Electrolyte and Acid Answer Key

Electrolyte and acid-base Online Practice 1- A nurse is assessing a client who has dehydratation . Which of the following assesments is the priority ? Skin turgor Urine outpot Weight Mental status 2- A nurse is reviewing the laboratory report of a client who has fluid volume excess . Which of the following laboratory values should the nurse expect ? Hgb 20 g/dL Hct 34 % BUN 25 mg /dL Urine specific gravity 1.050 3- A nurse is assessing a client who is receiving hydrochlorothiazide and notes that the client is confused and lethargic. Which of the following laboratory values should the nurse report to the provider? a.Sodium 128 mEq/L b. Potassium 4.8 mEq/L c. Calcium 9.1 mg/dL d. Magnesium 2.0 mEq/L 4- A nurse is providing dietary teaching to a client who has kidney disease. Which of the following food choices should the nurse include in the teaching as containing the lowest amount of magnesium? a. 1 large hard-boiled egg b. 1 cup bran cereal c. 1/2 cup almond d. 1 cup cooked spinach 5- 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 d. Bowel sounds 6- A nurse is caring for a client who has a sodium level of 155 mEq/L. Which of the following IV fluids should the nurse anticipate the provider to prescribe? a. Dextrose 5% in 0.9% sodium chloride b. Dextrose 5% in lactated Ringer's c. 3% sodium chloride d. 0.45% sodium chloride 7- A nurse is assessing a client who has hypomagnesemia. Which of the following findings should the nurse expect? a. Hyperactive deep-tendon reflexes b. Increased bowel sounds c. Drowsiness d. Decreased blood pressure 8- A nurse is assessing a client who has a phosphorus level of 2.4 mg/dL. Which of the following findings should the nurse expect? a. Hepatic failure b. Abdominal pain c. Slow peripheral pulses d. Increase in cardiac output 9- A nurse is caring for a client who is experiencing respiratory distress as a result of pulmonary edema. Which of the following actions should the nurse take first? a. Assist with intubation. b. Initiate high-flow oxygen therapy. c. Administer a rapid-acting diuretic. d. Provide cardiac monitoring. 10- 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 11- A nurse is providing teaching for a client who is at risk for developing respiratory acidosis following surgery. Which of the following statements by the client indicates an understanding of the teaching? a. "I should conserve energy by limiting my physical activity." b. "I will wait until my pain is at least six out of ten before I use the PCA." c. "I will limit my daily fluid intake to two to three glasses." d. "I will use the incentive spirometer every hour." 12- A nurse is assessing a client who is using PCA following a thoracotomy. The client is short of breath, appears restless, and has a respiratory rate of 28/min. The client's ABG results are pH 7.52, PoO2 89 mm hg, and HCO3- 24 mEq/L. Which of the following actions should the nurse take? a. Instruct the client to cough forcefully. b. Assist the client with ambulation. c. Provide calming interventions. d. Discontinue the PCA. 13- A nurse is reviewing the medical record of a client who had diabetes mellitus and is recieving regular insulin by continous IV infustion to treat diabetic ketoacidosis. Which of the following findings should the nurse report to the provider? a. Urine output of 30 mL/hr b. Blood glucose of 180 mg/dL c. Serum potassium 3.0 mEq/L d. BUN 18 mg/dL 14- A nurse is providing teaching for a client who has venous insufficiency of the lower extremities. Which of the following statements by the client indicates an understanding of the teaching? a. "If my stockings feel tight, I'll just roll them down for a while." b. "I'll put on my elastic stockings at the first sign of swelling." c. "When I sit down to watch television, I'll be sure to put my feet up." d. "It's okay to cross my legs as long as it's for less than an hour." 15- A nurse is providing dietary teaching to a client who has heart failure and is receiving furosemide. Which of the following foods should the nurse recommend as containing the greatest amount of potassium? a. 1/2 cup chopped celery b. 1 cup plain yogurt c. 1 slice whole grain bread d. 1/2 cup cooked tofu 16- A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse except? a. Confusion b. Peripheral edema c. Facial flushing d. Hyperreflexia 17- A nurse is admitting a client who takes 40 mg furosemide daily for heart failure and has experienced 3 days of vomiting. The nurse suspects hypokalemia. Which of the following medications should the nurse prepare to administer? a. Sodium polystyrene sulfonate 30 g/day b. 0.9% sodium chloride with 10 mEq/L of potassium chloride at 100 mL/hr c. Bumetanide 8 mg/day d. 100 mL of dextrose 10% in water with 10 units of insulin 18- A nurse is admitting a client who has status asthmaticus. The client's ABG results are pH 7.32, PaO2 74 mmhg, PaC02 56 mm hg, and HCO3- 26 mEq/L. The nurse should interpret these laboratory values as which of the following imbalances. a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis 19- A nurse is teaching nutritional strategies to a client who has a 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." 20- A nurse is caring for a client who reports difficulty breathing and tingling in both hands. His respiratory rate is 36/min and he appears very restless. Which of the following values should the nurse anticipate to be outside the expected reference range if the client is experiencing respiratory alkalosis? a. PaO2 b. PaCO2 c. Sodium d. Bicarbonate 21- A nurse is caring for a client who had dehydration and is receiving IV fluids. Which assessing for complications, the nurse should recognize which of the following manifestations as a sign of fluid overload? a. Increased urine specific gravity b. Hypoactive bowel sounds c. Bounding peripheral pulses d. Decreased respiratory rate 22- A nurse is planning care for a client who has experienced excessive fluid loss. Which of the following interventions should the nurse include in the plan of care? a. Administer IV fluids to the client evenly over 24 hr. b. Provide the client with a salt substitute. c. Assess the client for pitting edema. d. Encourage the client to rise slowly when standing up. e. Weigh the client every 8 hr. 23- A nurse is reviewing the 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 24- A nurse is assessing a client who has hyperkalemia. Which of the following findings should the nurse expect? a. Decreased muscle strength b. Decreased gastric motility c. Increased heart rate d. Increased blood pressure 25- A nurse is caring for a client who requires continuous cardiac monitoring. The nurse identifies a prolonged PR interval and a widened QRS complex. Which of the following laboratory values supports this finding? a. Sodium 152 mEq/L b. Chloride 102 mEq/L c. Magnesium 1.8 mEq/L d. Potassium 6.1 mEq/L 26- A nurse is reviewing the 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 27- A nurse is caring for a client who is receiving furosemide daily. During the morning assessment, the client tells the nurse that he is "feeling weak in the legs." Which of the following actions should the nurse take first? a. Monitor the client's bowel sounds. b. Review the client's daily laboratory results. c. Auscultate the client's lungs. d. Palpate the client's peripheral pulses. 28- While reviewing a client's laboratory results, a nurse notes a serum calcium level of 0.8 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. 29- 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. 30- A nurse is evaluating a client who is receiving IV fluids to treat isotonic dehydration. Which of the following laboratory findings indicates that the fluid therapy has been effective? a. BUN 26 mg/dL b. Serum sodium 138 mEq/L c. Hct 56% d. Urine specific gravity 1.035 RN Targeted Medical Surgical Perioperative Online Practice 1- A nurse is caring for a client who is receiving moderate (conscious) sedation with midazolam. The client's respiratory rate decreases from 16/min to 6/min, and their oxygen saturation decreases from 92% to 85%. Which of the following medications should the nurse administer? Flumazenil 2- A circulating nurse is monitoring the temperature in a surgical suite. The nurse should identify that cool temperatures reduce a client's risk for which of the following potential complications of surgery? Infection 3- A nurse is creating a plan of care for a client who is preoperative for a total hip arthroplasty. The client informs the nurse that they practice Judaism and adhere to a kosher diet. Which of the following interventions is the nurse's priority? Determine if the client's faith conflicts with the treatment plan 4- A nurse is assessing a client who received a preoperative IV dose of metoclopramide 1 hr ago. For which of the following findings should the nurse notify the provider? Muscle rigidity 5- A nurse is providing preoperative teaching to a client who is scheduled to have a mastectomy with reconstructive surgery. Which of the following statements by the client indicates an understanding of the teaching? "I will be able to shower after the doctor removes the drain." 6- A nurse is caring for a client who had an open transverse colectomy 5 days ago. The nurse enters the client's room and recognizes that the wound has eviscerated. After covering the wound with a sterile, saline soaked dressing, which of the following actions should the nurse take? Obtain vital signs to assess for shock 7- A nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place. Which of the following interventions should the nurse plan to include? Cleanse the drain plug with alcohol after emptying 8- A client is transferred from the surgical suite to the PACU following oral surgery. While monitoring the client's vital signs, the nurse finds that the client's tongue has become swollen and is obstructing the airway. Which of the following actions should the nurse take first? Use the head-tilt, chin-lift method to open the airway 9- A nurse in a PACU is assessing a client who is postoperative. Which of the following findings should the nurse report to the provider? Presence of inspiratory stridor 10- A nurse is assessing a client who is 2 hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? Urine output of 20 mL/hr 11- A nurse is monitoring a client who received succinylcholine during a surgical procedure. Which of the following actions should the nurse take if the client develops manifestations of malignant hyperthermia? Administer dantrolene 12- A nurse is caring for a client who is preoperative and is asking multiple questions about the risks of the procedure. Which of the following actions should the nurse take? Ask the surgeon to speak to the client for clarification 13- A nurse is receiving evening shift report on four clients who returned from the PACU that morning. Which of the following clients should the nurse assess first? A client who is postoperative following a thoractomy and has a chest tube with 150 mL of bright-red blood in the collection chamber from the past 1 hr. 14- A nurse is providing preoperative teaching to a client who is scheduled for a gastrectomy in 1 week. The client expresses anxiety about the upcoming surgery. Which of the following actions should the nurse take? Provide concise, factual information 15- A nurse is reviewing the medical record for a client who has a prescription for general anesthesia prior to surgery. Which of the following findings should the nurse report to the provider? Potassium 2.8 mEq/L 16- A nurse is caring for a client who has a surgical wound with a Penrose drain in place. Which of the following interventions should the nurse plan to perform? Use the sterile technique when performing dressing changes 17- A nurse is providing discharge teaching for a client who is postoperative following a rhinoplasty using general anesthesia. Which of the following instructions should the nurse include? Use a cool compress on your eyes, nose, and face." 18- A surgical nurse enters a surgical suite to ensure surgical asepsis is maintained. For which of the following findings should the nurse intervene? The scrub tech is wearing a watch under their scrubs. 19- A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a 0 to 10 scale. The nurse notes a hard, distended abdomen and absent bowel sounds. After conferring with the provider, which of the following actions should the nurse take first? Insert an NG tube 20- A nurse is caring for a client who is 12 hr postoperative from a gastrectomy and has an NG tube set to continuous low suction. Which of the following findings requires intervention by the nurse? Gastric distension 21- A nurse is providing teaching for a client who is scheduled to undergo moderate sedation for a bronchoscopy. Which of the following client statements indicates an understanding of the teaching? "I can expect to feel sleepy for several hours after the procedure." 22- A nurse is providing discharge instructions for a client who is postoperative following abdominal surgery. Which of the following client statements indicates an understanding of the teaching? "I will eat foods that are high in protein and vitamin C during my recovery." 23- A nurse is providing preoperative teaching for a client who is scheduled to have a belowthe-knee amputation. Which of the following instructions should the nurse include? "Your surgeon might prescribe an antibiotic before surgery." 24- A nurse is assessing a client who is preoperative. The nurse should identify that which of the following factors reported by the client increases the risk for a postoperative infection? Long-term use of corticosteroids 25- A nurse is reviewing the medical record of a client who is scheduled for an elective surgery. Which of the following medications should the nurse expect the provider to discontinue prior to surgery to minimize the risk for complications? Warfarin 26- A nurse is assessing a client who is recovering from spinal anesthesia. Which of the following sensations should the nurse expect to return to the client first? Touch 27- A nurse is caring for a client who has bradycardia following a surgical procedure using spinal anesthesia. The nurse should plan to administer which of the following medications to the client? Epinephrine 28- A nurse is assessing a client who is 2 days postoperative following a total prostatectomy. The nurse notes that the client's right calf is red, edematous, and warm to the touch. Which of the following actions should the nurse take? Elevate the client's right extremity 29- A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following interventions should the nurse perform to prevent respiratory complications? Advise the client to splint the surgical incision when coughing and deep breathing 30- A nurse is teaching a client who is in the immediate postoperative period about the use of a PCA pump. Which of the following statements should the nurse include in the teaching? "Do not allow visitors to push the PCA button if you are sleeping." RN targeted medical surgical Immune online practice A nurse is providing teaching to a client who is scheduled for a papanicolaou (pap) test. The nurse should inform the client that the Pap test is used to screen for which of the following? A. uterine cancer B. cervical cancer C. ovarian cysts D.fibroids the nurse should inform the client that a pap test is used to screen for cervical cancer A nurse is planning on education program for a group of high school teachers who will be taking students on a hike. Which of the following information should the nurse include regarding Lyme Disease? A. If bitten by a tick, you should be tested immediately. B. Ifyou have a tick embedded in your skin, apply a lit match to remove it C. You should wear dark colored clothing to deter ticks from biting D. If you develop pain and stiffness in your joints, you should see your doctor The nurse should inform the group that manifestations of stage 1 Lyme disease include influenza-like manifestations, a "bull's-eye" rash, muscle and joint pain, and stiffness. The nurse should instruct the group to report these findings to a provider. A nurse is reviewing the daily laboratory results for a female client who has acute leukemia. Which of the following values is an expected findings? A. WBC count 21000 B. Hgb 14 C. Hct 40% D. Platelets 170,000 The nurse should expect a client who has acute leukemia to have an elevated WBC count A nurse is providing teaching to a client who has systemic lupus erythematosus. Which of the following statements by the client indicates an understanding of the teaching? A.. I should use a sunscreen with a SPF of at least 15 B. Long-term immunosuppressive therapy could cure this disease C. I should wear gloves when it is cold outside A nurse is reviewing the laboratory report for a client who has hodgkin's lymphoma. Which of the following findings should the nurse expect? A. overgrowth of B-lymphocyte plasma cells B. Reed-Sternberg cells C. Epstein-Barr virus D. Overproduction of blast phase cells A nurse is providing teaching to a client who takes an oral contraceptive and has a new prescription for amoxicillin. Which of the following statements by the client indicates an understanding of the teaching? A. I will use a backup method of birth control while I am taking this medication B. I should take this medication on an empty stomach C. I should expect to have constipation while taking this medication D. I will keep taking this medication until I feel better A nurse is caring for a client who has viral pneumonia. Which of the following findings should the nurse report to the provider immediately? A. Negative blood culture B. Left shift in WBC differential C. Oxygen saturation 93% D. Crackles heard on auscultation A nurse is caring for a client who has neutropenia. Which of the following findings indicates a need for intervention? A. The client's grandchild is visiting and telling the client about the first day of kindergarten B. The client has a grilled ham and cheese sandwich, a banana, and yogurt on their lunch tray C. The client's family brings in a silk flower arrangement D. The client's assistive personnel places paper cups and plastic utensils in the client's room A nurse is providing teaching to a client who has Hodkin's lymphoma and is undergoing external radiation treatment. Which of the following instructions should the nurse include? A. Use an antibacterial soap to cleanse the skin B. Wash the ink marking off when showering C. Rub the skin with a towel when drying D. Avoid direct sun exposure to the skin A nurse is providing teaching to a group of clients regarding skin cancer prevention. Which of the following risk factors should the nurse include in the teaching? A. Light skin pigmentation B. Psoriasis C. History of frostbite D. Immunodeficiency disorder A nursing is educating a client who is scheduled for a kidney transplant. Which of the following information about hyperacute rejection should the nurse include in the teaching? A. Hyperacute rejection can occur during the first few weeks after the transplant B. If hyperacute rejection occurs, the kidney can become enlarged C. The organ will need to be removed if hyperacute rejection occurs D. Immunosuppressive therapy is given to reverse hyperacute rejection A nurse is caring for a client who reports a skin change. Which of the following findings should the nurse report to the provider? A. an asymmetrical papule that is pigmented B. A patch of silvery-white scales with a red epidermal base C. A collection of irregular, dry papules that are black D. An elevated red lesion that arises from a scar