RN TARGETED MEDICAL SURGICAL : FLUID, ELECTROLYTE & ACID BASE EXAM OnlinePractice 2019

RN TARGETED MEDICAL SURGICAL : FLUID, ELECTROLYTE & ACID BASE EXAM OnlinePractice 2019 2 / 10 1. A nurse is assessing a client who has dehydration.Which of the followingassessments is the priority? a. Skin turgor b. Urine output c. Weight d. Mental status ANSW : Mental status The greatest risk to this client is injury from declining mental status or a fall from worsened dehydration.Therefore, assessing the client's mentalstatusisthe priority. 2. A nurse is assessing a client who is using PCA following a thoracotomy.Theclient isshort of breath,appears restless, and has a respiratory rate of 28/min.The client's ABG results are pH 7.52, PoO2 89 mm hg, and HCO3- 24 mEq/L. Which of the following actions should the nurse take? a. Instruct the client to cough forcefully. b. Assist the client with ambulation. c. Provide calming interventions. d. Discontinue the PCA.: ANSW Provide calming interventions The client's respiratory rate is above the expected range.Calming the client shoulddecrease the respiratory rate, which will cause the client's carbon dioxide levels toincrease.This will help correct the pH imbalance. 3. A nurse is caring for a client who has a sodium level of 155 mEq/L.Which ofthe following IV fluids should the 3 / 10 nurse anticipate the provider to prescribe? a. Dextrose 5% in 0.9% sodium chloride b. Dextrose 5% in lactated Ringer's c. 3% sodium chloride d. 0.45% sodium chloride: 0.45% sodium chloride A sodium level of 155 mEq/L is an indication of hypernatremia. The nurse should anticipate a prescription for a hypotonic solution. The 0.45% sodium chloride is a hypotonic solution used to provide free water and treat cellular dehydration, whichpromotes waste elimination by the kidneys.Dextrose 5% in 0.9% sodium chloride is a hypertonic solution.The 3% sodium chloride is a hypertonic solution. LactatedRinger's solution contains sodium and other electrolytes and is not indicated for hypernatremia. 4 / 10 4. A nurse is evaluating a client who is receiving IV fluids to treat isotonic dehydration.Which of the following laboratory findingsindicatesthat the fluidtherapy has been effective? a. BUN 26 mg/dL b. Serum sodium 138 mEq/L c. Hct 56% d. Urine specific gravity 1.035: Serum sodium 142 mEq/L Isotonic dehydration includesloss of water and electrolytes due to a decrease in oralintake of water and salt. A serum sodium level of 142 mEq/L is within the expectedreference range and indicates that the fluid therapy has been effective.BUN is elevated. HCT is elevated and USG is elevated. 5. A nurse is providing dietary teaching to a client who has kidney disease. Which of the following food choices should the nurse include in the teachingas containing the lowest amount of magnesium? a. 1 large hard-boiled egg b. 1 cup bran cereal