Deck 6: Nursing Sciences

Question 1

The client with diabetes mellitus has a blood glucose level on admission of 596 mg/dL. The nurse anticipates that this client would be experiencing which of the following types of acid-base imbalance?

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

Answer 1

Metabolic acidosis

Question 2

The nurse is admitting a client with a diagnosis of Guillain-Barré syndrome to the hospital. The nurse knows that if the disease is severe enough, the client will be at risk for which of the following acid- base imbalances?

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

Answer 2

Respiratory acidosis

Question 3

A client is determined to be in respiratory alkalosis by blood gas analysis. The nurse would monitor this client for signs of which of the following electrolyte disorders that could accompany the acid- base imbalance?

A) Hypokalemia
B) Hypercalcemia
C) Hypochloremia
D) Hypernatremia

Answer 3

Hypokalemia

Question 4

The client with a chronic airflow limitation (CAL) is experiencing respiratory acidosis as acomplication. The nurse who is trying to enhance the client's respiratory status would avoid doing which of the following?

A) Keeping the head of the bed elevated
B) Monitoring the flow rate of supplemental oxygen
C) Assisting the client to turn, cough, and breathe deeply
D) Encouraging the client to breathe slowly and shallowly

Question 5

An anxious client is experiencing respiratory alkalosis from hyperventilation caused by anxiety. The nurse would do which of the following to help the client experiencing this acid-base disorder?

A) Put the client in a supine position.
B) Provide emotional support and reassurance.
C) Withhold all sedative or antianxiety medications.
D) Tell the client to breathe very deeply but more slowly.

Question 6

A client is being treated for metabolic acidosis with medication therapy and other measures. The nurse would plan to most carefully note the results of which of the following electrolytes, which could dramatically decline with effective treatment of the acidosis?

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

Question 7

The nurse is caring for a client who is experiencing metabolic alkalosis. The nurse plans to protect the client's safety, knowing the risks of this imbalance, by carefully implementing which of the following prescribed precautions?

A) Contact isolation
B) Seizure precautions
C) Bleeding precautions
D) Neutropenic precautions

Question 8

The nurse is caring for a client who overdosed on acetylsalicylic acid (aspirin) 24 hours ago. The nurse expects to note which of the following findings associated with an anticipated acid-base disturbance?

A) Disorientation and dyspnea
B) Drowsiness, headache, and tachypnea
C) Tachypnea, dizziness, and paresthesias
D) Decreased respiratory rate and depth, cardiac irregularities

Question 9

A client has been diagnosed with metabolic alkalosis as a result of excessive antacid use. The nurse should monitor this client, expecting to note which of the following signs and symptoms?

A) Disorientation and dyspnea
B) Decreased respiratory rate and depth
C) Drowsiness, headache, and tachypnea
D) Tachypnea, dizziness, and paresthesias

Question 10

The nurse enters a client's room to check the client who began receiving a blood transfusion 45 minutes earlier. The client is dyspneic and has a bounding pulse. The nurse listens to the client's lung sounds and notes the presence of crackles in the lung bases. The nurse determines that this client is most likely experiencing which of the following complications of blood transfusion therapy?

A) Bacteremia
B) Fluid overload
C) Hypervolemic shock
D) Allergic transfusion reaction

Question 11

A unit of packed red blood cells (PRBCs) was just received from the blood bank for transfusion to an assigned client. The nurse is careful to select tubing especially made for blood products, knowing that this tubing is manufactured with which of the following features?

A) An air vent
B) An in-line filter
C) A microdrip chamber
D) Tinted tubing to protect the blood from light

Question 12

The nurse overhears the physician stating that the client who is in hypovolemic shock requires plasma expansion. The nurse anticipates that the physician will write a prescription to transfuse which of the following blood products to this client?

A) Albumin
B) Platelets
C) Cryoprecipitate
D) Packed red blood cells

Question 13

The nurse is assisting in the care of a group of clients on the nursing unit. When considering effects of each medical diagnosis, the nurse determines that which of the following clients has the least risk for developing third-spacing of fluid?

A) Client with a major burn
B) Client with an ischemic stroke
C) Client with Laënnec's cirrhosis
D) Client with chronic renal failure

Question 14

The nurse is caring for a group of clients on the clinical nursing unit. Which of the following clients should the nurse plan to monitor for signs of fluid volume deficit?

A) Client with an ileostomy
B) Client in acute renal failure
C) Client in congestive heart failure
D) Client with controlled hypertension

Question 15

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse should monitor the client for hypokalemia as a side effect of therapy if the client has been receiving which of the following medications?

A) Spironolactone (Aldactone)
B) Bumetanide (Bumex)
C) Triamterene (Dyrenium)
D) Amiloride HCl (Midamor)

Question 16

The nurse is providing dietary teaching to a client receiving a potassium-sparing diuretic about foods that are low in potassium. The nurse should include which of the following on a list of foods that have low potassium content?

A) Apple
B) Carrots
C) Spinach
D) Avocado

Question 17

The nurse is obtaining the intershift report for a group of assigned clients. Which of the following assigned clients should the nurse monitor closelyfor signs of hyperkalemia?

A) A client with ulcerative colitis
B) A client with Cushing's syndrome
C) A client admitted 6 hours ago with a 40% burn injury
D) A client who has a history of long-term laxative abuse

Question 18

The nurse is caring for a client with a nasogastric tube (NGT) who has a prescription for NGT irrigation once every 8 hours. The nurse plans to irrigate the NGT with which of the following solutions to maintain homeostasis?

A) Tap water
B) Sterile water
C) 0.9% sodium chloride
D) 0.45% sodium chloride

Question 19

The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply for possible use to reverse this elevation?

A) Vitamin D
B) Calcium chloride
C) Calcium gluconate
D) Calcitonin

Question 20

The nurse is assisting in the care of a client with pheochromocytoma who has been experiencing clinical manifestations of hypermagnesemia. When evaluating the client, the nurse determines that the client's status is returning to normal if he no longer exhibits which of the following?

A) Tetany
B) Tremors
C) Areflexia
D) Muscular excitability

Question 21

The nurse is reading a computer printout of the results of a cerebrospinal fluid (CSF) analysis performed on an adult client who has undergone lumbar puncture. Evaluation of the results by the nurse leads to the determination that which of the following CSF findings is abnormal?

A) Red blood cells, 0
B) Glucose, 52 mg/dL
C) Protein, 100 mg/dL
D) White blood cells, 3 cells/mm³

Question 22

The client with a history of seizure disorder is having a routine serum phenytoin level drawn. The nurse who receives a telephone report of the results notes that the client's blood level of the medication is within the therapeutic range if the value reported is which of the following?

A) 6 mcg/mL
B) 15 mcg/mL
C) 28 mcg/mL
D) 35 mcg/mL

Question 23

The client with chronic obstructive pulmonary disease (COPD) has had a sample for a serum theophylline level drawn as part of routine follow-up care. Which of the following results would lead the nurse to conclude that the client has most likely been compliant with medication therapy?

A) 3 mcg/mL
B) 7 mcg/mL
C) 14 mcg/mL
D) 24 mcg/mL

Question 24

A long-term care nurse about to give a daily dose of digoxin (Lanoxin) is told that a serum digoxin level drawn earlier in the day measured 2.7 ng/mL. The nurse should take which of the following actions first?

A) Administer the daily dose of the medication.
B) Report the finding to the health care provider.
C) Record the normal value on the intershift report sheet.
D) Gather data from the client related to signs of toxicity.

Question 25

The client is receiving oral anticoagulant therapy with warfarin (Coumadin). The result of a newly drawn prothrombin time (PT) is 40 seconds. The nurse anticipates carrying out a prescription to do which of the following?

A) Hold the next dose of warfarin.
B) Increase the next dose of warfarin.
C) Administer the next dose of warfarin.
D) Stop the warfarin, and administer heparin.

Question 26

The adult client has had serum electrolyte levels drawn. The nurse receiving the results by telephone from the laboratory would be most concerned with which of the following results?

A) Sodium level, 142 mEq/L
B) Chloride level, 103 mEq/L
C) Potassium level, 5.4 mEq/L
D) Bicarbonate level, 24 mEq/L

Question 27

The client with heart disease is scheduled to receive a daily morning dose of furosemide (Lasix). The nurse would report which of the following serum potassium levels to the health care provider before administering the daily dose?

A) 5.1 mEq/L
B) 4.2 mEq/L
C) 3.8 mEq/L
D) 3.0 mEq/L

Question 28

The nurse is providing directions to a client about how to test a stool for occult blood. The nurse cautions that the presence of which of the following could cause a false -negative result?

A) Iodine
B) Colchicine
C) Ascorbic acid
D) Acetylsalicylic acid

Question 29

The nurse receives a telephone laboratory report indicating that a diabetic client has a glycosylated hemoglobin A_1c level of 7.6%. The nurse plans to provide diabetic teaching in which of the following priority areas?

A) Avoidance of infection
B) Rotation of insulin injection sites
C) Measures to prevent hyperglycemia
D) Avoidance of hypoglycemic episodes

Question 30

The nurse is assisting in monitoring a client who is receiving a transfusion of packed red blood cells (PRBCs). Before leaving the room, the nurse tells the client that it is most important to immediatelyreport which of the following symptoms of a transfusion reaction, if they occur? Select all that apply.

A) Chills
B) Sleepiness
C) Fatigue
D) Chest pain
E) Low back pain
F) Difficulty breathing

Question 31

The nurse is monitoring the client for hypocalcemia. Which of the following are indicative of this imbalance? Select all that apply.

A) Muscle cramps
B) Tingling sensations
C) Hyperactive reflexes
D) Severe muscle weakness
E) Irritability
F) Memory impairment