Answers
1. A nurse is caring for an 80-year-old patient who is receiving bumetanide (a loop
diuretic) for hypertension. The nurse notes that the patient admits to taking bisacodyl
(Dulcolax) daily to stimulate her bowels. The nurse should assess the patient for
possible symptoms of
a. hypoglycemia.
b. hypoparathyroidism.
c. hypokalemia.
d. hypocalcemia. - ANSWER C.
Loop diuretics act on the loop of Henle to block reabsorption of sodium and potassium
and are considered potassium-wasting diuretics. Daily use of laxatives such as
bisacodyl can lead to increased potassium loss through stool.
A nurse is caring for an adult patient who has gastric suction following abdominal
surgery. The patient tells the nurse that he has tingling in his fingers and toes and is
feeling dizzy. Which acid-base imbalance is the patient most likely experiencing?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis - ANSWER D
In metabolic alkalosis, there is an excess of bicarbonate ions, which raises the pH
above 7.45 and produces bicarbonate levels greater than 26 mEq/L. This occurs as a
result of loss of gastric acids through vomiting or nasogastric suctioning, among other
causes. Clinical manifestations include numbness and tingling in the fingers and toes.
The usual composition of TPN begins with a high glucose solution (usually 25%
glucose) and an amino acid solution. Because of the high glucose content, patients with
TPN may develop hyperglycemia. Frequent monitoring of blood glucose can detect this
increase. TPN can be used when the patient is NPO but can also be used as a
supplement when oral intake is inadequate. Hourly outputs and frequent vital signs are
not required for TPN infusions.
At 0900, the nurse hangs an IV of 1000 mL D5LR to infuse at 125 mL/hr. What time will
the nurse need to hang a new bag of IV fluid? Provide your answer in military time:
_____ hours. - ANSWER ANS: 1700
1000mL/125mL = 8 hours. If the IV was hung at 0900, it will be infused 8 hours later,
which is 1700 or 5:00 PM.