Exam 2 - Advanced Med Surg Galen College of Nursing with 100% complete solutions

Advance Med-Surg Exam 2 Evolve review
Questions

A++ GRADED
200 QUESTIONS AND ANSWERS
EXPERT VERIFIED EXPLANATIONS

CONTENTS

1. Metabolicalkalosis Y
S




(Because gastric secretions are rich in HCl acid,the patient who is vomiting will lo
YS YS YS YS YS YS YS Y
S YS YS YS YS Y S YS




se a significant amount of gastric acid and be at an increased risk for metabolic a
YS YS YS YS YS YS YS YS YS YS YS YS YS Y S YS




kalosis.) <Ans> You are admitting a patient with complaints of abdominal pain, naus
YS Y S YS YS YS YS YS YS YS Y S YS YS




a, and vomiting. A proximal bowel obstruction is suspected. Which acid-
YS YS YS YS YS YS YS YS Y S YS




base imbalance do you anticipate in this patient?
YS YS YS YS YS YS YS




Metabolicacidosis Metaboli Y
S Y S




calkalosis Respiratoryacido
Y
S Y S Y
S





YS YS

,sis Respiratoryalkalosis
Y S Y
S




2. 3.1 mEq/L YS




(The normal range for serum potassium is 3.5 to 5.0 mEq/L.This IV order provi
YS YS YS YS YS YS YS YS YS YS Y
S YS YS Y S




des a substantial amount of potassium.Thus the patient's potassium level mus
YS YS YS YS YS Y
S YS YS YS Y S YS




t be low.The only low value shown is 3.1 mEq/L.) <Ans> Which serum potassiu
YS YS Y
S YS YS YS YS YS YS YS YS Y S Y S YS




m result best supports the rationale for administering a stat dose of IV potassium chlo
YS YS YS YS YS YS YS YS YS YS Y S YS YS YS




ride 20 mEq in 200 mL of normal saline over 2 hours?
YS YS YS YS YS YS YS YS YS YS YS




3.1 mEq/L YS




3.9 mEq/L YS




4.6 mEq/L YS




5.3 mEq/L YS





YS YS

,3.Sodium, 135 mEq/L;potassium, 4.5 mEq/L
Y
S Y
S YS Y
S Y
S YS




(The normal range for serum sodium is 135 to 145 mEq/L, and the normal range
YS YS YS YS YS YS YS YS YS YS YS YS YS Y S YS




for potassium is 3.5 to 5.0 mEq/L.The change in the IV order decreases the amou
YS YS YS YS YS YS Y
S YS YS YS YS YS YS Y S YS




nt of potassium and increases the amount of sodium.Therefore, for this order to
YS YS YS YS YS YS YS YS Y
S Y
S Y S YS YS YS




be appropriate, the potassium level must be near the high end andthe sodiumle
YS YS YS YS YS YS YS YS YS YS Y S Y
S Y
S Y
S




velnear the lowendoftheir respectiveranges.) <Ans> You receive a physician's o
Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S YS Y S Y S YS YS YS




rder to change a patient's IV from D5½ NS with 40 mEq KCl/L to D5NS with 20 mEq KC
YS YS YS YS YS YS YS YS YS YS YS Y S YS YS YS YS YS YS




l/L.Which serum laboratory values on this same patient best support the rationale for th
Y
S YS YS YS YS YS YS Y S YS YS YS YS YS YS




is IV order change?
YS YS YS




Sodium, 136 mEq/L;potassium, 3.6 mEq/L YS YS Y
S YS YS




Sodium, 145 mEq/L;potassium, 4.8 mEq/L YS YS Y
S YS YS




Sodium, 135 mEq/L;potassium, 4.5 mEq/L YS YS Y
S YS YS




Sodium, 144 mEq/L;potassium, 3.7 mEq/L YS YS Y
S YS YS




4. within normal limits YS YS




(The normal pH is 7.35 to 7.45. Normal PaCO2 levels are 35 to 45 mm Hg, and
YS YS YS YS YS YS YS YS YS YS YS YS YS YS YS YS





YS YS

, HCO3is22to26mEq/L.NormalPaO2is>80mmHg.Normaloxygensaturation
Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S




is >95%. Because the patient's results all fall within these normal ranges, the nur
YS YS YS YS YS YS YS YS YS YS YS YS Y S




se can conclude that the patient's blood gas results are within normal limits.) <A
YS YS YS YS YS YS YS YS YS YS YS Y S YS




ns> You are caring for a patient admitted with an exacerbation of asthma.After several t
Y S YS YS YS YS YS YS YS YS YS YS Y S Y
S YS YS




reatments, the ABG results are pH 7.40, PaCO2 40 mm Hg, HCO3 24 mEq/L, PaO2 92 YS YS YS YS YS YS YS YS YS YS Y S YS YS YS YS




mm Hg, and O2 saturation of 99%.You interpret these results as metabolic acidosis.
YS YS YS YS YS YS Y
S YS YS Y S YS YS YS




respiratory acidosis. Y S




Y S respiratory alkalosis YS




. within normal limits.
Y S YS YS




5. Partially compensated respiratoryacidosis Y
S Y
S Y
S




(A low pH (normal,7.35- YS YS YS Y
S




7.45) indicates acidosis.In a patient with respiratory disease such as COPD, th
YS YS Y
S YS YS YS YS Y S YS YS YS YS




e patient retains carbon dioxide (normal, 35-
YS YS YS YS YS YS




45 mm Hg), which acts as an acid in the body. For this reason, the patient has
Y S YS YS YS YS YS YS YS YS YS YS YS YS YS YS YS




respiratory acidosis.The elevated HCO3 indicates a partial compensation for the YS Y
S YS YS YS YS YS YS YS Y S




levatedCO2.) <Ans> Youarecaringforapatientadmittedwithadiagnosisof chronic obs
Y
S YS Y S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y
S Y S YS




ructive pulmonary disease (COPD) who has the following arterial blood gas results <An
YS YS YS YS YS YS YS YS YS Y S YS YS




s> pH 7.33, PaO2 47 mm Hg, PaCO2 60 mm Hg, HCO3 32 mEq/L, and O2 saturation
Y S YS YS YS YS YS YS YS YS YS YS YS YS Y S YS YS Y




YS 92%.What is the correct interpretation of these results?
Y
S YS YS YS YS YS YS YS




Fully compensated respiratory alkalosis Partiall
YS YS YS Y S




y compensated respiratory acidosis Normal aci
Y
S YS YS Y S YS




d-base balance with hypoxemia Normalacid- YS YS YS Y S Y
S




basebalancewithhypercapnia Y
S Y
S Y
S




6. Phosphorus falling to 2.1 mg/dL YS YS YS YS





YS YS