CMS FUNDAMENTALS
PROCTORED PRACTICE
EXAM QUESTIONS AND
ANSWERS GRADED A+
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,replace potassium* (hypokalemia) - ✔✔✔ Correct Answer > -
provide dietary education and encourage foods high in potassium
(avocados, dried fruit, cantaloupe, bananas, potatoes, spinach)
- provide oral potassium and supplementation
- IV potassium administration can be required; it should always be
diluted and administered slowly by intermittent infusion
- NEVER IV BOLUS (high risk of cardiac arrest)hyperkalemia (expected findings) -
✔✔✔ Correct Answer > V/S: slow, irregular pulse, hypotension
NEUROMUSCULOSKELETAL: irritability, confusion, weakness with
ascending flaccid paralysis, paresthesias, lack of reflexes
GI: increased motility, diarrhea, abdominal cramps, hyperactive bowel
sounds
hyperkalemia (nursing care) - ✔✔✔ Correct Answer > - implement
continuous ECG monitoring
- decrease potassium intake (stop infusion of IV potassium, withhold
oral potassium, provide a potassium-restricted diet)
- if potassium levels are extremely high, dialysis might be required
- administer IV fluids with dextrose and regular insulin as prescribed to
promote the movement of potassium from the ECF to the ICF
- monitor cardiac rhythm, and intervene promptly as needed
- maintain IV access
- prepare the client for dialysis if prescribed
- administer sodium polystyrene sulfonate as prescribed
,hypocalcemia (expected findings) - ✔✔✔ Correct Answer >
MUSCLE TWITCHES/TETANY: numbness and tingling (fingers and
around mouth)
- frequent, painful muscle spasms at rest that can progress to tetany
- hyperactive DTRs
- positive Chvostek's sign
, - positive Trousseau's sign
- laryngospasms
CARDIOVASCULAR: weak, thready pulse, tachycardia or bradycardia
- cardiac dysrhythmias: prolonged QT interval and ST segments
GI: hyperactive bowel sounds, diarrhea, abdominal cramping
CNS: seizures due to overstimulation of the CNS
hypocalcemia (nursing care) - ✔✔✔ Correct Answer > - administer
oral or IV calcium supplements and vitamin D supplements
- initiate seizure and fall precautions
- keep emergency equipment on standby
- encourage foods high in calcium, including dairy products and dark
green vegetables
hypercalcemia (expected findings) - ✔✔✔ Correct Answer >
NEUROMUSCULAR: decreased reflexes, bone pain
CARDIOVASCULAR: dysrhythmias (shortened QT and ST intervals),
increased risk for blood clot
GI: anorexia, nausea, vomiting, constipation
CNS: weakness, lethargy, confusion, decreased LOC, personality change
GU: hypercalciuria
PROCTORED PRACTICE
EXAM QUESTIONS AND
ANSWERS GRADED A+
[Document subtitle]
[DATE]
[COMPANY NAME]
[Company address]
,replace potassium* (hypokalemia) - ✔✔✔ Correct Answer > -
provide dietary education and encourage foods high in potassium
(avocados, dried fruit, cantaloupe, bananas, potatoes, spinach)
- provide oral potassium and supplementation
- IV potassium administration can be required; it should always be
diluted and administered slowly by intermittent infusion
- NEVER IV BOLUS (high risk of cardiac arrest)hyperkalemia (expected findings) -
✔✔✔ Correct Answer > V/S: slow, irregular pulse, hypotension
NEUROMUSCULOSKELETAL: irritability, confusion, weakness with
ascending flaccid paralysis, paresthesias, lack of reflexes
GI: increased motility, diarrhea, abdominal cramps, hyperactive bowel
sounds
hyperkalemia (nursing care) - ✔✔✔ Correct Answer > - implement
continuous ECG monitoring
- decrease potassium intake (stop infusion of IV potassium, withhold
oral potassium, provide a potassium-restricted diet)
- if potassium levels are extremely high, dialysis might be required
- administer IV fluids with dextrose and regular insulin as prescribed to
promote the movement of potassium from the ECF to the ICF
- monitor cardiac rhythm, and intervene promptly as needed
- maintain IV access
- prepare the client for dialysis if prescribed
- administer sodium polystyrene sulfonate as prescribed
,hypocalcemia (expected findings) - ✔✔✔ Correct Answer >
MUSCLE TWITCHES/TETANY: numbness and tingling (fingers and
around mouth)
- frequent, painful muscle spasms at rest that can progress to tetany
- hyperactive DTRs
- positive Chvostek's sign
, - positive Trousseau's sign
- laryngospasms
CARDIOVASCULAR: weak, thready pulse, tachycardia or bradycardia
- cardiac dysrhythmias: prolonged QT interval and ST segments
GI: hyperactive bowel sounds, diarrhea, abdominal cramping
CNS: seizures due to overstimulation of the CNS
hypocalcemia (nursing care) - ✔✔✔ Correct Answer > - administer
oral or IV calcium supplements and vitamin D supplements
- initiate seizure and fall precautions
- keep emergency equipment on standby
- encourage foods high in calcium, including dairy products and dark
green vegetables
hypercalcemia (expected findings) - ✔✔✔ Correct Answer >
NEUROMUSCULAR: decreased reflexes, bone pain
CARDIOVASCULAR: dysrhythmias (shortened QT and ST intervals),
increased risk for blood clot
GI: anorexia, nausea, vomiting, constipation
CNS: weakness, lethargy, confusion, decreased LOC, personality change
GU: hypercalciuria
