NSG 3100 exam 4 Questions With Answers Graded A+
Assured Success
1. The nurse is providing teaching to clients regarding intake of dietary
potassium. The nurse recognizes that the client at risk of developing an
electrolyte imbalance of potassium is the client who
A. has fatty stools from taking an over-the-counter (OTC) weight loss product.
B. experiences anorexia.
C. has chronic heart failure (HF) that is being treated with diuretics.
D. takes very large doses of vitamin D as a chemotherapy supplement.
C. The client who has chronic heart failure (HF) that is being treated with
diuretics. Rationale: Clients with chronic heart failure (HF) who are being treated
with diuretics, particularly loop diuretics like furosemide, are at risk for hypokalemia
(low potassium levels) because diuretics increase the excretion of potassium through
urine. Monitoring potassium levels and ensuring adequate intake is critical for these
clients.
The other clients are at lower risk for potassium imbalances:
• Fatty stools from OTC weight loss products (A) may cause malabsorption of
fats but are less likely to affect potassium.
• Anorexia (B) can lead to multiple nutritional deficiencies, but potassium
imbalance may not be as immediate unless there is significant malnutrition or
vomiting.
• Large doses of vitamin D (D) do not directly affect potassium levels;
however, they may affect calcium and phosphate balance.
2. The nurse is caring for a client who has had diarrhea for 48 hours
and has developed fatigue, muscle weakness, and an irregular
pulse. Which of the following laboratory results should the nurse
correlate to these signs and symptoms?
A. Serum phosphate of 4 mEq/L.
B. Serum magnesium of 2 mEq/L.
C. Serum calcium of 9.5 mEq/L.
D. Serum potassium of 2.8 mEq/L.
D. Serum potassium of 2.8 mEq/L.
Rationale: A serum potassium level of 2.8 mEq/L indicates hypokalemia, which can
result from prolonged diarrhea. Hypokalemia is associated with symptoms such as
fatigue, muscle weakness, and cardiac dysrhythmias (irregular pulse), which are all
present in this client.
The other values are within normal ranges and are not typically associated with these
symptoms:
• Serum phosphate (A) normal range: 2.5-4.5 mEq/L.
• Serum magnesium (B) normal range: 1.5-2.5 mEq/L.
• Serum calcium (C) normal range: 8.5-10.5 mEq/L.
3. The nurse is caring for a client who has multiple draining wounds and has
been admitted for hypovolemia. Which of the following assessment findings
is consistent with hypovolemia?
, A. Increased urine output.
B. Decreased skin turgor.
C. Hypertension.
D. Bounding peripheral pulses.
B. Decreased skin turgor.
Rationale: Decreased skin turgor is a common sign of dehydration, which often
accompanies hypovolemia. It indicates that the skin does not quickly return to its
normal position after being pinched, reflecting reduced fluid volume in the body.
The other options are not consistent with hypovolemia:
• Increased urine output (A) would typically occur with hypervolemia or
conditions with excess fluid, not hypovolemia.
, • Hypertension (C) is usually associated with fluid overload, whereas
hypovolemia typically leads to hypotension.
• Bounding peripheral pulses (D) are more indicative of fluid overload
rather than hypovolemia, which usually causes weak or thready pulses.
4. The nurse is caring for assigned clients. The nurse should see the client
with which of the following symptoms first?
A. Serum potassium concentration is decreasing; abdominal distention, but
denies any difficult breathing.
B. Serum calcium concentration is increasing; reports constipation; is alert and
denies any discomfort.
C. Serum potassium concentration is increasing; has developed cardiac
dysrhythmias, but denies any difficulty breathing.
D. Serum calcium concentration is decreasing; reports constipation; is alert and
reports a pain level of 3 on a scale of 0 (no pain) to 10 (severe pain).
C. Serum potassium concentration is increasing; has developed cardiac
dysrhythmias, but denies any difficulty breathing.
Rationale: Elevated potassium levels (hyperkalemia) are the most critical concern among
the listed options because they can lead to life-threatening cardiac dysrhythmias, even
if the client is not experiencing difficulty breathing. Immediate intervention is required
to prevent serious complications, such as cardiac arrest.
The other symptoms listed are not as immediately life-threatening as hyperkalemia with
cardiac dysrhythmias:
• A: Decreasing potassium with abdominal distention should be monitored, but it is
less critical.
• B: Increasing calcium with constipation and no discomfort does not require
immediate intervention.
• D: Decreasing calcium with mild pain also does not pose an immediate threat.
5. The nurse is caring for the following clients. The nurse identifies which
client as being at risk for developing metabolic acidosis?
A. The client who is extremely anxious.
B. The client who has had diarrhea for over a week.
C. The client who has a nasogastric (NG) tube.
D. The client who has newly diagnosed pneumonia.
B. The client who has had diarrhea for over a week.
Rationale: Prolonged diarrhea leads to the loss of bicarbonate, which is a critical buffer in
the body. When bicarbonate is lost in large amounts, the body becomes more acidic,
leading to metabolic acidosis.
The other conditions are associated with different imbalances:
• A. Extremely anxious: This may lead to respiratory alkalosis due to
hyperventilation.
• C. Nasogastric (NG) tube: This may cause metabolic alkalosis due to the loss
of stomach acids.
• D. Newly diagnosed pneumonia: This could lead to respiratory acidosis due
to impaired gas exchange, not metabolic acidosis.
6. The nurse is reviewing laboratory results for assigned clients. The
nurse should follow-up with a client who has a
, A. serum chloride of 100 mEq/dL.
B. specific gravity of 1.025.
C. blood sugar of 125 mg/dL.
D. serum potassium of 6 mEq/L.
Assured Success
1. The nurse is providing teaching to clients regarding intake of dietary
potassium. The nurse recognizes that the client at risk of developing an
electrolyte imbalance of potassium is the client who
A. has fatty stools from taking an over-the-counter (OTC) weight loss product.
B. experiences anorexia.
C. has chronic heart failure (HF) that is being treated with diuretics.
D. takes very large doses of vitamin D as a chemotherapy supplement.
C. The client who has chronic heart failure (HF) that is being treated with
diuretics. Rationale: Clients with chronic heart failure (HF) who are being treated
with diuretics, particularly loop diuretics like furosemide, are at risk for hypokalemia
(low potassium levels) because diuretics increase the excretion of potassium through
urine. Monitoring potassium levels and ensuring adequate intake is critical for these
clients.
The other clients are at lower risk for potassium imbalances:
• Fatty stools from OTC weight loss products (A) may cause malabsorption of
fats but are less likely to affect potassium.
• Anorexia (B) can lead to multiple nutritional deficiencies, but potassium
imbalance may not be as immediate unless there is significant malnutrition or
vomiting.
• Large doses of vitamin D (D) do not directly affect potassium levels;
however, they may affect calcium and phosphate balance.
2. The nurse is caring for a client who has had diarrhea for 48 hours
and has developed fatigue, muscle weakness, and an irregular
pulse. Which of the following laboratory results should the nurse
correlate to these signs and symptoms?
A. Serum phosphate of 4 mEq/L.
B. Serum magnesium of 2 mEq/L.
C. Serum calcium of 9.5 mEq/L.
D. Serum potassium of 2.8 mEq/L.
D. Serum potassium of 2.8 mEq/L.
Rationale: A serum potassium level of 2.8 mEq/L indicates hypokalemia, which can
result from prolonged diarrhea. Hypokalemia is associated with symptoms such as
fatigue, muscle weakness, and cardiac dysrhythmias (irregular pulse), which are all
present in this client.
The other values are within normal ranges and are not typically associated with these
symptoms:
• Serum phosphate (A) normal range: 2.5-4.5 mEq/L.
• Serum magnesium (B) normal range: 1.5-2.5 mEq/L.
• Serum calcium (C) normal range: 8.5-10.5 mEq/L.
3. The nurse is caring for a client who has multiple draining wounds and has
been admitted for hypovolemia. Which of the following assessment findings
is consistent with hypovolemia?
, A. Increased urine output.
B. Decreased skin turgor.
C. Hypertension.
D. Bounding peripheral pulses.
B. Decreased skin turgor.
Rationale: Decreased skin turgor is a common sign of dehydration, which often
accompanies hypovolemia. It indicates that the skin does not quickly return to its
normal position after being pinched, reflecting reduced fluid volume in the body.
The other options are not consistent with hypovolemia:
• Increased urine output (A) would typically occur with hypervolemia or
conditions with excess fluid, not hypovolemia.
, • Hypertension (C) is usually associated with fluid overload, whereas
hypovolemia typically leads to hypotension.
• Bounding peripheral pulses (D) are more indicative of fluid overload
rather than hypovolemia, which usually causes weak or thready pulses.
4. The nurse is caring for assigned clients. The nurse should see the client
with which of the following symptoms first?
A. Serum potassium concentration is decreasing; abdominal distention, but
denies any difficult breathing.
B. Serum calcium concentration is increasing; reports constipation; is alert and
denies any discomfort.
C. Serum potassium concentration is increasing; has developed cardiac
dysrhythmias, but denies any difficulty breathing.
D. Serum calcium concentration is decreasing; reports constipation; is alert and
reports a pain level of 3 on a scale of 0 (no pain) to 10 (severe pain).
C. Serum potassium concentration is increasing; has developed cardiac
dysrhythmias, but denies any difficulty breathing.
Rationale: Elevated potassium levels (hyperkalemia) are the most critical concern among
the listed options because they can lead to life-threatening cardiac dysrhythmias, even
if the client is not experiencing difficulty breathing. Immediate intervention is required
to prevent serious complications, such as cardiac arrest.
The other symptoms listed are not as immediately life-threatening as hyperkalemia with
cardiac dysrhythmias:
• A: Decreasing potassium with abdominal distention should be monitored, but it is
less critical.
• B: Increasing calcium with constipation and no discomfort does not require
immediate intervention.
• D: Decreasing calcium with mild pain also does not pose an immediate threat.
5. The nurse is caring for the following clients. The nurse identifies which
client as being at risk for developing metabolic acidosis?
A. The client who is extremely anxious.
B. The client who has had diarrhea for over a week.
C. The client who has a nasogastric (NG) tube.
D. The client who has newly diagnosed pneumonia.
B. The client who has had diarrhea for over a week.
Rationale: Prolonged diarrhea leads to the loss of bicarbonate, which is a critical buffer in
the body. When bicarbonate is lost in large amounts, the body becomes more acidic,
leading to metabolic acidosis.
The other conditions are associated with different imbalances:
• A. Extremely anxious: This may lead to respiratory alkalosis due to
hyperventilation.
• C. Nasogastric (NG) tube: This may cause metabolic alkalosis due to the loss
of stomach acids.
• D. Newly diagnosed pneumonia: This could lead to respiratory acidosis due
to impaired gas exchange, not metabolic acidosis.
6. The nurse is reviewing laboratory results for assigned clients. The
nurse should follow-up with a client who has a
, A. serum chloride of 100 mEq/dL.
B. specific gravity of 1.025.
C. blood sugar of 125 mg/dL.
D. serum potassium of 6 mEq/L.
