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1111 exam 5 pt.1

Total questions: 100

Worksheet time: 50mins

Name
Class
Date
1.

A nurse is assessing a client with dehydration. Which finding should the nurse expect?

a)

Crackles in the lungs

b)

Increased urine specific gravity

c)

Distended neck veins

d)

Bounding pulse

2.

A client with hyponatremia is admitted. Which intervention should the nurse include in the plan of care?

a)

Restrict free water intake

b)

Administer hypotonic IV fluids

c)

Encourage sodium-free diet

d)

Provide diuretics

3.

The nurse reviews a client’s lab results: Na+ 150 mEq/L. Which condition should the nurse suspect?

a)

Hyponatremia

b)

Hypokalemia

c)

Hypernatremia

d)

Hypocalcemia

4.

Which IV solution is isotonic and used for fluid volume replacement in hypovolemia?

a)

0.9% Sodium Chloride (Normal Saline)

b)

3% Sodium Chloride

c)

D5W

d)

0.45% Sodium Chloride

5.

A nurse is providing care for a client with potassium level 2.8 mEq/L. Which food should the nurse encourage?

a)

Apples

b)

Carrots

c)

Chicken breast

d)

Bananas

6.

Which lab value indicates hypercalcemia?

a)

Calcium 8.5 mg/dL

b)

Calcium 9.2 mg/dL

c)

Calcium 11.2 mg/dL

d)

Calcium 7.6 mg/dL

7.

The nurse recognizes which manifestation as a symptom of hypomagnesemia?

a)

Positive Chvostek’s sign

b)

Bradycardia

c)

Hypoactive reflexes

d)

Respiratory depression

8.

The nurse recognizes which manifestation as a symptom of hypomagnesemia?

a)

Positive Chvostek’s sign

b)

Bradycardia

c)

Hypoactive reflexes

d)

Respiratory depression

9.

Which of the following nursing actions prevents air embolism during central line removal?

a)

Place the client supine

b)

Instruct the client to exhale slowly

c)

Instruct the client to perform Valsalva maneuver

d)

Remove the line during inspiration

10.

The nurse is assessing a client receiving a hypertonic solution. Which finding requires immediate intervention?

a)

Dry mucous membranes

b)

Mild thirst

c)

Crackles in the lungs

d)

Decreased heart rate

11.

A nurse caring for a client with dehydration evaluates that fluid replacement is effective when which finding is noted?

a)

Urine specific gravity 1.040

b)

BP 90/50 mm Hg

c)

Urine output 60 mL/hr

d)

Heart rate 118 bpm

12.

The nurse is assessing a client with hypervolemia. Which finding requires immediate attention?

a)

Crackles in the lungs

b)

Dry mucous membranes

c)

Weak pulses

d)

Flat neck veins

13.

A client’s lab results show potassium 6.2 mEq/L. Which action should the nurse anticipate?

a)

Administer potassium supplement

b)

Prepare to administer Kayexalate

c)

Restrict sodium intake

d)

Provide a potassium-rich diet

14.

Which electrolyte imbalance is associated with muscle weakness and cardiac arrhythmias?

a)

Hyponatremia

b)

Hypercalcemia

c)

Hypokalemia

d)

Hypomagnesemia

15.

The nurse reviews a client’s serum sodium level of 130 mEq/L. Which intervention is appropriate?

a)

Encourage water intake

b)

Administer hypotonic fluids

c)

Administer hypertonic saline as prescribed

d)

Offer a sodium-restricted diet

16.

Which finding is expected in a client with hypernatremia?

a)

Bradycardia

b)

Weight loss

c)

Moist mucous membranes

d)

Increased thirst

17.

A nurse is reviewing a client’s chart. Which finding indicates hypocalcemia?

a)

Positive Trousseau’s sign

b)

Bradycardia

c)

Flaccid muscles

d)

Depressed reflexes

18.

Which IV solution is hypertonic?

a)

0.9% Sodium Chloride

b)

3% Sodium Chloride

c)

D5W

d)

0.45% Sodium Chloride

19.

The nurse caring for a client with dehydration should monitor for which manifestation?

a)

Bounding pulse

b)

Tachycardia

c)

Jugular vein distention

d)

Crackles in lungs

20.

A nurse suspects hyponatremia when the client exhibits which symptom?

a)

Dry mouth

b)

Flushed skin

c)

Increased thirst

d)

Confusion and lethargy

21.

Which lab test best measures a client’s hydration status?

a)

Serum osmolality

b)

ALT

c)

Hemoglobin

d)

Hematocrit

22.

The nurse identifies which condition as a risk factor for hypokalemia?

a)

Renal failure

b)

Prolonged vomiting

c)

Addison’s disease

d)

Potassium-sparing diuretic use

23.

Which electrolyte should be closely monitored in a client receiving loop diuretics?

a)

Potassium

b)

Sodium

c)

Calcium

d)

Chloride

24.

Which electrolyte should be closely monitored in a client receiving loop diuretics?

a)

Potassium

b)

Sodium

c)

Calcium

d)

Chloride

25.

The nurse reviews a client’s calcium level of 7.8 mg/dL. What symptom should the nurse monitor?

a)

Constipation

b)

Muscle spasms

c)

Diminished reflexes

d)

Weakness

26.

Which lab value indicates normal magnesium?

a)

0.9 mEq/L

b)

2.8 mEq/L

c)

1.6 mEq/L

d)

0.4 mEq/L

27.

A client with dehydration has a urine specific gravity of 1.035. What does this indicate?

a)

Concentrated urine

b)

Overhydration

c)

Kidney failure

d)

Fluid overload

28.

The nurse is caring for a client with hypovolemia. Which IV fluid should the nurse anticipate administering?

a)

D5W

b)

3% Sodium Chloride

c)

0.45% Sodium Chloride

d)

0.9% Normal Saline

29.

Which hormone increases water reabsorption in the kidneys?

a)

A. Aldosterone

b)

B. Cortisol

c)

C. Antidiuretic hormone (ADH)

d)

D. Insulin

30.

Which condition can lead to hyperkalemia?

a)

Renal failure

b)

Diuretic therapy

c)

Vomiting

d)

Diarrhea

31.

A client receiving IV fluids develops swelling at the insertion site with cool, pale skin. What is the nurse’s priority action?

a)

Apply warm compress

b)

Elevate the extremity

c)

Stop the infusion immediately

d)

Notify the provider

32.

Which lab test is most useful in evaluating kidney function?

a)

CBC

b)

Serum calcium

c)

BUN and creatinine

d)

Serum protein

33.

Which electrolyte imbalance would cause cardiac dysrhythmias?

a)

Potassium imbalance

b)

Sodium imbalance

c)

Chloride imbalance

d)

Phosphorus imbalance

34.

The nurse identifies which client as most at risk for dehydration?

a)

A. A 25-year-old athlete

b)

B. An 80-year-old with dementia

c)

C. A 40-year-old with hypertension

d)

D. A 10-year-old after immunization

35.

A nurse caring for a client with hypervolemia should expect which finding?

a)

Bounding pulse

b)

Flat neck veins

c)

Poor skin turgor

d)

Dry mucous membranes

36.

Which action should the nurse take to prevent infection with IV therapy?

a)

Change the IV site every 5 days

b)

Use sterile technique during insertion

c)

Flush with tap water

d)

Leave dressing unchanged for 1 week

37.

Which electrolyte imbalance is most likely with long-term laxative abuse?

a)

Hyponatremia

b)

Hypokalemia

c)

Hypernatremia

d)

Hypercalcemia

38.

Which nursing assessment is priority for a client with hyperkalemia?

a)

Peripheral pulses

b)

Cardiac monitoring

c)

Bowel sounds

d)

Skin integrity

39.

Which fluid is classified as hypotonic?

a)

0.45% Sodium Chloride

b)

0.9% Sodium Chloride

c)

D5NS

d)

3% Sodium Chloride

40.

The nurse is monitoring for signs of hypovolemia. Which finding is consistent with this condition?

a)

Decreased blood pressure

b)

Edema

c)

Crackles in lungs

d)

Bounding pulses

41.

The nurse notes a client’s magnesium level is 0.7 mEq/L. What should the nurse anticipate administering?

a)

Calcium carbonate

b)

Kayexalate

c)

IV magnesium sulfate

d)

Sodium bicarbonate

42.

A nurse observes peaked T waves on a client’s ECG. Which electrolyte imbalance should be suspected?

a)

Hypokalemia

b)

Hyperkalemia

c)

Hypocalcemia

d)

Hypernatremia

43.

Which intervention is appropriate for a client with hypernatremia?

a)

Administer hypotonic IV fluids

b)

Restrict free water

c)

Encourage sodium-rich foods

d)

Provide salt tablets

44.

The nurse is caring for a client with severe dehydration. Which lab finding is expected?

a)

Low BUN

b)

Low hematocrit

c)

Elevated serum osmolality

d)

Low sodium

45.

Which electrolyte imbalance may occur in a client with chronic renal failure?

a)

Hyponatremia

b)

Hypokalemia

c)

Hypermagnesemia

d)

Hypocalcemia

46.

Which electrolyte is primarily found in the intracellular fluid?

a)

Sodium

b)

Potassium

c)

Chloride

d)

Calcium

47.

A nurse identifies which as a symptom of hypocalcemia?

a)

Lethargy

b)

Constipation

c)

Numbness and tingling of fingers

d)

Hypoactive reflexes

48.

A client receiving blood transfusion develops itching and shortness of breath. What should the nurse do first?

a)

Slow the transfusion rate

b)

Administer diphenhydramine

c)

Stop the transfusion immediately

d)

Notify the provider after completion

49.

Which electrolyte should be monitored in a client with diarrhea?

a)

Calcium

b)

Sodium

c)

Potassium

d)

Chloride

50.

The nurse understands albumin plays which role in the body?

a)

Increases urine output

b)

Maintains oncotic pressure

c)

Stimulates ADH release

d)

Balances electrolytes

51.

The nurse notes edema and crackles in a client’s lungs. Which fluid imbalance should the nurse suspect?

a)

Hypervolemia

b)

Dehydration

c)

Hypovolemia

d)

Hyponatremia

52.

Which finding indicates effective treatment for hypovolemia?

a)

Weak pulses

b)

Dry mucous membranes

c)

Decreased urine output

d)

Blood pressure returns to baseline

53.

Which electrolyte imbalance is most likely to cause tetany?

a)

Hypocalcemia

b)

Hypernatremia

c)

Hypokalemia

d)

Hypermagnesemia

54.

The nurse should monitor which lab value when a client is receiving IV potassium chloride?

a)

Calcium

b)

Glucose

c)

Renal function (BUN and Creatinine)

d)

Hemoglobin

55.

A nurse caring for a client with hypermagnesemia should prepare to administer which medication if cardiac symptoms occur?

a)

Calcium gluconate

b)

Potassium chloride

c)

Magnesium sulfate

d)

Sodium bicarbonate

56.

Which of the following is an example of insensible fluid loss?

a)

Urination

b)

Drainage

c)

Vomiting

d)

Perspiration

57.

Which electrolyte should be closely monitored in a client receiving digoxin therapy?

a)

Potassium

b)

Sodium

c)

Calcium

d)

Phosphate

58.

Which manifestation should alert the nurse to possible hypovolemia?

a)

Bradycardia

b)

Orthostatic hypotension

c)

Bounding pulse

d)

Distended veins

59.

Which statement best describes osmosis?

a)

Movement of solutes from high to low concentration

b)

Active movement of molecules using energy

c)

Movement of water across a semipermeable membrane

d)

Movement of fluid due to pressure gradients

60.

Which action should the nurse take when administering IV magnesium sulfate?

a)

Give as a rapid bolus

b)

No cardiac monitoring is necessary

c)

Use an infusion pump for accuracy

d)

Administer through a peripheral IM route

61.

Which client is at highest risk for hyperkalemia?

a)

A client taking loop diuretics

b)

A client with acute renal failure

c)

A client with vomiting

d)

A client receiving insulin

62.

The nurse recognizes which value as normal serum osmolality?

a)

310 mOsm/kg

b)

290 mOsm/kg

c)

250 mOsm/kg

d)

320 mOsm/kg

63.

A nurse reviews a patient’s BMP. Which value should be reported immediately?

a)

Sodium 140 mEq/L

b)

Potassium 2.9 mEq/L

c)

Calcium 9.5 mg/dL

d)

Chloride 100 mEq/L

64.

Which fluid replacement should the nurse anticipate for a client with isotonic dehydration?

a)

D5W

b)

0.9% Sodium Chloride

c)

3% Sodium Chloride

d)

0.45% Sodium Chloride

65.

The nurse should teach a client taking furosemide to include which food in their diet?

a)

Cheese

b)

Bacon

c)

Bananas

d)

Pretzels

66.

Which finding indicates a potential complication of IV therapy?

a)

Vein feels soft

b)

Transparent dressing intact

c)

Redness and warmth at the site

d)

Catheter secured with tape

67.

Which lab finding confirms dehydration?

a)

Serum sodium 136 mEq/L

b)

Elevated BUN and hematocrit

c)

Decreased urine specific gravity

d)

Serum osmolality 270 mOsm/kg

68.

Which is an expected outcome after administering isotonic fluids for hypovolemia?

a)

BP 88/50 mm Hg

b)

Heart rate decreases to normal range

c)

Decreased urine output

d)

Crackles in lungs

69.

Which hormone conserves sodium and water in response to low blood volume?

a)

Antidiuretic hormone

b)

Aldosterone

c)

Insulin

d)

Thyroxine

70.

Which symptom indicates fluid overload in a client receiving IV fluids?

a)

Dry mouth

b)

Hypotension

c)

Edema and crackles

d)

Flat neck veins

71.

Which type of fluid moves water out of the cell, causing cellular dehydration?

a)

Isotonic

b)

Hypertonic

c)

Hypotonic

d)

Colloid

72.

Which electrolyte is essential for cardiac electrical conduction?

a)

Potassium

b)

Sodium

c)

Chloride

d)

Magnesium

73.

Which action demonstrates safe IV potassium administration?

a)

Give undiluted IV push

b)

Shake solution vigorously

c)

Administer via IV pump slowly

d)

Infuse through IM route

74.

Which electrolyte imbalance is associated with a Chvostek’s sign?

a)

Hyperkalemia

b)

Hypocalcemia

c)

Hypernatremia

d)

Hypokalemia

75.

Which nursing assessment should be priority for a client with hyponatremia?

a)

Monitor neurological status

b)

Assess bowel sounds

c)

Observe for tetany

d)

Monitor blood glucose

76.

Which of the following lab results should alert the nurse to hyperkalemia?

a)

K+ 3.5 mEq/L

b)

K+ 5.9 mEq/L

c)

K+ 4.0 mEq/L

d)

K+ 2.9 mEq/L

77.

Which client is most likely to experience hypomagnesemia?

a)

Client with renal failure

b)

Client with heart failure

c)

Chronic alcoholic client

d)

Client with hyperparathyroidism

78.

Which electrolyte imbalance increases the risk for digoxin toxicity?

a)

Hyperkalemia

b)

Hypokalemia

c)

Hypernatremia

d)

Hypercalcemia

79.

Which nursing intervention promotes safety for a client with hypocalcemia?

a)

Encourage high-protein diet

b)

Implement seizure precautions

c)

Provide high-fat meals

d)

Increase mobility

80.

The nurse should recognize which finding as a sign of hypervolemia?

a)

Orthostatic hypotension

b)

Dry skin

c)

Distended neck veins

d)

Weak peripheral pulses

81.

Which assessment finding indicates dehydration in an older adult client?

a)

Elastic skin turgor

b)

Moist mucous membranes

c)

Concentrated urine

d)

Decreased hematocrit

82.

Which fluid is appropriate for a client with hypernatremia and dehydration?

a)

D5W (after sodium correction)

b)

3% Sodium Chloride

c)

Lactated Ringer’s

d)

D10W

83.

The nurse recognizes that ADH release results in which effect?

a)

Decreased urine output

b)

Increased sodium excretion

c)

Increased diuresis

d)

Lowered blood pressure

84.

Which of the following findings indicates hypokalemia?

a)

Muscle twitching

b)

Hyperreflexia

c)

Weak, irregular pulse

d)

Slow respirations

85.

Which laboratory test provides information about serum protein affecting fluid balance?

a)

CBC

b)

Magnesium level

c)

Albumin

d)

Glucose

86.

A client receiving IV therapy complains of pain and redness along the vein. Which complication should the nurse suspect?

a)

Infiltration

b)

Phlebitis

c)

Hematoma

d)

Air embolism

87.

The nurse should expect which finding in a client with hypomagnesemia?

a)

Decreased deep tendon reflexes

b)

Bradycardia

c)

Muscle tremors

d)

Hypotension

88.

Which fluid type is best for a client who lost blood during surgery?

a)

Hypotonic saline

b)

Isotonic (Lactated Ringer’s)

c)

Hypertonic saline

d)

D10W

89.

The nurse should recognize which as a normal serum calcium level?

a)

8.2 mg/dL

b)

9.6 mg/dL

c)

11.4 mg/dL

d)

7.4 mg/dL

90.

Which electrolyte imbalance should be monitored in a client with parathyroid dysfunction?

a)

Sodium

b)

Potassium

c)

Calcium

d)

Chloride

91.

Which action prevents infection when changing an IV dressing?

a)

Use clean gloves only

b)

Clean the site with chlorhexidine

c)

Tape over old dressing

d)

Skip cleaning if site looks fine

92.

Which fluid imbalance results from inadequate fluid intake and excessive losses?

a)

Hypervolemia

b)

Hypovolemia

c)

Water intoxication

d)

Hypernatremia

93.

The nurse recognizes that diffusion involves:

a)

Fluid movement by pressure gradients

b)

Solutes moving from high to low concentration

c)

Active energy transport

d)

Protein movement across membranes

94.

Which finding is consistent with hypercalcemia?

a)

Muscle spasms

b)

Positive Trousseau’s sign

c)

Decreased deep tendon reflexes

d)

Tetany

95.

The nurse should monitor which lab in a client receiving sodium bicarbonate?

a)

Glucose

b)

Albumin

c)

Serum pH

d)

Hematocrit

96.

A nurse is preparing to administer blood. Which IV solution should be used?

a)

0.9% Sodium Chloride

b)

D5W

c)

Lactated Ringer’s

d)

0.45% Sodium Chloride

97.

Which clinical finding is most concerning for a client receiving IV fluids?

a)

Increased urine output

b)

Shortness of breath and crackles

c)

Capillary refill <3 sec

d)

Pink, warm skin

98.

The nurse recognizes that filtration occurs due to:

a)

Osmotic gradients

b)

Sodium-potassium pump

c)

Hydrostatic pressure differences

d)

Enzymatic transport

99.

Which food should be encouraged for a client with hypocalcemia?

a)

Yogurt

b)

Canned tuna

c)

Lettuce

d)

Apples

100.

Which condition results from rapid infusion of hypotonic fluids?

a)

Pulmonary edema

b)

Hypertension

c)

Cellular swelling

d)

Hypernatremia