Fluid and Electrolytes
A client is admitted with hypernatremia. What signs and symptoms would the nurse expect to observe in this client?
A) Bradycardia, confusion, and muscle cramps
B) Tachycardia, restlessness, and intense thirst
C) Hypotension, lethargy, and abdominal distention
D) Hyperreflexia, dry skin, and bradypnea
B) Tachycardia, restlessness, and intense thirst
A client with chronic obstructive pulmonary disease (COPD) presents with increased carbon dioxide retention. Which compensatory mechanism is primarily utilized by the kidneys in response to respiratory acidosis?
A) Retention of carbon dioxide
B) Retention of bicarbonate
C) Increased respiratory rate
D) Decreased respiratory rate
B) Retention of bicarbonate
A client with a history of smoking and chronic bronchitis presents to the emergency department with fever, cough, and green/yellow sputum production. Which diagnostic test is essential to confirm the diagnosis of pneumonia in this client?
A) Pulmonary function tests
B) Tuberculin skin test (Mantoux)
C) Fluorochrome or acid-fast bacilli sputum test
D) Peak flow meter assessment
C) Fluorochrome or acid-fast bacilli sputum test
Which condition is characterized by a localized outpouching or dilation of a vessel wall, most commonly affecting the aorta?
A) Peripheral arterial disease
B) Infective endocarditis
C) Myocardial infarction
D) Aneurysm
D) Aneurysm
A patient with hypothyroidism is at risk for which cardiovascular manifestation due to decreased contractility and increased cholesterol levels?
A) Bradycardia
B) Tachycardia
C) Palpitations
D) Hypertension
A) Bradycardia
What is the priority nursing intervention for a client with severe hyponatremia to prevent complications such as encephalopathy due to brain swelling?
A) Encouraging a high fluid intake
B) Strict intake and output monitoring
C) Administering IV normal saline slowly
D) Placing the client on seizure precautions
C) Administering IV normal saline slowly
What clinical manifestation is commonly associated with respiratory alkalosis due to hyperventilation?
A) Confusion and hypocalcemia
B) Tachycardia and hypokalemia
C) Slow, shallow respirations
D) Muscle cramps and dizziness
A) Confusion and hypocalcemia
What is a hallmark sign of a pneumothorax that requires urgent medical intervention?
A) Dry cough
B) Pleuritic chest pain
C) Hemoptysis
D) Diminished breath sounds
B) Pleuritic chest pain
What is the hallmark clinical manifestation of a patient experiencing an acute myocardial infarction (MI)?
A) Pulsus alternans
B) Pleuritic chest pain
C) Silent chest
D) Severe chest pain not relieved by rest or nitrate administration
D) Severe chest pain not relieved by rest or nitrate administration
Which diagnostic test is specific for distinguishing Graves' disease from other thyroid disorders?
A) Thyroid-stimulating hormone (TSH)
B) Thyroid peroxidase (TPO) antibodies
C) Radioactive iodine uptake test
D) Free thyroxine (free T4)
C) Radioactive iodine uptake test
Which intervention is appropriate for a client with hyperkalemia to promote potassium excretion?
A) Administering oral potassium supplements
B) Encouraging potassium-rich foods in the diet
C) Initiating dialysis
D) Using IV insulin and dextrose
C) Initiating dialysis
A client with diabetic ketoacidosis (DKA) is admitted with metabolic acidosis. What treatment would be appropriate for this condition?
A) Mechanical ventilation
B) Insulin IV
C) Antiemetics
D) IV fluids
B) Insulin IV
Which medication is commonly used to treat pulmonary embolism by preventing further clot formation?
A) Warfarin
B) Antiemetics
C) Insulin
D) Heparin
D) Heparin
Which medication is commonly used in the collaborative care of heart failure to control symptoms and reduce cardiovascular disease risk factors?
A) Insulin
B) NSAIDs
C) ACE inhibitors
D) Antiemetics
C) ACE inhibitors
A patient with Cushing's syndrome presents with truncal obesity, "moon face," and purple striae on the abdomen. These manifestations are primarily due to:
A) Increased aldosterone secretion
B) Decreased cortisol levels
C) Elevated androgen production
D) Excess cortisol secretion
D) Excess cortisol secretion
A client is prescribed potassium chloride for treatment of hypokalemia. What is the maximum oral dose that should be given per dose?
A) 20 mEq
B) 30 mEq
C) 40 mEq
D) 50 mEq
C) 40 mEq
A client presents with severe vomiting and is diagnosed with metabolic alkalosis. What is a key nursing intervention to address this condition?
A) Administering potassium supplements
B) Monitoring serum bicarbonate levels
C) Providing anti-anxiety medications
D) Stopping gastric suctioning
D) Stopping gastric suctioning
A client with pleural effusion is scheduled for thoracentesis to drain excess fluid. What is a critical nursing intervention during this procedure?
A) Administering diuretics to reduce fluid volume
B) Positioning the client in a supine position
C) Asking the client to hold their breath during needle insertion
D) Monitoring blood pressure for signs of hypertension
C) Asking the client to hold their breath during needle insertion
A client with peripheral arterial disease (PAD) complains of leg pain that resolves with rest. This symptom is known as:
A) Ischemic muscle pain
B) Claudication
C) Parathesia
D) Non-healing arterial ulcers
B) Claudication
Which electrolyte imbalance is the most serious complication of chronic kidney disease (CKD) and is associated with dysrhythmias and cardiac arrest?
A) Hyponatremia
B) Hyperkalemia
C) Hypocalcemia
D) Hypomagnesemia
B) Hyperkalemia
What are the typical signs and symptoms of hypocalcemia that the nurse should monitor for in a client?
A) Hypertension and confusion
B) Muscle cramps and hyperreflexia
C) Warm flushed skin and hypothermia
D) Lethargy and decreased deep tendon reflexes
B) Muscle cramps and hyperreflexia
What compensatory mechanism is typically seen in response to metabolic acidosis?
A) Hyperventilation
B) Retention of bicarbonate by the kidneys
C) Increased renal excretion of bicarbonate
D) Decreased respiratory rate
A) Hyperventilation
Asthma is characterized by recurrent wheezing and airway inflammation. Which assessment finding indicates worsening asthma and potential respiratory failure?
A) Increased work of breathing
B) Restlessness
C) Silent chest
D) Prolonged expiration
C) Silent chest
What diagnostic test is most specific for detecting myocardial infarction and has the highest specificity?
A) Chest x-ray
B) Troponin
C) Echocardiogram
D) MRI
B) Troponin
What is a characteristic feature of peritoneal dialysis (PD) that patients are at high risk for and should be monitored for signs such as cloudy drainage, abdominal pain, and fever?
A) Peritonitis
B) Hypertension
C) Arrhythmias
D) Pulmonary edema
A) Peritonitis