NUR 308 EAQ PRACTICE QUESTIONS ANSWERS AVAILABLE

NUR 308 EAQ PRACTICE QUESTIONS ANSWERS AVAILABLE 1. Fluid therapy for a 38-year-old male who has been admitted for an outpatient surgical procedure. A. LACTATED RINGERS B. 5% DEXTROSE IN WATER Ans: For this clinical situation, an isotonic fluid would be indicated for short term fluid therapy. Five percent dextrose in water is a hypotonic fluid that could potentially cause fluid shifts. 2. Fluid therapy for a 16-year-old female trauma patient who has head trauma and suspected cerebral edema following an automobile accident. A. MANNITOL B. ALBUMIN Ans: Mannitol is an osmotic diuretic and would be indicated to treat cerebral edema. Albumin would be indicated to treat shock. 3. 22-year-old female patient who is pregnant and admitted with hyperemesis gravidarum. A. COLLOID B. CRYSTALLOID Ans: Crystalloid therapy would be used in fluid replacement for a pregnant patient with hyperemesis. Colloid therapy would not be indicated. The use of colloid therapy would be contraindicated because it would remain in the intravascular space and contribute to fluid shifting and fluid retention. 4. 58-year-old male patient admitted for hypokalemia who requires potassium replacement therapy parentally. A. GIVEN AS IVP BOLUS B. GIVEN IN IV SOLUTION Ans: Potassium replacement therapy is considered to be a high-alert medication and as such should never be administered as an IVP bolus. Safety considerations require that potassium be administered as part of an IV solution. 5. 80-year-old male patient who is hypotensive admitted for fluid replacement therapy. A. 3% NORMAL SALINE B. NORMAL SALINE Ans: An isotonic fluid would be indicated for replacement therapy for a hypotensive elderly patient. Three percent normal saline is a hypertonic solution and would cause fluid shifting and worsen cellular dehydration. 6. Which types of fluid solutions would result in fluid shifting occurring within the body? Select all that apply. A. Hypertonic B. Hypotonic C. Colloid D. Isotonic E. Crystalloid 7. Which compensatory mechanism would be initiated in the body in response to a low volume state? A. Inhibition of osmoreceptors to prevent further fluid loss B. Increase in urine output C. Inhibition of aldosterone release D. Release of antidiuretic hormone 8. An elderly patient who is hypotensive has been admitted to the nursing unit for fluid replacement therapy. What solution would the nurse expect to administer? A. 3% saline B. Lactated Ringer’s C. Albumin D. Normal saline 9. A patient has been receiving parenteral therapy while in the hospital. As a result of fluid administration, fluid shifting is noted with the cells of the body becoming more edematous. Which type of fluid would the nurse anticipate being responsible for cellular swelling? A. Hypotonic solution B. Hypertonic solution C. Lactated Ringer’s solution D. Normal saline 10. Which findings could lead to the presence of edema? Select all that apply. A. Decrease in fluid pressure B. Decreased oncotic pressure C. Decreased albumin D. Hypernatremia E. Release of antidiuretic hormone 11. Which finding in a patient’s medical history may lead to an increased risk for euvolemic hyponatremia? Select all that apply. A. The patient is taking a thiazide diuretic. B. The patient has congestive heart failure. C. The patient has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion. D. The patient has a diagnosis of adrenal insufficiency. E. The patient has severe hypothyroidism. 12. A patient has been diagnosed with chronic hyponatremia and replacement therapy has been started per protocol. Which finding would require that the nurse immediately contact the healthcare provider? A. Parenteral sodium replacement is being administered per protocol using an infusion pump. B. Correction total has been calculated to 20 mEq/L/day. C. Patient’s medical history indicates alcoholism. D. Correction rate is calculated as 0.5 mEq/L per hour. 13. Which observations would the nurse anticipate seeing in a patient with hypernatremia? Select all that apply. A. Hallucinations B. Alert and oriented to surroundings C. Elevated heart rate D. Increased appetite E. Decreased urine output 14. A patient presents with muscle cramps, paresthesia to weakness, abdominal cramping, and electrocardiogram changes. What electrolyte imbalance would the nurse suspect? A. Hypochloremia B. Hypokalemia C. Hypermagnesemia D. Hyperkalemia 15. Sodium level of 150 mEq/dL A. Patient has been taking nutritional canned feedings to support dietary needs due to flulike symptoms. B. Patient is taking Lasix (furosemide) 80 mg by mouth once a day. C. Patient has a hemoglobin A1C level of 7.0. D. Patient is being treated for bipolar disorder with lithium therapy. E. Patient has had limited fluid intake for several days due to flulike symptoms. 16. Potassium level of 6.5 mEq/L A. Patient has a Glomerular Filtration Rate (GFR) of 50. B. Patient has been taking naproxen sodium for minor back pain for two days as directed. C. Patient reports diarrhea for the past day. D. Patient is allergic to sulfa. 17. Magnesium level of 0.8 mEq/L A. Potassium level is 4.0 mEq/L. B. Chovstek sign is present. C. Patient is an alcoholic. D. Patient is receiving chemotherapy. 18. Total calcium level of 12.9 mg/dL A. Vitamin D deficiency B. Lymphoma diagnosis C. Limited milk intake D. Theophylline for management of asthma E. Trousseau sign 19. Phosphate level of 1.0 mg/dL A. Respiratory alkalosis B. Chovstek’s sign C. Excessive antacid use D. Acute hemolysis E. Vitamin D intoxication 20. Which ion is in abundance in the extracellular fluid? A. Sodium B. Potassium C. Calcium D. Bicarbonate 21. A patient is bipolar and taking lithium therapy. For which electrolyte disturbance does the nurse anticipate that there is an increased risk to develop? A. Hypokalemia B. Potassium imbalances C. Calcium imbalances D. Hypernatremia 22. Which finding may be associated with hypercalcemia? A. Malignant tumor B. Elevated serum theophylline level C. Positive Trousseau sign D. Presence of Kernig’s sign 23. How can the relationship of calcium and phosphorus in the body be classified? A. Increases in both ions occur in normal states. B. Decreases in serum calcium are a result of dietary intake whereas decreases in phosphorus levels are linked to potassium intake. C. Increases in calcium are associated with an increase in phosphorus. D. There is a reciprocal relationship. 24. A patient with a history of alcoholism is admitted to the nursing unit. The nurse knows that this patient would be at risk for which electrolyte imbalance? A. Hypercalcemia B. Hypomagnesemia C. Hypocalcemia D. Hypermagnesemia 25. Which statements are accurate with regard to acid-base imbalances? Select all that apply. A. Acidemia is reflected by a pH value of 7.55. B. Hypoventilation results in respiratory acidosis. C. Respiratory parameter with regard to acid-base imbalances is reflected by bicarbonate level. D. Increase in bicarbonate levels is associated with alkalosis. E. Oxygen saturation is not used to evaluate acid-base balance. 26. The renal buffering system provides acid-base compensation by: A. Decreasing serum bicarbonate level. B. Limiting excretion of hydrogen ions via urine output. C. Making urine more alkaline. D. Decreasing pH. 27. Oxygen saturation of arterial blood is used to primarily evaluate which of the following? A. Fluid-electrolyte balance B. Respiratory function C. Carbon dioxide levels D. Acid-base balance 28. Which treatment method would be used for a patient who is exhibiting respiratory acidosis? A. Administering aspirin therapy B. Insertion of chest tube C. Administering a sedative D. Administering an antipyretic 29. The nurse is caring for a patient with respiratory alkalosis. What nursing interventions would the nurse expect to include? Select all that apply. A. Encouraging slow, deep breathing B. Administering sodium bicarbonate, as ordered C. Providing emotional support D. Assisting with activities of daily living E. Providing hemodynamic monitoring 30. Amanda's blood gas results reveal the following: pH 7.25, CO2 35 and HCO3 18. A. metabolic alkalosis B. complete compensation C. respiratory acidosis D. metabolic acidosis E. partial compensation 31. Ron's blood gas results reveal the following: pH 7.38, CO2 40 and HCO3 25. A. metabolic alkalosis B. complete compensation C. respiratory acidosis D. metabolic acidosis E. partial compensation 32. Jennifer's blood gas results reveal the following: pH 7.50, CO2 40 and HCO3 30. A. metabolic alkalosis B. complete compensation C. respiratory acidosis D. metabolic acidosis E. partial compensation 33. Kirk's blood gas results reveal the following: pH 7.18, CO2 50 and HCO3 25. A. metabolic alkalosis B. complete compensation C. respiratory acidosis D. metabolic acidosis E. partial compensation 34. Jessica's blood gas results reveal the following: pH 7.24, CO2 50 and HCO3 27. A. metabolic alkalosis B. complete compensation C. respiratory acidosis D. metabolic acidosis E. partial compensation 35. Which finding in a patient’s arterial blood gas result indicates a normal blood pH level? A. pH value of 7.30 B. pH value of 7.25 C. pH value of 7.42 D. pH value of 7.55 36. Metabolic acidosis is indicated by which arterial blood gas result? A. Within range pH and increased carbon dioxide levels B. Decreased serum pH and bicarbonate levels C. Increases in serum pH and bicarbonate levels D. Decrease in serum pH and increases in both carbon dioxide and bicarbonate levels 37. The nurse is providing patient teaching to a patient with metabolic acidosis. What statement should the nurse include in her teaching? A. “With metabolic acidosis, the heart and lungs compensate.” B. “Metabolic acidosis can be due to excess bicarbonate.” C. “Metabolic acidosis can be due to a loss of acid.” D. “Metabolic acidosis is any acidosis not due to a respiratory issue.” 38. What are the component parts of an arterial blood gas? Select all that apply. A. Serum pH levels B. Pulse oximetry C. Bicarbonate level D. Carbon dioxide level E. Oxygen 39. A patient’s diagnostic test results indicate an increased anion gap. Based on this finding, what would the nurse anticipate that the patient’s lab results may also reveal? A. Metabolic alkalosis B. Increased ketone and lactic acid levels C. Normal blood chemistry D. Absence of ketones 40.