Exam Review

A client admitted to the emergency department with bacterial pneumonia has ABGs showing pH 7.25, PCO2 68 mmHg, and HCO3 24 mEq/L. The client is started on antibiotics and oxygen therapy. Which nursing intervention should be prioritized to address this client's acid-base imbalance and respiratory status?
A)
Monitor vital signs frequently.
B)
Administer sodium bicarbonate to correct the acidosis immediately.
C)
Monitor cardiac rhythm.
D)
Encourage coughing and deep breathing.
A nurse is reviewing the laboratory data of a client following a hemodialysis treatment. The nurse should expect to find a decrease in which of the following laboratory values?
A)
Phosphorus.
B)
Calcium.
C)
RBC count.
D)
Protein.
A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?
A)
Urine output of 240 mL in the past 12 hr.
B)
First-voided urine in the morning has a strong odor.
C)
Urine output of 2,200 mL in the past 24 hr.
D)
Urine is cloudy after sitting in the urinal for 6 hr.
A 36-year-old diabetic patient reports taking several large doses of Ibuprofen after a back injury. Upon assessment the nurse notes weakness, palpitations, and EKG changes (peaked T-waves). Based on these findings, which condition is the client most likely experiencing?
A)
Hyperkalemia.
B)
Hypokalemia.
C)
Hyperphosphatemia.
D)
Hypercalcemia.

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Exam Review

A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values: pH 7.22, PaCO2 68 mm Hg, Base excess -2, PaO2 78 mm Hg, Saturation 80 Which of the following is an appropriate analysis of the ABGs?
A)
Respiratory acidosis fully compensated.
B)
Metabolic acidosis partially compensated.
C)
Respiratory acidosis uncompensated.
D)
Respiratory alkalosis partially compensated.
A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of an acute kidney injury. Which of the following findings should the nurse identify as indicating an increased risk of acute kidney injury (AKI)?
A)
Serum Osmolality 290 mOsm/kg.
B)
Magnesium 2.0 mEq/L.
C)
Serum creatinine 1.8 mg/dL.
D)
Blood urea nitrogen (BUN) 22 mg/dL.
A nurse is caring for a client following his first hemodialysis treatment. The client reports a headache, nausea, and restlessness. The nurse should identify these findings as manifestations of which of the following complications?
A)
Septicemia.
B)
Peritonitis.
C)
Dialysis disequilibrium.
D)
Air embolism.
A nurse is reviewing the arterial blood gas results for a client in the ICU who has pneumonia and acute tubular necrosis (ATN). The nurse determines that the client has metabolic acidosis. Which of the following findings should the nurse expect?
A)
Widened QRS complexes.
B)
Cool, pale to cyanotic skin.
C)
Bounding peripheral pulses.
D)
Hyperactive deep tendon reflexes.

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Exam Review

A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. Which of the following scheduled medications should the nurse plan to administer?
(SATA)
A)
Lisinopril.
B)
Potassium iodide.
C)
Bumex.
D)
Sodium polystyrene sulfonate.
A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?
A)
Lethargy and confusion.
B)
Abdominal pain.
C)
Dry skin.
D)
Numbness of fingers.
A patient presents with arterial blood gas values showing a low pH and an elevated pCO2. Based on these findings, which conditions could be responsible for this acid-base imbalance? Select all that apply.
A)
Hypoventilation from opioid overdose.
B)
Respiratory failure due to neuromuscular disease.
C)
Severe asthma attack with bronchiole constriction.
D)
Excessive antacid ingestion.
E)
End stage renal failure.
F)
Hyperventilation from anxiety.
G)
Acute exacerbation of chronic obstructive pulmonary disease (COPD).
H)
Acute diarrhea causing bicarbonate loss.
I)
Diabetic ketoacidosis.
A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? Select all that apply.
A)
Bradypnea.
B)
Hypotension.
C)
Pruritus.
D)
Slurred speech.
E)
Bone pain.

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Exam Review

A nurse is reviewing the arterial blood gas results of a client with the following values: pH 7.51, HCO3 33 mEq/L, and PaCO2 45 mm Hg. Based on these results, which acid-base imbalance should the nurse identify, and what is the most appropriate initial nursing action?
A)
Metabolic acidosis: prepare to administer sodium bicarbonate if condition worsens.
B)
Metabolic alkalosis: monitor respiratory rate and monitor oxygenation status.
C)
Respiratory alkalosis: administer a sedative to reduce hyperventilation.
D)
Respiratory acidosis: prepare for intubation and mechanical ventilation immediately.
A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte imbalances should the nurse expect?
A)
Hypercalcemia.
B)
Hypokalemia.
C)
Hypophosphatemia.
D)
Hyponatremia.
A nurse reviews the arterial blood gas results of a client with a pH of 7.48, PaCO2 of 33 mm Hg, and HCO3 of 23 mEq/L. Which acid-base imbalance should the nurse identify, and what is the priority nursing intervention?
A)
Metabolic acidosis: administer sodium bicarbonate to correct low bicarbonate levels.
B)
Respiratory alkalosis: encourage the client to breathe into a paper bag to increase CO2 retention.
C)
Metabolic alkalosis: monitor for hypokalemia and restrict bicarbonate intake.
D)
Respiratory acidosis: assess airway patency and prepare to assist with ventilation if needed.
A nurse is assessing a client who has end-stage kidney disease and is receiving hemodialysis. Which of the following findings should the nurse identify as an indication the client is experiencing stable weight gain?
A)
Flattened neck veins.
B)
Oxygen saturation 93
C)
The client has a 2 lb weight gain since yesterday.
D)
Return of skin to previous position when the client's shin is palpated.

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Exam Review

An infant with prolonged vomiting secondary to pyloric stenosis has arterial blood gases (ABG) drawn. Which ABG results should a nurse expect when reviewing the laboratory report if the infant has an acid-base imbalance?
A)
Elevated pH, decreased HCO3, and increased PaCO2 indicating respiratory alkalosis with metabolic compensation.
B)
Decreased pH, increased HCO3, and decreased PaCO2 indicating respiratory acidosis with metabolic compensation.
C)
Elevated pH, increased HCO3, and decreased PaCO2 indicating metabolic alkalosis with respiratory compensation.
D)
Decreased pH, decreased HCO3, and increased PaCO2 indicating metabolic acidosis with respiratory compensation.
A nurse is teaching a client who has chronic kidney disease about the process of continuous ambulatory peritoneal dialysis (CAPD). Which of the following information should the nurse include in the teaching?
A)
CAPD filters the client's blood through an artificial device called a dialyzer.
B)
CAPD requires a rigid schedule of exchange times.
C)
CAPD is the dialysis treatment of choice for clients who have a history of abdominal surgery.
D)
CAPD requires the client to follow fewer dietary and fluid restrictions than hemodialysis requires.
A nurse is teaching a client who has chronic kidney failure about planning a low-protein diet. The client states, "Why do I have to be concerned about protein?" Which of the following responses should the nurse make?
A)
"A low-protein diet reduces the risk for uremia.”.
B)
"A low-protein diet will reduce the risk for hyperkalemia.”.
C)
"A low-protein diet reduces the risk for edema.”.
D)
"A low-protein diet will increase the nitrogenous wastes in the blood.”.
A nurse is caring for a group of clients diagnosed with polycystic kidney disease (PKD). While teaching about ways to slow the progression to end-stage renal disease (ESRD), which of the following topics would be most important for the nurse to include?
A)
Fluid restriction.
B)
Blood glucose control.
C)
Pain management.
D)
Blood pressure control.

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Exam Review

A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has respiratory alkalosis. Which of the following results should the nurse expect to see to confirm respiratory alkalosis?
A)
pH above 7.45.
B)
PaO2 below 70 mm Hg.
C)
HCO3 above 26 mEq/L.
D)
PaCO2 below 35 mm Hg.
A nurse is reviewing the arterial blood gas values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
A)
pH 7.50, HCO3 20 mEq/L, PaCO2 32 mm Hg.
B)
pH 7.55, HCO3 30 mEq/L, PaCO2 31 mm Hg.
C)
pH 7.25, HCO3 19 mEq/L, PaCO2 30 mm Hg.
D)
pH 7.30, HCO3 26 mEq/L, PaCO2 50 mm Hg.
A nurse is admitting a client who presents with a fever, tachypnea, hyperactive reflexes and reports worsening anxiety and new onset of tremors. The nurse should recognize that the client is experiencing which of the following conditions.
A)
Respiratory acidosis.
B)
Respiratory alkalosis.
C)
Metabolic acidosis.
D)
Metabolic alkalosis.
A nurse is caring for a client who presented to the emergency room with an overdose of salicylate (aspirin) with a respiratory rate of 22 per min. Which of the following acid-base imbalances should the nurse identify the client as being at risk for developing initially.
A)
Respiratory acidosis.
B)
Respiratory alkalosis.
C)
Metabolic alkalosis.
D)
Metabolic acidosis.

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