Final exam review LPN to RN questions
and answers
A client's most recent blood work indicates a K+ level of 7.2 mEq/L (7.2 mmol/L), a finding that
constitutes hyperkalemia. For what signs and symptoms should the nurse vigilantly monitor? -
ANSWER-cardiac irregularities
The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths per minute.
Which arterial blood gas data does the nurse anticipate finding? - ANSWER-In metabolic acidosis,
arterial blood gas results are anticipated to reflect pH guch as 64; 42.
A client loses consciousness after strenuous exercise and needs to be admitted to a health care
facility. The client is diagnosed with dehydration. The nurse knows that the client needs restoration
of: - ANSWER-electrolytes.
Non-electrolytes are chemical compounds that remain bound together when dissolved in a solution.
Interstitial fluid is the fluid in the tissue space between and around cells.
Colloids are substances that do not dissolve into a true solution and do not pass through a
semipermeable membrane.
When the nurse is starting an intravenous infusion on a client who will be receiving multiple
intravenous antibiotics, which guideline should the nurse follow? - ANSWER-Use distal veins before
proximal veins
leaving the more proximal sites for later venipunctures.
The primary extracellular electrolytes are: - ANSWER-sodium, chloride, and bicarbonate.
Potassium is needed for neural, muscle, and: - ANSWER-cardiac function.
,A client reports she has lactose intolerance and questions the nurse about alternative sources of
calcium. What options can be provided by the nurse? - ANSWER-Spinach
Sardines, whole grains, and green leafy vegetables also provide calcium.
Which age group is at risk for fluid and electrolyte imbalances resulting from fad dieting? - ANSWER-
Adolescents
A physician orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/mL. What is the flow
rate? - ANSWER-50 gtt/min
The flow rate (gtt/min) equals the volume (mL) times the drop factor (gtt/mL) divided by the time in
minutes.
The oncoming nurse is assigned to the following clients. Which client should the nurse assess first? -
ANSWER-a newly admitted 88-year-old with a 2-day history of vomiting and loose stools
Mr. Jones is admitted to the nurse's unit from the emergency department with a diagnosis of
hypocalcemia. His laboratory results show a serum calcium level of 8.2 mg/dL (2.05 mmol/L). For
what assessment findings will the nurse be looking? - ANSWER-muscle cramping and tetany (muscle
spasms)
hypercalcemia = nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion,
lethargy, and slurred speech.
hyperchloremia = diminished cognitive ability and hypertension
Constipation is a sign of hypercalcemia.
Which nursing diagnosis would the nurse make based on the effects of fluid and electrolyte
imbalance on human functioning? - ANSWER-Acute Confusion related to cerebral edema
The student nurse asks, "what is interstitial fluid?" What is the appropriate nursing response? -
ANSWER-"Fluid in the tissue space between and around cells."
,Intracellular fluid (fluid inside cells) represents the greatest proportion of water in the body.
The remaining body fluid is extracellular fluid (fluid outside cells). Extracellular fluid is further
subdivided into interstitial fluid (fluid in the tissue space between and around cells) and intravascular
fluid (the watery plasma, or serum, portion of blood).
The nurse working at the blood bank is speaking with potential blood donor clients. Which client
statement requires nursing intervention? - ANSWER-"I received a blood transfusion in the United
Kingdom."
The nurse is preparing to administer granulocytes to a client admitted with a severe infection. Which
teaching by the nurse is most appropriate? - ANSWER-"Granulocytes are a type of white blood cell
that can help fight infection."
The nurse is calculating an infusion rate for the following order: Infuse 1000 ml of 0.9% Na Cl over 12
hours using an electronic infusion device. What is the infusion rate? - ANSWER-83 ml/hour
When calculating the infusion rate with an electronic device, divide the total volume to be infused
(1000 ml) by the total amount of time in hours (12). This is 83 ml/hour
A client with dehydration will have an increase in: - ANSWER-aldosterone
Which of the following statements is an appropriate nursing diagnosis for an client 80 years of age
diagnosed with congestive heart failure, with symptoms of edema, orthopnea, and confusion? -
ANSWER-Extracellular Volume Excess related to heart failure, as evidenced by edema and orthopnea
The nurse is caring for a client, who was admitted after falling from a ladder. The client has a brain
injury which is causing the pressure inside the skull to increase, which may result in a lack of
circulation and possible death to brain cells. Considering this information, which intravenous
solution would be most appropriate? - ANSWER-Hypertonic
Plasma is an isotonic solution.
, The nurse is caring for a client who was found without food or water for 2 days in the desert. What
explanation for the need for fluid does the client have? Select all that apply. - ANSWER-facilitates
cellular metabolism
helps maintain normal body temperature
acts as a solvent for electrolytes
A healthy client eats a regular, balanced diet and drinks 3,000 mL of liquids during a 24-hour period.
In evaluating this client's urine output for the same 24-hour period, the nurse realizes that it should
total approximately how many mL? - ANSWER-3,000
Fluid intake and fluid output should be approximately the same in order to maintain fluid balance.
Any other amount could lead to a fluid volume excess or deficit
The nurse is caring for elderly patients in a long-term care facility. What age-related alteration
should the nurse consider when planning care for these patients? - ANSWER-Cardiac volume
intolerance
A client admitted to the facility is diagnosed with metabolic alkalosis based on arterial blood gas
values. When obtaining the client's history, which statement would the nurse interpret as a possible
underlying cause? - ANSWER-"I've been taking antacids almost every 2 hours over the past several
days."
Metabolic alkalosis occurs when there is excessive loss of body acids or with unusual intake of
alkaline substances. It can also occur in conjunction with an ECF deficit or potassium deficit. V or
nasogastric suction
diarrhea = metabolic acidosis
The nurse is providing care to a client who has a serum potassium level of 5.2 mEq/L (5.2 mmol/L).
Which findings would the nurse expect to assess? Select all that apply. - ANSWER-Diarrhea
Cardiac dysrhythmia
The nurse works at an agency that automatically places certain clients on intake and output (I&O).
For which client will the nurse document all I&O? - ANSWER-55-year old with congestive heart
failure on furosemide
and answers
A client's most recent blood work indicates a K+ level of 7.2 mEq/L (7.2 mmol/L), a finding that
constitutes hyperkalemia. For what signs and symptoms should the nurse vigilantly monitor? -
ANSWER-cardiac irregularities
The nurse is caring for a client with metabolic alkalosis whose breathing rate is 8 breaths per minute.
Which arterial blood gas data does the nurse anticipate finding? - ANSWER-In metabolic acidosis,
arterial blood gas results are anticipated to reflect pH guch as 64; 42.
A client loses consciousness after strenuous exercise and needs to be admitted to a health care
facility. The client is diagnosed with dehydration. The nurse knows that the client needs restoration
of: - ANSWER-electrolytes.
Non-electrolytes are chemical compounds that remain bound together when dissolved in a solution.
Interstitial fluid is the fluid in the tissue space between and around cells.
Colloids are substances that do not dissolve into a true solution and do not pass through a
semipermeable membrane.
When the nurse is starting an intravenous infusion on a client who will be receiving multiple
intravenous antibiotics, which guideline should the nurse follow? - ANSWER-Use distal veins before
proximal veins
leaving the more proximal sites for later venipunctures.
The primary extracellular electrolytes are: - ANSWER-sodium, chloride, and bicarbonate.
Potassium is needed for neural, muscle, and: - ANSWER-cardiac function.
,A client reports she has lactose intolerance and questions the nurse about alternative sources of
calcium. What options can be provided by the nurse? - ANSWER-Spinach
Sardines, whole grains, and green leafy vegetables also provide calcium.
Which age group is at risk for fluid and electrolyte imbalances resulting from fad dieting? - ANSWER-
Adolescents
A physician orders an infusion of 250 mL of NS in 100 minutes. The set is 20 gtt/mL. What is the flow
rate? - ANSWER-50 gtt/min
The flow rate (gtt/min) equals the volume (mL) times the drop factor (gtt/mL) divided by the time in
minutes.
The oncoming nurse is assigned to the following clients. Which client should the nurse assess first? -
ANSWER-a newly admitted 88-year-old with a 2-day history of vomiting and loose stools
Mr. Jones is admitted to the nurse's unit from the emergency department with a diagnosis of
hypocalcemia. His laboratory results show a serum calcium level of 8.2 mg/dL (2.05 mmol/L). For
what assessment findings will the nurse be looking? - ANSWER-muscle cramping and tetany (muscle
spasms)
hypercalcemia = nausea, vomiting, constipation, bone pain, excessive urination, thirst, confusion,
lethargy, and slurred speech.
hyperchloremia = diminished cognitive ability and hypertension
Constipation is a sign of hypercalcemia.
Which nursing diagnosis would the nurse make based on the effects of fluid and electrolyte
imbalance on human functioning? - ANSWER-Acute Confusion related to cerebral edema
The student nurse asks, "what is interstitial fluid?" What is the appropriate nursing response? -
ANSWER-"Fluid in the tissue space between and around cells."
,Intracellular fluid (fluid inside cells) represents the greatest proportion of water in the body.
The remaining body fluid is extracellular fluid (fluid outside cells). Extracellular fluid is further
subdivided into interstitial fluid (fluid in the tissue space between and around cells) and intravascular
fluid (the watery plasma, or serum, portion of blood).
The nurse working at the blood bank is speaking with potential blood donor clients. Which client
statement requires nursing intervention? - ANSWER-"I received a blood transfusion in the United
Kingdom."
The nurse is preparing to administer granulocytes to a client admitted with a severe infection. Which
teaching by the nurse is most appropriate? - ANSWER-"Granulocytes are a type of white blood cell
that can help fight infection."
The nurse is calculating an infusion rate for the following order: Infuse 1000 ml of 0.9% Na Cl over 12
hours using an electronic infusion device. What is the infusion rate? - ANSWER-83 ml/hour
When calculating the infusion rate with an electronic device, divide the total volume to be infused
(1000 ml) by the total amount of time in hours (12). This is 83 ml/hour
A client with dehydration will have an increase in: - ANSWER-aldosterone
Which of the following statements is an appropriate nursing diagnosis for an client 80 years of age
diagnosed with congestive heart failure, with symptoms of edema, orthopnea, and confusion? -
ANSWER-Extracellular Volume Excess related to heart failure, as evidenced by edema and orthopnea
The nurse is caring for a client, who was admitted after falling from a ladder. The client has a brain
injury which is causing the pressure inside the skull to increase, which may result in a lack of
circulation and possible death to brain cells. Considering this information, which intravenous
solution would be most appropriate? - ANSWER-Hypertonic
Plasma is an isotonic solution.
, The nurse is caring for a client who was found without food or water for 2 days in the desert. What
explanation for the need for fluid does the client have? Select all that apply. - ANSWER-facilitates
cellular metabolism
helps maintain normal body temperature
acts as a solvent for electrolytes
A healthy client eats a regular, balanced diet and drinks 3,000 mL of liquids during a 24-hour period.
In evaluating this client's urine output for the same 24-hour period, the nurse realizes that it should
total approximately how many mL? - ANSWER-3,000
Fluid intake and fluid output should be approximately the same in order to maintain fluid balance.
Any other amount could lead to a fluid volume excess or deficit
The nurse is caring for elderly patients in a long-term care facility. What age-related alteration
should the nurse consider when planning care for these patients? - ANSWER-Cardiac volume
intolerance
A client admitted to the facility is diagnosed with metabolic alkalosis based on arterial blood gas
values. When obtaining the client's history, which statement would the nurse interpret as a possible
underlying cause? - ANSWER-"I've been taking antacids almost every 2 hours over the past several
days."
Metabolic alkalosis occurs when there is excessive loss of body acids or with unusual intake of
alkaline substances. It can also occur in conjunction with an ECF deficit or potassium deficit. V or
nasogastric suction
diarrhea = metabolic acidosis
The nurse is providing care to a client who has a serum potassium level of 5.2 mEq/L (5.2 mmol/L).
Which findings would the nurse expect to assess? Select all that apply. - ANSWER-Diarrhea
Cardiac dysrhythmia
The nurse works at an agency that automatically places certain clients on intake and output (I&O).
For which client will the nurse document all I&O? - ANSWER-55-year old with congestive heart
failure on furosemide
