NR 324 Exam 1 Practice Questions with
|\ |\ |\ |\ |\ |\ |\
ANSWERS
The nurse is caring for a client with a nasogastric tube that is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
attached to low suction. The nurse monitors the client for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
manifestations of which disorder that the client is at risk for? |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Metabolic acidosis
|\ |\
B. Metabolic alkalosis
|\ |\
C. Respiratory acidosis
|\ |\
D. Respiratory alkalosis - CORRECT ANSWERS ✔✔B. Metabolic
|\ |\ |\ |\ |\ |\ |\ |\
alkalosis
Rationale:
>Metabolic alkalosis is defined as a deficit or loss of hydrogen
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ions or acids or an excess of base (bicarbonate) that results from
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the accumulation of base or from a loss of acid without a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
comparable loss of base in the body fluids. |\ |\ |\ |\ |\ |\ |\
>This occurs in conditions resulting in hypovolemia, the loss of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
gastric fluid, excessive bicarbonate intake, the massive
|\ |\ |\ |\ |\ |\ |\
transfusion of whole blood, and hyperaldosteronism.
|\ |\ |\ |\ |\
>Loss of gastric fluid via nasogastric suction or vomiting causes
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
metabolic alkalosis as a result of the loss of hydrochloric acid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,On review of the clients' medical records, the nurse determines
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that which client is at risk for
|\ |\ |\ |\ |\ |\
fluid volume excess?|\ |\
A. The client taking diuretics who has tenting of the skin
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. The client with an ileostomy from a recent abdominal surgery
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. The client who requires intermittent gastrointestinal suctioning
|\ |\ |\ |\ |\ |\ |\
D. The client with kidney disease and a 12-year history of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
diabetes mellitus - CORRECT ANSWERS ✔✔D. The client with
|\ |\ |\ |\ |\ |\ |\ |\ |\
kidney disease and a 12-year history of diabetes mellitus
|\ |\ |\ |\ |\ |\ |\ |\
Which client is at risk for the development of a potassium level of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
5.5 mEq/L (5.5 mmol/L)?
|\ |\ |\ |\
A. The client with colitis
|\ |\ |\ |\
B. The client with Cushing's syndrome
|\ |\ |\ |\ |\
C. The client who has been overusing laxatives
|\ |\ |\ |\ |\ |\ |\
D. The client who has sustained a traumatic burn - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔D. The client who has sustained a traumatic burn
|\ |\ |\ |\ |\ |\ |\ |\ |\
, Rationale: |\
>The normal potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mmol/L). A serum potassium level higher than 5.0 mEq/L (5.0
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mmol/L) indicates hyperkalemia. |\ |\
>Clients who experience cellular shifting of potassium in the
|\ |\ |\ |\ |\ |\ |\ |\ |\
early stages of massive cell destruction, such as with trauma,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
burns, sepsis, or metabolic or respiratory acidosis, are at risk for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
hyperkalemia.
>The client with Cushing's syndrome or colitis and the client who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
has been overusing laxatives are at risk for hypokalemia
|\ |\ |\ |\ |\ |\ |\ |\ |\
A client with a 3-day history of nausea and vomiting presents to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the emergency department.
|\ |\
The client is hypoventilating and has a respiratory rate of 10
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
breaths per minute. The |\ |\ |\
electrocardiogram (ECG) monitor displays tachycardia, with a |\ |\ |\ |\ |\ |\ |\
heart rate of 120 beats per minute. Arterial blood gases are
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
drawn and the nurse reviews the results, expecting to note
|\ |\ |\ |\ |\ |\ |\ |\ |\
which finding? |\
A. A decreased pH and an increased Paco2
|\ |\ |\ |\ |\ |\ |\
B. An increased pH and a decreased Paco2
|\ |\ |\ |\ |\ |\ |\
C. A decreased pH and a decreased HCO3-
|\ |\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\ |\
ANSWERS
The nurse is caring for a client with a nasogastric tube that is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
attached to low suction. The nurse monitors the client for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
manifestations of which disorder that the client is at risk for? |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
A. Metabolic acidosis
|\ |\
B. Metabolic alkalosis
|\ |\
C. Respiratory acidosis
|\ |\
D. Respiratory alkalosis - CORRECT ANSWERS ✔✔B. Metabolic
|\ |\ |\ |\ |\ |\ |\ |\
alkalosis
Rationale:
>Metabolic alkalosis is defined as a deficit or loss of hydrogen
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ions or acids or an excess of base (bicarbonate) that results from
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the accumulation of base or from a loss of acid without a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
comparable loss of base in the body fluids. |\ |\ |\ |\ |\ |\ |\
>This occurs in conditions resulting in hypovolemia, the loss of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
gastric fluid, excessive bicarbonate intake, the massive
|\ |\ |\ |\ |\ |\ |\
transfusion of whole blood, and hyperaldosteronism.
|\ |\ |\ |\ |\
>Loss of gastric fluid via nasogastric suction or vomiting causes
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
metabolic alkalosis as a result of the loss of hydrochloric acid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,On review of the clients' medical records, the nurse determines
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that which client is at risk for
|\ |\ |\ |\ |\ |\
fluid volume excess?|\ |\
A. The client taking diuretics who has tenting of the skin
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
B. The client with an ileostomy from a recent abdominal surgery
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
C. The client who requires intermittent gastrointestinal suctioning
|\ |\ |\ |\ |\ |\ |\
D. The client with kidney disease and a 12-year history of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
diabetes mellitus - CORRECT ANSWERS ✔✔D. The client with
|\ |\ |\ |\ |\ |\ |\ |\ |\
kidney disease and a 12-year history of diabetes mellitus
|\ |\ |\ |\ |\ |\ |\ |\
Which client is at risk for the development of a potassium level of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
5.5 mEq/L (5.5 mmol/L)?
|\ |\ |\ |\
A. The client with colitis
|\ |\ |\ |\
B. The client with Cushing's syndrome
|\ |\ |\ |\ |\
C. The client who has been overusing laxatives
|\ |\ |\ |\ |\ |\ |\
D. The client who has sustained a traumatic burn - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔D. The client who has sustained a traumatic burn
|\ |\ |\ |\ |\ |\ |\ |\ |\
, Rationale: |\
>The normal potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mmol/L). A serum potassium level higher than 5.0 mEq/L (5.0
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
mmol/L) indicates hyperkalemia. |\ |\
>Clients who experience cellular shifting of potassium in the
|\ |\ |\ |\ |\ |\ |\ |\ |\
early stages of massive cell destruction, such as with trauma,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
burns, sepsis, or metabolic or respiratory acidosis, are at risk for
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
hyperkalemia.
>The client with Cushing's syndrome or colitis and the client who
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
has been overusing laxatives are at risk for hypokalemia
|\ |\ |\ |\ |\ |\ |\ |\ |\
A client with a 3-day history of nausea and vomiting presents to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the emergency department.
|\ |\
The client is hypoventilating and has a respiratory rate of 10
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
breaths per minute. The |\ |\ |\
electrocardiogram (ECG) monitor displays tachycardia, with a |\ |\ |\ |\ |\ |\ |\
heart rate of 120 beats per minute. Arterial blood gases are
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
drawn and the nurse reviews the results, expecting to note
|\ |\ |\ |\ |\ |\ |\ |\ |\
which finding? |\
A. A decreased pH and an increased Paco2
|\ |\ |\ |\ |\ |\ |\
B. An increased pH and a decreased Paco2
|\ |\ |\ |\ |\ |\ |\
C. A decreased pH and a decreased HCO3-
|\ |\ |\ |\ |\ |\ |\
