Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
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1. For which conditions would the nurse include plan of care interventions
related to the potential development of hypophosphatemia? Select all that
apply.
1
Renal failure
2
Respiratory alkalosis
3
Diabetic ketoacidosis
4
Tumor lysis syndrome
5
Malabsorption syndrome: 2 respiratory alkalosis
3 diabetic ketoacidosis
5 malabsorption syndrome
The nurse would include interventions to address hypophosphatemia when providing care to patients with respiratory
alkalosis, diabetic ketoacidosis, and malabsorption syndrome. The nurse should create a care plan for hyperphos-
phatemia when providing care to patients with renal failure and tumor lysis syndrome.
2. Which patient disorder has a potential complication of developing increased
extracellular fluids?
1 Osmotic diuresis
2
Renal impairment
3
Intestinal obstruction
4
Drainage from a rectal fistula: 2 renal impairment
Extracellular fluid accounts for one third of total body fluids, which consist of interstitial fluid, plasma, and transcellular
fluid. The extracellular fluid may become excessive when the elimination of water is impaired, especially during kidney
failure. Conditions such as fistula drainage, osmotic diuresis, and intestinal obstruction result in a loss of body fluid.
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
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3. Which clinical manifestations would the nurse observe when assessing car-
diovascular changes in a patient suspected of having a medical diagnosis of
fluid volume excess? Select all that apply.
1
Full, bounding pulse
2
Distended neck veins
3
Orthostatic hypotension
4
Increase in the heart rate
5
Presence of an S3 heart sound: 1, 2, 5
Fluid volume excess results in a full, bounding pulse; presence of an S3 heart sound; and jugular venous distention
(distended neck veins). Orthostatic hypotension and an increased heart rate are clinical manifestations of deficient, not
excess, fluid volume.
4. The patient presents with a one-time prescription for potassium chloride 20
mEq in 250 mL of normal saline IV, to be given immediately. Upon reviewing
a more recent potassium level, which result would trigger the nurse to seek
clarification of the patient's prescription?
1
1.7 mEq/L
2
2.9 mEq/L
3
3.6 mEq/L
4
4.5 mEq/L: 4
The normal range for serum potassium is 3.5 to 5 mEq/L. The IV prescription provides a substantial amount of
potassium, so the patient's potassium level must be low. A level of 4.5 mEq/L would not warrant this medication.
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
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5. Which medical diagnosis would cause the nurse to include nursing interven-
tions appropriate for hyponatremia in the plan of care?
1
Diabetes insipidus
2
Cushing syndrome
3
Congestive heart failure
4
Uncontrolled diabetes mellitus: 3
Congestive heart failure increases the patient's risk for developing hyponatremia due to inefficient pumping of excessive
fluids; therefore this diagnosis would cause the nurse to include interventions specific to hyponatremia in the plan
of care. Diabetes insipidus, Cushing syndrome, and uncontrolled diabetes mellitus increase the patient's risk for
hypernatremia, not hyponatremia.
6. To prevent a recurrence of hypocalcemia, the nurse would encourage the
patient to increase intake of which foods?
1
Fish
2
Lean meat
3
Dairy products
4
Potatoes and starches: 3
7. Which syndrome would the nurse suspect when a patient has a potassium
level of 6.2 mEq/dL?
1
Cushing syndrome
2
Milk-alkali syndrome
3
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
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Tumor lysis syndrome
4
Malabsorption syndrome: 3
Tumor lysis syndrome causes movement of potassium from the intracellular fluid (ICF) to the extracellular fluid
(ECF), resulting in hyperkalemia. Cushing syndrome may cause hypernatremia. Milk-alkali syndrome may cause
hypermagnesemia or hypercalcemia and occurs when ingesting an increased amount of antacids, Maalox, or Milk of
Magnesia; the electrolytes are affected; and the patient develops metabolic alkalosis. Malabsorption syndrome may
cause hypophosphatemia.
8. The morning laboratory results of a patient admitted with heart failure reveal
a serum potassium level of 2.9 mEq/L. Which classification of medications
would be withheld until consulting with the health care provider?
1
Antibiotics
2
Loop diuretics
3
Bronchodilators
4
Antihypertensives: 2
Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the kidneys
to excrete sodium and potassium. Thus administration of this type of medication at this time would worsen the
hypokalemia, putting the patient at risk for dysrhythmias. The prescribing health care provider should be consulted for
potassium replacement therapy, and the drug should be withheld until the potassium has returned to normal range.
Antibiotics, bronchodilators, and antihypertensives are not an issue in this case.
9. In the regulation of water balance, which system's primary effect is antiin-
flammatory and increases serum glucose levels?
1
Renal
2
Cardiac
3
Study online at https://quizlet.com/_h77857
1. For which conditions would the nurse include plan of care interventions
related to the potential development of hypophosphatemia? Select all that
apply.
1
Renal failure
2
Respiratory alkalosis
3
Diabetic ketoacidosis
4
Tumor lysis syndrome
5
Malabsorption syndrome: 2 respiratory alkalosis
3 diabetic ketoacidosis
5 malabsorption syndrome
The nurse would include interventions to address hypophosphatemia when providing care to patients with respiratory
alkalosis, diabetic ketoacidosis, and malabsorption syndrome. The nurse should create a care plan for hyperphos-
phatemia when providing care to patients with renal failure and tumor lysis syndrome.
2. Which patient disorder has a potential complication of developing increased
extracellular fluids?
1 Osmotic diuresis
2
Renal impairment
3
Intestinal obstruction
4
Drainage from a rectal fistula: 2 renal impairment
Extracellular fluid accounts for one third of total body fluids, which consist of interstitial fluid, plasma, and transcellular
fluid. The extracellular fluid may become excessive when the elimination of water is impaired, especially during kidney
failure. Conditions such as fistula drainage, osmotic diuresis, and intestinal obstruction result in a loss of body fluid.
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
Study online at https://quizlet.com/_h77857
3. Which clinical manifestations would the nurse observe when assessing car-
diovascular changes in a patient suspected of having a medical diagnosis of
fluid volume excess? Select all that apply.
1
Full, bounding pulse
2
Distended neck veins
3
Orthostatic hypotension
4
Increase in the heart rate
5
Presence of an S3 heart sound: 1, 2, 5
Fluid volume excess results in a full, bounding pulse; presence of an S3 heart sound; and jugular venous distention
(distended neck veins). Orthostatic hypotension and an increased heart rate are clinical manifestations of deficient, not
excess, fluid volume.
4. The patient presents with a one-time prescription for potassium chloride 20
mEq in 250 mL of normal saline IV, to be given immediately. Upon reviewing
a more recent potassium level, which result would trigger the nurse to seek
clarification of the patient's prescription?
1
1.7 mEq/L
2
2.9 mEq/L
3
3.6 mEq/L
4
4.5 mEq/L: 4
The normal range for serum potassium is 3.5 to 5 mEq/L. The IV prescription provides a substantial amount of
potassium, so the patient's potassium level must be low. A level of 4.5 mEq/L would not warrant this medication.
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
Study online at https://quizlet.com/_h77857
5. Which medical diagnosis would cause the nurse to include nursing interven-
tions appropriate for hyponatremia in the plan of care?
1
Diabetes insipidus
2
Cushing syndrome
3
Congestive heart failure
4
Uncontrolled diabetes mellitus: 3
Congestive heart failure increases the patient's risk for developing hyponatremia due to inefficient pumping of excessive
fluids; therefore this diagnosis would cause the nurse to include interventions specific to hyponatremia in the plan
of care. Diabetes insipidus, Cushing syndrome, and uncontrolled diabetes mellitus increase the patient's risk for
hypernatremia, not hyponatremia.
6. To prevent a recurrence of hypocalcemia, the nurse would encourage the
patient to increase intake of which foods?
1
Fish
2
Lean meat
3
Dairy products
4
Potatoes and starches: 3
7. Which syndrome would the nurse suspect when a patient has a potassium
level of 6.2 mEq/dL?
1
Cushing syndrome
2
Milk-alkali syndrome
3
, Med Surg Exam 1, Med Surg Exam 3, Med Surg 1 (Exam 2), MedSurg 4
Study online at https://quizlet.com/_h77857
Tumor lysis syndrome
4
Malabsorption syndrome: 3
Tumor lysis syndrome causes movement of potassium from the intracellular fluid (ICF) to the extracellular fluid
(ECF), resulting in hyperkalemia. Cushing syndrome may cause hypernatremia. Milk-alkali syndrome may cause
hypermagnesemia or hypercalcemia and occurs when ingesting an increased amount of antacids, Maalox, or Milk of
Magnesia; the electrolytes are affected; and the patient develops metabolic alkalosis. Malabsorption syndrome may
cause hypophosphatemia.
8. The morning laboratory results of a patient admitted with heart failure reveal
a serum potassium level of 2.9 mEq/L. Which classification of medications
would be withheld until consulting with the health care provider?
1
Antibiotics
2
Loop diuretics
3
Bronchodilators
4
Antihypertensives: 2
Loop diuretics are contraindicated during episodes of hypokalemia because these medications cause the kidneys
to excrete sodium and potassium. Thus administration of this type of medication at this time would worsen the
hypokalemia, putting the patient at risk for dysrhythmias. The prescribing health care provider should be consulted for
potassium replacement therapy, and the drug should be withheld until the potassium has returned to normal range.
Antibiotics, bronchodilators, and antihypertensives are not an issue in this case.
9. In the regulation of water balance, which system's primary effect is antiin-
flammatory and increases serum glucose levels?
1
Renal
2
Cardiac
3
