EAQ related questions Flashcards
Which laboratory finding would provide the nurse with the rationale for administering sodium polystyrene sulfonate rectally to a patient with an irregular pulse and lower extremity weaknes?
A. Hypokalemia
B. Hypocalcemia
C. Hyperkalemia
D. Hypercalcemia
Hyperkalemia
An irregular pulse and weakness of the lower extremities are generally seen in patients with hyperkalemia. SPS binds with potassium in exchange for sodium (inversely related), thereby reducing hyperkalemia.
The patient presents with a one-time prescription for 20 mEq of potassium chloride in 250 mL of IV normal saline, to be given immediately. Which serum potassium level would prompt the nurse to seek clarification regarding the patient’s prescription?
A. 1.7 mEq/L
B. 2.9 mEq/L
C. 3.6 mEq/L
D. 4.5 mEq/L
4.5 mEq/L
A patient with heart failure accidentally overused the prescribed diuretics. Which respiratory manifestation would the nurse anticipate finding in the patient?
A. Shortness of breath
B. Pulmonary congestion
C. Increased respiratory rate
D. Moist crackles on inspiration
C. Increased respiratory rate
Patients with deficient fluid volume experience decreased tissue perfusion and hypoxia, resulting in increased respiratory rates. Pulmonary congestion, shortness of breath, and moist crackles on inspiration are all characterisitic of a fluid volume excess, not a fluid volume deficit.
Which clinical manifestation would the nurse associate with the patient’s admitting problem of deficient fluid volume related to nausea and vomiting?
A. Polyuria
B. Decreased pulse
C. Difficulty breathing
D. General restlnessness
General restlessness
Restlessness is an early cerebral sign that dehydration has progressed to the point where an intacellular fluid shift is occuring. If dehydration is left untreated, cerebral signs could progress to confusion and later coma. Polyuria, difficulty breathing, and a decreased pulse rate do not support a determination of deficient fluid volume.
For which metabolic alteration would the nurse prepare to administer IV albumin in a 5% solution?
A. Alkalosis
B. Hypovolemia
C. Hyperkalemia
D. Mixed acid-base disorder
Hypovolemia
Albumin is a colloid solution that pulls fluid into the blood vessels, which restores blood volume. This medication is used to treat hypovolemia.
A patient with diabetes mellitus, malnutrition, and a massive gastrointestinal (GI) bleed is NPO, has a NG tube, and has received multiple units of packed red blood cells. The patient’s morning potassium level is 5.5 mEq/L. Which rationale would the nurse use to explain the morning’s potassium level? SATA
A. The elevated potassium level may be due to high blood glucose levels produced when the bpdy experiences physical stress.
B. The postassium level increase may be related to decreased renal perfusion associated with the fluid volume deficit
C. The patient may be excreting extra sodium and retaining potassium because of malnutrition.
D. The transfusion of multiple units of stored hemolyzed blood may have increased the patient’s potassium level
E. The patient, who has been NPO and has a NG tube in place, is most likely experiencing metabolic acidosis.
A. The elevated potassium level may be due to high blood glucose levels produced when the bpdy experiences physical stress.
B. The postassium level increase may be related to decreased renal perfusion associated with the fluid volume deficit
D. The transfusion of multiple units of stored hemolyzed blood may have increased the patient’s potassium level
Alteration in which electrolyte level may be associated with occurrence of postoperative dysrhythmia?
A. Blood urea nitrogen
B. Sodium
C. Chloride
D. Potassium
Potassium
Heart electrolyte!
Sodium is brain
Which electrocardiogram (ECG) changes would the nurse observe if the patient is receiving IV dextrose therapy and exhibits an irregular pulse, a blood glucose of 165 mg/dL, and soft, flabby muscles? (SATA)
A. Loss of P wave
B. Prolonged QRS
C. Peaked T wave
D. Presence of U wave
E. ST segment depression
Prolonged QRS
Presence of U wave
ST depression
The symptoms described (fatigue, nausea, hyperglycemia, and muscle weakness) are correlated with hypokalemia.
A patient who sustained multiple injuries in a motor vehicle accident received multiple blood transfusions to replace blood lost from a wound hemorrhage. The nurse finds that the patient has developed laryngeal stridor, dysphagia, and numbness and tingling around the mouth. Which condition would the nurse associate with these changes?
A. These manifestations indicate fluid overload from multiple transfusions.
B. The identified clinical changes indicate the development of hypocalcemia
C. The patient developed anemia secondary to acute blood loss
D. The newly developed signs and symptoms indicate a hemolytic reaction
The identified clinical changes inidcate the development of hypocalcemia
Laryngeal stridor, dysphagia, and numbness and tingling around the mouth after multiple blood transfusion can be attributed to hypocalcemia. Blood and blood products contain citrate, which can bind calcium in the body and make it unavailable.
Which intervention would the nurse implement when providing care for a patient with hypercalcemia? SATA
A. Give isotonic saline infusions
B. Administer a biphosphonate
C. Administer a calcitonin
D. Restrict oral fluid intake to 1000 mL
E. Encourage the patient to breathe into a paper bag
Give isotonic saline infusions
Administer a biphosphate
Administer a calcitonin
Hypercalcemia is treated by hydrating the patient and promoting urinary excretion of calcium. The nurse would keep the patient hydrated by administering isotonic saline infusions, administering a bisphosphonate to inhibit the activity of osteoclasts, and giving calcitonin to rapidly increase renal calcium excretion.
The patient would be encouraged to breathe into a paper bag if signs of hypocalcemia were present.
Which condition increases the risk of a patient experiencing hypokalemia?
A. Alkalosis
B. Renal disease
C. Intense exercise
D. Adrenal insufficiency
Alkalosis
Renal disease, intense exercise, and adrenal insufficency place the patient at risk for hyperkalemia
Which electrolyte imbalance would prompt the nurse to instruct a patient to consume more dairy products? SATA
A. Hyperkalemia
B. Hypocalcemia
C. Hypercalcemia
D. Hypophosphatemia
E. Hyperphosphatemia
Hypocalcemia
Hypophosphatemia
Hypophosphatemia is decreased levels of phosphates in the body, whihc can also be alleviated through the consumption of dairy products, as they are rich in phosphates
The nurse receives a healthcare provider’s prescription to change a patient’s IV from D5 1/2 normal saline with 40 mEq KCI/L to D5NS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
A. Sodium level of 146 mEq/L, potassium level of 4.5 mEq/L
B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L
C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L
D. Sodium level of 144 mEq/L, potassium level of 3.7 mEq/L
Sodium level of 146 mEq/L, potassium level of 4.5 mEq/L
The change in IV presciption decreases the amount of potassium and increases the amount of sodium. For this prescription to be appropriate, the potassium level must be near the high end of its range and the sodium level near the low end of its range/
Which prescription would the nurse question if prescribed for a patient whose ECG tracing has a short QT interval and a high peaked T wave?
A. 1000 mL of D5W with 20 mEq KCL to run at 125 mL/hr
B. 20 grams of sodium polystyrene sulfonate by mouth
C. 10 units of regular insulin via intravenous push (IVP) and half an ampule of D50W IVP
D. 2 grams of intravenous (IV) calcium gluconate administered over 2 minutes
1000 mL of D5W with 20 mEq KCL to run at 125 mL/hr
A short QT and a high peaked T wave are indicative of hyperkalemia.
Which clincial manifestation would the nurse look for when assessing a patient with primary hypoparathyroidism? SATA
A. Anorexia
B. Easy fatiability
C. Depressed reflexes
D. Circumoral numbness
E. Positive Trousseau sign
Easy fatigability
Circumoral numbness
Positive Trousseau sign
Circumoral numbness is Chvostek
Primary hypoparathyroidism can result in a lack of parathyroid hormone, leading to hypocalcemia. Manifestations of low calcium levels include the ones listed above.
Anorexia and depressed reflexes are manifestations of hypercalcemia
The nurse adminsiters regular IV insulin to a patient with hyperkalemia. Which additional IV medication would the nurse adminster along with the insulin to prevent complications from this treatment?
A. Dextrose
B. Furosemide
C. Pamidronate
D. Calcium gluconate
Dextrose
The nurse also adminsiters dextrose to prevent hypoglycemia.
For which clinical manifestation would the nurse monitor a patient with a total serum calcium level of 11.2 mg/dL? SATA
A. Polyuria
B. Hypotension
C. Nephrolithiasis
D. Chvostek sign
E. Trousseau sign
Polyuria
Nephrolithiasis
Kidney stones
The rest of the symptoms are hypercalcemia
Which assessment would the nurse perform to avoid risk factoes associated with administration of a hypertonic solution in a patient with hyponatremia? SATA
A. Lung sounds
B. Bowel sounds
C. BP
D. Serum sodium levels
E. Serum potassium levels
Lung sounds
BP
Serum sodium levels
Monitored frequently because of the risk for excessive intravascular volume with hypertonic solutions
Which medication would the nurse administer to counter the signs of toxicity when infusing IV magnesium sulfate into a patient with preeclampsia?
A. IV calcium gluconate
B. Magnesium hydroxide
C. IV potassium chloride
D. 3% sodium chloride solution
IV calcium gluconate
Magnesium toxicity can be treated by administering IV calcium gluconate to antagonize the effects of megnesium on the cardiac muscles.
Which laboratory finding indicates that the nurse would withhold the patient’s scheduled dose of potassium phosphate?
A. Calcium of 6.4 mg/dL
B. Sodium level of 133 mEq/L
C. Magnesium level of 1.8 mEq/L
D. Potassium level of 4.0 mEq/L
Calcium of 6.4 mg/dL
Too low, phosphate and calcium have an inverse relationship with each other
Upon reviewing the morning laboratory reports, the nurse would conclude that which patient is at greatest risk of developing hypomagnesemia?
A. An 83-year-old man with lung cancer and hypertension
B. An unhoused 65-year-old woman with a history of chronic alcohol use disorder
C. A 32-year-old pregnant woman who has been treated for eclampsia
D. A 63-year-old man with benign prostatic hyperplasia (BPH) and a urinary tract infection (UTI)
An unhoused 65-year-old woman with a history of chronic alchohol use disorder
Which clinical manifestations would the nurse anticipate when providing care for a patient with hyperkalemia? SATA
A. +1 deep tendon reflexes
B. Rapid and shallow respirations
C. Serum blood glucose of 350 mg/dL
D. Numbness and tingling in the hands and feet
E. Ventricular fibrillation noted on the electrocardiogram
+1 deep tendon reflexes
Numbness and tingling in the hands and feet
Ventricular fibrillation noted on the electrocardiogram
Rapid and shallow respirations and hyperglycemia would be anticipated for hypokalemia
Which clincial manifestation would the nurse expect to see when assessing a patient with hypocalcemia?
A. Shortened ST segment
B. Prolonged QT segment
C. Ventricular dysrhythmias
D. Increased digitalis effects
Prolonged QT segments
The rest are for hypercalcemia
A patient with chronic kidney disease reports eating many nuts, bananas, peanut butter, and chocolate. The nurse’s assessment indicates a loss od deep tendon reflexes, an altered respiratory status, and somnolence. Which treatment option would the nurse associate with these clinical findings?
A. Renal dialysis
B. IV potassium chloride
C. IV furosemide
D. IV normal saline at 250 mL per hour
Which electrolyte is this concerning?
Renal dialysis
Because the patient has CKD and inadequate renal fnuction, the patient will need renal dialysis to remove the excess serum magnesium resulting from the patient’s increased intake of magnesium-rich foods.
Furosemide could have been an option if not for the patient’s impaired output.
Which clinical manifestation would the nurse look for if the patient is receiving a potassium-sparing diuretic? SATA
A. Hyperglycemia
B. Confusion and irritability
C. A tall, peaked T wave on the ECG
D. The presence of a U wave
E. Abdominal cramping and diarrhea
F. Paresthesias and weakness of lower extremities
Confusion and irritability
A tall, peaked T wave on the ECG
Abdominal cramping and diarrhea
Paresthesias and weakness of lower extremities
Which food would the nurse instruct a patient to include in their diet if the patient has been diagnosed with hypertension and has a magnesium level of 1.2 mEq/L?
A. Sugar
B. Oranges
C. Bananas
D. White flour
E. Peanut butter
Oranges
Bananas
Peanut butter
Which patient statement about hypercalcemia indicates an unerstanding of content taught by the nurse? SATA
A. “I can use antacids as needed for heartburn”
B. “I should restrict my fluid intake to less than 2000 mL/day”
C. “Increasing my daily fluid intake to 3000 to 4000 mL is good”
D. “Renal calculi may occur as a complication of hypercalcemia”
E. “Weight-bearing excercises can help keep calcium in my bones”
C. “Increasing my daily fluid intake to 3000 to 4000 mL is good”
D. “Renal calculi may occur as a complication of hypercalcemia”
E. “Weight-bearing excercises can help keep calcium in my bones”
Whihc medical diagnosis would prompt the nurse to include interventions for hyponatremia in the patient’s plan of care?
A. Diabetes insipidus
B. Cushing syndrome
C. Congestive heart failure
D. Uncontrolled diabetes mellitus
Congestive heart failure
CHF increases risk due to inefficent pumping of the heart. The rest are a risk for hypernatremia
The morning laboratory results of a patient admitted with heart failure reveal a serum potassium level of 2.9 mEq/L. Which classification of medications would be withheld until the nurse consults with a HCP?
A. Antibiotics
B. Loop diuretics
C. Bronchodilators
D. Antihypertensives
Loop diuretics
