HURST Review Elevate Q-Cards | 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.
, 5. Incorrect: A negative Chvostek's sign is a good thing. It would be positive if the calcium level is low.
An intravenous infusion of 0.9% normal saline is prescribed at a rate of 1000 mL in 12 hours. The tubing
has a drop factor of 15. How many drops per minute (gtts/min) are delivered? Round your answer to the
nearest whole number.
Provide your answer using numbers and decimal points only. - ✔✔ANS: 21
The formula used to calculate drop rates is the total number of milliliters divided by the total number of
minutes multiplied by the drop factor. In this circumstance, the minutes portion must be figured first,
that is, 12 hours equals 720 minutes. Then, dividing 1000 by 720 equals 1.38888889. This is multiplied by
the drop factor, which is 15. Multiplying 15 by 1.38888889 equals 20.83, which rounds to 21.
A client arrives at the emergency department after being removed from a burning building. The nurse
suspects carbon monoxide poisoning when the client exhibits which signs and symptoms?
1. Almond odor to breath
2. Blurred Vision
3. Dull headache
4. Excess salivation
5. Respirations 10 - ✔✔ANS: 2., 3., 5.
2.,3. & 5. Correct: Not enough oxygen is getting to the vital organs, such as the brain and heart, so
blurred vision, a dull headache and respiratory depression can occur.
1. Incorrect: An almond odor to the breath is a manifestation of cyanide poisoning.
4. Incorrect: Excessive salivation can be seen with ingestion of acids or alkalis.
The client has pustules on the arm from intravenous drug abuse. The microbiology laboratory informs
the nurse that the client's cultures are growing methicillin-resistant Staphylococcus aureus (MRSA).
Which action would the nurse take?
1. Cover the pustules to prevent drainage.
2. Implement contact precautions immediately.
3. Instruct the client on the importance of hand hygiene.
4. Inform the client to wear a mask when ambulating in the hall.
5. Instruct visitors to wash hands before entering the client's room. - ✔✔ANS: 1., 2., 3., 5.
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.
, 5. Incorrect: A negative Chvostek's sign is a good thing. It would be positive if the calcium level is low.
An intravenous infusion of 0.9% normal saline is prescribed at a rate of 1000 mL in 12 hours. The tubing
has a drop factor of 15. How many drops per minute (gtts/min) are delivered? Round your answer to the
nearest whole number.
Provide your answer using numbers and decimal points only. - ✔✔ANS: 21
The formula used to calculate drop rates is the total number of milliliters divided by the total number of
minutes multiplied by the drop factor. In this circumstance, the minutes portion must be figured first,
that is, 12 hours equals 720 minutes. Then, dividing 1000 by 720 equals 1.38888889. This is multiplied by
the drop factor, which is 15. Multiplying 15 by 1.38888889 equals 20.83, which rounds to 21.
A client arrives at the emergency department after being removed from a burning building. The nurse
suspects carbon monoxide poisoning when the client exhibits which signs and symptoms?
1. Almond odor to breath
2. Blurred Vision
3. Dull headache
4. Excess salivation
5. Respirations 10 - ✔✔ANS: 2., 3., 5.
2.,3. & 5. Correct: Not enough oxygen is getting to the vital organs, such as the brain and heart, so
blurred vision, a dull headache and respiratory depression can occur.
1. Incorrect: An almond odor to the breath is a manifestation of cyanide poisoning.
4. Incorrect: Excessive salivation can be seen with ingestion of acids or alkalis.
The client has pustules on the arm from intravenous drug abuse. The microbiology laboratory informs
the nurse that the client's cultures are growing methicillin-resistant Staphylococcus aureus (MRSA).
Which action would the nurse take?
1. Cover the pustules to prevent drainage.
2. Implement contact precautions immediately.
3. Instruct the client on the importance of hand hygiene.
4. Inform the client to wear a mask when ambulating in the hall.
5. Instruct visitors to wash hands before entering the client's room. - ✔✔ANS: 1., 2., 3., 5.
