NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
A patient's blood gases reveal the following findings: pH, 7.3; bicarbonate (HCO3) 27
mEq/L; carbon dioxide (CO2), 58 mm Hg. What is the interpretation of these gases?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis - correct answer ANS: C
The values provided in this question characterize only acute uncompensated
respiratory acidosis.
What causes the clinical manifestations of confusion, convulsions, cerebral
hemorrhage, and coma in hypernatremia?
a. High sodium in the blood vessels pulls water out of the brain cells into the blood
vessels, causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain
cells, causing them to swell.
c. High sodium in the blood vessels pulls potassium out of the brain cells, which slows
the synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by
water, causing the brain cells to swell - correct answer ANS: A
Hypertonic (hyperosmolar) imbalances result in an extracellular fluid concentration
greater than 0.9% salt solution (e.g., water loss or solute gain); cells shrink in a
hypertonic fluid (see Table 3-7). This shrinking of cells results in the symptoms
described in the question. The other options do not accurately describe the cause of
these symptoms as they relate to hypernatremia
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium to maintain cation
balance
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis - correct answer ANS: C
When vomiting with the depletion of ECF and chloride (hypochloremic metabolic
alkalosis) causes acid loss, renal compensation is not effective; the volume depletion
and loss of electrolytes (sodium [Na+], potassium [K+], hydrogen [H+], chlorine [Cl-])
stimulate a paradoxic response by the kidneys. The kidneys increase sodium and
bicarbonate reabsorption with the excretion of hydrogen. Bicarbonate is reabsorbed to
maintain an anionic balance because the ECF chloride concentration is decreased. The
other options do not accurately describe the mechanism that results from vomiting-
induced metabolic alkalosis.
Insulin is used to treat hyperkalemia because it:
a. Stimulates sodium to be removed from the cell in exchange for potassium.
b. Binds to potassium to remove it through the kidneys.
c. Transports potassium from the blood to the cell along with glucose.
d. Breaks down the chemical components of potassium, causing it to be no longer
effective. - correct answer ANS: C
Insulin contributes to the regulation of plasma potassium levels by stimulating the
Na+, potassium-adenosine triphosphatase (K+-ATPase) pump, thereby promoting the
movement of potassium simultaneously into the liver and muscle cells with glucose
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
transport after eating. The intracellular movement of potassium prevents an acute
hyperkalemia related to food intake. The other options do not accurately describe how
insulin is used to treat hyperkalemia
During acidosis, the body compensates for the increase in serum hydrogen ions by
shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen
b. Sodium
c. Potassium
d. Magnesium - correct answer ANS: C
In states of acidosis, hydrogen ions shift into the cells in exchange for intracellular
fluid potassium; hyperkalemia and acidosis therefore often occur together. This is not
true of the other options.
Causes of hyperkalemia include:
a. Hyperparathyroidism and malnutrition
b. Vomiting and diarrhea
c. Renal failure and Addison disease
d. Hyperaldosteronism and Cushing disease - correct answer ANS: C
Hyperkalemia should be investigated when a history of renal disease, massive trauma,
insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic
acidosis exists. The other options are not known to be causes of hyperkalemia
In hyperkalemia, what change occurs to the cells' resting membrane potential?
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization - correct answer ANS: A
If extracellular potassium concentration increases without a significant change in
intracellular potassium, then the resting membrane potential becomes more positive
(i.e., changes from -90 to -80 mV) and the cell membrane is hypopolarized (i.e., the
inside of the cell becomes less negative or partially depolarized [increase excitability]).
The calcium and phosphate balance is influenced by which three substances?
a. Parathyroid hormone, vasopressin, and vitamin D
b. Parathyroid hormone, calcitonin, and vitamin D
c. Thyroid hormone, vasopressin, and vitamin A
d. Thyroid hormone, calcitonin, and vitamin A - correct answer ANS: B
Three hormones regulate calcium and phosphate balance: parathyroid hormone (PTH),
vitamin D, and calcitonin. Vasopressin, thyroid hormone, and vitamin A do not influence
calcium and phosphate balance
It is true that Kussmaul respirations indicate:
a. Anxiety is a cause of respiratory acidosis.
b. A compensatory measure is needed to correct metabolic acidosis.
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
A patient's blood gases reveal the following findings: pH, 7.3; bicarbonate (HCO3) 27
mEq/L; carbon dioxide (CO2), 58 mm Hg. What is the interpretation of these gases?
a. Respiratory alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Metabolic alkalosis - correct answer ANS: C
The values provided in this question characterize only acute uncompensated
respiratory acidosis.
What causes the clinical manifestations of confusion, convulsions, cerebral
hemorrhage, and coma in hypernatremia?
a. High sodium in the blood vessels pulls water out of the brain cells into the blood
vessels, causing brain cells to shrink.
b. High sodium in the brain cells pulls water out of the blood vessels into the brain
cells, causing them to swell.
c. High sodium in the blood vessels pulls potassium out of the brain cells, which slows
the synapses in the brain.
d. High sodium in the blood vessels draws chloride into the brain cells followed by
water, causing the brain cells to swell - correct answer ANS: A
Hypertonic (hyperosmolar) imbalances result in an extracellular fluid concentration
greater than 0.9% salt solution (e.g., water loss or solute gain); cells shrink in a
hypertonic fluid (see Table 3-7). This shrinking of cells results in the symptoms
described in the question. The other options do not accurately describe the cause of
these symptoms as they relate to hypernatremia
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:
a. Retained sodium to bind with the chloride
b. Hydrogen to move into the cell and exchange with potassium to maintain cation
balance
c. Retention of bicarbonate to maintain the anion balance
d. Hypoventilation to compensate for the metabolic alkalosis - correct answer ANS: C
When vomiting with the depletion of ECF and chloride (hypochloremic metabolic
alkalosis) causes acid loss, renal compensation is not effective; the volume depletion
and loss of electrolytes (sodium [Na+], potassium [K+], hydrogen [H+], chlorine [Cl-])
stimulate a paradoxic response by the kidneys. The kidneys increase sodium and
bicarbonate reabsorption with the excretion of hydrogen. Bicarbonate is reabsorbed to
maintain an anionic balance because the ECF chloride concentration is decreased. The
other options do not accurately describe the mechanism that results from vomiting-
induced metabolic alkalosis.
Insulin is used to treat hyperkalemia because it:
a. Stimulates sodium to be removed from the cell in exchange for potassium.
b. Binds to potassium to remove it through the kidneys.
c. Transports potassium from the blood to the cell along with glucose.
d. Breaks down the chemical components of potassium, causing it to be no longer
effective. - correct answer ANS: C
Insulin contributes to the regulation of plasma potassium levels by stimulating the
Na+, potassium-adenosine triphosphatase (K+-ATPase) pump, thereby promoting the
movement of potassium simultaneously into the liver and muscle cells with glucose
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
transport after eating. The intracellular movement of potassium prevents an acute
hyperkalemia related to food intake. The other options do not accurately describe how
insulin is used to treat hyperkalemia
During acidosis, the body compensates for the increase in serum hydrogen ions by
shifting hydrogen ions into the cell in exchange for which electrolyte?
a. Oxygen
b. Sodium
c. Potassium
d. Magnesium - correct answer ANS: C
In states of acidosis, hydrogen ions shift into the cells in exchange for intracellular
fluid potassium; hyperkalemia and acidosis therefore often occur together. This is not
true of the other options.
Causes of hyperkalemia include:
a. Hyperparathyroidism and malnutrition
b. Vomiting and diarrhea
c. Renal failure and Addison disease
d. Hyperaldosteronism and Cushing disease - correct answer ANS: C
Hyperkalemia should be investigated when a history of renal disease, massive trauma,
insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic
acidosis exists. The other options are not known to be causes of hyperkalemia
In hyperkalemia, what change occurs to the cells' resting membrane potential?
, NURS 6320 Final Ch 2, 3, 8, 9 (Latest
Update )
QUESTIONS AND CORRECT DETAILED
ANSWER [GRADE A+]
a. Hypopolarization
b. Hyperexcitability
c. Depolarization
d. Repolarization - correct answer ANS: A
If extracellular potassium concentration increases without a significant change in
intracellular potassium, then the resting membrane potential becomes more positive
(i.e., changes from -90 to -80 mV) and the cell membrane is hypopolarized (i.e., the
inside of the cell becomes less negative or partially depolarized [increase excitability]).
The calcium and phosphate balance is influenced by which three substances?
a. Parathyroid hormone, vasopressin, and vitamin D
b. Parathyroid hormone, calcitonin, and vitamin D
c. Thyroid hormone, vasopressin, and vitamin A
d. Thyroid hormone, calcitonin, and vitamin A - correct answer ANS: B
Three hormones regulate calcium and phosphate balance: parathyroid hormone (PTH),
vitamin D, and calcitonin. Vasopressin, thyroid hormone, and vitamin A do not influence
calcium and phosphate balance
It is true that Kussmaul respirations indicate:
a. Anxiety is a cause of respiratory acidosis.
b. A compensatory measure is needed to correct metabolic acidosis.
