A patient is on a lacto-ovo vegetarian diet. What type of foods can the patient eat?

a)

Fish, milk, and poached eggs

b)

Oysters, yogurt, and turkey

c)

Chicken, cheese, and grilled eggplant

d)

Boiled eggs and chocolate milk

10.

A patient’s potassium level is 6.0. Which food should the patient avoid?

a)

Raisins

b)

Egg yolks

c)

6.0 is a normal potassium level so the patient can eat whatever they want without an effect

d)

Rice

11.

A patient receiving dialysis should avoid what type of foods?

a)

Microwaved sweet potatoes, boiled cabbage, and artichokes

b)

Steamed broccoli, broiled mackerel, and artificial sweeteners

c)

Canned soups, cold cut sandwiches, and Chinese take-out

d)

Fresh fruits and vegetable, poultry, and beans

12.

A patient is suffering from a broken jaw. Which foods would be most beneficial for this patient?

a)

Carrots, fried chicken, and cereal

b)

Soup, pudding, and ice cream

c)

Tacos, peanuts, and fresh broccoli

d)

Rice, watermelon, and smoked fish

13.

A patient is diagnosed with Congestive Heart Failure and must follow a specific diet. Which spices are okay for the patient to use daily?

a)

Garlic Sodium & Nutmeg

b)

Sea Salt & Pepper

c)

Onion Salt & Garlic Powder

d)

Ginger & Bay Leaves

14.

A patient was recently admitted for a Deep Vein Thrombosis and was started on Coumadin. During your education with the patient you would instruct the patient to avoid what food?

a)

Lettuce

b)

Bananas

c)

Processed meats

d)

Spinach

15.

A patient is post-opt from gallbladder surgery and is ordered a clear liquid diet. Which of the selection can the patient have?

a)

Fudge Popsicle

b)

Apple Juice

c)

Vanilla Custard

d)

Creamy Chicken Soup

16.

A patient who has a colostomy is complaining about having excess gas. You ask the patient to tell you what he has ate in the past 48 hours. Which food would you suspect is causing the patient excessive gas?

a)

Squash, Spinach, and Pickles

b)

Chicken, grapes, and raspberries

c)

Cherries, Radishes, and Watermelon

d)

Caraway seeds, tomato soup, and eggs

17.

A patient’s blood tests show they have a critically low parathyroid hormone (PTH). What effect would this have on phosphate and calcium levels in the blood?

a)

Phosphate and calcium levels high

b)

Phosphate and calcium levels low

c)

Phosphate levels low, calcium levels high

d)

Phosphate levels high, calcium levels low

18.

A patient is experiencing hypercalcemia and has developed renal calculi. What is the effect on the phosphate level in hypercalcemia?

a)

Phosphate level remain the same

b)

Phosphate level increases

c)

Phosphate level decreases

d)

Phosphate level normalizes

19.

Which of the following would you NOT expect to see with a phosphate level of 1.2?

a)

Confusion

b)

Positive Trousseau’s Sign

c)

Osteomalacia

d)

Weakness

20.

A patient undergoing treatment for Rhabdomyolysis with a phosphate level of 6.0 is about to eat their dinner. What food from their food tray would you remove due to it high contents of phosphate?

a)

Breaded chicken and French fries

b)

Baby carrots and peas

c)

Macaroni and 2 oz of canned tuna

d)

Rice and broccoli

21.

Which patient is likely to present with a phosphate level of 6.0?

a)

A patient on total parenteral nutrition therapy (TPN).

b)

A patient who reports drinking a 12 pack of beer daily.

c)

A patient taking an aluminum hydroxide-based antacid four times a day.

d)

A patient in end-stage renal failure who is scheduled for dialysis tomorrow.

22.

A patient has a phosphate level of 5.6. The doctor orders the patient to take Phoslo. What education will you provide to this patient regarding this medication?

a)

Take the medication with 8 oz of water

b)

Take the medication with a meal or right after

c)

Take the medication on an empty stomach

d)

Take the medication before bedtime when phosphate levels are the highest

23.

What of the following is NOT an expected treatment for a phosphate level of 1.5?

a)

Administering Phoslo by mouth with meals

b)

Ensuring patient safety due to risk of bone fractures

c)

Encouraging the patient to eat fish, beef, chicken, and organ meats

d)

Administering Vitamin-D supplements

24.

A patient is being discharged after being hospitalized with a phosphate level of 1.8. What type of foods will you encourage the patient to consume in your diet teaching?

a)

Organs meats and beef

b)

Fresh fruits and vegetables

c)

Beans and beets

d)

Turnips and cauliflower

25.

A patient has been undergoing chemotherapy for treatment of breast cancer. The patient has started to exhibit early signs of Tumor Lysis Syndrome (TLS). Which of the following findings correlates with TLS?

a)

Phosphate level of 2.0

b)

Phosphate level of 2.9

c)

Phosphate level of 4.0

d)

Phosphate level of 6.5

26.

A patient with a magnesium level of 3.6 would exhibit which of the signs and symptoms EXCEPT?

a)

Hypotension

b)

Profound Lethargy

c)

Respiratory failure

d)

Hyperreflexia of the deep tendons

27.

Magnesium is absorbed by what system of the body?

a)

Gastrointestinal

b)

Hepatic

c)

Lymphatic

d)

Renal

28.

Which of the following patients is MOST at risk for hypermagnesemia?

a)

A patient with alcoholism

b)

A patient taking a proton-pump inhibitor called Protonix

c)

A patient suffering from Crohn’s Disease

d)

A patient with a magnesium level of 0.6 receiving IV magnesium sulfate

29.

A patient is admitted to the ER. The patient receives dialysis on Tuesdays and Thursdays of every week, and presents with a palpable AV shunt (thrill present) in the left upper arm. The patient is extremely lethargic and family members are present to help answer questions. While collecting the patient’s medication history the daughter states her mother has been taking “a lot” of Maalox lately due to upset stomach. You note this to be a significant finding. Which of the following lab values correlates with this finding?

a)

Magnesium level of 1.0

b)

Magnesium level of 2.4

c)

Magnesium level of 3.6

d)

Magnesium level of 1.4

30.

A patient is being discharged after being hospitalized with a Magnesium level of 0.7. After diet teaching with this patient, which statement by the patient warrants you to re-educate the patient?

a)

“I love eating salads with kale and spinach”.

b)

“I’m shocked mackerel contains magnesium”.

c)

“I can’t believe I have to give up dark chocolate”.

d)

“Tonight I’m cooking fried potatoes with a side dish of peas”.

31.

A patient’s magnesium level is 0.9. The doctor orders Magnesium Sulfate IV. Which nursing intervention takes PRIORITY?

a)

Assessing for hypertension

b)

Monitoring deep tendon reflexes

c)

Monitoring potassium levels

d)

Monitoring skin turgor

32.

Which arrhythmia is a patient who has a Mg+ level of 0.8 most likely to experience?

a)

Heart block

b)

Bradycardia

c)

Torsades de pointes

d)

Normal sinus rhythm

33.

On admission, a patient blood alcohol limit is greater than 400 mg/dL. The patient reports drinking a 12 pack of beer on a daily basis. Which of the following conditions is this patient MOST at risk for?

a)

Hypomagnesemia

b)

Hypermagnesemia

c)

Hyponatremia

d)

Hypernatremia

34.

A patient has a Magnesium level of 1.3. Which of the following is NOT a sign or symptom of this condition?

a)

Tall T-wave and depressed ST segment

b)

Torsades de pointes

c)

Positive Trouesseau’s and Chvostek’s

d)

Absent deep tendon reflexes

35.

A patient’s magnesium level is 3.0. The cater associate brings the patient a dinner tray. Which item on the tray would you remove to ensure the patient does not eat?

a)

Macaroni

b)

Tomatoes

c)

Kale

d)

Onions

36.

A patient with a sodium level of 112 is taking Lithium. Which of the following is a nursing priority?

a)

Hold further doses of Lithium

b)

Monitor Lithium drug level due to risk of toxicity

c)

Monitor potassium level due to increased risk of toxicity

d)

No priority is need. 112 is a normal sodium level

37.

A patient with a sodium level of 178 is ordered to be started on 0.45% Saline. What is the most IMPORTANT nursing intervention for this patient?

a)

Maintain patent IV

b)

Give rapidly to ensure fluids levels are shifted properly

c)

Clarify doctor's order because 0.45% saline is contraindicated in hypernatremia

d)

Give slowly and watch for signs and symptoms of cerebral edema

38.

You have completed diet teaching with a patient who has hypernatremia. Which statement by the patient causes concern?

a)

"I will buy fresh vegetables and fruits."

b)

"I will avoid eating canned foods."

c)

"I'm glad I can still eat sandwiches with bologna."

d)

"I will avoid cooking with butter."

39.

A patient with Cushing's Syndrome has been experiencing an infection and has a fever of 102'F. On assessment, you find the patient to be confused, restless, has dry mucous membranes, and flushed skin. Which finding below correlates with the presentation of this patient?

a)

Sodium level of 144

b)

Sodium level of 115

c)

Sodium level of 170

d)

Sodium level of 135

40.

Which patient below is considered hypernatremic?

a)

A patient with a sodium level of 155

b)

A patient with a sodium level of 145

c)

A patient with a sodium level of 120

d)

 A patient with a sodium level of 136

41.

A patient with hypovolemic hyponatremia is started on IV fluids. Which of the following fluids do you expect the patient to be started on?

a)

0.45% Saline

b)

3% Saline

c)

D5W

d)

0.33% Saline

42.

A patient has a sodium level of 119. Which of the following is NOT related to this finding?

a)

Oversecretion of ADH (antidiuretic hormone)

b)

Low salt diet

c)

Inadequate water intake

d)

Hypotonic fluid infusion (overload)

43.

A patient has a sodium level of 130. What is this condition called?

a)

Hyponatremia

b)

Hypernatremia

c)

Normal Sodium Level

d)

Hypercalcemia

44.

Which of the following is not a cause of hypocalcemia?

a)

Low parathyroid hormone

b)

Crohn's Disease

c)

Acute Pancreatitis

d)

Thiazide Diuretics

45.

Stimulation of the facial nerve via the masseter muscle causes twitching of the nose/lips in hypocalcemia is known as?

a)

Trousseau's Sign

b)

Chvostek's Sign

c)

Homan's Sign

d)

Goodell's Sign

46.

A patient's calcium level is 6.9. Which of the following is a nursing priority?

a)

Initiate seizure precautions

b)

Educate patient about foods rich in calcium

c)

Administer Calcitonin

d)

Administer Vitamin D supplements as ordered

47.

A patient’s lab work shows that they have a high parathyroid hormone level. Which condition is the patient at risk for?

a)

Hyperkalemia

b)

Hypocalcemia

c)

Hypokalemia

d)

Hypercalcemia

48.

A patient's calcium level is 11.2. Which option below could be the cause?

a)

None, 11.2 is a normal calcium level

b)

Cushing's Syndrome

c)

Hydrochlorothiazide

d)

Hypoparathyroidism

49.

A patient has a calcium level of 12.5. Which medication will most likely be ordered for this patient?

a)

Calcium Chloride

b)

10% Calcium Gluconate

c)

Calcitonin

d)

Hydrochlorothiazide

50.

A patient is being discharged home after hospitalization with hypocalcemia. Which statement by the patient indicates she understood the dietary instructions?

a)

"I will avoid sardines."

b)

"I'll avoid salt and Vitamin-D supplements."

c)

"I will tell my husband to only purchase skim milk."

d)

"I will be sure to eat lots of cheese, tofu and spinach."

51.

A patient is recovering from parathyroid surgery. Morning labs values are back. Which of the following lab values would correlate as a complication from this type of surgery?

a)

Calcium 8.7

b)

Calcium 12.5

c)

Calcium 6.9

d)

Calcium 9.2

52.

A patient has a potassium level of 9.0. Which nursing intervention is priority?

a)

Prepare the patient for dialysis and place the patient on a cardiac monitor

b)

Administer Spironolactone

c)

Place patient on a potassium restrictive diet

d)

Administer a laxative

53.

Which of the following is not a symptom of hyperkalemia?

a)

Positive Chvostek’s sign

b)

Decreased blood pressure

c)

Muscle twitches/cramps

d)

Weak and slow heart rate

54.

Tall peaked T-waves, flat P-waves, prolonged PR intervals and widened QRS complexes can present in which of the following conditions?

a)

Hypocalemia

b)

Hypercalemia

c)

Hypokalemia

d)

Hyperkalemia

55.

Which patient is at risk for hyperkalemia?

a)

Patient with Parathyroid cancer

b)

Cushing’s Syndrome

c)

Patient with Addison’s Disease

d)

Patient with breast cancer

56.

A patient’s potassium level is 3.0. Which foods would you encourage the patient to consume?

a)

Cheese, collard greens, and fish

b)

Avocados, strawberries, and potatoes

c)

Tofu, oatmeal, and peas

d)

Peanuts, bread, and corn

57.

A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered a morning dose of Lasix 20mg IV. Patient’s potassium level is 3.0. What is your next nursing intervention?

a)

Hold the dose of Lasix and notify the doctor for further orders

b)

Administered the Lasix and notify the doctor for further orders

c)

Turn off the nasogastric suctioning and administered a laxative

d)

No intervention is need the potassium level is within normal range

58.

Which patient is at a potential risk for Digoxin toxicity?

a)

A patient with Cushing’s syndrome taking Lasix 20 mg IV twice a day

b)

A patient with a calcium level of 8.9

c)

A patient with a potassium level of 3.8

d)

A patient presenting with painful muscle spasms and positive Trousseau’s sign

59.

A patient has a potassium level of 2.0. What would you expect to be ordered for this patient?

a)

Potassium 30 meq IV push

b)

Infusion of Potassium intravenously

c)

An oral supplement of potassium

d)

Intramuscular injection of Potassium

60.

A patient with a potassium level of 2.1 has been taking Lasix daily. What medication will the patient most likely be switched to?

a)

Spironolactone

b)

None the patient will likely stay on the Lasix

c)

Hydrochlorothiazide

d)

Torsemide

61.

When the cell presents with the same concentration on the inside and outside with no shifting of fluids this is called?

a)

Hypotonic

b)

Hypertonic

c)

Isotonic

d)

Osmosis

62.

Which of the following is not a hypertonic fluid?

a)

3% Saline

b)

D5W

c)

10% Dextrose in Water (D10W)

d)

5% Dextrose in Lactated Ringer’s

63.

What type of fluid would a patient with severe hyponatremia most likely be started on?

a)

Hypotonic

b)

Hypertonic

c)

Isotonic

d)

Colloid

64.

When administering a hypertonic solution the nurse should closely watch for?

a)

Signs of dehydration

b)

Pulmonary Edema

c)

Fluid volume deficient

d)

Increased Lactate level

65.

A patient with cerebral edema would most likely be order what type of solution?

a)

3% Saline

b)

0.9% Normal Saline

c)

Lactated Ringer’s

d)

0.225% Normal Saline

66.

_______ solutions cause cell dehydration and help increase fluid in the extracellular space.

a)

Hypotonic

b)

Osmosis

c)

Isotonic

d)

Hypertonic

67.

Which solution below is NOT a hypertonic solution?

a)

5% Dextrose in 0.9% Saline

b)

5% Saline

c)

5% Dextrose in Lactated Ringer’s

d)

0.33% saline (1/3 NS)

68.

Which patient below would NOT be a candidate for a hypotonic solution?

a)

Patient with increased intracranial pressure

b)

Patient with Diabetic Ketoacidosis

c)

Patient experiencing Hyperosmolar Hyperglycemia

d)

All of the options are correct

69.

Which condition below could lead to cell lysis, if not properly monitored?

a)

Isotonicity

b)

Hypertonicity

c)

Hypotonicity

d)

None of the options are correct

70.

________ fluids remove water from the extracellular space into the intracellular space.

a)

Hypotonic

b)

Hypertonic

c)

Isotonic

d)

Colloids

71.

Isotonic fluids cause shifting of water from the extracellular space to the intracellular space.

a)

True

b)

False

72.

A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you expect the patient to be started on?

a)

5% Dextrose in 0.9% Saline

b)

0.33% saline

c)

0.225% saline

d)

0.9% Normal Saline

73.

The doctor orders an isotonic fluid for a patient. Which of the following is not an isotonic fluid?

a)

0.9% Normal Saline

b)

Lactated Ringer's

c)

0.45% Saline

d)

5% Dextrose in 0.225% saline