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ATI - Electrolyte Imbalance Q&A
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 pressue - ANS A. Decreased muscle strength 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 - ANS A. Sodium 128 mEq/L A nurse is assessing a client who is using PCA following a thoracotomy. The client is short of breath, appears restless, and has respirations of 28/min. The client's ABG results are pH 7.52, PaO2 89mm hg, PaCO2 28 mmHg, 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. - ANS C. Provide calming interventions. 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 - ANS B. Cardiac rhythm A nurse is caring for a client who is experiencing respiratory distress as a result of acute 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. Administer morphine IV - ANS B. Initiate high-flow oxygen therapy 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 - ANS B. Serum sodium 138 mEq/L 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 extra cheese because I can't drink milk." B. "I will 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." - ANS D. "I will add broccoli and kale to my diet."
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." - ANS C. "When I sit down to watch television, I'll be sure to put my feet up." A nurse is reviewing the laboratory data on four clients. Which of the following serum laboratory values should the nurse expect off for the client who is experiencing 2+ pitting ankle edema? A. Sodium 138 mEq/L B. Hematocrit 34% C. BUN 22 mg/dL D. Protein 9 g/L - ANS B. Hematocrit 34% A nurse is caring for a client who has a serum sodium level of 155 mEq/L. Which of the following IV fluid prescriptions should the nurse anticipate administering? A. 1,000 mL 0.9% sodium chloride B. 1,000 mL dextrose 5% in water C. 1,000 mL dextrose 10% in water D. 1,000 mL 0.225% sodium chloride - ANS D. 1,000 mL 0.225% sodium chloride 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 6 out of 10 before I use the PCA." C. "I will limit my daily fluid intake to 2 to 3 glasses." D. "I will use the incentive spirometer every hour." - ANS D. "I will use the incentive spirometer every hour."
A nurse is planning dietary teaching for a client who has hypermagnesemia. Which of the following food choices contains the most magnesium and is, therefore, a food the nurse should plan to instruct the client to avoid? A. Hard-boiled eggs B. Cheddar cheese C. Raw rhubarb D. Raw spinach - ANS D. Raw spinach 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 - ANS C. Withhold the medication A nurse is caring for a client who reports difficulty breathing and tingling in both hands. His respirations are 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. PaO B. PaCO C. Sodium D. Bicarbonate - ANS B. PaCO While reviewing a client's laboratory results, a nurse notes a serum calcium level of 8.0 mg/dL. Which of the following actions should the nurse take? A. Implement seizure precautions B. Administer phosphate C. Initiate diuretic therapy
A nurse is reviewing the medical record of a client who has diabetes mellitus and is receiving regular insulin by continuous IV infusion 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 - ANS C. Serum potassium 3.0 mEq/L A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect? A. Hypotension B. Peripheral edema C. Facial flushing D. Hyperreflexia - ANS A. Hypotension A nurse is assessing a client who has a serum 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 pulsations D. Increase in cardiac output - ANS C. Slow peripheral pulsations A nurse is caring for a client who requires nasogastric suctioning. Which of the following sets of laboratory results indicates that the client has metabolic alkalosis? A. pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3 -31 mEq/L B. pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3 -26 mEq/L C. pH 7.31, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3 -23 mEq/L
D. pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3 -20 mEq/L - ANS A. pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3 -31 mEq/L 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 - ANS B. Orthostatic hypotension A nurse is caring for a client who has heart failure and is receiving furosemide. The client is experiencing irritability and anxiety. Which of the following actions should the nurse anticipate taking? A. Offer whole grain wheat breads with meals B. Recommend a potassium-sparing diuretic C. Give potassium 20 mEq/L by IV bolus D. Restrict oral fluids - ANS B. Recommend a potassium-sparing diuretic 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 mg/L - ANS D. Potassium 6.1 mg/L 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
What is the abbreviation for 5% Dextrose and 0.45% Sodium Chloride? - ANS D5 1/2NS What is the abbreviation for 0.45% Sodium Chloride? - ANS 1/2 NS What is the abbreviation for Lactated Ringer's and 5% Dextrose? - ANS D5 LR What is the abbreviation for 0.9% Sodium Chloride? - ANS NS What is the constancy in the environment of the body that is naturally maintained by adaptive responses? A. Osmosis B. Homeostasis C. Immune Response D. Balance - ANS B. Homeostasis What is the most vital human nutrient? A. Calcium B. Protein C. Water D. Oxygen - ANS C. Water What type of amino acids are essential and obtained from the daily diet? A. Indispensable B. Dispensable - ANS A. Indispensable What type of amino acids are non-essential and can be produced from other amino acids?
A. Indispensable B. Dispensable - ANS B. Dispensable Dietary proteins consist of how much of the caloric intake? A. 5-10% B. 10-20% C. 10-35% D. 30-40% - ANS C. 10-35% What type of dietary protein is incomplete or missing essential pieces? A. Animal B. Plant - ANS B. Plant What type of dietary protein is complete and not missing any essential pieces? A. Animal B. Plant - ANS A. Animal Albumin is ____% of the plasma proteins. A. 20% B. 40% C. 50% D. 60% - ANS C. 50% True/False Fibrinogen is a protein that is produced by the liver. It helps to stop bleeding by helping blood clots form. - ANS True
What is the normal range of Phosphorus (PO4) in the body? - ANS 2.5-4.5 mg/dL What is the normal range of Magnesium (Mg) in the body? - ANS 1.3-2.3 mg/dL What is the normal range of Chloride (Cl) in the body? - ANS 96-108 mEq/L What is the passive solute movement across a permeable membrane from high to low until equal going downhill? A. Filtration B. Osmosis C. Diffusion D. Active - ANS C. Diffusion What is the energy transportation, expending energy by going against the concentration gradient, and traveling from an area of lower concentration to higher going uphill? A. Filtration B. Osmosis C. Passive D. Active - ANS D. Active What it the movement of water in and out of a permeable membrane from an area of higher pressure to one of lower pressure? A. Filtration B. Osmosis C. Passive D. Diffusion - ANS A. Filtration
What is the pushing force out into the interstitial space? A. Filtration B. Colloid osmotic pressure C. Hydrostatic pressure D. Capillary hydrostatic pressure - ANS D. Capillary hydrostatic pressure What is the pulling force into the capillary area? A. Filtration B. Colloid osmotic pressure C. Hydrostatic pressure D. Capillary hydrostatic pressure - ANS B. Colloid osmotic pressure What is the movement of water only through a semipermeable cell membrane from an area of less concentration of particles to an area of greater? A. Osmolarity B. Diffusion C. Active D. Osmosis - ANS D. Osmosis True/False Hypertonic solutions cause cells to swell. - ANS False Hypertonic solution causes cells to shrink because it is pulling fluid out of the cells. What is the osmolarity of blood? - ANS 300 mOsmol/L (Select all that apply)
A. Respiratory, chemical, renal B. Chemical, renal, respiratory C. Renal, respiratory, chemical D. Chemical, respiratory, renal - ANS D. Chemical, respiratory, renal What is the patient experiencing: pH 7.48 PCO2 28 HCO3 24 A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis - ANS B. Respiratory alkalosis What is the patient experiencing: pH 7.30 PCO2 37 HCO3 20 A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis - ANS C. Metabolic acidosis What is the patient experiencing: pH 7.48 PCO2 39 HCO3 30 A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis - ANS D. Metabolic alkalosis
What is the patient experiencing: pH 7.49 PCO2 30 HCO3 26 A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis - ANS A. Respiratory Alkalosis True/False When a patient is in an acidotic state, their potassium levels increase. - ANS True A patient is ordered to receive hypotonic IV solution to provide free water replacement. Which of the following solutions will the nurse anticipate administering? a) Lactated Ringer's solution b) 0.45% NaCl c) 5% NaCl d) 0.9% NaCl - ANS b) 0.45% NaCl The nurse is caring for a patient with a serum sodium level of 113 mEq/L. The nurse should monitor the patient for the development of which of the following? a) Hallucinations b) Nausea c) Confusion d) Headache - ANS c) Confusion The nurse is analyzing the arterial blood gas (AGB) results of a patient diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis?
b) Blood pressure, heart rate, and rhythm c) Strength testing for muscle wasting d) Nutritional status and diet e) Skin assessment for edema and turgor - ANS a) Intake and output, urine volume, and color b) Blood pressure, heart rate, and rhythm e) Skin assessment for edema and turgor When caring for a patient who has risk factors for fluid and electrolyte imbalances, which of the following assessment findings is the highest priority for the nurse to follow up? a) Mild confusion b) Irregular heart rate c) Weight loss of 4 lb d) Blood pressure 96/53 mm Hg - ANS b) Irregular heart rate The nurse is caring for a patient undergoing alcohol withdrawal. Which of the following serum laboratory values should the nurse monitor most closely? a) Magnesium b) Potassium c) Phosphorus d) Calcium - ANS a) Magnesium The nurse is caring for a patient in the intensive care unit (ICU) following a saltwater near-drowning event. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen dry tongue, flushed skin, and peripheral edema. The nurse anticipated that the patient's serum sodium value would be which of the following? a) 155 mEq/L b) 135 mEq/L
c) 125 mEq/L d) 145 mEq/L - ANS a) 155 mEq/L The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium level of 2.9 mEq/L. Which of the following statements made by the patient indicates the need for further teaching? a) "I will take a potassium supplement daily as prescribed." b) "I will be sure to buy frozen vegetables when I grocery shop." c) "I can use laxatives and enemas but only once a week." d) "A good breakfast for me will include milk and a couple of bananas." - ANS c) "I can use laxatives and enemas but only once a week." A patient with a magnesium level of 2.6 mEq/L is being treated on a medical-surgical unit. Which of the following treatments should the nurse anticipate will be used? a) Oral magnesium oxide (MagOx) b) Dialysis c) Fluid restriction d) IV furosemide (Lasix) - ANS d) IV furosemide (Lasix) A patient is being treated in the ICU 24 hours after having a radical neck dissection completed. The patient's serum calcium level is 7.6 mg/dL. Which of the following physical examination findings is consistent with this electrolyte imbalance? a) Slurred speech b) Muscle weakness c) Negative Chvostek's sign d) Presence of Trousseau's sign - ANS d) Presence of Trousseau's sign
