Fluid, electrolyte, and acid base

Question 1

A nurse is assessing a client who has dehydration which of the following assessment is the priority

Answer 1

Mental status – the greatest risk to the client is injury from fall due to decline and their mental status

Question 2

A nurse is reviewing the laboratory report of a client who has fluid volume excess which of the following laboratory value should the nurse expect

Answer 2

-HCT below expected range
37 - 47/42–52

-BUN below expected reference range
10–20

-urine specific gravity above below reference range
1.010–1.025

Hgb Below expected reference range
12–16/14–18

Question 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

Answer 3

sodium below the expected range of one 35–1 45 which is likely to cause altered mental status the nurse should report this finding in monitor for Weeknd respiratory effort 

Question 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

Answer 4

One large hard-boiled egg

Question 5

The nurse is assessing a client who has calcium level of 8.1 which of the following findings is priority for the nurse to assess

Answer 5

Cardiac rhythm when using the airway breathing circulation approach the client care the nurse should assess the client cardiac rhythm because this total serum calcium level is below expected range hypocalcemia can cause ECG changes, bradycardia, or tachycardia

Question 6

A nurse is caring for a client who has a sodium level of 155 which of the following IV fluids should the nurse anticipate the provider to prescribe

Answer 6

0.45% sodium chloride Dash prescription for a hypotonic solution such as 0.45% sodium chloride is used to provide free water and treat cellular dehydration which promotes waste illumination by the kidneys

Question 7

A nurse is assessing a client who has hypomagnesium Which of the following should the nurse expect

Answer 7

Hyper active DTR, muscle cramps, numbness, tingling

Question 8

A nurse is assessing a client who has phosphorus level of 2.4 which of the following findings should the nurse expect

Answer 8

Slow peripheral pulses, difficult to find an easy to block

Question 9

A nurse is caring for a client who is experiencing respiratory distress as a result of pulmonary edema which of the following action should the nurse take first

Answer 9

Initiate high flow oxygen therapy five facemask at 5 to 6 L/minute to keep oxygen saturation above 90%

Question 10

A nurse is planning care for a client who has a potassium level of three The nurse should plan to monitor the client for which of the following findings

Answer 10

Orthostatic hypotension respiratory distress, weak thready pulse is, hypo reflexia – week hand grip strength and weak DTR

Question 11

A nurse is providing teaching to 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

Answer 11

I will use the incentive spirometer every hour

Question 12

A nurse is assessing a client who is using PCA following a direct me the client is short of breath, appears restless, and has a respiratory rate of 28/men. The clients ABG results are PH 7.52, PaO2 89, PaCO2 28, HCO3 24 which of the following action should the nurse take

Answer 12

PH ⬆️
PaO2 WNL
PaCO2 ⬇️
HCO3 WNL

Provide calming interventions – the client should decrease respiratory rate, which will cause the clients carbon dioxide levels to increase and lower the pH

Question 13

A nurse is reviewing the medical record of a client who has DM and is receiving regular insulin I can continuous IV infusion to treat diabetic keto acidosis which of the following findings should the nurse report to the provider

Answer 13

Serum potassium below the expected range. Hypokalemia is a serious complication that can occur when a client who has DKA is receiving insulin to treat the condition

Question 14

A nurse is providing teaching to a client who has venous insufficiency of the lower extremities which of the following statement by the client indicates an understanding of the teaching

Answer 14

when I sit down to watch TV I will be sure to put my feet up – elevating the feet will increase venous return the client should elevate their feet for at least 20 minutes several times per day

Question 15

A nurse is providing dietary teaching to a client who has heart failure and is receiving for Rosa made which of the following food should the nurse recommend as containing the greatest amount of potassium

Answer 15

One cup plain yogurt

Question 16

The nurse is assessing a client who has respiratory acidosis which of the following findings should the nurse expect

Answer 16

Confusion dash from a lack of cerebral perfusion if acidosis is not reverse the clients level of consciousness will decrease and, can occur

Question 17

A nurse is admitting a client who takes 40 Milligrams for Rosa my daily for heart failure and has experience three days of vomiting the nurse suspects hypokalemia which of the following medication should the nurse is preparing to administer

Answer 17

0.9% sodium chloride with 10 MAQ/L a potassium chloride at 100 mL per hour

This IV solution will provide adequate fluid and potassium replacement to offset the losses from vomiting

Question 18

A nurse is admitting a client who has status asthmaticus the client ABG results are pH 7.32 PaO2 74, PaCO2 56, HCO3 26 the nurse should interpret these laboratory values as which of the following imbalances

Answer 18

PH⬇️
PaO2 ⬇️
PaCO2 ⬆️
HCO3 WNL

Respiratory acidosis

Question 19

A nurse is teaching nutritional strategies to a client who has a low Calcium level and an allergy to milk. Which of the following statements by the client indicates an understanding of the teaching?

Answer 19

I will add broccoli and kale to my diet – which are good sources of calcium as alternatives to dairy products

Question 20

A nurse is caring for a client who reports difficulty breathing and tingling in both hands is respiratory rate is 36 per minute and he appears very restless which of the following values should the nurse anticipate to be outside of the expected reference range if the client is experiencing respiratory alkalosis

Answer 20

PaCO2 will be decreased due to hyperventilation

Question 21

A nurse is caring for a client who has dehydration and is receiving IV fluids when assessing for complications the nurse should recognize which of the following manifestations as a sign of fluid overload

Answer 21

Bounding peripheral pulses, increase respiratory rate, increase G.I. motility, decreased urine specific gravity

Question 22

A nurse is planning care for a client who is experienced excessive fluid loss which of the following intervention should the nurse include in the plan of care

Answer 22

Administer IV fluids to a client evenly over 24 hours, encourage the client to rise slowly when standing up, with a client every eight hours

Question 23

A nurse is caring for a client who requires nasogastric suctioning which of the following sets of laboratory results indicate that the client has metabolic alkalosis

Answer 23

PH⬆️
HcO3 ⬆️

PH 7.51, PaO2 94, PaCO2 36, HCO3 31

Question 24

The nurse is assessing a client who has hyperkalemia which of the following findings should the nurse expect

Answer 24

decreased Muscle strength, weakness, fatigue, paresthesia, nausea

Question 25

A nurse is caring for a client requires continuous cardiac monitoring the nurse identifies a prolonged PR interval, widened QRS complex which of the following laboratory values support this finding

Answer 25

Potassium above five can cause prolonged PR interval’s, wide QRS complex, a flat or absent P waves, and tall peaked T waves

Question 26

 A nurse is caring for a client who is receiving for us my daily during the morning assessment the client tells the nurse he is feeling weak in the legs which of the following action should the nurse take first

Answer 26

auscultate the lungs, hypokalemia an adverse effect

Question 27

While reviewing a clients laboratory results a nurse notes a serum calcium level of 8.0 which of the following action should the nurse take

Answer 27

initiate seizure precautions