NUR 3227 Nursing Care of the Adult, Clinical Focus Exam with Questions and Answers

It covers key domains which include; Fluid, Electrolyte, and Acid-Base Balance, Perioperative Nursing, Cardiovascular Disorders, Respiratory Health, Endocrine and Metabolic Alterations, Gastrointestinal and Renal Function, Musculoskeletal and Integumentary Systems, Neurological Health and Oncological Nursing. A nurse is caring for a patient diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH). Which assessment finding would the nurse expect? a. Severe polyuria with dilute urine and hypernatremia b. Low urine output with concentrated urine and hyponatremia c. Increased thirst with high serum sodium and low urine specific gravity d. Flaccid muscle weakness with elevated potassium levels Correct Answer: b Rationale: In SIADH, excess antidiuretic hormone leads to water retention, resulting in dilutional hyponatremia, low serum osmolality, and highly concentrated urine with low urine output. The kidneys retain water despite normal or increased fluid volume, which distinguishes SIADH from diabetes insipidus where polyuria occurs. A patient has the following arterial blood gas results: pH 7.30, PaCO₂ 52 mmHg, HCO₃⁻ 24 mEq/L. How should the nurse interpret this finding? a. Uncompensated metabolic acidosis b. Fully compensated respiratory alkalosis c. Uncompensated respiratory acidosis d. Metabolic alkalosis with compensation Correct Answer: c Rationale: The pH is low (acidosis) and the PaCO₂ is elevated, indicating respiratory origin. The bicarbonate level is normal, showing no metabolic compensation has occurred yet. Therefore, this is uncompensated respiratory acidosis, commonly seen in hypoventilation states such as COPD exacerbation or opioid overdose.