Fluid & Electrolytes 1
A client with heart failure presents with confusion, muscle cramps, and serum sodium of 118 mEq/L. Which provider order should the nurse question?
A. Administer 3% saline IV
B. Restrict oral fluids
C. Administer oral sodium tablets
D. Encourage oral water intake
D. Encourage oral water intake
A client with hypothyroidism is started on levothyroxine. Which statement indicates teaching was effective?
A. “I will take this medication with my calcium supplement.”
B. “I should take this medication every morning on an empty stomach.”
C. “I can stop taking it once I feel better.”
D. “I should expect my heart rate to slow down.”
B. “I should take this medication every morning on an empty stomach.”
Which finding is most characteristic of Type 2 diabetes?
A. Autoimmune destruction of beta cells
B. Absolute insulin deficiency
C. Insulin resistance
D. Ketone production at diagnosis
C. Insulin resistance
A client with leukemia has a WBC count of 500/mm³. Which nursing action is the priority?
A. Encourage oral fluids
B. Place the client on neutropenic precautions
C. Provide a high‑protein diet
D. Monitor for bruising
B. Place the client on neutropenic precautions
A client receiving chemotherapy develops thrombocytopenia. Which instruction is most appropriate?
A. Use an electric razor
B. Increase fluid intake
C. Avoid high‑fiber foods
D. Ambulate frequently
A. Use an electric razor
A client’s ECG shows tall, peaked T waves. Which laboratory value would the nurse expect to find?
A. Potassium 2.8 mEq/L
B. Potassium 6.2 mEq/L
C. Calcium 7.5 mg/dL
D. Magnesium 1.2 mg/dL
B. Potassium 6.2 mEq/L
A client with acute pancreatitis develops sudden sweating, shakiness, and confusion. The nurse notes a blood glucose of 54 mg/dL. Which pathophysiologic process best explains the client’s hypoglycemia?
A. Increased secretion of digestive enzymes into the bloodstream
B. Impaired glucagon release due to pancreatic inflammation
C. Excessive bicarbonate secretion into the duodenum
D. Increased gastric emptying caused by pancreatic edema
B. Impaired glucagon release due to pancreatic inflammation
A client with pancreatitis reports severe epigastric pain radiating to the back. Which lab value supports this diagnosis?
A. Low amylase
B. Elevated lipase
C. Low bilirubin
D. Elevated hemoglobin
B. Elevated lipase
A client receiving radiation therapy to the neck reports difficulty swallowing. What is the most likely cause?
A. Bone marrow suppression
B. Esophagitis from localized tissue damage
C. Oral candidiasis
D. Hypercalcemia
B. Esophagitis from localized tissue damage
A client with advanced prostate cancer is receiving androgen‑deprivation therapy (ADT). Which finding indicates the therapy is effective?
A. Increased libido
B. Decreased PSA level
C. Elevated testosterone level
D. Increased bone pain
B. Decreased PSA level
A client with chronic kidney disease has a phosphorus level of 6.2 mg/dL. Based on the reciprocal relationship between calcium and phosphorus, which additional laboratory value would the nurse expect?
A. Calcium 11.0 mg/dL
B. Calcium 9.5 mg/dL
C. Calcium 7.4 mg/dL
D. Calcium 10.2 mg/dL
C. Calcium 7.4 mg/dL
A client with suspected hyperthyroidism presents with weight loss, heat intolerance, and tachycardia. Which lab result supports this diagnosis?
A. Elevated TSH
B. Low T3 and T4
C. Low TSH
D. Normal T3 and T4
C. Low TSH
A client with type 1 diabetes reports shakiness, sweating, and confusion. What is the priority action?
A. Administer glucagon IM
B. Give 4 oz of juice
C. Reassess client in 60 minutes
D. Start an IV line
B. Give 4 oz of juice
A client with suspected lymphoma presents with painless enlarged lymph nodes. Which diagnostic test is most definitive?
A. CT scan
B. Lymph node biopsy
C. CBC with differential
D. PET scan
B. Lymph node biopsy
A client reports persistent low‑grade fevers, unintentional weight loss, and feeling “exhausted all the time.” Which interpretation by the nurse is most appropriate?
A. These symptoms are consistent with mild dehydration
B. These symptoms may indicate systemic effects of malignancy
C. These symptoms suggest a viral infection that will resolve
D. These symptoms are expected with aging
B. These symptoms may indicate systemic effects of malignancy
A client with a sodium level of 150 mEq/L is receiving treatment. Which order should the nurse question?
A. 0.45% normal saline
B. Increase oral fluids
C. Sodium restriction
D. Administer 3% saline
D. Administer 3% saline
Which symptom is most concerning in a client with hyperparathyroidism?
A. Constipation
B. Muscle weakness
C. Shortened QT interval
D. Severe flank pain
D. Severe flank pain
A client receiving NPH insulin should be monitored for hypoglycemia at which time?
A. 1 hour after administration
B. 2 hours after administration
C. 4–12 hours after administration
D. Immediately before the next dose
C. 4–12 hours after administration
A client receiving doxorubicin reports shortness of breath and fatigue. Which assessment is most important?
A. Lung sounds
B. Cardiac monitoring
C. Bowel sounds
D. Skin turgor
B. Cardiac monitoring
A client receiving chemotherapy has a hemoglobin level of 7.6 g/dL. The nurse recognizes that the client is at risk for cellular hypoxia. Which finding best reflects this complication?
A. Increased urine output
B. Cool, pale skin
C. Bounding peripheral pulses
D. Decreased respiratory rate
B. Cool, pale skin
A nurse is assessing a client with suspected hypocalcemia. Which clinical manifestations should the nurse expect? (Select all that apply.)
A. Positive Trousseau sign
B. Constipation
C. Muscle twitching and spasms
D. Decreased deep tendon reflexes
E. Numbness and tingling around the mouth
A. Positive Trousseau sign
C. Muscle twitching and spasms
E. Numbness and tingling around the mouth
The nurse is teaching sick‑day rules for a client with type 1 diabetes. Which instructions are appropriate? (Select all that apply.)
A. Continue taking insulin
B. Check blood glucose every 3–4 hours
C. Stop drinking fluids if nauseated
D. Test urine for ketones
E. Skip insulin if not eating
A. Continue taking insulin
B. Check blood glucose every 3–4 hours
D. Test urine for ketones
The nurse is caring for a client with pancreatitis. Which interventions are appropriate? (Select all that apply.)
A. Maintain NPO status
B. Administer IV fluids
C. Provide high‑fat meals
D. Administer PO pain medication
E. Encourage early ambulation
A. Maintain NPO status
B. Administer IV fluids
A client with metastatic cancer is being evaluated for possible oncologic emergencies. Which findings should the nurse recognize as complications associated with oncologic emergencies?
A. Serum calcium 13.2 mg/dL
B. Elevated uric acid level
C. New onset lower‑extremity weakness
D. Serum potassium 3.3 mg/dL
E. Periorbital edema
A. Serum calcium 13.2 mg/dL
B. Elevated uric acid level
C. New onset lower‑extremity weakness
E. Periorbital edema
Which clients are at increased risk for developing melanoma? Select all that apply.
A. A client with a history of blistering sunburns
B. A client with dark brown skin
C. A client who uses tanning beds
D. A client with multiple atypical moles
E. A client who works night shift indoors
A. A client with a history of blistering sunburns
C. A client who uses tanning beds
D. A client with multiple atypical moles