NUR401 Midterm Exam Questions with
Answers
A client is prone to hyponatremia. Which factors should the nurse identify that can precipitate
hyponatremia? Select all that apply.
Wound drainage
Diuretic therapy
Gastrointestinal (GI) suction
Parenteral infusion of 0.9% sodium chloride
Inappropriate anti-diuretic hormone (ADH) secretion - ✔✔Wound Drainage
Diuretic Therapy
GI Suction
Inappropriate Anti-Diuretic Hormone Secretion
Rationale:
Wound drainage can result in hyponatremia from loss of sodium ions. Most diuretics interfere
with sodium reabsorption in the nephrons and have the side effect of hyponatremia.
Gastrointestinal fluids are rich in sodium ions, which are lost by GI suction. With the syndrome
of inappropriate anti-diuretic hormone (SIADH), high levels of the anti-diuretic hormone (ADH)
are produced, causing the body to retain water instead of excreting it normally in the urine.
Parenteral infusion of 0.9% sodium chloride, an isotonic solution, should be compatible with
body fluids; if given in excess, it may lead to hypernatremia.
The nurse is assessing the respiratory status of the client at 2-hour intervals as a nursing safety
priority. Which condition is affecting the client?
, Hypokalemia
Hyperkalemia
Hyponatremia
Hypernatremia - ✔✔Hypokalemia
Rationale:
In case of hypokalemia, the nurse should assess the respiratory status of the client every 2
hours. In case of hyperkalemia, the nurse should notify the healthcare team if the heart rate
falls below 60 beats per minute or T waves become spiked. In case of hyponatremia, the nurse
should be aware of muscle weakness in the client and immediately check respiratory
effectiveness. In case of hypernatremia, the nurse should assess the client hourly for excessive
losses of fluid, sodium, or potassium.
The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia
often complicate renal failure?
1. Increase in blood pressure
2. Decrease in erythropoietin
3. Increase in serum phosphate levels
4. Decrease in serum sodium concentration - ✔✔2. Decrease in erythropoietin
Rationale:
The hormone erythropoietin, produced by the kidneys, stimulates the bone marrow to produce
red blood cells. In renal failure there is a deficiency of erythropoietin that often results in the
client developing anemia. Therefore the nurse is instructed to administer blood. In renal failure,
increased blood pressure is due to impairment of renal vasodilator factors and is not treated by
administration of blood. Phosphate is retained in the body during renal failure, causing binding
of calcium leading to done demineralization, not anemia. Increase in urinary sodium
Answers
A client is prone to hyponatremia. Which factors should the nurse identify that can precipitate
hyponatremia? Select all that apply.
Wound drainage
Diuretic therapy
Gastrointestinal (GI) suction
Parenteral infusion of 0.9% sodium chloride
Inappropriate anti-diuretic hormone (ADH) secretion - ✔✔Wound Drainage
Diuretic Therapy
GI Suction
Inappropriate Anti-Diuretic Hormone Secretion
Rationale:
Wound drainage can result in hyponatremia from loss of sodium ions. Most diuretics interfere
with sodium reabsorption in the nephrons and have the side effect of hyponatremia.
Gastrointestinal fluids are rich in sodium ions, which are lost by GI suction. With the syndrome
of inappropriate anti-diuretic hormone (SIADH), high levels of the anti-diuretic hormone (ADH)
are produced, causing the body to retain water instead of excreting it normally in the urine.
Parenteral infusion of 0.9% sodium chloride, an isotonic solution, should be compatible with
body fluids; if given in excess, it may lead to hypernatremia.
The nurse is assessing the respiratory status of the client at 2-hour intervals as a nursing safety
priority. Which condition is affecting the client?
, Hypokalemia
Hyperkalemia
Hyponatremia
Hypernatremia - ✔✔Hypokalemia
Rationale:
In case of hypokalemia, the nurse should assess the respiratory status of the client every 2
hours. In case of hyperkalemia, the nurse should notify the healthcare team if the heart rate
falls below 60 beats per minute or T waves become spiked. In case of hyponatremia, the nurse
should be aware of muscle weakness in the client and immediately check respiratory
effectiveness. In case of hypernatremia, the nurse should assess the client hourly for excessive
losses of fluid, sodium, or potassium.
The nurse is preparing a blood transfusion for a client with renal failure. Why does anemia
often complicate renal failure?
1. Increase in blood pressure
2. Decrease in erythropoietin
3. Increase in serum phosphate levels
4. Decrease in serum sodium concentration - ✔✔2. Decrease in erythropoietin
Rationale:
The hormone erythropoietin, produced by the kidneys, stimulates the bone marrow to produce
red blood cells. In renal failure there is a deficiency of erythropoietin that often results in the
client developing anemia. Therefore the nurse is instructed to administer blood. In renal failure,
increased blood pressure is due to impairment of renal vasodilator factors and is not treated by
administration of blood. Phosphate is retained in the body during renal failure, causing binding
of calcium leading to done demineralization, not anemia. Increase in urinary sodium
