NUR 325 – Exam 3 | Comprehensive Nursing Review of Endocrine, Renal, and
Fluid/Electrolyte Disorders – Question & Answers
A nures is caring for an older adult clients who has COPD with pneumonia. The nurse should
monitor the client for which of the following acid-base imbalances?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis B (Respiratory acidosis is a common complication of COPD. This
complication occurs because clients who have COPD are unable to exhale carbon dioxide due to
a loss of elastic recoil in the lungs.)
A nurse is providing instructions about pursed-lip breathing for a client who has COPD with
emphysema. The nurse should explain that this breathing technique accomplishes which of the
following?
a. Increases oxygen intake
b. Promotes CO2 elimination
c. Uses intercostal muscles
d. Strengthens the diaphragm B (The client who has COPD with emphysema should use
pursed-lip breathing when experiencing dyspnea. This is one of the simplest ways to control
dyspnea. It slows the client's pace of breathing, making each breath more effective. Pursed-lip
breathing releases trapped air in the lungs and prolongs exhalation to slow the breathing rate.
This improved breathing pattern moves CO2 out of the lungs more efficiently.)
A nurse on a medical-surgical unit is caring for a client who is postoperative following a hip
replacement surgery. The client reports feeling apprehensive and restless. which of the
following findings should the nurse recognize as an indication of pulmonary embolism?
a. Sudden onset of dyspnea
b. Tracheal deviation
,c. Bradycardia
d. Difficulty swallowing A (Dyspnea occurs due to reduced blood flow to the lungs.
Tachycardia is a clinical manifestation of pulmonary embolism.)
A nurse is planning care for a client who has COPD and is malnourished. Which of the following
recommendations to promote nutritional intake should the nurse include in the plan?
a. Eat high calorie foods first.
b. Increase intake of water at meal times
c. Perform ative ROM exercises before meals
d. Keep saltine crackers nearby for snacking A (A client who has COPD often experiences
early satiety. Therefore, the client should eat calorie-dense foods first. The client should limit
intake of water at mealtimes to reduce the felling of early satiety. The client should rest before
meals to decrease dyspnea while eating. The client should keep foods on hand for snacking, but
should avoid dry and salty foods, which can place the client at risk for aspiration and make the
client's mouth dry.)
A nures in a clinic is assessing the lower extremities and ankles of a client who has a history of
PAD. Which of the following findings should the nurse expect?
a. Pitting edema
b. Areas of reddish-brown pigmentation
c. Dry, pale skin with minimal body hair
d. Sunburned appearance with desquamation C (Venous insufficiency causes edema. A
client who has venous insufficiency can display areas of reddish-brown pigmentation because
the valves of the veins are damaged from venous hypertension. A client who has PAD can
display dry, scaly, pale or mottled skin with minimal body hair.)
A nurse is providing discharge teaching to a client who has experience diabetic ketoacidosis.
Which of the following information should the nurse include in the teaching? (Select all that
apply.)
,a. Drink 2 L of fluids daily
b. Monitor BG every 4 hour when ill
c. Administer insulin as prescribed when ill
d. Notify the provider when BG is 200 mg/dL
e. Report ketones in the urine after 24 hr of illness A B C E (Drinking 2 L of fluids daily can
prevent dehydration. BG tends to increase during illness, BG should be monitored every 4 hr.
The provider should be notifies if there are ketones in the urine after 24 hr of illness.)
The nurse determines that the patient is not experiencing adverse effects of albuterol
(Proventil) after noting which patient vital sign?
a. Temperature of 98.4°F
b. Oxygen saturation 96%
c. Pulse rate of 72 beats/min
d. Respiratory rate of 18/ breaths/min C
The nurse determines that a patient is experiencing common adverse effects from the inhaled
corticosteroid beclomethasone after what occurs?
a. Hypertension and pulmonary edema
b. Oropharyngeal candidiasis and hoarseness
c. Elevation of blood glucose and calcium levels
d. Adrenocortical dysfunction and hyperglycemia B (Oropharyngeal candidiasis and
hoarseness are common adverse effects from the use of inhaled corticosteroids because the
medication can lead to overgrowth of organisms and local irritation if the patient does not rinse
the mouth following each dose.)
, The nurse is evaluating if a patient understands how to safely determine whether a metered-
dose inhaler (MDI) is empty. The nurse interprets that the patient understands this important
information to prevent medication underdosing when the patient describes which method to
check the inhaler?
a. Place it in water to see if it floats.
b. Keep track of the number of inhalations used.
c. Shake the canister while holding it next to the ear.
d. Check the indicator line on the side of the canister. B (It is no longer appropriate to see if
a canister floats in water or not because this is not an accurate way to determine the remaining
inhaler doses. The best method to determine when to replace an inhaler is by knowing the
maximum puffs available per MDI and then replacing it after the number of days when those
inhalations have been used (100 puffs/2 puffs each day = 50 days).)
The nurse evaluates that nursing interventions to promote airway clearance in a patient
admitted with chronic obstructive pulmonary disease (COPD) are successful based on which
finding?
a. Absence of dyspnea
b. Improved mental status
c. Effective and productive coughing
d. PaO2 within normal range for the patient C (Airway clearance is most directly evaluated
as successful if the patient can engage in effective and productive coughing. Absence of
dyspnea, improved mental status, and PaO2 within normal range for the patient show
improved respiratory status but do not evaluate airway clearance.)
When caring for a patient with chronic obstructive pulmonary disease (COPD), the nurse
identifies a nursing diagnosis of imbalanced nutrition: less than body requirements after noting
a weight loss of 30 lb. Which intervention should the nurse add to the plan of care for this
patient?
a. Order fruits and fruit juices to be offered between meals.
Fluid/Electrolyte Disorders – Question & Answers
A nures is caring for an older adult clients who has COPD with pneumonia. The nurse should
monitor the client for which of the following acid-base imbalances?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis B (Respiratory acidosis is a common complication of COPD. This
complication occurs because clients who have COPD are unable to exhale carbon dioxide due to
a loss of elastic recoil in the lungs.)
A nurse is providing instructions about pursed-lip breathing for a client who has COPD with
emphysema. The nurse should explain that this breathing technique accomplishes which of the
following?
a. Increases oxygen intake
b. Promotes CO2 elimination
c. Uses intercostal muscles
d. Strengthens the diaphragm B (The client who has COPD with emphysema should use
pursed-lip breathing when experiencing dyspnea. This is one of the simplest ways to control
dyspnea. It slows the client's pace of breathing, making each breath more effective. Pursed-lip
breathing releases trapped air in the lungs and prolongs exhalation to slow the breathing rate.
This improved breathing pattern moves CO2 out of the lungs more efficiently.)
A nurse on a medical-surgical unit is caring for a client who is postoperative following a hip
replacement surgery. The client reports feeling apprehensive and restless. which of the
following findings should the nurse recognize as an indication of pulmonary embolism?
a. Sudden onset of dyspnea
b. Tracheal deviation
,c. Bradycardia
d. Difficulty swallowing A (Dyspnea occurs due to reduced blood flow to the lungs.
Tachycardia is a clinical manifestation of pulmonary embolism.)
A nurse is planning care for a client who has COPD and is malnourished. Which of the following
recommendations to promote nutritional intake should the nurse include in the plan?
a. Eat high calorie foods first.
b. Increase intake of water at meal times
c. Perform ative ROM exercises before meals
d. Keep saltine crackers nearby for snacking A (A client who has COPD often experiences
early satiety. Therefore, the client should eat calorie-dense foods first. The client should limit
intake of water at mealtimes to reduce the felling of early satiety. The client should rest before
meals to decrease dyspnea while eating. The client should keep foods on hand for snacking, but
should avoid dry and salty foods, which can place the client at risk for aspiration and make the
client's mouth dry.)
A nures in a clinic is assessing the lower extremities and ankles of a client who has a history of
PAD. Which of the following findings should the nurse expect?
a. Pitting edema
b. Areas of reddish-brown pigmentation
c. Dry, pale skin with minimal body hair
d. Sunburned appearance with desquamation C (Venous insufficiency causes edema. A
client who has venous insufficiency can display areas of reddish-brown pigmentation because
the valves of the veins are damaged from venous hypertension. A client who has PAD can
display dry, scaly, pale or mottled skin with minimal body hair.)
A nurse is providing discharge teaching to a client who has experience diabetic ketoacidosis.
Which of the following information should the nurse include in the teaching? (Select all that
apply.)
,a. Drink 2 L of fluids daily
b. Monitor BG every 4 hour when ill
c. Administer insulin as prescribed when ill
d. Notify the provider when BG is 200 mg/dL
e. Report ketones in the urine after 24 hr of illness A B C E (Drinking 2 L of fluids daily can
prevent dehydration. BG tends to increase during illness, BG should be monitored every 4 hr.
The provider should be notifies if there are ketones in the urine after 24 hr of illness.)
The nurse determines that the patient is not experiencing adverse effects of albuterol
(Proventil) after noting which patient vital sign?
a. Temperature of 98.4°F
b. Oxygen saturation 96%
c. Pulse rate of 72 beats/min
d. Respiratory rate of 18/ breaths/min C
The nurse determines that a patient is experiencing common adverse effects from the inhaled
corticosteroid beclomethasone after what occurs?
a. Hypertension and pulmonary edema
b. Oropharyngeal candidiasis and hoarseness
c. Elevation of blood glucose and calcium levels
d. Adrenocortical dysfunction and hyperglycemia B (Oropharyngeal candidiasis and
hoarseness are common adverse effects from the use of inhaled corticosteroids because the
medication can lead to overgrowth of organisms and local irritation if the patient does not rinse
the mouth following each dose.)
, The nurse is evaluating if a patient understands how to safely determine whether a metered-
dose inhaler (MDI) is empty. The nurse interprets that the patient understands this important
information to prevent medication underdosing when the patient describes which method to
check the inhaler?
a. Place it in water to see if it floats.
b. Keep track of the number of inhalations used.
c. Shake the canister while holding it next to the ear.
d. Check the indicator line on the side of the canister. B (It is no longer appropriate to see if
a canister floats in water or not because this is not an accurate way to determine the remaining
inhaler doses. The best method to determine when to replace an inhaler is by knowing the
maximum puffs available per MDI and then replacing it after the number of days when those
inhalations have been used (100 puffs/2 puffs each day = 50 days).)
The nurse evaluates that nursing interventions to promote airway clearance in a patient
admitted with chronic obstructive pulmonary disease (COPD) are successful based on which
finding?
a. Absence of dyspnea
b. Improved mental status
c. Effective and productive coughing
d. PaO2 within normal range for the patient C (Airway clearance is most directly evaluated
as successful if the patient can engage in effective and productive coughing. Absence of
dyspnea, improved mental status, and PaO2 within normal range for the patient show
improved respiratory status but do not evaluate airway clearance.)
When caring for a patient with chronic obstructive pulmonary disease (COPD), the nurse
identifies a nursing diagnosis of imbalanced nutrition: less than body requirements after noting
a weight loss of 30 lb. Which intervention should the nurse add to the plan of care for this
patient?
a. Order fruits and fruit juices to be offered between meals.
