NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
Hypercalcemia causes - ans- excessive oral intake of calcium and Vitamin D
- kidney failure
- use of thiazide diuretics
Hypercalcemia s/s - ans- serum level higher than 10.5
- severe muscle weakness and decreased deep tendon reflexes
- confusion
- lethargy
- INCREASED HR & BP
- severe prolonged - electrical conduction depression
- cyanosis, pallor
- blood clots
Hypercalcemia treatment - ans- D/C thiazide diuretics and replace with diuretics that enhance excretion of
calcium (lasix/furosemide)
- administer IV fluids (0.9% NS)
- sodium increases kidney excretion of calcium
Hyperkaelmia treatment - ans- assess cardiac complications
- fall prevention
- Kayexalate
- hold oral potassium supplements
- potassium restricted diet
- tele montior
Hyperkalemia causes - ans- potassium-sparing diuretics
- salt substitutes
ACE inhibitors
- kidney failure
-rapid infusion of potassium containing IV solutions
Hyperkalemia s/s - ans- serum level greater than 5.0
- SLOW, WEAK, IRREGULAR HEART RATE
- decreased BP
- profound skeletal muscle weakness
- CARDIAC DYSRHYTHMIA - TALL PEAKED T WAVES AND WIDE QRS COMPLEXES
Hypermagnesemia causes - ans- increased magnesium-containing antacids and laxatives
- increased magnesium replacement
- decreased kidney excretion of magnesium due to kidney disease
hypermagnesemia s/s - ans- serum level greater than 2.5
- bradycardia
- respiratory depression
- peripheral vasodilation
- hypotension
- EKG changes
- lethargy
- decreased or absent deep tendon reflexes
Hypermagnesemia treatment - ans- goal is to reduce magnesium levels and correct the underlying
problem that caused the imbalance
Hypernatremia causes - ans- serum level greater than 145
,NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
- corticosteroids
- excessive intake of sodium
- kidney failure
- watery diarrhea
- excessive IV solution containing sodium
Hypernatremia s/s - ans- muscle twitches
- skeletal muscle weakness
- extreme thirst
- decreased urinary output
- presence or absence of edema (depending on fluid volume changes)
- decreased or absent deep tendon reflexes (late)
Hypernatremia treatment - ans- patient education regarding limiting daily sodium intake (processed foods,
bacon, ham, hot dogs, condiments, etc.)
Hypervolemia causes - ans- excessive fluid replacement
- heart failure
- kidney failure
- long-term corticosteroid therapy
Hypervolemia s/s - ans- fluid intake EXCEEDS the fluid needs of the body
- bounding/increased pulse rate
- shallow rapid respirations
- distended neck veins and hand veins
- moist crackles
- pitting edema in dependent areas
- shortness of breath
Hypervolemia treatment - ans- restore normal fluid balance - administer diuretics as ordered
- restrict fluid and sodium intake
- daily weights
- maintain skin integrity
- assess lung sounds
Hypocalcemia causes - ans- inadequate oral intake of calcium and Vitamin D
- kidney failure
- malabsorption syndrome (Chrohn's disease)
- lactose intolerance
- ESKD
Hypocalcemia s/s - ans- serum level below 9
- painful muscle spasms in calf/foot during rest or sleep
- positive Chvostek's and Trousseau's signs
- parethesias, tingling, numbness
- WEAK THREADY HEART RATE that may be slower or faster than normal
Hypocalcemia treatment - ans- oral or IV calcium supplements
- seizure precautions
- Vitamin D to help with the absorption of calcium from the GI tract
Hypokalemia causes - ans- Excessive use of diuretics, digitalis, corticosteroids
- diarrhea & vomiting
- kidney disease
, NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
- wound drainage
- prolonged gastric suctioning
Hypokalemia s/s - ans- serum level less than 3.5
- THREADY, WEAK, IRREGULAR PULSE
- orthostatic hypotension
- lethargy
- skeletal muscle weakness
- CARDIAC DYSRHYTHMIAS
Hypokalemia treatment - ans- increase serum potassium levels - oral of IV potassium
- NEVER GIVE VIA IV PUSH
- hold diuretics
- fall prevention
- use potassium-sparing diuretics if NEEDED
Hypomagnesemia causes - ans- malnutrition
- diarrhea
- Crohn's disease
- ethanol ingestion
- diuretics
Hypomagnesemia s/s - ans- serum level less than 1.5
- anorexia
- nausea
- positive Chvostek's and Trousseau's sign
- tetany
- seizures
Hypomagnesemia treatment - ans- seizure precautions
- instruct patient to increase intake of magnesium-rich foods (avocados, milk, peanut butter, raisins)
- Administer magnesium sulfate
Hyponatremia causes - ans- excessive diaphoresis
- wound drainage
- low-salt diet
- NPO status
Hyponatremia s/s - ans- serum level less than 135
- confusion
- personality changes
- generalized skeletal muscle weakness
- rapid weak thready pulse
- orthostatic hypotension
- increased GI motility
Hyponatremia treatment - ans- restore serum sodium levels and monitor for signs for fluid overload
- severe hyponatremia can be treated with hypertonic saline (3% saline solution) in small amounts
- prevent falls due to decreased blood pressure
- increase oral sodium intake and restrict oral fluid intake
Hypovolemia (dehydration) s/s - ans- INCREASED AND THREADY PULSE RATE
- dyspnea
- orthostatic hypotension
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
Hypercalcemia causes - ans- excessive oral intake of calcium and Vitamin D
- kidney failure
- use of thiazide diuretics
Hypercalcemia s/s - ans- serum level higher than 10.5
- severe muscle weakness and decreased deep tendon reflexes
- confusion
- lethargy
- INCREASED HR & BP
- severe prolonged - electrical conduction depression
- cyanosis, pallor
- blood clots
Hypercalcemia treatment - ans- D/C thiazide diuretics and replace with diuretics that enhance excretion of
calcium (lasix/furosemide)
- administer IV fluids (0.9% NS)
- sodium increases kidney excretion of calcium
Hyperkaelmia treatment - ans- assess cardiac complications
- fall prevention
- Kayexalate
- hold oral potassium supplements
- potassium restricted diet
- tele montior
Hyperkalemia causes - ans- potassium-sparing diuretics
- salt substitutes
ACE inhibitors
- kidney failure
-rapid infusion of potassium containing IV solutions
Hyperkalemia s/s - ans- serum level greater than 5.0
- SLOW, WEAK, IRREGULAR HEART RATE
- decreased BP
- profound skeletal muscle weakness
- CARDIAC DYSRHYTHMIA - TALL PEAKED T WAVES AND WIDE QRS COMPLEXES
Hypermagnesemia causes - ans- increased magnesium-containing antacids and laxatives
- increased magnesium replacement
- decreased kidney excretion of magnesium due to kidney disease
hypermagnesemia s/s - ans- serum level greater than 2.5
- bradycardia
- respiratory depression
- peripheral vasodilation
- hypotension
- EKG changes
- lethargy
- decreased or absent deep tendon reflexes
Hypermagnesemia treatment - ans- goal is to reduce magnesium levels and correct the underlying
problem that caused the imbalance
Hypernatremia causes - ans- serum level greater than 145
,NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
- corticosteroids
- excessive intake of sodium
- kidney failure
- watery diarrhea
- excessive IV solution containing sodium
Hypernatremia s/s - ans- muscle twitches
- skeletal muscle weakness
- extreme thirst
- decreased urinary output
- presence or absence of edema (depending on fluid volume changes)
- decreased or absent deep tendon reflexes (late)
Hypernatremia treatment - ans- patient education regarding limiting daily sodium intake (processed foods,
bacon, ham, hot dogs, condiments, etc.)
Hypervolemia causes - ans- excessive fluid replacement
- heart failure
- kidney failure
- long-term corticosteroid therapy
Hypervolemia s/s - ans- fluid intake EXCEEDS the fluid needs of the body
- bounding/increased pulse rate
- shallow rapid respirations
- distended neck veins and hand veins
- moist crackles
- pitting edema in dependent areas
- shortness of breath
Hypervolemia treatment - ans- restore normal fluid balance - administer diuretics as ordered
- restrict fluid and sodium intake
- daily weights
- maintain skin integrity
- assess lung sounds
Hypocalcemia causes - ans- inadequate oral intake of calcium and Vitamin D
- kidney failure
- malabsorption syndrome (Chrohn's disease)
- lactose intolerance
- ESKD
Hypocalcemia s/s - ans- serum level below 9
- painful muscle spasms in calf/foot during rest or sleep
- positive Chvostek's and Trousseau's signs
- parethesias, tingling, numbness
- WEAK THREADY HEART RATE that may be slower or faster than normal
Hypocalcemia treatment - ans- oral or IV calcium supplements
- seizure precautions
- Vitamin D to help with the absorption of calcium from the GI tract
Hypokalemia causes - ans- Excessive use of diuretics, digitalis, corticosteroids
- diarrhea & vomiting
- kidney disease
, NUR 242 MED SURG EXAM 3 LATEST ACTUAL EXAM 180 QUESTIONS
AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY
GRADED A+||GALEN COLLEGE OF NURSING
- wound drainage
- prolonged gastric suctioning
Hypokalemia s/s - ans- serum level less than 3.5
- THREADY, WEAK, IRREGULAR PULSE
- orthostatic hypotension
- lethargy
- skeletal muscle weakness
- CARDIAC DYSRHYTHMIAS
Hypokalemia treatment - ans- increase serum potassium levels - oral of IV potassium
- NEVER GIVE VIA IV PUSH
- hold diuretics
- fall prevention
- use potassium-sparing diuretics if NEEDED
Hypomagnesemia causes - ans- malnutrition
- diarrhea
- Crohn's disease
- ethanol ingestion
- diuretics
Hypomagnesemia s/s - ans- serum level less than 1.5
- anorexia
- nausea
- positive Chvostek's and Trousseau's sign
- tetany
- seizures
Hypomagnesemia treatment - ans- seizure precautions
- instruct patient to increase intake of magnesium-rich foods (avocados, milk, peanut butter, raisins)
- Administer magnesium sulfate
Hyponatremia causes - ans- excessive diaphoresis
- wound drainage
- low-salt diet
- NPO status
Hyponatremia s/s - ans- serum level less than 135
- confusion
- personality changes
- generalized skeletal muscle weakness
- rapid weak thready pulse
- orthostatic hypotension
- increased GI motility
Hyponatremia treatment - ans- restore serum sodium levels and monitor for signs for fluid overload
- severe hyponatremia can be treated with hypertonic saline (3% saline solution) in small amounts
- prevent falls due to decreased blood pressure
- increase oral sodium intake and restrict oral fluid intake
Hypovolemia (dehydration) s/s - ans- INCREASED AND THREADY PULSE RATE
- dyspnea
- orthostatic hypotension
