NURS 320 Exam 1 Questions with
Complete Answers
The patient must be re-hyrdated and the sodium levels should be decreased at the
same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do this.
The solution is hypertonic because of the 5% Dextrose which will rapidly metabolize
to the cells. When the dextrose metabolizes to the cells it leaves behind 0.9% NA
which acts as a isotonic solution. This allows the 0.45% NA to act as a hypotonic
solution to repair the vascular compartment. After these fluids are infused the
patient's NA level should decrease, BP increase, HR return to normal etc. It is a
complicated physiological process because the Dextrose has unique capabilities
when it is metabolized....although the solution is labeled as hypertonic it becomes a
hypotonic solution when the Dextrose is metabolized by the cells.
After obtaining an EKG on a patient you notice that ST depression is present along
with an inverted T wave and prominent U wave. What lab value would be the cause
of this finding?
A)Potassium level of 2.2
B)Potassium level of 5.6
C)Magnesium level of 2.3
D)Phoshorus level of 2.0 - ANSWER-A
Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type of
EKG findings.
Which patient below would have a potassium level of 5.5?
A)A 76 year old who reports taking lasix four times a day
B)A patient with Addison's disease
C)A 55 year old woman who have been vomiting for 3 days consistently
D)A patient with liver failure - ANSWER-B
A patient with Addison disease suffers from increased potassium levels due to
adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in
patients with Addison's disease.
You are taking a patient's blood pressure manually. As you pump up the cuff above
the systolic pressure for a few minutes you notice that the patient develop a carpal
spasm. Which of the following is true?
A)This is known as Trousseau's Sign and is present in patients with hypocalemia
B)This is known as Trousseau's Sign and is present in patients with HYPERcalemia
C)This is known as Chvostek's Sign
D)The patient is having a normal nervous response to an inflating blood pressure
cuff that is inflated above the systolic pressure - ANSWER-A
The correct answer is "this is known as Trousseau's Sign and is present in patients
with hypocalemia". Patient's with hypokalemia may present with a positive
Trousseau's and Chvostek sign.
,Which patient is at most risk for hypomagnesemia?
A)A 55 year old chronic alcoholic
B)A 57 year old with hyperthroidism
C)A patient reporting overuse of anatacids and laxatives
D)A 25 year old suffering from hypoglycemia - ANSWER-A
The correct answer is a 55 year old who is a chronic alcoholic. Patients who suffer
from alcoholism have an increased secretion of magnesium and usually do not eat a
proper diet, therefore, they are at risk for lower magnesium levels.
In report from a transferring facility you receive information that your patient's
Magnesium level is 1.2. When the patient arrives you are ordered by the doctor to
administer Magnesium Sulfate via IV. Which of the following interventions takes
priority?
A)Monitor the patient's for reduced deep tendon reflexes and initiate seizure
precautions
B)Set-up IV Atropine at bedside due to the bradycardia effects of Magnesium Sulfate
C)Set-up bedside suction
D)None of the above are correct - ANSWER-A
As the nurse administering Magnesium sulfate IV, you must monitor for reduced
deep tendon reflexes because the patient could quickly develop hypermagnesemia.
In addition, seizure precautions should be initiated due to the patient's low
magnesium level.
Which patient is at most risk for fluid volume deficient?
A)A patient who has been vomiting and having diarrhea for 2 days.
B)A patient with continous nasogastric suction.
C)A patient with an abdominal wound vac at intermittent suction.
D)All of the above are correct. - ANSWER-D
As the nursing administering Magnesium sulfate IV, you must monitor for reduced
deep tendon reflexes because the patient could quickly develop hypermagnesemia.
In addition, seizure precautions should be initiated due to the patient's low
magnesium level.
A patient is admitted with exacerbation of congestive heart failure. What would you
expect to find during your admission assessment?
A)Flat neck and hand veins
B)Furrowed dry tongue
C)Increased blood pressure and crackles throughout the lungs
D)Bradycardia and pitting edema in lower extremities - ANSWER-C
The correct answer is increased blood pressure and crackles throughout the lungs.
Patients with CHF are in fluid volume overload and the heart can not compensate for
the extra fluid volume, therefore, the fluid starts to "backup". You would find an
increased blood pressure and crackles in the lungs. You would also see pitting
edema in the lower extremities but NOT bradycardia.
, A patient has a potassium level of 9.0. Which nursing intervention is priority?*
A. Prepare the patient for dialysis and place the patient on a cardiac monitor
B. Administer Spironolactone
C. Place patient on a potassium restrictive diet
D. Administer a laxative - ANSWER-A
Which of the following is not a symptom of hyperkalemia?*
A. Positive Chvostek's sign
B. Decreased blood pressure
C. Muscle twitches/cramps
D. Weak and slow heart rate - ANSWER-A
Tall peaked T-waves, flat P-waves, prolonged PR intervals and widened QRS
complexes can present in which of the following conditions?*
A. Hypocalemia
B. Hypercalemia
C. Hypokalemia
D. Hyperkalemia - ANSWER-D
Which patient is at risk for hyperkalemia?*
A. Patient with Parathyroid cancer
B. Patient with Cushing's Syndrome
C. Patient with Addison's Disease
D. Patient with breast cancer - ANSWER-C
A patient's potassium level is 3.0. Which foods would you encourage the patient to
consume?*
A. Cheese, collard greens, and fish
B. Avocados, strawberries, and potatoes
C. Tofu, oatmeal, and peas
D. Peanuts, bread, and corn - ANSWER-B
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered
a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. What is your next
nursing intervention?*
A. Hold the dose of Lasix and notify the doctor for further orders
B. Administered the Lasix and notify the doctor for further orders
C. Turn off the nasogastric suctioning and administered a laxative
D. No intervention is need the potassium level is within normal range - ANSWER-A
A patient is presenting with an orthostatic blood pressure of 80/40 when she stands
up, thready and weak pulse of 58, and shallow respirations. In addition, the patient
has been having frequent episodes of vomiting and nausea and is taking
hydrochlorothiazide. Which of the following findings would explain the patient's
condition?*
A. Potassium level of 7.0
B. Potassium level of 3.5
C. Potassium level of 2.4
D. None of the options are correct - ANSWER-C
Complete Answers
The patient must be re-hyrdated and the sodium levels should be decreased at the
same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do this.
The solution is hypertonic because of the 5% Dextrose which will rapidly metabolize
to the cells. When the dextrose metabolizes to the cells it leaves behind 0.9% NA
which acts as a isotonic solution. This allows the 0.45% NA to act as a hypotonic
solution to repair the vascular compartment. After these fluids are infused the
patient's NA level should decrease, BP increase, HR return to normal etc. It is a
complicated physiological process because the Dextrose has unique capabilities
when it is metabolized....although the solution is labeled as hypertonic it becomes a
hypotonic solution when the Dextrose is metabolized by the cells.
After obtaining an EKG on a patient you notice that ST depression is present along
with an inverted T wave and prominent U wave. What lab value would be the cause
of this finding?
A)Potassium level of 2.2
B)Potassium level of 5.6
C)Magnesium level of 2.3
D)Phoshorus level of 2.0 - ANSWER-A
Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type of
EKG findings.
Which patient below would have a potassium level of 5.5?
A)A 76 year old who reports taking lasix four times a day
B)A patient with Addison's disease
C)A 55 year old woman who have been vomiting for 3 days consistently
D)A patient with liver failure - ANSWER-B
A patient with Addison disease suffers from increased potassium levels due to
adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in
patients with Addison's disease.
You are taking a patient's blood pressure manually. As you pump up the cuff above
the systolic pressure for a few minutes you notice that the patient develop a carpal
spasm. Which of the following is true?
A)This is known as Trousseau's Sign and is present in patients with hypocalemia
B)This is known as Trousseau's Sign and is present in patients with HYPERcalemia
C)This is known as Chvostek's Sign
D)The patient is having a normal nervous response to an inflating blood pressure
cuff that is inflated above the systolic pressure - ANSWER-A
The correct answer is "this is known as Trousseau's Sign and is present in patients
with hypocalemia". Patient's with hypokalemia may present with a positive
Trousseau's and Chvostek sign.
,Which patient is at most risk for hypomagnesemia?
A)A 55 year old chronic alcoholic
B)A 57 year old with hyperthroidism
C)A patient reporting overuse of anatacids and laxatives
D)A 25 year old suffering from hypoglycemia - ANSWER-A
The correct answer is a 55 year old who is a chronic alcoholic. Patients who suffer
from alcoholism have an increased secretion of magnesium and usually do not eat a
proper diet, therefore, they are at risk for lower magnesium levels.
In report from a transferring facility you receive information that your patient's
Magnesium level is 1.2. When the patient arrives you are ordered by the doctor to
administer Magnesium Sulfate via IV. Which of the following interventions takes
priority?
A)Monitor the patient's for reduced deep tendon reflexes and initiate seizure
precautions
B)Set-up IV Atropine at bedside due to the bradycardia effects of Magnesium Sulfate
C)Set-up bedside suction
D)None of the above are correct - ANSWER-A
As the nurse administering Magnesium sulfate IV, you must monitor for reduced
deep tendon reflexes because the patient could quickly develop hypermagnesemia.
In addition, seizure precautions should be initiated due to the patient's low
magnesium level.
Which patient is at most risk for fluid volume deficient?
A)A patient who has been vomiting and having diarrhea for 2 days.
B)A patient with continous nasogastric suction.
C)A patient with an abdominal wound vac at intermittent suction.
D)All of the above are correct. - ANSWER-D
As the nursing administering Magnesium sulfate IV, you must monitor for reduced
deep tendon reflexes because the patient could quickly develop hypermagnesemia.
In addition, seizure precautions should be initiated due to the patient's low
magnesium level.
A patient is admitted with exacerbation of congestive heart failure. What would you
expect to find during your admission assessment?
A)Flat neck and hand veins
B)Furrowed dry tongue
C)Increased blood pressure and crackles throughout the lungs
D)Bradycardia and pitting edema in lower extremities - ANSWER-C
The correct answer is increased blood pressure and crackles throughout the lungs.
Patients with CHF are in fluid volume overload and the heart can not compensate for
the extra fluid volume, therefore, the fluid starts to "backup". You would find an
increased blood pressure and crackles in the lungs. You would also see pitting
edema in the lower extremities but NOT bradycardia.
, A patient has a potassium level of 9.0. Which nursing intervention is priority?*
A. Prepare the patient for dialysis and place the patient on a cardiac monitor
B. Administer Spironolactone
C. Place patient on a potassium restrictive diet
D. Administer a laxative - ANSWER-A
Which of the following is not a symptom of hyperkalemia?*
A. Positive Chvostek's sign
B. Decreased blood pressure
C. Muscle twitches/cramps
D. Weak and slow heart rate - ANSWER-A
Tall peaked T-waves, flat P-waves, prolonged PR intervals and widened QRS
complexes can present in which of the following conditions?*
A. Hypocalemia
B. Hypercalemia
C. Hypokalemia
D. Hyperkalemia - ANSWER-D
Which patient is at risk for hyperkalemia?*
A. Patient with Parathyroid cancer
B. Patient with Cushing's Syndrome
C. Patient with Addison's Disease
D. Patient with breast cancer - ANSWER-C
A patient's potassium level is 3.0. Which foods would you encourage the patient to
consume?*
A. Cheese, collard greens, and fish
B. Avocados, strawberries, and potatoes
C. Tofu, oatmeal, and peas
D. Peanuts, bread, and corn - ANSWER-B
A patient with nasogastric suctioning is experiencing diarrhea. The patient is ordered
a morning dose of Lasix 20mg IV. Patient's potassium level is 3.0. What is your next
nursing intervention?*
A. Hold the dose of Lasix and notify the doctor for further orders
B. Administered the Lasix and notify the doctor for further orders
C. Turn off the nasogastric suctioning and administered a laxative
D. No intervention is need the potassium level is within normal range - ANSWER-A
A patient is presenting with an orthostatic blood pressure of 80/40 when she stands
up, thready and weak pulse of 58, and shallow respirations. In addition, the patient
has been having frequent episodes of vomiting and nausea and is taking
hydrochlorothiazide. Which of the following findings would explain the patient's
condition?*
A. Potassium level of 7.0
B. Potassium level of 3.5
C. Potassium level of 2.4
D. None of the options are correct - ANSWER-C
