While reviewing a client's lab results, a nurse notes a serum calcium level of 8.0 mg/dL. Which
of the following actions should the nurse take?
a. Implement seizure precautions
b. Administer Phosphate
c. Initiate diuretic therapy
d. Prepare the client for hemodialysis - answer✔✔a. Implement seizure precautions
The client is at risk for seizures due to low excitation threshold as a result of a decreased calcium
level. The nurse should initiate seizure precautions to prevent injury
A nurse is preparing to administer oral potassium for a client who has a potassium level of 5.5
mEq/L. Which of the following actions should the nurse take first?
a. Administer a hypertonic solution.
b. Repeat the potassium level.
c. Withhold the medication.
d. Monitor for paresthesia - answer✔✔c. Withhold the medication.
The greatest risk to the client is bradycardia, hypotension, and life-threatening cardiac
complications due to hyperkalemia, defined as a potassium level above 5.0 mEq/L. Therefore,
the nurse's priority action is to withhold the oral potassium and notify the provider
A nurse is reviewing the lab report of a client who has fluid volume excess. Which of the
following lab values should the nurse expect?
a. Hemoglobin 20 g/dL
b. Hematocrit 34%
c. BUN 25 mg/dL
d. Urine specific gravity 1.050 - answer✔✔b. Hematocrit 34%
The nurse should identify that a client who has fluid volume excess can have a hematocrit level
that is below the expected reference range of 37 to 47% for females or 42 to 52% for males.
Fluid volume excess can cause hemodilution and a decreased hematocrit level.
A nurse is assessing a client who has respiratory acidosis. Which of the following findings
should the nurse expect?
a. Confusion
b. Peripheral edema
c. Facial flushing
d. Hyperreflexia - answer✔✔a. Confusion
A client who has respiratory acidosis will experience confusion from a lack of cerebral
perfusion. If acidosis is not reversed, the client's level of consciousness will decrease and coma
may occur.
A nurse is teaching nutritional strategies to a client who has low serum calcium level and an
allergy to milk. Which of the following statements by the client indicates an understanding of the
teaching?
a. "I will eat more cheese because I can't drink milk."
b. "I need to avoid foods with vitamin D because I am allergic to milk."
c. "I will stop taking my calcium supplements if they irritate my stomach."
d. "I will add broccoli and kale to my diet." - answer✔✔d. "I will add broccoli and kale to my
diet."
The nurse should recommend that the client consume broccoli and kale, which are good sources
of calcium, as alternatives to dairy products.
A nurse is reviewing ABG results for four clients. Which of the following findings should the
nurse identify as metabolic acidosis?
a. pH 7.51, PaO2 94 mm Hg, PaCO2 38 mm Hg, HCO3- 29 mEq/L
b. pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 24 mEq/L
c. pH 7.36, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 26 mEq/L
d. pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L - answer✔✔d. pH 7.26,
PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L
A pH below 7.35 is an indication of acidosis. HCO3- below 22 mEq/L is an indication of
metabolic acidosis.
A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL. Which of the
following findings is the priority for the nurse to assess?
a. Deep-tendon reflexes
b. Cardiac rhythm
c. Peripheral sensation
When using the airway, breathing, circulation approach to client care, the nurse should first
assess the client's cardiac rhythm because this total serum calcium level is below the expected
reference range. Hypocalcemia can cause ECG changes, bradycardia, or tachycardia.
A nurse is planning care for a client who has a serum potassium level of 3.0 mEq/L. The nurse
should plan to monitor the client for which of the following findings?
a. Hyperactive deep-tendon reflexes
b. Orthostatic hypotension
c. Rapid, deep respirations
d. Strong, bounding pulse - answer✔✔b. Orthostatic hypotension
The nurse should plan to monitor the client for orthostatic hypotension, which places him at risk
for falls. Orthostatic hypotension is a manifestation of hypokalemia.
A nurse is admitting a client who has status asthmaticus. The client's ABG results are:
pH: 7.32
paO2: 74 mmHg
PaCO2: 56 mmHg
HCO3: 26 mEq/L
The nurse should interpret these lab values as which of the following imbalances?
a. Respiratory acidosis
b. Respiratory alkalosis
c. Metabolic acidosis
d. Metabolic alkalosis - answer✔✔a. Respiratory acidosis
Status asthmaticus causes inadequate gas exchange, resulting in a low pH and PaO2, an elevated
PaCO2, and an HCO3- within the expected reference range. These laboratory values indicate
respiratory acidosis.
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