Elevate Module 1 Review Quiz 100% Correct Answers Verified Latest 2024 Version

What clinical manifestation does the nurse expect to see in a client suspected of having hypercalcemia? 1. Tachycardia 2. Positive Chvostek 3. Lethargy 4. Tachypnea 5. Decreased deep tendon reflexes - ANS: 3., 5. 3., & 5. Correct: Hypercalcemia is a condition in which the calcium level in blood is above normal. Too much calcium in blood can weaken bones, create kidney stones, and interfere with heart and brain function. Hypercalcemia is usually a result of overactive parathyroid glands. Other causes include cancer, some medications, and taking too much of calcium and vitamin D supplements. Signs and symptoms of hypercalcemia range from nonexistent to severe. Lethargy and decreased deep tendon reflexes are two manifestations of hypercalcemia. 1. Incorrect: Bradycardia rather than tachycardia is seen with hypercalcemia. Remember - muscles are sedated. 2. Incorrect: A Negative Chvostek will be seen with hypercalcemia. It will be positive in hypocalcemia. 4. Incorrect: Hypercalcemia will result in a decreased, rather than increased respiratory rate. A client has been admitted with a diagnosis of septic shock and has been successfully intubated. The nurse performs and documents a rapid assessment. Which information from the assessment requires the most immediate action by the nurse? Vital Signs: Blood Pressure 92/54 mmHg, Heart Rate 116 bpm, Respiratory Rate 22 breaths/min, Temperature 103F (39.4C), Oxygen Saturation 91%. Documentation: Heart tones irregular, distant. Face flushed and warm. Extremities cool and mottled. Radial pulses faintly palpable. Pedal pulses non-palpable. Denies chest pain. Endotracheal tube taped in place via oropharynx. Right anterior and posterior lung sounds clear. Unable to hear left lung sounds. Grimaces with light abdominal palpation over pelvic bone. Urine amber and cloudy with red streaks. 100 mL urine output in foley catheter bag. Opens eyes and moves to command. Pupils equal, round, and react to light.1. Lung assessment findi - ANS: 1. 1. Correct: Look at the clues: Endotracheal tube taped in place via oropharynx. Right anterior and posterior lung sounds clear. Unable to hear left lung sounds. The ET tube is likely down in the right main stem bronchus. This means the left lung is not being oxygenated. 2. Incorrect: The BP is above 90 systolic, so the vital organs are still being perfused. The nurse will definitely keep monitoring, but this is not the priority. 3. Incorrect: The second priority is to treat the infection that is likely the cause of the temperature elevation. But take care of that airway first. 4. Incorrect: This is the likely cause of the sepsis, but the priority is to fix the airway problem. Based on the results of the arterial blood gases (ABGs), what imbalance does the nurse understand the client to be exhibiting? ABGs: pH - 7.35 PaO2 - 95% PaCO2 - 49 HCO3 - 30 1. Respiratory acidosis compensated 2. Respiratory acidosis partially compensated 3. Metabolic acidosis compensated 4. Metabolic acidosis partially compensated - ANS: 1. 1. Correct: The pH is normal but is on the acidic side of normal. The PaCO2 is elevated, causing acid formation. The HCO3 is alkalotic and is increased to buffer the acid. The pH and PaCO2 match, so the original problem was respiratory acidosis, but compensation has occurred since the pH is now normal. 2. Incorrect: The pH is normal but is on the acidic side of normal. The PaCO2 is acid. The HCO3 is alkalotic. The pH and PaCO2 match, so the original problem was respiratory acidosis, but compensation has occurred since the pH is now low. 3. Incorrect: The pH is normal but is on the acidic side of normal. The PaCO2 is acid. The HCO3 is alkalotic. The pH and PaCO2 match, so the original problem was respiratory acidosis, but compensation has occurred since the pH is now low.4. Incorrect: The pH is normal but is on the acidic side of normal. The PaCO2 is acid. The HCO3 is alkalotic. The pH and PaCO2 match, so the original problem was respiratory acidosis, but compensation has occurred since the pH is now low. The nurse is caring for a client in the emergency department with agitation, diarrhea, and peripheral edema. Family reports client has a history of chronic renal damage and has been taking a lot of antacids for indigestion. Which alterations in the arterial blood gases would the nurse expect to find? 1. pH: 7.34, PaCO2: 48, HCO3: 29 2. pH: 7.50, PaCO2: 35, HCO3: 32 3. pH: 7.32, PaCO2: 36, HCO3: 20 4. pH: 7.42, PaCO2: 40, HCO3: 24 - ANS: 2. 2. Correct: Metabolic alkalosis may not show any symptoms. People with this type of alkalosis more often complain of the underlying conditions that are causing it. These can include vomiting, diarrhea, swelling in the lower legs, and fatigue. Severe cases of metabolic alkalosis can cause agitation, disorientation, seizures, and coma. So we are looking for ABGs that indicate that this client is in metabolic alkalosis. A pH of 7.50 is higher than the normal pH value of 7.45, which indicates alkalosis. The PaCO2 is 35, which is on the low end of normal (34-45). The HCO3 is 32, which is higher than the normal HCO3 of 26, which indicates alkalosis. So the Bicarb (Kidney chemical) matches the pH. Metabolic alkalosis. 1. Incorrect: This is partially compensated respiratory acidosis. pH: 7.34 (acid), PaCO2: 48 (acid), HCO3: 29 (alkaline) 3. Incorrect: This is metabolic acidosis. pH: 7.32 (acid), PaCO2: 36 (normal), HCO3: 20 (acid) 4. Incorrect: These are normal ABGs. pH: 7.42 (normal), PaCO2: 40 (normal), HCO3: 24 (normal) Which signs and symptoms would concern the nurse if assessed in a client post radical neck surgery? 1. Dysphagia 2. Facial numbness 3. Flushed and warm skin 4. Laryngeal stridor 5. Negative Chvostek's sign - ANS: 1., 2., 4. 1., 2., & 4. Correct: Dyspnea, facial numbness and laryngeal stridor are signs indicating that muscles are rigid and tight due to a low calcium level. Some of the parathyroids could have been removed resulting in hypocalcemia. 3. Incorrect: Flushed and warm skin would be seen with hypermagnesemia due to vasodilation