Understanding Pathophysiology 7th Edition TestBank

Understanding Pathophysiology 7th Edition TestBank The most common cause of water loss is increased renal clearance of free water as a result of impaired tubular function. Hyperventilation can cause water loss, but it is not the most common cause. Sodium loss leads to hyponatremia, not pure water deficit. Insufficient water intake causes hypernatremia, not water deficit. Cognitive Level: Comprehension 106 17. Hyperlipidemia and hyperglycemia are associated with: a. Hypernatremia b. Hypertonic hyponatremia c. Hypokalemia d. Acidosis ANS: B Hypertonic hyponatremia develops with hyperlipidemia, hyperproteinemia, and hyperglycemia. Increases in plasma lipids displace water volume and decrease sodium concentration. Hyperlipidemia and hyperglycemia are associated with hyponatremia, not hypernatremia. Hyperlipidemia and hyperglycemia are associated with hyponatremia, not hypokalemia. Hyperlipidemia and hyperglycemia are associated with hyponatremia, not acidosis. Cognitive Level: Comprehension 107 18. A 52-year-old diabetic male presents to the ER with lethargy, confusion, and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Lab results indicate hyperglycemia. Which assessment finding is most likely to occur? a. Clammy skin b. Decreased sodium c. Decreased urine formation d. Metabolic alkalosis ANS: B Hypertonic hyponatremia develops with hyperglycemia. Increases in plasma lipids displace water volume and decrease sodium concentration, leading to the symptoms described. The patient is experiencing symptoms of hyponatremia and hyperglycemia, not hypernatremia and hypoglycemia. The patient will have increased ECF and would have increased urine formation. Metabolic acidosis would occur, not alkalosis. Cognitive Level: Comprehension 107 19. When taking care of a patient with hyperkalemia, which principle is priority? Hyperkalemia causes a(n) in resting membrane potential with excitability of cardiac muscle. a. Increase; increased b. Decrease; increased c. Increase; decreased d. Decrease; decreased ANS: A Hyperkalemia causes an increase in resting membrane potential and increased excitability of cardiac muscle. Hyperkalemia does cause an increased excitability of cardiac muscle, but the result is an increase in resting membrane potential. Hyperkalemia does cause an increase in resting membrane potential, but the result is an increase in excitability of cardiac muscle. Hyperkalemia causes an increase in resting membrane potential and increased excitability of cardiac muscle. Cognitive Level: Comprehension 110 20. Which of the following patients is most prone to hypochloremia? A patient with: a. Hypernatremia b. Hypokalemia c. Hypercalcemia d. Increased bicarbonate intake ANS: D Hypochloremia is the result of elevated bicarbonate concentration, as occurs in metabolic alkalosis. Hypochloremia is the result of hyponatremia, not hypernatremia. Hypochloremia is the result of hyponatremia, not hypokalemia. Hypochloremia is the result of hyponatremia, not hypercalcemia. Cognitive Level: Comprehension 106 21. Which of the following conditions would cause the nurse to monitor for hyperkalemia? a. Excess aldosterone b. Acute acidosis c. Insulin usage d. Metabolic alkalosis ANS: B In acidosis, ECF hydrogen ions shift into the cells in exchange for ICF potassium and sodium; hyperkalemia and acidosis therefore often occur together. Acidosis causes hyperkalemia, not excess aldosterone. Insulin would help treat hyperkalemia, not cause it. It is acidosis, not alkalosis, that leads to hyperkalemia. Cognitive Level: Comprehension 110 22. Which organ system should the nurse monitor when the patient has long-term potassium deficits? a. Central nervous system (CNS) b. Lungs c. Kidneys d. Gastrointestinal tract ANS: C Long-term potassium deficits lasting more than 1 month may damage renal tissue, with interstitial fibrosis and tubular atrophy. Long-term potassium deficits damage the kidneys, not the CNS. Long-term potassium deficits damage the kidneys, not the lungs. Long-term potassium deficits damage the kidneys, not the gastrointestinal tract. Cognitive Level: Comprehension 10