BSN 246 HESI Review QUESTIONS
WITH ANSWERS
Hypokalemia appearance on EKG - CORRECT ANSWERS - U waves
- inverted T waves
- depressed ST segment
Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia.
Which actions should the nurse take to plan for preparation and administration of the potassium?
Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution. - CORRECT
ANSWERS 1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.
Potassium chloride administered intravenously must always be diluted in IV fluid and infused via an
infusion pump. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by IV
push can result in cardiac arrest. The nurse should ensure that the potassium is diluted in the
appropriate amount of diluent or fluid. The IV bag containing the potassium chloride should always be
labeled with the volume of potassium it contains. The IV site is monitored closely, because potassium
chloride is irritating to the veins and there is risk of phlebitis. In addition, the nurse should monitor for
infiltration. The nurse monitors urinary output during administration and contacts the primary health
care provider if the urinary output is less than 30 mL/hr.
,The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of
hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?
1. Twitching
2. Hypoactive bowel sounds
3. Negative Trousseau's sign
4. Hypoactive deep tendon reflexes - CORRECT ANSWERS 1. Twitching
: A client with lactose intolerance is at risk for developing hypocalcemia, because food products that
contain calcium also contain lactose. The normal serum calcium level is 9 to 10.5 mg/dL (2.25 to 2.75
mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalcemia. Signs of
hypocalcemia include paresthesias followed by numbness, hyperactive deep tendon reflexes, and a 267
positive Trousseau's or Chvostek's sign. Additional signs of hypocalcemia include increased
neuromuscular excitability, muscle cramps, twitching, tetany, seizures, irritability, and anxiety.
Gastrointestinal symptoms include increased gastric motility, hyperactive bowel sounds, abdominal
cramping, and diarrhea.
. The nurse is caring for a client with Crohn's disease who has a calcium level of 8 mg/dL (2 mmol/L).
Which patterns would the nurse watch for on the electrocardiogram? Select all that apply.
1. U waves
2. Widened T wave
3. Prominent U wave
4. Prolonged QT interval
5. Prolonged ST segment - CORRECT ANSWERS 4. Prolonged QT interval
5. Prolonged ST segment
A client with Crohn's disease is at risk for hypocalcemia. The normal serum calcium level is 9 to 10.5
mg/dL (2.25 to 2.75 mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates
hypocalcemia. Electrocardiographic changes that occur in a client with hypocalcemia include a
prolonged QT interval and prolonged ST segment. A shortened ST segment and a widened T wave occur
with hypercalcemia. ST depression and prominent U waves occur with hypokalemia.
The nurse reviews the electrolyte results of a client with chronic kidney disease and notes that the
potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac
monitor as a result of the laboratory value? Select all that apply.
, 1. ST depression
2. Prominent U wave
3. Tall peaked T waves
4. Prolonged ST segment
5. Widened QRS complexes - CORRECT ANSWERS 3. Tall peaked T waves
5. Widened QRS complexes
The client with chronic kidney disease is at risk for hyperkalemia. The normal potassium level is 3.5 to
5.0 mEq/L (3.5 to 5.0 mmol/L). A serum potassium level greater than 5.0 mEq/L (5.0 mmol/L) indicates
hyperkalemia. Electrocardiographic changes associated with hyperkalemia include flat P waves,
prolonged PR intervals, widened QRS complexes, and tall peaked T waves. ST depression and a
prominent U wave occurs in hypokalemia. A prolonged ST segment occurs in hypocalcemia.
The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On
assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and
diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the
nurse expect to note in a client with hyponatremia?
1. Muscle twitches
2. Decreased urinary output
3. Hyperactive bowel sounds
4. Increased specific gravity of the urine - CORRECT ANSWERS 3. Hyperactive bowel sounds
The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). Hyponatremia is evidenced by
a serum sodium level lower than 135 mEq/L (135 mmol/L). Hyperactive bowel sounds indicate
hyponatremia. The remaining options are signs of hypernatremia. In hyponatremia, muscle weakness,
increased urinary output, and decreased specific gravity of the urine would be noted.
The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate)
level is 1.8 mg/dL (0.58 mmol/L). Which 264 condition most likely caused this serum phosphorus level?
1. Malnutrition
2. Renal insufficiency
3. Hypoparathyroidism
4. Tumor lysis syndrome - CORRECT ANSWERS 1. Malnutrition
WITH ANSWERS
Hypokalemia appearance on EKG - CORRECT ANSWERS - U waves
- inverted T waves
- depressed ST segment
Potassium chloride intravenously is prescribed for a client with heart failure experiencing hypokalemia.
Which actions should the nurse take to plan for preparation and administration of the potassium?
Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution. - CORRECT
ANSWERS 1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the solution.
Potassium chloride administered intravenously must always be diluted in IV fluid and infused via an
infusion pump. Potassium chloride is never given by bolus (IV push). Giving potassium chloride by IV
push can result in cardiac arrest. The nurse should ensure that the potassium is diluted in the
appropriate amount of diluent or fluid. The IV bag containing the potassium chloride should always be
labeled with the volume of potassium it contains. The IV site is monitored closely, because potassium
chloride is irritating to the veins and there is risk of phlebitis. In addition, the nurse should monitor for
infiltration. The nurse monitors urinary output during administration and contacts the primary health
care provider if the urinary output is less than 30 mL/hr.
,The nurse is assessing a client with a lactose intolerance disorder for a suspected diagnosis of
hypocalcemia. Which clinical manifestation would the nurse expect to note in the client?
1. Twitching
2. Hypoactive bowel sounds
3. Negative Trousseau's sign
4. Hypoactive deep tendon reflexes - CORRECT ANSWERS 1. Twitching
: A client with lactose intolerance is at risk for developing hypocalcemia, because food products that
contain calcium also contain lactose. The normal serum calcium level is 9 to 10.5 mg/dL (2.25 to 2.75
mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates hypocalcemia. Signs of
hypocalcemia include paresthesias followed by numbness, hyperactive deep tendon reflexes, and a 267
positive Trousseau's or Chvostek's sign. Additional signs of hypocalcemia include increased
neuromuscular excitability, muscle cramps, twitching, tetany, seizures, irritability, and anxiety.
Gastrointestinal symptoms include increased gastric motility, hyperactive bowel sounds, abdominal
cramping, and diarrhea.
. The nurse is caring for a client with Crohn's disease who has a calcium level of 8 mg/dL (2 mmol/L).
Which patterns would the nurse watch for on the electrocardiogram? Select all that apply.
1. U waves
2. Widened T wave
3. Prominent U wave
4. Prolonged QT interval
5. Prolonged ST segment - CORRECT ANSWERS 4. Prolonged QT interval
5. Prolonged ST segment
A client with Crohn's disease is at risk for hypocalcemia. The normal serum calcium level is 9 to 10.5
mg/dL (2.25 to 2.75 mmol/L). A serum calcium level lower than 9 mg/dL (2.25 mmol/L) indicates
hypocalcemia. Electrocardiographic changes that occur in a client with hypocalcemia include a
prolonged QT interval and prolonged ST segment. A shortened ST segment and a widened T wave occur
with hypercalcemia. ST depression and prominent U waves occur with hypokalemia.
The nurse reviews the electrolyte results of a client with chronic kidney disease and notes that the
potassium level is 5.7 mEq/L (5.7 mmol/L). Which patterns would the nurse watch for on the cardiac
monitor as a result of the laboratory value? Select all that apply.
, 1. ST depression
2. Prominent U wave
3. Tall peaked T waves
4. Prolonged ST segment
5. Widened QRS complexes - CORRECT ANSWERS 3. Tall peaked T waves
5. Widened QRS complexes
The client with chronic kidney disease is at risk for hyperkalemia. The normal potassium level is 3.5 to
5.0 mEq/L (3.5 to 5.0 mmol/L). A serum potassium level greater than 5.0 mEq/L (5.0 mmol/L) indicates
hyperkalemia. Electrocardiographic changes associated with hyperkalemia include flat P waves,
prolonged PR intervals, widened QRS complexes, and tall peaked T waves. ST depression and a
prominent U wave occurs in hypokalemia. A prolonged ST segment occurs in hypocalcemia.
The nurse is caring for a client with heart failure who is receiving high doses of a diuretic. On
assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and
diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the
nurse expect to note in a client with hyponatremia?
1. Muscle twitches
2. Decreased urinary output
3. Hyperactive bowel sounds
4. Increased specific gravity of the urine - CORRECT ANSWERS 3. Hyperactive bowel sounds
The normal serum sodium level is 135 to 145 mEq/L (135 to 145 mmol/L). Hyponatremia is evidenced by
a serum sodium level lower than 135 mEq/L (135 mmol/L). Hyperactive bowel sounds indicate
hyponatremia. The remaining options are signs of hypernatremia. In hyponatremia, muscle weakness,
increased urinary output, and decreased specific gravity of the urine would be noted.
The nurse reviews a client's laboratory report and notes that the client's serum phosphorus (phosphate)
level is 1.8 mg/dL (0.58 mmol/L). Which 264 condition most likely caused this serum phosphorus level?
1. Malnutrition
2. Renal insufficiency
3. Hypoparathyroidism
4. Tumor lysis syndrome - CORRECT ANSWERS 1. Malnutrition
