Midterm

Question 1

If a patient is expelling an abundance of waste from their body, which of these is
generally true to determine whether they are
more likely to develop metabolic alkalosis or
metabolic acidosis?

D. Metabolic acidosis can be caused by vomiting, while metabolic alkalosis can be caused by increased urination.
A. Metabolic alkalosis can be caused by vomiting, while metabolic acidosis can be
caused by diarrhea.
B. Metabolic alkalosis can be caused by vomiting, while metabolic acidosis can be
caused by increased urination
C. Metabolic acidosis can be caused by vomiting, while metabolic alkalosis can be caused by diarrhea.

Answer 1

A. Metabolic alkalosis can be caused by
vomiting, while metabolic acidosis can be
caused by diarrhea.

Question 2

The burned client newly arrived from an accident scene is prescribed to receive 4 mg of morphine sulfate by IV push. What is the most important reason to administer the opioid analgesic to this client by the
intravenous route?

D. It is less likely to interfere with the client’s breathing and oxygenation
C. The medication will be effective more quickly than if given intramuscularly
B. The danger of an overdose during fluid remobilization is reduced
A. The client delayed gastric emptying

Answer 2

D. It is less likely to interfere with the
client’s breathing and oxygenation

Question 3

Alexander has experienced an electrical injury, with the entrance site on the
left hand and the exit site on the left foot. What are the priority assessment data to
obtain from this client on admission?

C. Current range of motion in all extremities
D. Heart rate and rhythm
B. Choice 3
A. Airway patency

Answer 3

D. Heart rate and rhythm

Question 4

It is possible to interfere with the Countercurrent exchange system by

E. drinking too much water
A. eating too much salt drinking too much or too little water
B. drinking too much fruit juice or eating too much salt
D. drinking too little water
C. drinking too much or too little water

Answer 4

C. drinking too much or too little water

Question 5

Dr. Lyndon is verifying a patient’s blood pressure by taking it manually. As he
pump up the cuff above the systolic pressure for a few minutes he notice that the patient develop a carpal spasm. Which of the
following is true?

C. This is known as Chvostek’s Sign
D. This is known as Trousseau’s Sign and is present in patients with
hypocalcemia
A. The patient is having a normal nervous response to an inflating blood pressure
cuff that is inflated above the systolic pressure
B. This is known as Trousseau’s Sign and is present in patients with Hypercalcemia

Answer 5

D. This is known as Trousseau’s Sign and is present in patients with
hypocalcemia

Question 6

Miss Francine Anderson might have a urinary tract infection (UTI ). Which statement by the patient suggests that a UTI is likely?

C. ‘‘I go hours without the urge to pee.”
A. ‘‘I pee a lot.”
B. ‘‘It burns when I pee.”
D. ‘‘My pee smells sweet.”

Answer 6

B. ‘‘It burns when I pee.”

Question 7

EJ is an 18 y.o. student is admitted with dark urine, fever, and flank pain and is
diagnosed with acute glomerulonephritis.
Which would most likely be in this student’s
health history?

B. Renal trauma
A. Renal calculi
D. Family history of acute glomerulonephritis
C. Recent sore throat

Answer 7

B. Renal trauma

Question 8

Diomel, a client is brought to the Emergency Department after passing out in a local department store. The client has been fasting and has ketones in the urine.
Which acid-base imbalance would the nurse expect to assess in this client?

C. Metabolic alkalosis
B. Respiratory alkalosis
A. Metabolic acidosis
D. Respiratory acidosis

Answer 8

A. Metabolic acidosis

Question 9

Mr. Apollo Mercury is a patient with obstructive lung disease and shortness of
breath comes into your clinic. You would most likely expect:

B. A low pH, low CO2, and low bicarbonate
C. A high pH, high CO2, high bicarbonate
D. Metabolic acidosis
A. Respiratory acidosis

Answer 9

A. Respiratory acidosis

Question 10

What is the most important hormone involved in determining how diluted or concentrated your urine will be?

D. Aldosterone
C. ADH
B. T4
A. ACTH
E. Renin

Answer 10

C. ADH

Question 11

A student nurse is correct when he says that __ is the stage of shock that is irreversible and unmanageable?

B. Initial
D. Refractory
A. Progressive
C. Exudative

Answer 11

D. Refractory

Question 12

Mr. Destiny is experiencing septic shock and infrequent bowel sounds. To ensure adequate nutrition, nurse Dream administers

C. A full liquid diet
A. continuous infusion of total parenteral nutrition
B. Isotonic enteral nutrition every 6 hours
D. An infusion of crystalloids at an increased rate of flow

Answer 12

A. continuous infusion of total parenteral nutrition

Question 13

Which statements are INCORRECT about the compensatory stage of shock. Select all that apply:

D. One hallmark sign of this stage is that there is an increase in capillary permeability.
B. During this stage blood is shunted away from the kidneys, lungs, skin, and
gastrointestinal system to the brain and heart.
A. This stage is reversible
E. A patient is at risk for a paralytic ileus during this stage.
C. During this stage blood flow to the kidneys is reduced, which causes the
kidneys to activate the renin-angiotensin system, and this will lead to major vasodilation to the arterial and venous

Answer 13

D. One hallmark sign of this stage is that there is an increase in capillary permeability.

C. During this stage blood flow to the kidneys is reduced, which causes the
kidneys to activate the renin-angiotensin system, and this will lead to major vasodilation to the arterial and venous

Question 14

An athlete was brought to the emergency department of a hospital after he
fell into the ground and hurt his left leg. He is noted to be tachycardic and tachypneic. Painkillers were carried out to lessen his pain. Suddenly, he started complaining that he is still in pain and now experiencing muscle cramps, tingling, and paresthesia. Measurement of arterial blood gas reveals pH 7.6, Pa02 120 mm Hg, PaC02 31 mm Hg, and HC03 25 mmol/L. What does this
mean?

B. Respiratory Acidosis, Partially, Compensated
D. Metabolic Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
A. Respiratory Acidosis, Uncompensated

Answer 14

C. Metabolic Alkalosis, Uncompensated

Question 15

Baby Nikkie was rushed to the Emergency Room of Chopper Medical City following her mother’s complaint that the infant has been irritable, difficult to breastfeed, and has had diarrhea for the past 3 days. The infant’s respiratory rate is elevated and the fontanels are sunken. The Emergency Room physician orders ABGs after assessing the ABCs. The results from the ABG results show pH 7 .39, Pa CO2 27 mmHg, and HC03 19 mEq/L. What does this mean?

A. Respiratory Alkalosis, Fully
Compensated
B. Metabolic Acidosis, Fully Compensated
B. Metabolic Acidosis, Uncompensated
D. Respiratory Acidosis, Uncompensated

Answer 15

B. Metabolic Acidosis, Fully Compensated

Question 16

Patient Jehu Tagamochi has severe burns around the righ,t hip. Which position is
most important to be emphasized by the nurse that the client maintain to retain maximum function of this joint?

B. Hip, knee, and ankle all at maximum flexion
C. Hip flexed 90 degrees and knee flexed 90 degrees
D. Hip maintained in 30-degree flexion, knee flexion
A. Hip at zero flexion with leg flat

Answer 16

A. Hip at zero flexion with leg flat

Question 17

Which of the following risk factors exhibited by patient Clint presenting in the Emergency Department would place him at risk for metabolic acidosis? Select all that apply.

A. Abdominal fistulas
E. Hypovolemic shock
B. Chronic obstructive pulmonary disease

Answer 17

ALL

Question 18

You’re caring for a patient who is experiencing shock. Which lab result below
demonstrates that the patient’s cells are using anaerobic metabolism?
A. Ammonia 18 µ/dl
B. Potassium 4.5 mEq/L
D. Bicarbonate 23 mEq/L
C. Serum Lactate 9 mmol/L

Answer 18

C. Serum Lactate 9 mmol/L

Question 19

A burn ICU nurse receives a new admission with burns over 30% of the body.
Client M is sedated, receiving IV pain medication, and edematous. Which of the
following is the nurse’s main concern?
A. Wound care
B. Indwelling catheter care
D. Hypovolemic shock
C. Pain management

Answer 19

D. Hypovolemic shock

Question 20

Medusa Bekeneris unexpectedly fell asleep while sun bathing. By the time she woke up, it had been more than six hours
since she had something to eat or drink. She began vomiting and having diarrhea. Her electrolyte balance could be disrupted from which of the following?

C. Low blood sugar
A. Dehydration
B. Hyperthermia
D. Demineralization

Answer 20

A. Dehydration

Question 21

A client is admitted to the hospital following a burn injury to the left hand and
arm. The client’s burn is described as white and leathery with no blisters. Which degree of severity is this burn?

B. Second degree burn
D. Fourth degree burn
A. First degree burn
C. Third degree burn

Answer 21

C. Third degree burn

Question 22

Patient Luke is receiving peritoneal dialysis. What should a nurse do when he
notices the return fluid is slowly draining?

C. Place the patient in a reverse Trendelenburg position.
A. Check for kinks in the outflow tubing
D. Ask the patient to cough.
B. Raise the drainage bag above the
level of the abdomen.

Answer 22

A. Check for kinks in the outflow tubing

Question 23

Ten hours after patient Yohan with
50% burns is admitted, his blood glucose level is 90 mg/dl. What is the nurse’s best action?
D. Document the finding as the only action
A. Notify the emergency team
C. Ask the client if anyone in her family has diabetes mellitus
B. Slow the intravenous infusion of
dextrose 5% in Ringer’s lactate

Answer 23

D. Document the finding as the only action

Question 24

What is the primary disadvantage of using peritoneal dialysis for long-term management of chronic renal failure?

A. The danger of hemorrhage is high.
C. It is a time-consuming method of treatment.
B. It cannot correct severe imbalances.
D. The risk of contracting hepatitis is
high.

Answer 24

B. It cannot correct severe imbalances.

Question 25

Mr. Curlie Tops, a patient with diabetes has had many renal calculi over the past
years and now has chronic renal failure.
Which substance must be reduced in this patient’s diet?

B. Fats
D. Vitamin C
C. Protein
A. Carbohydrates

Answer 25

C. Protein

Question 26

Nurse Jason James is caring for client with a new donor site that was harvested to
treat a new burn. The nurse positions the client to:

D. To prevent infection
A. Avoid pressure on the site
C. Allow ventilation of the site
B. Keep the site fully covered

Answer 26

A. Avoid pressure on the site

Question 27

When caring for Carl a patient in acute septic shock, nurse Clark would anticipate

C. Administering intravenous
diphenhydramine (Benadryl).
D. Assisting with insertion of a ventricular assist device (VAD).
A. Administering osmotic and/or loop diuretics.
B. Infusing large amounts of intravenous fluids.

Answer 27

B. Infusing large amounts of intravenous fluids.

Question 28

Benjie’s grandmother has been suffering from persistent vomiting for two
days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes 4 seconds. She is diagnosed as
having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, Pa02 85 mm Hg, PaC02 40 mm Hg, and HC03 34 mmol/L. What acid-base
disorder is shown?

A. Respiratory Alkalosis, Uncompensated
B. Respiratory Acidosis, Partially Compensated
C. Metabolic Alkalosis, Uncompensated
D. Metabolic Alkalosis, Partially Compensated

Answer 28

C. Metabolic Alkalosis, Uncompensated

Question 29

A condition whereupon a person’s body is unable to form concentrated urine,
due to an absence or lack of a response to
ADH, is called____

B. insulin dependent diabetes mellitus
C. diabetes insipidus
D. diabetes nephrogenicus
A. diabetes mellitus

Answer 29

C. diabetes insipidus

Question 30

Four of the patients at Medical ward are presented below. Which patient is at risk of developing a sodium level at 130 mEq/L (130 mmol/L)?

A. The client who i.s taking diuretics
D. The client who is taking corticosteroids
C. The client with Cushing’s syndrome
B. The client with hyperaldosteronism

Answer 30

A. The client who i.s taking diuretics

Question 31

When too much CO2 is retained in the body, the result is:

A. Hypercapnia
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis

Answer 31

A. Hypercapnia

Question 32

When the body is attempting to compensate for shock the adrenal carte release aldosterone due to the presence o angiotensin Select all the effects
aldosterone will have on the body in attempt to increase cardiac output and maintain
tissue perfusion: SATA

D. Cause the urine to have a low osmolality
A. Increase blood volume
C. Causes the kidneys to excrete sodium and water
B. Causes the kidneys to keep sodium and water

Answer 32

A. Increase blood volume
B. Causes the kidneys to keep sodium and water

Question 33

Johnanrey, a medical ward nurse is caring for a patient in liver failure with ascites. Nurse Johnanrey correctly
understands that the ascites is due to w of the following?

C. An increase in oncotic pressure resulting in peritoneal edema
A. An increase in serum osmolarity resulting in hypertension
B. A decrease in serum osmolarity resulting in peripheral edema
D. A decrease in oncotic pressure resulting in third spacing

Answer 33

D. A decrease in oncotic pressure resulting in third spacing

Question 34

Mr. RE, who is 2 weeks postburn with a 40% deep partial-thickness injury, still a
open wounds. On taking the morning vital signs, He is found to have a below-normal temperature, is hypotensive, and has
diarrhea. What is the nurse’s best action? -

A. Assess the client’s airway and oxygen saturation
B. Increase the temperature in the room and increase the IV infusion rate
C. Nothing, because the findings are normal for clients during the acute phase of recovery
D. Notify the burn emergency team

Answer 34

D. Notify the burn emergency team

Question 35

Which of the following is the most significant sign of peritoneal infection?

C. Poor drainage of the dialysate fluid
B. Swelling in the legs
D. Redness at the catheter insertion site~
A. Cloudy dialysate fluid

Answer 35

A. Cloudy dialysate fluid

Question 36

A patient is admitted to the ER with the following findings: heart rate of 110 (thread upon palpation), 80/62 blood pressure, 25 ml/hr urinary output, and Sodium level of 160. What interventions do you expect the medical doctor to order for this patient?

C. Administer hypotonic IV fluid and administer sodium tablets.
A. Restrict fluid intake and monitor daily weights
D. No interventions are expected
B. Administer hypertonic solution of 5% Dextrose 0.45% Sodium Chloride and
monitor urinary output

Answer 36

B. Administer hypertonic solution of 5% Dextrose 0.45% Sodium Chloride and
monitor urinary output

Question 37

A Japanese patient named Harru is in metabolic alkalosis due to diuretic therapy. How do you expect the potassium level and bicarbonate level to be affected?

A. Increased potassium level and increased bicarb level
C. Increased potassium level and decreased bicarb level
B. Decreased potassium level and decreased bicarb level
D. Decreased potassium level and increase bicarb level

Answer 37

C. Increased potassium level and decreased bicarb level

Question 38

Nurse Magnus is preparing to care for a client with a potassium deficit. Nurse
Magnus reviews the client’s record and determines that the client is at risk for developing the potassium deficit because of which situation?

A. Sustained tissue damage
D. Uric acid level of 9.4 mg/dl (559 µmol/L)
C. Has a history of Addison’s disease
B. Requires nasogastric suction

Answer 38

B. Requires nasogastric suction

Question 39

Which among the following patient is at greatest risk for developing a urinary tract
infection (UTI)?

A. A 35 y.o. woman with a fractured wrist
B. A 20 y.o. woman with asthma
D. A 28 y.o. with angina
C. A 50 y.o. postmenopausal woman

Answer 39

C. A 50 y.o. postmenopausal woman

Question 40

Anne, who is drinking beer at a party, falls and hits her head on the ground. Her friend Liza dials “911” because Anne is unconscious, depressed ventilation(shallow and slow respirations), rapid heart rate, and is profusely bleeding from both ears. Which primary acid-base imbalance is Anne at for if medical attention is not provided?

A. Metabolic Acidosis
B. Metabolic Alkalosis
D. Respiratory Alkalosis
C. Respiratory Acidosis

Answer 40

C. Respiratory Acidosis