Knowledge Assessment
Vitamin B is considered water soluble. What would be the best food option for the patient who is deficient?
Fortified milk and cereals
poultry and fish
citrus fruits and bell peppers
spinach broccoli and kale
poultry and fish
Patient notes to have wheeping fluid in the legs, severe edema of all extremities, and rapid shallow respirations. Provider orders 40mg of lasix to be given IV to immediately pull of fluid and an indwelling catheter to monitor I/A. What is the most reliable indicator of a patient fluid status?
daily weights
Stephen, a 6-year-old boy, was brought to the hospital with her mother’s complaint that her son is vomiting, nauseated, and showed overall weakness. After some tests, the nurse finds the laboratory results: potassium: 2.9 mEq. the boy is at risk for which primary acid-base imbalance if medical intervention is not carried out?
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
metabolic alkalosis
The nurse is interpreting the following ABG results: ph 7.53, PaCo2 21, HCO3 23. Which of the following is occurring?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Respiratory Alkalosis
The nurse is working in the ED caring for a client who presents with slow, shallow respirations related to a suspected narcotic overdose. The provider orders blood work, including ABGs. Which of the following acid base imbalances would the nurse expect for this client?
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
respiratory acidosis
Normal lab value for sodium
135-145
What is the vital sign that indicates a fluid volume deficit as it is trying to compensate for the deficit within the body?
HR (tachycardia)
An old beggar gets admitted to the emergency department for shortness of breath, fever, and a productive cough. After examination, crackles and wheezes are found in the lower lobes; he appears to be tachycardic and shows a bounding pulse. Measurement of arterial blood gas shows pH 7.2, PaCO2 66 mm Hg, HCO3 27 mmol/L, and PaO2 65 mm Hg. As a knowledgeable nurse, you know what the normal value is for pH:
7.30
7.40
7.48
7.25
7.40 (normal values 7.35-7.45)
The nurse is planning to teach a client with malabsorption syndrome about the necessity of following a low fat diet. The nurse develops a list of high fat foods to avoid and should include which of the following item on the list?
oranges
asparagus
cream cheese
artisan breads
cream cheese
the nurse instructs a client with kidney disease who is receiving hemodialysis about dietary modifications. the nurse determines that the client understands these dietary modifications if the client selects which items from the menu?
cream of wheat, blueberries, coffee
sausage eggs banana and orange juice
bacon cantaloupe melon and tomato juice
cured pork grits strawberries and OJ
An elevated potassium level will typically result in:
cardiac dysrhythmias
Name three causes of hypervolemia
heart failure, rapid fluid replacement, chronic kidney disease
Liza’s mother is seen in the emergency department at a community hospital. She admits that her mother has been taking many tablets of aspirin (salicylates) over the last 24-hour period because of a severe headache. Also, the mother complains of an inability to urinate. The nurse on duty took her vital signs and noted the following: Temp = 97.8 °F; apical pulse = 95; respiration = 22 and deep. Which primary acid-base imbalance is the gentleman at risk for if medical attention is not provided?
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
metabolic acidosis (kidney injury and high uses of aspirin causing toxicity)
The nurse is caring for client with heart failure. on assessment the nurse notes that the client is dyspneic, and crackles are audible on auscultation. What additional manifestations would the nurse expect to note in this client if excess fluid is present?
weight loss and dry skin
flat neck and hand veins and decreased urinary output
an increase in blood pressure and respirations
weakness and decreased central venous pressure
an increase in blood pressure and respirations
the nurse is preparing to care for a client with a potassium deficit. the nurse reviews the client's record and determines that the client is at risk for developing the potassium deficit because of which situation? SATA
sustained tissue damage
nasogastric suction
has history of Addison disease
uric acid level of 9.4mg/dL
sustained tissue damage and nasogastric suction
An elevation in magnesium will carry which s/s present in patients:
increased respirations
decreased respirations
irritability
hyperreflexia
decreased respirations
Assessment findings of a patient with hypervolemia will have bounding pulses, distended neck veins, dilute urine and which associated lab value?
Increased BUN
Normal RBCS
hyponatremia
elevated specific gravity
hyponatremia
A patient who is hospitalized due to vomiting and a decreased level of consciousness displays slow and deep (Kussmaul breathing), and he is lethargic and irritable in response to stimulation. The doctor diagnosed him of having dehydration. Measurement of arterial blood gas shows pH 7.0, PaO2 90 mm Hg, PaCO2 22 mm Hg, and HCO3 14 mmol/L; other results are Na+ 120 mmol/L, K+ 2.5 mmol/L, and Cl- 95 mmol/L. As a knowledgeable nurse, you know that the normal value for CO2 is:
55
68
30
41
41 in range of 35-45
A client presents to the ED in respiratory distress. The nurse obtains a set of vitals, starts a 20 gauge IV in the right antecubital, and places the client on 3l )2. After reporting the results to the provider, the provider orders a lab draw and a set of ABGs. The nurse correctly understands which of the following to be appropriate reasoning for ABGs?
A. arterial blood draws carry less complications than venous blood draw
B. arterial blood will reflect a partial pressure of gas
C. arterial blood gives more accurate results for acid base but not blood gas
D arterial blood providers more accurate systemic results for blood gas than venous blood
D
An expected physiological response to low potassium level is:
cardiac dysrhythmias
hyperglycemia
hypertension
respiratory failure
cardiac dysrhythmias
Patient has a calcium level of 15, with convulsions and tremors. The nurse expects that the provider will order which medication to decrease the high levels of calcium, and treat associated symptoms?
calcium gluconate
pyridium
betamethasone
calcitonin and phosphorus
calcitonin and phosphorus
The nurse notes the difference between hypertonic vs hypotonic IV solution is:
hypertonic moves fluid out of the cells causing the cells to shrink and hypotonic solution causes the cells to swell.
A company driver is found at the scene of an automobile accident in a state of emotional distress. He tells the paramedics that he feels dizzy, tingling in his fingertips, and does not remember what happened to his car. Respiratory rate is rapid at 44/minute. Which primary acid-base disturbance is the young man at risk for if medical attention is not provided?
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
Respiratory Alkalosis (hyperventilation)
the nurse monitors the serum electrolyte levels of a client who is taking digoxin. Which of the following electrolyte imbalances is common cause of digoxin toxicity?
hyponatremia
hypocalcemia
hypokalemia
hypomagnesemia
hypokalemia
A nurse is caring for a client Acute Respiratory Distress and views the ABG results seen below. Based on the ABG result, which of the following findings would the nurse most likely find in this client. (Time to critically think!)
ph 7.48, PaCo2 26, HCO3 24, PaO2 95
A. SpO2 82%
B. HR 94
C. RR 32
D. BP 148/ 92
C
patient is hyperventilating. the patient ph is high the HCO3 is low range normal but the PaCo2 is abnormally low. A low Co2 is seen with alkalosis. respiratory alkalosis primary cause is blowing off too much Co2.