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Chapter : Agents Affecting the Volume and Ion
Content of Body Fluids
Multiple Choice
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1002. A nurse is caring for a postoperative patient who has a nasogastric tube with continuous
suction. The nurse notes that the patient has shallow respirations and suspects that this
patienthas developed:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratoary acidosis.
d. respiratory alkalosis.
ANS: B
Metabolic alkalosis occurs with excessive loss of acid, such as gastric acid, or an excessive increase
in alkalinizing salts. The body compensates for metabolic alkalosis by hypoventilating in an
attempt to retain CO2. Metabolic acidosis is usually caused by ingestion of acids or excessive loss
of bicarbonate and is compensated by hyperventilation. Respiratory acidosis results from
hypoventilation. Respiratory alkalosis is the result of hyperventilation.DIF: Cognitive Level:
ApplicationREF: p. 1004TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Physiologic Adaptation
1003. A patient with congestive heart failure is admitted to the hospital. During the admission
assessment, the nurse learns that the patient is taking a thiazide diuretic. The nurse notes
that the admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of
95 mEq/L, and a potassium level of 3 mEq/L. The prescriber has ordered digoxin to be given
immediately. What will the nurse do initially?
a. Give the digoxin and maintain close cardiac monitoring.
b. Hold the digoxin and report the laboratory values to the provider.
c. Hold the thiazide diuretic and give the digoxin.
d. Request an order for an electrocardiogram (ECG).
ANS: B
, rs or
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Nu s f
ce ic
ti ut
ac pe
897
Pr era
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Ad har
Potassium depletion is common with thiazide diuretics, and hypokalemia is especially dangerous
P
for patients receiving digoxin, because the drug can precipitate a fatal dysrhythmia and digoxin
toxicity. The provider should be notified of the serum potassium level so that it can be corrected
before the digoxin is administered. Giving the digoxin could produce a fatal adverse effect, so this
is not an appropriate course of action. Holding the thiazide diuretic will not correct the potassium
deficiency. An ECG is not the initial priority.DIF: Cognitive Level: ApplicationREF: p. 1005TOP:
Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction
of Risk Potential
1004. A patient who is a chronic alcoholic is admitted to the hospital. Admission laboratory work
reveals a magnesium level of 1.2 mEq/L. The prescriber orders intravenous magnesium sulfate
in a 10% solution at a rate of 10 mL/min. What will the nurse do?
es
Nu s f
ce ic
ti ut
ac pe
895
Pr era
ed th
nc co
va ma
Ad har
P
Chapter : Agents Affecting the Volume and Ion
Content of Body Fluids
Multiple Choice
, rs or
es
Nu s f
ce ic
ti ut
ac pe
896
Pr era
ed th
nc co
va ma
Ad har
P
1002. A nurse is caring for a postoperative patient who has a nasogastric tube with continuous
suction. The nurse notes that the patient has shallow respirations and suspects that this
patienthas developed:
a. metabolic acidosis.
b. metabolic alkalosis.
c. respiratoary acidosis.
d. respiratory alkalosis.
ANS: B
Metabolic alkalosis occurs with excessive loss of acid, such as gastric acid, or an excessive increase
in alkalinizing salts. The body compensates for metabolic alkalosis by hypoventilating in an
attempt to retain CO2. Metabolic acidosis is usually caused by ingestion of acids or excessive loss
of bicarbonate and is compensated by hyperventilation. Respiratory acidosis results from
hypoventilation. Respiratory alkalosis is the result of hyperventilation.DIF: Cognitive Level:
ApplicationREF: p. 1004TOP: Nursing Process: Assessment MSC: NCLEX Client Needs Category:
Physiologic Integrity: Physiologic Adaptation
1003. A patient with congestive heart failure is admitted to the hospital. During the admission
assessment, the nurse learns that the patient is taking a thiazide diuretic. The nurse notes
that the admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of
95 mEq/L, and a potassium level of 3 mEq/L. The prescriber has ordered digoxin to be given
immediately. What will the nurse do initially?
a. Give the digoxin and maintain close cardiac monitoring.
b. Hold the digoxin and report the laboratory values to the provider.
c. Hold the thiazide diuretic and give the digoxin.
d. Request an order for an electrocardiogram (ECG).
ANS: B
, rs or
es
Nu s f
ce ic
ti ut
ac pe
897
Pr era
ed th
nc co
va ma
Ad har
Potassium depletion is common with thiazide diuretics, and hypokalemia is especially dangerous
P
for patients receiving digoxin, because the drug can precipitate a fatal dysrhythmia and digoxin
toxicity. The provider should be notified of the serum potassium level so that it can be corrected
before the digoxin is administered. Giving the digoxin could produce a fatal adverse effect, so this
is not an appropriate course of action. Holding the thiazide diuretic will not correct the potassium
deficiency. An ECG is not the initial priority.DIF: Cognitive Level: ApplicationREF: p. 1005TOP:
Nursing Process: Assessment MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction
of Risk Potential
1004. A patient who is a chronic alcoholic is admitted to the hospital. Admission laboratory work
reveals a magnesium level of 1.2 mEq/L. The prescriber orders intravenous magnesium sulfate
in a 10% solution at a rate of 10 mL/min. What will the nurse do?
