NURSING345 Adult Health Final Exam Quiz Guide
Exam 1
● IV 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 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion
Rationale: IV KCl is administered at a maximal rate of 10 mEq/hr.
Rapid IV infusion of KCl can cause cardiac arrest. KCl can cause
inflammation of peripheral veins, but it can be administered by this
route. Cardiac monitoring should be continued while patient is
receiving potassium because of the risk for dysrhythmias.
Review: Treatment for potassium imbalance
● A postoperative patient who had surgery for a perforated gastric
ulcer has been receiving nasogastric suction for 3 days. The patient
now has a serum sodium level of 127 mEq/L (127 mmol/L). Which
prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
b. Administer 3% saline at 50 mL/hr for a total of 200 mL.
c. Administer IV morphine sulfate 4 mg every 2 hours PRN.
d. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for
nausea.
Rationale: Because the patient's gastric suction has been
depleting electrolytes, the IV solution should include electrolyte
replacement. Solutions such as lactated Ringer's solution would
usually be ordered for this patient. The other orders are appropriate
for a postoperative patient with gastric suction.
Review: Treatment for sodium imbalance
● A patient who was involved in a motor vehicle crash has had a
tracheostomy placed to allow for continued mechanical
ventilation. How should the nurse interpret the following arterial
blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg,
and HCO3 25 mEq/L?
a. Metabolic acidosis
c. Respiratory acidosis
b. Metabolic alkalosis
d. Respiratory
alkalosis Review:
Acid base
● A patient receives 3% NaCl solution for correction of
,hyponatremia. Which assessment is most important for the nurse
to monitor for while the patient is receiving this infusion?
a. Lung sounds
c. Peripheral pulses
b. Urinary output
, d. Peripheral edema
Rationale: Hypertonic solutions cause water retention, so the
patient should be monitored for symptoms of fluid excess. Crackles in
the lungs may indicate the onset of pulmonary edema and are a
serious manifestation of fluid excess. Peripheral pulses, peripheral
edema, or changes in urine output are also important to monitor when
administering hypertonic solutions, but they do not indicate acute
respiratory or cardiac decompensation.
Review: Sodium imbalance treatment
● A patient who is lethargic and exhibits deep, rapid respirations has
the following arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm
Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. How should the nurse
interpret these results?
a. Metabolic acidosis
c. Respiratory acidosis
b. Metabolic alkalosis
d. Respiratory
alkalosis Review:
acid bases
● A patient who has been receiving diuretic therapy is admitted to the
emergency department with a serum potassium level of 3.0 mEq/L.
The nurse should alert the health care provider immediately that the
patient is on which medication?
a. Digoxin (Lanoxin) 0.25 mg/day
b. Metoprolol (Lopressor) 12.5 mg/day
c. Ibuprofen (Motrin) 400 mg every 6 hours
d. Lantus insulin 24 U subcutaneously every evening
Rationale: Hypokalemia increases the risk for digoxin toxicity,
which can cause serious dysrhythmias. The nurse will also need to
do more assessment regarding the other medications, but they are
not of as much concern with the potassium level.
Review: meds that affect potassium
● The nurse is caring for a patient who has a calcium level of 12.1
mg/dL. Which nursing action should the nurse include on the care
plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau's and Chvostek's signs.
d. Encourage fluid intake up to 4000 mL every day.
Rationale: To decrease the risk for renal calculi, the patient should
have a fluid intake of 3000 to 4000 mL daily. Ambulation helps
decrease the loss of calcium from bone and is encouraged in patients
with hypercalcemia.
, Trousseau's and Chvostek's signs are monitored when there is a
possibility of hypocalcemia. There is no indication that the patient
needs frequent assessment of lung sounds,although these would be
assessed every shift.
Review: Care for patient with a calcium imbalance
Exam 1
● IV 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 10 mEq/hour.
c. Only give the KCl through a central venous line.
d. Discontinue cardiac monitoring during the infusion
Rationale: IV KCl is administered at a maximal rate of 10 mEq/hr.
Rapid IV infusion of KCl can cause cardiac arrest. KCl can cause
inflammation of peripheral veins, but it can be administered by this
route. Cardiac monitoring should be continued while patient is
receiving potassium because of the risk for dysrhythmias.
Review: Treatment for potassium imbalance
● A postoperative patient who had surgery for a perforated gastric
ulcer has been receiving nasogastric suction for 3 days. The patient
now has a serum sodium level of 127 mEq/L (127 mmol/L). Which
prescribed therapy should the nurse question?
a. Infuse 5% dextrose in water at 125 mL/hr.
b. Administer 3% saline at 50 mL/hr for a total of 200 mL.
c. Administer IV morphine sulfate 4 mg every 2 hours PRN.
d. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for
nausea.
Rationale: Because the patient's gastric suction has been
depleting electrolytes, the IV solution should include electrolyte
replacement. Solutions such as lactated Ringer's solution would
usually be ordered for this patient. The other orders are appropriate
for a postoperative patient with gastric suction.
Review: Treatment for sodium imbalance
● A patient who was involved in a motor vehicle crash has had a
tracheostomy placed to allow for continued mechanical
ventilation. How should the nurse interpret the following arterial
blood gas results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg,
and HCO3 25 mEq/L?
a. Metabolic acidosis
c. Respiratory acidosis
b. Metabolic alkalosis
d. Respiratory
alkalosis Review:
Acid base
● A patient receives 3% NaCl solution for correction of
,hyponatremia. Which assessment is most important for the nurse
to monitor for while the patient is receiving this infusion?
a. Lung sounds
c. Peripheral pulses
b. Urinary output
, d. Peripheral edema
Rationale: Hypertonic solutions cause water retention, so the
patient should be monitored for symptoms of fluid excess. Crackles in
the lungs may indicate the onset of pulmonary edema and are a
serious manifestation of fluid excess. Peripheral pulses, peripheral
edema, or changes in urine output are also important to monitor when
administering hypertonic solutions, but they do not indicate acute
respiratory or cardiac decompensation.
Review: Sodium imbalance treatment
● A patient who is lethargic and exhibits deep, rapid respirations has
the following arterial blood gas (ABG) results: pH 7.32, PaO2 88 mm
Hg, PaCO2 37 mm Hg, and HCO3 16 mEq/L. How should the nurse
interpret these results?
a. Metabolic acidosis
c. Respiratory acidosis
b. Metabolic alkalosis
d. Respiratory
alkalosis Review:
acid bases
● A patient who has been receiving diuretic therapy is admitted to the
emergency department with a serum potassium level of 3.0 mEq/L.
The nurse should alert the health care provider immediately that the
patient is on which medication?
a. Digoxin (Lanoxin) 0.25 mg/day
b. Metoprolol (Lopressor) 12.5 mg/day
c. Ibuprofen (Motrin) 400 mg every 6 hours
d. Lantus insulin 24 U subcutaneously every evening
Rationale: Hypokalemia increases the risk for digoxin toxicity,
which can cause serious dysrhythmias. The nurse will also need to
do more assessment regarding the other medications, but they are
not of as much concern with the potassium level.
Review: meds that affect potassium
● The nurse is caring for a patient who has a calcium level of 12.1
mg/dL. Which nursing action should the nurse include on the care
plan?
a. Maintain the patient on bed rest.
b. Auscultate lung sounds every 4 hours.
c. Monitor for Trousseau's and Chvostek's signs.
d. Encourage fluid intake up to 4000 mL every day.
Rationale: To decrease the risk for renal calculi, the patient should
have a fluid intake of 3000 to 4000 mL daily. Ambulation helps
decrease the loss of calcium from bone and is encouraged in patients
with hypercalcemia.
, Trousseau's and Chvostek's signs are monitored when there is a
possibility of hypocalcemia. There is no indication that the patient
needs frequent assessment of lung sounds,although these would be
assessed every shift.
Review: Care for patient with a calcium imbalance
