ATI Med-Surg Exam 1 Practice Questions and Answers

What laboratory findings does the nurse determine are consistent with hypovolemia in a female patient? (Select all that apply.) 1. BUN : serum creatinine ratio of 12.1 2. Urine positive for blood 3. Hematocrit level of 47% 4. Urine specific gravity of 1.027 5. Urine osmolality of 450 mOsm/kg - Correct answer: 3. 4. and 5. More than half of students who answered this question in Wolters Kluwer's adaptive learning systems, powered by PrepU, answered "BUN : serum creatinine ratio of 12.1." The BUN to creatinine ratio is above 20:1 in hypovolemia due to dehydration or decreased renal perfusion and function. The planning component of the teaching-learning process is organized in a sequential manner. Which of the following is the first step for the nurse? Select the appropriate teaching strategy. 1. Define the expected outcomes. 2. Document the plan. 3. Develop the planned goals for the learning outcome. - Correct answer: 3. Develop the planned goals for the learning outcome. -Nearly half of students who answered this question in Wolters Kluwer's adaptive learning systems, powered by PrepU, answered "Select the appropriate teaching strategy." Before the teaching strategy can be determined, the goals of learning must be developed. The nurse is interviewing a patient who says he has a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking? 1. Aspirin 2. Bronchodilators 3. Cardiac glycosides 4. Angiotensin converting enzyme (ACE) inhibitors - Correct answer: 4. Angiotensin converting enzyme (ACE) inhibitors -More than one-quarter of students who answered this question in Wolters Kluwer's adaptive learning systems, powered by PrepU, answered "Bronchodilators." Bronchodilators are prescribed to open constricted bronchial tubes. They do not produce cough; angiotensin converting enzyme (ACE) inhibitors do. A patient is to receive an oxygen concentration of 70%. What is the best way for the nurse to deliver this concentration? 1. A nasal cannula 2. A partial rebreathing mask 3. A Venturi mask 4. An oropharyngeal catheter - Correct answer: 2. A partial rebreathing mask Nearly half of students who answered this question in Wolters Kluwer's adaptive learning systems, powered by PrepU, answered "A Venturi mask." To provide an oxygen concentration of 70%, a partial rebreathing mask should be used. A Venturi mask provides less than 30% oxygen concentration. A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis? 1. pH, 7.40; PaCO2 35 mm Hg 2. pH, 7.5; PaCO2 30 mm Hg 3. pH, 7.25; PaCO2 50 mm Hg 4. pH, 7.35; PaCO2 40 mm Hg - 3. pH, 7.25; PaCO2 50 mm Hg A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? 1. Nausea or vomiting 2. Light-headedness or paresthesia 3. Hallucinations or tinnitus 4. Abdominal pain or diarrhea - 2. Light-headedness or paresthesia Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? 1. Administer an ordered decongestant. 2. Offer the client fluids frequently. 3. Instruct the client to breathe into a paper bag. 4. Administer ordered supplemental oxygen. - 3. Instruct the client to breathe into a paper bag. -The ABG results reveal respiratory alkalosis. The best intervention to raise the PaCO2 level would be to have the client breathe into a paper bag. Administering a decongestant, offering fluids frequently, and administering supplemental oxygen wouldn't raise the lowered PaCO2 level. Which of the following is the most common cause of symptomatic hypomagnesemia? 1. Alcoholism 2. Burns 3. IV drug use 4. Sedentary lifestyle - 1. Alcoholism You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults? 1. Hypovolemia 2. Dehydration 3. Hypervolemia 4. Fluid volume excess - 2. Dehydration - Because of reduced thirst sensation that often accompanies aging, older adults tend to drink less water. Use of diuretic medications, laxatives, or enemas may also deplete fluid volume in older adults. Chronic fluid volume deficit can lead to other problems such as electrolyte imbalances. Therefore, options A, C, and D are incorrect. Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? 1. Potassium 2. Magnesium 3. Calcium 4. Sodium - 4. Sodium -Sodium plays a major role in controlling water distribution throughout the body because it does not easily cross the intracellular wall membrane and because of its abundance and high concentration in the body. Potassium, calcium, and magnesium are not primary determinants of ECF osmolality.