Deck 76: Musculoskeletal Disorders

Question 1

The nurse is preparing a client for testing to determine acidosis or alkalosis. Which laboratory test would be ordered?

A) Complete blood count (CBC)
B) Clotting factors
C) Arterial blood gas (ABG)
D) Liver function tests (LFT)

Answer 1

Arterial blood gas (ABG)

Question 2

Which assessments should the nurse conduct to identify possible indicators of fluid and electrolyte imbalances? Select all that apply.

A) Skin for poor skin turgor
B) Vital signs for decreased heart rate
C) Gastrointestinal for presence of anorexia
D) Respiratory for breathing pattern
E) Urinary for comparison between intake and output
F) Vital signs for hyperthermia

Answer 2

Skin for poor skin turgor
Respiratory for breathing pattern
Urinary for comparison between intake and output

Question 3

The nurse is caring for a client diagnosed with fluid volume excess that has resulted in edematous legs. Which intervention should the nurse implement to help resolve the edema?

A) Keep the legs in the same position to avoid irritating the skin.
B) Elevate the legs to a position higher than the heart's level.
C) Limit walking to prevent the formation of ulcers.
D) Perform skin care on the legs at least every 4 hours.

Answer 3

Elevate the legs to a position higher than the heart's level.

Question 4

What is a common cause of fluid volume excess?

A) Too-slow administration of IV fluids containing sodium
B) Increased urine output as occurs with kidney disorders
C) Excess ingestion of sodium from table salt or medications containing sodium
D) Inability of the body to conserve and reuse water by concentrating urine

Question 5

Which client should this nurse monitor closely for an increased risk for developing edema?

A) A 30-year-old client with a prolonged fever
B) A 16-year-old client diagnosed with anorexia nervosa
C) A 20-year-old client who is vomiting excessively
D) A 78-year-old client diagnosed with liver cirrhosis

Question 6

What is the preferred route of electrolyte administration when the oral route is contraindicated?

A) Intramuscular
B) Intravenous
C) Subcutaneous
D) Intradermal

Question 7

What causes fluid retention in the body?

A) Elevated protein levels
B) Increased venous pressure
C) Elevated osmotic pressure
D) Increased excretion of sodium

Question 8

Which discharge instruction should the nurse provide a client diagnosed with chronic renal failure?

A) Monitor for differences between fluid intake and output.
B) Allow feet to dangle at least 3 hours per day.
C) Check the weight on a weekly basis.
D) Keep walking to a minimum.

Question 9

A 25-year-old client is admitted to a healthcare facility with complaints of fever,
Vomiting, and watery diarrhea for 2 days. On examination, the client has dry skin, delayed skin turgor, and hypotension. What is the most likely nursing diagnosis?

A) Impaired urinary elimination
B) Acute gastroenteritis
C) Infective diarrhea
D) Deficient fluid volume

Question 10

An assessment indicates that the client's skin rebound from slight pressure in slightly less than 2 seconds. How should the nurse document this finding?

A) No edema present
B) +1 pitting edema
C) +2 pitting edema
D) Nonpitting edema present

Question 11

A nurse assessing a client documents +4 pitting edema in several different locations. What condition is commonly associated with +4 pitting edema?

A) Sacral edema
B) Dependent edema
C) Anasarca
D) Pulmonary edema

Question 12

The nurse caring for a postoperative client documents the following data: flushed dry skin, dry mucous membranes, hypotension, and lethargy. The client states that he is thirsty and requests water. Which medical condition is supported by this data?

A) Hypernatremia
B) Hyperkalemia
C) Hypercalcemia
D) Hypermagnesemia

Question 13

Which major electrolyte in the extracellular fluid (ECF) influences the distribution of water and maintains acid-base balance and nerve function?

A) Potassium
B) Sodium
C) Calcium
D) Phosphorus

Question 14

A client diagnosed with diabetes insipidus is prescribed a restricted diet. What dietary restriction should the nurse incorporate in the diet plan for this client?

A) Potassium
B) Calcium
C) Chloride
D) Sodium

Question 15

For which electrolyte disturbance should the nurse monitor when caring for a client diagnosed with Hodgkin disease?

A) Hyponatremia
B) Hypercalcemia
C) Hypochloremia
D) Hyperphosphatemia

Question 16

A nurse is documenting the electrolyte report of a client on diuretic therapy for heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbance should the nurse report to the physician?

A) Hyponatremia
B) Hypochloremia
C) Hypokalemia
D) Hypocalcemia

Question 17

Which characteristics of aging predispose the older adult client to the risk of fluid and electrolyte imbalances? Select all that apply.

A) Increased renal functioning
B) Depressed thirst mechanism
C) Atypical or subtle confusion
D) Self-medication with analgesics
E) Decreased elasticity of skin
F) Incontinence

Question 18

Which condition is most commonly associated with hypocalcemia?

A) Cancer
B) Parathyroid hormone deficit
C) Primary hyperparathyroidism
D) Immobilization

Question 19

The nurse is caring for an alcoholic client. Which electrolyte imbalance typically occurs as the result of diuretic therapy?

A) Hyperphosphatemia
B) Hyperkalemia
C) Hypernatremia
D) Hypomagnesemia

Question 20

A 16-year-old presents at the emergency room with altered mental status, bradycardia, and cardiac dysrhythmia caused by uncontrolled diabetes mellitus. What acid-base imbalance is most likely occurring in this client?

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

Question 21

Which client condition poses the highest risk for the development of respiratory acidosis?

A) Renal disease
B) Hyperventilating
C) Excessive gastric suctioning
D) Chronic emphysema

Question 22

Which description accurately identifies metabolic alkalosis?

A) - HCO- >±26mEq/L
B) ¯ CO< 35
C) ¯ HCO- < ±22 mEq/L
D) - CO₂ >45

Question 23

A diabetic client is admitted to a healthcare facility for diarrhea, nausea, vomiting, and altered mental status. The arterial blood gas (ABG) report of the client shows decreased pH and decreased HCO₃^-. What immediate action should the nurse take?

A) Give a bicarbonate infusion.
B) Give Ringer solution.
C) Notify the physician.
D) Apply a rebreathing mask.

Question 24

A nurse is caring for a client admitted to the healthcare facility with narcotic overdose. The client has shallow respirations, tremors, headache, weakness, altered sensorium, and fruity-smelling breath. According to the arterial blood gas evaluation, the client's ^{pH is decreased and PCO}2 ^{is increased. Which acid-base imbalance has occurred?}

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

Question 25

Which nursing intervention should the nurse implement for a client diagnosed with respiratory acidosis?

A) Notify the healthcare provider of skin changes.
B) Lower the head of the client's bed.
C) Administer prescribed antibiotics.
D) Administer ordered oxygen.

Question 26

Which nursing intervention is recommended for the management of respiratory alkalosis?

A) Administering oxygen
B) Breathing into a paper bag
C) Administering bicarbonate
D) IV infusion of lactated Ringer solution

Question 27

Which acid-base imbalance, if not corrected, could lead to the need for mechanical ventilation?

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