NURS 6320 Final QUESTIONS AND
ANSWERS
A patient's blood gases reveal the following findings: pH, 7.3; bicarbonate (HCO3)
27 mEq/L; carbon dioxide (CO2), 58 mm Hg. What is the interpretation of these
gases?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis - ANSWER>>ANS: C
The values provided in this question characterize only acute uncompensated
respiratory acidosis.
What causes the clinical manifestations of confusion, convulsions, cerebral
hemorrhage, and coma in hypernatremia?
a. High sodium in the blood vessels pulls water out of the brain cells into the
blood vessels, causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain
cells, causing them to swell.
c. High sodium in the blood vessels pulls potassium out of the brain cells, which
slows the synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by
water, causing the brain cells to swell - ANSWER>>ANS: A
,Hypertonic (hyperosmolar) imbalances result in an extracellular fluid
concentration greater than 0.9% salt solution (e.g., water loss or solute gain); cells
shrink in a hypertonic fluid (see Table 3-7). This shrinking of cells results in the
symptoms described in the question. The other options do not accurately
describe the cause of these symptoms as they relate to hypernatremia
Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium to maintain
cation balance
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis - ANSWER>>ANS: C
When vomiting with the depletion of ECF and chloride (hypochloremic metabolic
alkalosis) causes acid loss, renal compensation is not effective; the volume
depletion and loss of electrolytes (sodium [Na+], potassium [K+], hydrogen [H+],
chlorine [Cl-]) stimulate a paradoxic response by the kidneys. The kidneys increase
sodium and bicarbonate reabsorption with the excretion of hydrogen.
Bicarbonate is reabsorbed to maintain an anionic balance because the ECF
chloride concentration is decreased. The other options do not accurately describe
the mechanism that results from vomiting-induced metabolic alkalosis.
Insulin is used to treat hyperkalemia because it:
a. Stimulates sodium to be removed from the cell in exchange for potassium.
b. Binds to potassium to remove it through the kidneys.
,c. Transports potassium from the blood to the cell along with glucose.
d. Breaks down the chemical components of potassium, causing it to be no longer
effective. - ANSWER>>ANS: C
Insulin contributes to the regulation of plasma potassium levels by stimulating the
Na+, potassium-adenosine triphosphatase (K+-ATPase) pump, thereby promoting
the movement of potassium simultaneously into the liver and muscle cells with
glucose transport after eating. The intracellular movement of potassium prevents
an acute hyperkalemia related to food intake. The other options do not accurately
describe how insulin is used to treat hyperkalemia
During acidosis, the body compensates for the increase in serum hydrogen ions by
shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen
b. Sodium
c. Potassium
d. Magnesium - ANSWER>>ANS: C
In states of acidosis, hydrogen ions shift into the cells in exchange for intracellular
fluid potassium; hyperkalemia and acidosis therefore often occur together. This is
not true of the other options.
Causes of hyperkalemia include:
a. Hyperparathyroidism and malnutrition
b. Vomiting and diarrhea
, c. Renal failure and Addison disease
d. Hyperaldosteronism and Cushing disease - ANSWER>>ANS: C
Hyperkalemia should be investigated when a history of renal disease, massive
trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or
metabolic acidosis exists. The other options are not known to be causes of
hyperkalemia
In hyperkalemia, what change occurs to the cells' resting membrane potential?
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization - ANSWER>>ANS: A
If extracellular potassium concentration increases without a significant change in
intracellular potassium, then the resting membrane potential becomes more
positive (i.e., changes from -90 to -80 mV) and the cell membrane is
hypopolarized (i.e., the inside of the cell becomes less negative or partially
depolarized [increase excitability]).
The calcium and phosphate balance is influenced by which three substances?
a. Parathyroid hormone, vasopressin, and vitamin D
b. Parathyroid hormone, calcitonin, and vitamin D
c. Thyroid hormone, vasopressin, and vitamin A
ANSWERS
A patient's blood gases reveal the following findings: pH, 7.3; bicarbonate (HCO3)
27 mEq/L; carbon dioxide (CO2), 58 mm Hg. What is the interpretation of these
gases?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis - ANSWER>>ANS: C
The values provided in this question characterize only acute uncompensated
respiratory acidosis.
What causes the clinical manifestations of confusion, convulsions, cerebral
hemorrhage, and coma in hypernatremia?
a. High sodium in the blood vessels pulls water out of the brain cells into the
blood vessels, causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain
cells, causing them to swell.
c. High sodium in the blood vessels pulls potassium out of the brain cells, which
slows the synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by
water, causing the brain cells to swell - ANSWER>>ANS: A
,Hypertonic (hyperosmolar) imbalances result in an extracellular fluid
concentration greater than 0.9% salt solution (e.g., water loss or solute gain); cells
shrink in a hypertonic fluid (see Table 3-7). This shrinking of cells results in the
symptoms described in the question. The other options do not accurately
describe the cause of these symptoms as they relate to hypernatremia
Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium to maintain
cation balance
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis - ANSWER>>ANS: C
When vomiting with the depletion of ECF and chloride (hypochloremic metabolic
alkalosis) causes acid loss, renal compensation is not effective; the volume
depletion and loss of electrolytes (sodium [Na+], potassium [K+], hydrogen [H+],
chlorine [Cl-]) stimulate a paradoxic response by the kidneys. The kidneys increase
sodium and bicarbonate reabsorption with the excretion of hydrogen.
Bicarbonate is reabsorbed to maintain an anionic balance because the ECF
chloride concentration is decreased. The other options do not accurately describe
the mechanism that results from vomiting-induced metabolic alkalosis.
Insulin is used to treat hyperkalemia because it:
a. Stimulates sodium to be removed from the cell in exchange for potassium.
b. Binds to potassium to remove it through the kidneys.
,c. Transports potassium from the blood to the cell along with glucose.
d. Breaks down the chemical components of potassium, causing it to be no longer
effective. - ANSWER>>ANS: C
Insulin contributes to the regulation of plasma potassium levels by stimulating the
Na+, potassium-adenosine triphosphatase (K+-ATPase) pump, thereby promoting
the movement of potassium simultaneously into the liver and muscle cells with
glucose transport after eating. The intracellular movement of potassium prevents
an acute hyperkalemia related to food intake. The other options do not accurately
describe how insulin is used to treat hyperkalemia
During acidosis, the body compensates for the increase in serum hydrogen ions by
shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen
b. Sodium
c. Potassium
d. Magnesium - ANSWER>>ANS: C
In states of acidosis, hydrogen ions shift into the cells in exchange for intracellular
fluid potassium; hyperkalemia and acidosis therefore often occur together. This is
not true of the other options.
Causes of hyperkalemia include:
a. Hyperparathyroidism and malnutrition
b. Vomiting and diarrhea
, c. Renal failure and Addison disease
d. Hyperaldosteronism and Cushing disease - ANSWER>>ANS: C
Hyperkalemia should be investigated when a history of renal disease, massive
trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or
metabolic acidosis exists. The other options are not known to be causes of
hyperkalemia
In hyperkalemia, what change occurs to the cells' resting membrane potential?
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization - ANSWER>>ANS: A
If extracellular potassium concentration increases without a significant change in
intracellular potassium, then the resting membrane potential becomes more
positive (i.e., changes from -90 to -80 mV) and the cell membrane is
hypopolarized (i.e., the inside of the cell becomes less negative or partially
depolarized [increase excitability]).
The calcium and phosphate balance is influenced by which three substances?
a. Parathyroid hormone, vasopressin, and vitamin D
b. Parathyroid hormone, calcitonin, and vitamin D
c. Thyroid hormone, vasopressin, and vitamin A
