NURS 101 FINAL EXAM COMPLETE QUESTIONS AND VERIFIED ACCURATE SOLUTION (DETAILED & ELABORATED) |100% ACCURATE!! TEST!!

NURS 101 FINAL EXAM COMPLETE QUESTIONS AND VERIFIED ACCURATE SOLUTION (DETAILED & ELABORATED) |100% ACCURATE!! TEST!! A client is prone to hyponatremia. Which factors should the nurse identify that can precipitate hyponatremia? Select all that apply. Wound drainage Diuretic therapy Gastrointestinal (GI) suction Parenteral infusion of 0.9% sodium chloride Inappropriate anti-diuretic hormone (ADH) secretion Correct Answer Wound Drainage Diuretic Therapy GI Suction Inappropriate Anti-Diuretic Hormone Secretion Rationale: Wound drainage can result in hyponatremia from loss of sodium ions. Most diuretics interfere with sodium reabsorption in the nephrons and have the side effect of hyponatremia. Gastrointestinal fluids are rich in sodium ions, which are lost by GI suction. With the syndrome of inappropriate anti-diuretic hormone (SIADH), high levels of the anti-diuretic hormone (ADH) are produced, causing the body to retain water instead of excreting it normally in the urine. Parenteral infusion of 0.9% sodium chloride, an isotonic solution, should be compatible with body fluids; if given in excess, it may lead to hypernatremia. The nurse is assessing the respiratory status of the client at 2 hour intervals as a nursing safety priority. Which condition is affecting the client? Hypokalemia Hyperkalemia Hyponatremia Hypernatremia Correct Answer Hypokalemia Rationale: In case of hypokalemia, the nurse should assess the respiratory status of the client every 2 hours. In case of hyperkalemia, the nurse should notify the healthcare team if the heart rate falls below 60 beats per minute or T waves become spiked. In case of hyponatremia, the nurse should be aware of muscle weakness in the client and immediately check respiratory effectiveness. In case of hypernatremia, the nurse should assess the client hourly for excessive losses of fluid, sodium, or potassium. The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia often complicate renal failure? 1. Increase in blood pressure 2. Decrease in erythropoietin 3. Increase in serum phosphate levels 4. Decrease in serum sodium concentration Correct Answer 2. Decrease in erythropoietin Rationale: The hormone erythropoietin, produced by the kidneys, stimulates the bone marrow to produce red blood cells. In renal failure there is a deficiency of erythropoietin that often results in the client developing anemia. Therefore the nurse is instructed to administer blood. In renal failure, increased blood pressure is due to impairment of renal vasodilator factors and is not treated by administration of blood. Phosphate is retained in the body during renal failure, causing binding of calcium leading to done demineralization, not anemia. Increase in urinary sodium concentration and decrease in serum sodium concentration trigger the release of renin from the juxtaglomerular cells. A client's serum potassium level has increased to 5.8 mEq/L (5.8 mmol/L). What action should the nurse implement first? 1. Call the laboratory to repeat the test. 2. Take vital signs and notify the healthcare provider. 3. Inform the cardiac arrest team to place them on alert. 4. Take an electrocardiogram and have lidocaine available Correct Answer 2. take vs and notify healthcare provider rationale: Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac dysrhythmias. The healthcare provider should be notified because medical intervention may be necessary. A repeat laboratory test will take time and probably reaffirm the original results; the client needs immediate attention. The cardiac arrest team is always on alert and will respond when called for a cardiac arrest. Taking an electrocardiogram and having lidocaine available are insufficient interventions. A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the primary healthcare provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis? 1. Ascites 2. Acidosis 3. Hypertension 4. Hyperkalemia Correct Answer 4. Hyperkalemia Rationale: Protein breakdown liberates cellular potassium ions, leading to hyperkalemia, which can cause a cardiac dysrhythmia and standstill. The failure of the kidneys to maintain a balance of potassium is one of the main indications for dialysis. Ascites occurs in liver disease and is not an indication for dialysis. Dialysis is not the usual treatment for acidosis; usually this responds to administration of alkaline drugs. Dialysis is not a treatment for hypertension; this is usually controlled by antihypertensive medication and diet.