LEWIS: MEDICAL-SURGICAL NURSING~CHAPTER 17
QUESTIONS CORRECT ANSWERS _2025 WELL UPDATED
When caring for a patient admitted with hyponatremia, which actions will the nurse anticipate
taking?
a. Restrict patient's oral free water intake.
b. Avoid use of electrolyte-containing drinks.
c. Infuse a solution of 5% dextrose in a 0.45% saline.
d. Administer vasopressin (antidiuretic hormone, [ADH]). - CORRECT ANSWERS-Answer:
a. Restrict patient's oral free water intake.
To help improve serum sodium levels, water intake is restricted. Electrolyte-containing
beverages will improve the patients sodium level. Administration of vasopressin or hypotonic IV
solutions will decrease the serum sodium level further.
Intravenous potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with
severe hypokalemia. Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 20 mEq/hour.
c. Give the KCl only through a central venous line.
d. Add no more than 40 mEq/L to a liter of IV fluid. - CORRECT ANSWERS-Answer: b.
Infuse the KCl at a rate of 20 mEq/hour.
Intravenous KCl is administered at a maximal rate of 20 mEq/hr. Rapid IV infusion of KCl can
cause cardiac arrest. Although the preferred concentration for KCl is no more than 40 mEq/L,
concentrations up to 80 mEq/L may be used for some patients. KCl can cause inflammation of
peripheral veins, but it can be administered by this route.
A postoperative patient who has been receiving nasogastric suction for 3 days has a serum
sodium level of 125 mEq/L (125 mmol/L). Which of these prescribed therapies that the patient
has been receiving should the nurse question?
a. Infuse 5% dextrose in water at 125 ml/hr.
, b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium drops to less than 128 mEq/L. - CORRECT
ANSWERS-Answer: a. Infuse 5% dextrose in water at 125 ml/hr.
Because the patients gastric suction has been depleting electrolytes, the IV solution should
include electrolyte replacement. Solutions such as lactated Ringers solution would usually be
ordered for this patient. The other orders are appropriate for a postoperative patient with gastric
suction.
A patient who has required prolonged mechanical ventilation has the following arterial blood gas
results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L. The nurse
interprets these results as:
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis - CORRECT ANSWERS-Answer: d. respiratory alkalosis
The pH indicates that the patient has alkalosis and the low PaCO2 indicates a respiratory
cause. The other responses are incorrect based on the pH and the normal HCO3.
The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep
respirations. Which action should the nurse take?
a. Notify the patient's health care provider.
b. Give the prescribed PRN lorazepam (Ativan).
c. Start the prescribed PRN oxygen at 2 to 4 L/min.
d. Encourage the patient to take deep, slow breaths. - CORRECT ANSWERS-Answer: a.
Notify the patient's health care provider.
The rapid, deep (Kussmaul) respirations indicate a metabolic acidosis and the need for actions
such as administration of sodium bicarbonate, which will require a prescription by the health
care provider. Oxygen therapy is not indicated because there is no indication that the increased
QUESTIONS CORRECT ANSWERS _2025 WELL UPDATED
When caring for a patient admitted with hyponatremia, which actions will the nurse anticipate
taking?
a. Restrict patient's oral free water intake.
b. Avoid use of electrolyte-containing drinks.
c. Infuse a solution of 5% dextrose in a 0.45% saline.
d. Administer vasopressin (antidiuretic hormone, [ADH]). - CORRECT ANSWERS-Answer:
a. Restrict patient's oral free water intake.
To help improve serum sodium levels, water intake is restricted. Electrolyte-containing
beverages will improve the patients sodium level. Administration of vasopressin or hypotonic IV
solutions will decrease the serum sodium level further.
Intravenous potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with
severe hypokalemia. Which action should the nurse take?
a. Administer the KCl as a rapid IV bolus.
b. Infuse the KCl at a rate of 20 mEq/hour.
c. Give the KCl only through a central venous line.
d. Add no more than 40 mEq/L to a liter of IV fluid. - CORRECT ANSWERS-Answer: b.
Infuse the KCl at a rate of 20 mEq/hour.
Intravenous KCl is administered at a maximal rate of 20 mEq/hr. Rapid IV infusion of KCl can
cause cardiac arrest. Although the preferred concentration for KCl is no more than 40 mEq/L,
concentrations up to 80 mEq/L may be used for some patients. KCl can cause inflammation of
peripheral veins, but it can be administered by this route.
A postoperative patient who has been receiving nasogastric suction for 3 days has a serum
sodium level of 125 mEq/L (125 mmol/L). Which of these prescribed therapies that the patient
has been receiving should the nurse question?
a. Infuse 5% dextrose in water at 125 ml/hr.
, b. Administer IV morphine sulfate 4 mg every 2 hours PRN.
c. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
d. Administer 3% saline if serum sodium drops to less than 128 mEq/L. - CORRECT
ANSWERS-Answer: a. Infuse 5% dextrose in water at 125 ml/hr.
Because the patients gastric suction has been depleting electrolytes, the IV solution should
include electrolyte replacement. Solutions such as lactated Ringers solution would usually be
ordered for this patient. The other orders are appropriate for a postoperative patient with gastric
suction.
A patient who has required prolonged mechanical ventilation has the following arterial blood gas
results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L. The nurse
interprets these results as:
a. metabolic acidosis
b. metabolic alkalosis
c. respiratory acidosis
d. respiratory alkalosis - CORRECT ANSWERS-Answer: d. respiratory alkalosis
The pH indicates that the patient has alkalosis and the low PaCO2 indicates a respiratory
cause. The other responses are incorrect based on the pH and the normal HCO3.
The nurse notes that a patient who was admitted with diabetic ketoacidosis has rapid, deep
respirations. Which action should the nurse take?
a. Notify the patient's health care provider.
b. Give the prescribed PRN lorazepam (Ativan).
c. Start the prescribed PRN oxygen at 2 to 4 L/min.
d. Encourage the patient to take deep, slow breaths. - CORRECT ANSWERS-Answer: a.
Notify the patient's health care provider.
The rapid, deep (Kussmaul) respirations indicate a metabolic acidosis and the need for actions
such as administration of sodium bicarbonate, which will require a prescription by the health
care provider. Oxygen therapy is not indicated because there is no indication that the increased
