Module 1 FINAL EXAM REVIEW

Question 1

The kidneys should be eliminating \_\_\_\_ mL/hour. 
A. 60 mL/hr 
B. 30 mL/hr 
C. 40 mL/hr 
D. 50 mL/hr

Answer 1

B. 30 mL/hr

Question 2

If a patient has an excess blood volume what will that cause their blood pressure to do?
A. Go up
B. Go down

Answer 2

A. Go up

Question 3

Orthostatic hypotension causes your blood pressure to do what?
A. Go up
B. Go down

Answer 3

B. Go down

Question 4

Hypernatremia Signs and Symptoms Pneumonic:
“you are fried”
Fever (low-grade), flushed skin
Restlessness (irritable)
Increased fluid retention and increased b.p
Edema (peripheral and pitting)
Decreased urinary output, dry mouth

Answer 4

Hypernatremia Signs and Symptoms Pneumonic:
“you are fried”
Fever (low-grade), flushed skin
Restlessness (irritable)
Increased fluid retention and increased b.p
Edema (peripheral and pitting)
Decreased urinary output, dry mouth

Question 5

What is hypernatremia?
A. Sodium concentration above 145 mEq/L
B. Sodium concentration below 135 mEq/L

Answer 5

A. Sodium concentration above 145 mEq/L

Question 6

What is hyperkalemia?
A. Potassium level above 5.0 mEq/L
B. Potassium level below 3.5 mEq/L

Answer 6

A. Potassium level above 5.0 mEq/L

Question 7

Causes of Hyperkalemia Mneumonic 
"Machine" 
Medications- ACE inhibitors & NSAIDS 
Acidosis- Metabolic & Respiratory 
Cellular destruction- Burns, traumatic injury 
Hypoaldosteronism, hemolysis 
Intake- Excessive 
Nephrons, renal failure 
Excretion- Impaired

Answer 7

Causes of Hyperkalemia Mneumonic 
"Machine" 
Medications- ACE inhibitors & NSAIDS 
Acidosis- Metabolic & Respiratory 
Cellular destruction- Burns, traumatic injury 
Hypoaldosteronism, hemolysis 
Intake- Excessive 
Nephrons, renal failure 
Excretion- Impaired

Question 8

Signs and Symptoms of Increased Vitamin K Mneumonic 
"Murder" 
Muscle Weakness 
Urine, oliguria, anuria
Respiratory distress 
Decreased cardiac contractility 
Ecg changes 
Reflexes, hyperreflexia, or areflexia (flaccid)

Answer 8

Signs and Symptoms of Increased Vitamin K Mneumonic 
"Murder" 
Muscle Weakness 
Urine, oliguria, anuria
Respiratory distress 
Decreased cardiac contractility 
Ecg changes 
Reflexes, hyperreflexia, or areflexia (flaccid)

Question 9

What is hypocalcemia?
A. Calcium level above 10.5 mg/dL
B. Calcium level below 9.0 mg/dL

Answer 9

B. Calcium level below 9.0 mg/dL

Question 10

Hypocalcemia Signs and Symptoms Mneumonic 
"cats" 
Convulsions 
Arrhythmias 
Tetany 
Spasms and stridor

Answer 10

Hypocalcemia Signs and Symptoms Mneumonic 
"cats" 
Convulsions 
Arrhythmias 
Tetany 
Spasms and stridor

Question 11

A nurse enters a client’s room to administer an IV medication and finds that the IV site is swollen, cool, and pale. The client reports discomfort at the insertion site. The nurse recognizes that this may be:
A. Phlebitis 
B. Infiltration 
C. An Allergic Reaction 
D. Sepsis

Answer 11

B. Infiltration

Question 12

The nurse administers serum albumin to a client to assist in?
A.Development of osmotic pressure
B.Activation of white blood cells
C.Formation of red blood cells
D.Clotting of blood

Answer 12

A. Development of osmotic pressure

Question 13

A client with hypercalcemia has a serum calcium level of 14 mg/dl. The nurse should instruct the client to avoid which of the following foods upon discharge? Select all that apply:
A. Nuts
B. Canned salmon
C. Broccoli
D. Fish
E. Organ meats
F. Eggs

Answer 13

A. Nuts
B. Canned Salmon
C. Broccoli

Question 14

The nurse prepares for the possibility of magnesium sulfate toxicity by having at the beside:
A. Suction equipment
B. Nalline
C. Calcium gluconate
D. Oxygen

Answer 14

C. Calcium Gluconate

Question 15

During an assessment of a newly admitted client, the nurse notes that the client's heart rate is 110 beats/minute, his blood pressure shows orthostatic changes when he stands up, and his tongue has a sticky, paste-like coating. The client's spouse tells the nurse that he seems a little confused and unsteady on his feet. Based on these assessment findings, the nurse suspects that the client has which condition?
A. Dehydration
B. Hypokalemia
C. Fluid Overload
D. Hypernatremia

Answer 15

A. Dehydration

Question 16

The nurse is caring for a client with a diagnosis of dehydration, and the client is receiving intravenous (IV) fluids. Which assessment data would indicate to the nurse that the dehydration remains unresolved?
A. An oral temperature of 98.8 F
B. A urine specific gravity of 1.043
C. A urine output that is pale yellow
D. A blood pressure of 120/80 mmHg

Answer 16

B. A urine specific gravity of 1.043

Question 17

The nurse is caring for a client with heart failure. On assessment, the nurse notes that the client is dyspneic and crackles are audible on auscultation. What additional signs would the nurse expect to note in this client if excess fluid volume is present?
A. Weight Loss
B. Flat neck and Hand veins
C. An increase in blood pressure
D. Decreased central venous pressure (CVP)

Answer 17

C. An increase in blood pressure

Question 18

A nurse is caring for a client whose magnesium level is 3.5 mg/dL. Which assessment finding should the nurse most likely expect to note in the client based on this magnesium level?
A. Tetany
B. Twitches
C. Positive Trousseau's sign
D. Loss of deep tendon reflexes

Answer 18

D. Loss of deep tendon reflexes
Rationale:
The normal magnesium level is 1.6 to 2.6 mg/dL. A client with a magnesium level of 3.5 mg/dL is experiencing hypermagnesemia. Assessment findings include neurological depression, drowsiness and lethargy, loss of deep tendon reflexes, respiratory insufficiency, bradycardia, and hypotension.

Question 19

A nurse is planning care for a client with hypokalemia. Which interventions should be included in the plan of care? Select all that apply.
A. Ensure adequate fluid intake.
B. Implement safety measures to prevent falls
C. Encourage low fiber foods to prevent diarrhea.
D. Instruct the client about foods that contain
potassium.
E. Encourage the client to obtain assistance to
ambulate.

Answer 19

A. Ensure adequate fluid intake.
B. Implement safety measures to prevent falls
D. Instruct the client about foods that contain
potassium.
E. Encourage the client to obtain assistance to
ambulate.

Question 20

The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which cardiovascular manifestation would the nurse expect to note?
A. Hypotension
B. Increased heart rate
C. Bounding peripheral pulses
D. Shortened QT interval on electrocardiography
(ECG)

Answer 20

A. Hypotension

Question 21

Which of the following interventions would be the best choice to monitor fluid and electrolyte balance?
A.  assess if the client is voiding
B. assess daily weight
C. evaluate daily urine specimens
D. check daily sodium levels

Answer 21

B. Assess daily weight

Question 22

Which of the following are symptoms of hypovolemia?

A. oliguria
B. weight gain
C. decreased pulse and increased BP
D. distended jugular veins

Answer 22

A. oliguria

Question 23

An older adult client is admitted with dehydration. Which nursing assessment data identify that the client is at risk for falling?
A. Dry oral mucous membranes
B. Orthostatic blood pressure changes
C. Pulse rate of 72 beats/min and bounding
D. Serum potassium level of 4.0 mEq/L

Answer 23

B. Orthostatic blood pressure changes

Question 24

The nurse instructs an older adult client to increase the intake of dietary potassium when the client is prescribed which classification of drugs?
A. Alpha antagonists
B. Beta-blockers
C. Corticosteroids
D. High-ceiling (loop) diuretics

Answer 24

D. High-ceiling (loop) diuretics

Question 25

The nurse is reviewing serum electrolytes and blood chemistry for a newly admitted client. Which result causes the greatest concern?
A. Glucose: 97 mg/dL
B. Magnesium: 2.1 mEq/L
C. Potassium: 5.9 mEq/L
D. Sodium: 143 mEq/L

Answer 25

C. Potassium: 5.9 mEq/L

Question 26

A client develops fluid overload while in the intensive care unit. Which nursing intervention does the nurse perform first?
A. Draws blood for laboratory tests
B. Elevates the head of the bed
C. Places the extremities in a dependent position
D. Puts the client in a side-lying position

Answer 26

B. Elevates the head of the bed

Question 27

The nurse is assessing a client with hyponatremia. Which finding requires immediate action?
A. Diminished bowel sounds
B. Heightened acuity
C. Muscular weakness
D. Urine output of 35 mL/hr

Answer 27

C. Muscular weakness

Question 28

The charge nurse on a medical-surgical unit is completing assignments for the day shift. Which client is assigned to the LPN/LVN?
A. A 44-year-old with congestive heart failure (CHF) who has gained 3 pounds since the previous day
B. A 58-year-old with chronic renal failure (CRF) who has a serum potassium level of 6 mEq/L
C. A 76-year-old with poor skin turgor who has a serum osmolarity of 300 mOsm/L
D. An 80-year-old with 3+ peripheral edema and crackles throughout the posterior chest

Answer 28

C. A 76-year-old with poor skin turgor who has a serum osmolarity of 300 mOsm/L
Rationale-
This client is the most stable.

Question 29

The nurse is planning care for a 72-year-old resident of a long-term care facility who has a history of dehydration. Which action does the nurse delegate to unlicensed assistive personnel (UAP)?
A. Assessing oral mucosa for dryness
B. Choosing appropriate oral fluids
C. Monitoring skin turgor for tenting
D. Offering fluids to drink every hour

Answer 29

D. offering fluids to drink every hour
rationale:
Encouraging a client to take oral fluids is within the scope of practice for UAP. Assessments of oral mucosa, selection of appropriate fluids, and assessment of skin turgor should be done by licensed nursing staff, who have the needed education and scope of practice to implement these more complex actions.

Question 30

The health care provider writes orders for a client who is admitted with a serum potassium level of 6.9 mEq/L. What does the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally.
B. Ensure that a potassium-restricted diet is ordered.
C. Place the client on a cardiac monitor.
D. Teach the client about foods that are high in potassium.

Answer 30

C. Place the client on a cardiac monitor

Question 31

Normal saline is used to increase/decrease in extracellular fluid volume.

Answer 31

increase