Med Surg Exam 1 Questions and Answers Graded A

Med Surg Exam 1 Questions and Answers Graded A A 23-year old patient is found unresponsive with a respiratory rate of 6 per minute after a narcotic overdose. Which acid-base imbalance should the nurse anticipate? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis - ANS -D A diabetic patient is found unconscious at home and the family member calls the clinic. After determining that a glucometer is not available, what should the nurse advise the family to do? A. Have the patient drink 4 ounces of orange juice B. Administer 10u of regular insulin subcutaneously C. Administer glucagon 1mg intramuscularly or subcutaneously D. call for an ambulance to transport the patient to a medical facility - ANS -C A nurse is caring for a patient who has dysrhythmias. Which laboratory result would the nurse expect to see for this patient? A. Sodium 165 mEq/L B. Potassium 6.8 mEq/L C. Hematocrit 40% D. Glucose 60 mL/dL - ANS -B A nurse is planning care for a client with a fluid volume deficit. Which of the following are appropriate nursing actions? (Select all that apply) A. Administer a diuretic B. Turn the patient at least ever two hours C. infuse a hypertonic IV solution as ordered D. Teach the patient to sit on the side of bed first before standing E. Assess the patient's level of consciousness and mental status - ANS -B, D, E A patient develops acute renal failure. Which acid-base imbalance should the nurse anticipate? A. Respiratory alkalosis B. Respiratory acidosis C. Metabolic alkalosis D. Metabolic acidosis - ANS -D A patient with a fluid volume deficit is monitored for his fluid volume status with hourly measurements of his urine output. Which clinical finding should the nurse report to the primary care provider? A. Urine output of 30 mLs at 10am and 25 mLs at 11am B. Urine output of 100 mLs at 10am and 75 mLs at 11am C. Urine output of 45 mLs at 10 am and 60 mLs at 11am D. Urine output of 50 mLs at 10am and 100 mLs at 11am - ANS -A BUN - ANS -5-25 mg/dL Chronic complications of uncontrolled Type I and Type II DM includes: Select all that apply: a. happiness b. coronary artery disease c. stroke d. retinopathy e. nephropathy - ANS -B, C, D, E Creatinine - ANS -0.5-1.5 mg/dL Decreased serum osmolality is present in which type of fluid imbalance? A. Fluid volume excess B. Fluid volume deficit C. Both fluid volume excess and fluid volume deficit - ANS -A Glucose - ANS -70-100 mg/dL glycosylated hemoglobin - ANS -4.0-5.5% HCO3 - ANS -22-26 mEq/L Hct - ANS -Men: 40-54% Women: 36-46% Hgb - ANS -Men: 13.5-18 g/dL Women: 12-15 g/dL In determining if the patient is hypoglycemic, the nurse should assess for the following manifestations. Select all the apply: A. hunger B. Sweating C. Excessive urination D. Decreased level of consciousness E. Kussmaul's Respirations - ANS -A, B, D Increased thirst is a symptom of which disorders? Select all that apply A. Dehydration B. Cerebral edema C. Hypernatremia D. Hypophosphatemia E. Hypomagnesaemia - ANS -A, C INR - ANS -2.0-3.0 Jugular vein distention is present in which type of fluid imbalance? A. Fluid volume excess B. Fluid volume deficit C. Both fluid volume excess and fluid volume deficit - ANS -A Mr. Smith is a patient who has been admitted to a nursing unit with a diagnosis of heart failure resulting in fluid volume excess. Upon entering his room Mr. Smith complains of difficulty breathing. What should be the nurse's first action? A. Contact the primary care provider B. Assess his fluid status by obtaining a daily weight C. Elevate the head of bed and obtain an oxygen saturation level D. Administer a diuretic to help correct his diagnosis of a fluid volume excess - ANS -C PCO2 - ANS -35-45 mmHg pH - ANS -7.34-7.45 Platelets - ANS -150,000-350,000 mm3 PO2 - ANS -80-100 mmHg Potassium - ANS -3.4-5.3 mEq/L PT - ANS -11-13 seconds PTT/aPTT - ANS -60-70 seconds / 20-35 seconds SaO2 - ANS -95-99% Sodium - ANS -135-145 mEq/L Tachycardia is present in which type of fluid imbalance? A. Fluid volume excess B. Fluid volume deficit C. Both fluid volume excess and fluid volume deficit - ANS -C The home health nurse is caring for a patient with diabetes. Upon initial assessment, the patient's vital signs are blood pressure 142/90, pulse 84, respirations 22, and temperature 101F. Which finding should be of the most immediate concern to the nurse? a. blood pressure b. pulse c. respirations d. temperature - ANS -D The nurse is assessing a patient with chronic alcoholism for signs of hypocalcaemia. Which action should the nurse take to assess for Trouseeau's signs? A. inflate a blood pressure cuff on the upper arm above systolic pressure for 2 to 5 minutes B. Tap the facial nerve in front of the ear and observe for contraction of the facial muscles C. Monitor neurological function including mental status and level of consciousness D. Asses for numbness and tingling around the mouth and in the hands and feet - ANS -A The nurse is assigned to care for all of the following patients. Which patient is at risk for hypokalemia? (select all that apply) A. 64 year old with a diagnosis of kidney failure B. 35 year old with diarrhea and vomiting for the past 2 days C. 83 year old with a hypertension who uses salt substitutes D. 26 year old in a motor vehicle accident who received 3 units of blood E. 19 year old with a history of anorexia, laxative abuse, and diuretic use - ANS -B, E The nurse is caring for a patient in diabetic ketoacidosis who is being treated with intravenous Normal Saline and insulin. Which manifestation should the nurse immediately report to the primary care provider? a. headache b. muscle weakness c. polyuria d. thirst - ANS -B The nurse is caring for a patient who manifests muscle weakness that first began in the legs and has progressed to include weakness in the arms. Based on this information, what statement can be made about imbalances in potassium? A. These can be symptoms associated only with hypokalemia B. These can be symptoms associated only with hyperkalemia C. These symptoms are not related to imbalances in potassium D. These symptoms can occur in either hypokalemia or hyperkalemia - ANS -D The nurse is conducting a health history interview. Which symptoms should the nurse recognize as classic manifestations of Type 1 Diabetes Mellitus? A. obesity B. fatigue C. Excessive hunger D. excessive thirst E. Weight loss - ANS -B, C, D, E