Question

A patient is admitted to the emergency department for vomiting and diarrhea that has lasted 4 days. The patient's current weight is 154 pounds. The health care provider has diagnosed the patient with a viral infection. The nurse has been monitoring intravenous fluids and urine output. Which urinary output indicates the efforts to rehydrate this patient have been successful?

Answer 1

Correct Answers:

40 mL/hr

Rationale :

🟢 The best indicator of adequate kidney perfusion and hydration is urine output.

🟢 For adults, the expected urine output is at least 30 mL/hr (≈ 0.5 mL/kg/hr).

🟢 At 40 mL/hr, this patient’s urine output shows effective rehydration and adequate renal function.

🟢 Outputs of 10, 20, or 25 mL/hr indicate oliguria, suggesting that the patient is still volume-depleted or has impaired kidney perfusion.

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Answer 2

Correct Answers:

Fluid volume excess

Rationale :

🟢 In older adults, receiving IV fluids at a rapid rate (150 mL/hr) can easily lead to fluid overload due to decreased cardiac and renal reserve.

🟢 Signs of fluid volume excess include crackles in the lungs (pulmonary congestion), shortness of breath (dyspnea), jugular vein distention (JVD), and peripheral edema.

🟢 This condition can progress to pulmonary edema and heart failure if not promptly managed by slowing or stopping fluids and notifying the healthcare provider.

🟢 Allergic reaction presents with rash, itching, or anaphylaxis; septic shock is linked to infection; pulmonary embolism presents with sudden chest pain and hypoxemia—none fit the findings here.

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Answer 3

Correct Answers:

13

Rationale :

Given:

Total volume = 50 mL
Time = 4 hours

Formula:

mL/hr = Total Volume ÷ Time

mL/hr = 50 ÷ 4 = 12.5 mL/hr

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Answer 4

Correct Answers:

Flaccid muscle tone

Rationale :

🔹 Hypermagnesemia (Mg 3.2 mEq/L) depresses the central nervous system and neuromuscular junction. Instead of stimulating the muscles, excess magnesium reduces excitability, which leads to muscle weakness and hyporeflexia.

🔹 As levels rise above normal, patients may lose deep tendon reflexes and exhibit flaccid muscle tone. This is in contrast to hypomagnesemia, which causes twitching, tetany, and hand contractions (Chvostek’s/Trousseau’s signs).

🔹 The nurse would also monitor for additional complications such as bradycardia, hypotension, and respiratory depression, since magnesium acts as a smooth muscle relaxant.

🔹 Flaccid muscle tone is the hallmark neuromuscular effect of high magnesium and indicates the need for close monitoring and possible interventions (such as stopping magnesium-containing infusions and preparing to administer calcium gluconate as an antidote).

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Answer 5

Correct Answers:

Muscle tremors

Rationale :

🔹 Hypomagnesemia overstimulates the nervous system, which can manifest as tremors, tetany, seizures, and positive Chvostek’s/Trousseau’s signs.

🔹 Weakness and paralysis are more typical of hypermagnesemia, where the muscles become flaccid.

🔹 Hypotension can occur in hypermagnesemia due to vasodilation.

🔹 At very low magnesium, the main hallmark is neuromuscular hyperexcitability → tremors.

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Answer 6

Correct Answers:

Cardiac dysrhythmias

Rationale :

🔹 Hypokalemia alters cardiac repolarization, which can cause premature ventricular contractions, atrial or ventricular tachycardia, and in severe cases, ventricular fibrillation.

🔹 Furosemide (a loop diuretic) promotes potassium loss in the urine, making this complication common.

🔹 Symptoms can also include muscle weakness and cramps, but the most dangerous complication is cardiac dysrhythmia.

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Answer 7

Correct Answers:

Nitroglycerin

Rationale :

⭐Furosemide (Lasix) is a loop diuretic that increases the excretion of sodium, chloride, and water, but it also causes significant potassium loss in the urine. This makes hypokalemia (like 2.4 mEq/L) a common adverse effect.

⭐Nitroglycerin is a vasodilator used for angina/heart failure, but it does not lower potassium.

⭐Metoprolol (Lopressor), a beta-blocker, affects heart rate and blood pressure but not potassium levels.

⭐Spironolactone (Aldactone) is a potassium-sparing diuretic, which retains potassium and can even cause hyperkalemia, not hypokalemia.

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Answer 8

Correct Answers:

Tingling of the extremities

Rationale :

⚡Hypocalcemia increases neuromuscular excitability. Common findings include numbness, tingling of the fingers, toes, and mouth, muscle cramps, tetany, and positive Chvostek’s and Trousseau’s signs.

⚡Hypoactive reflexes, constipation, and shortened QT intervals are associated with hypercalcemia (too much calcium suppresses excitability).

⚡Since the client had a thyroidectomy, damage or removal of the parathyroid glands may have caused low calcium levels.

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Answer 9

Correct Answers:

Phosphorus 1.7 mg/dL

Rationale :

📌Normal phosphorus = 2.5–4.5 mg/dL. A level of 1.7 mg/dL indicates hypophosphatemia, which can impair ATP production, muscle function, and oxygen delivery. This is a significant concern in the preoperative setting, as it may cause respiratory muscle weakness, cardiac dysfunction, and neurological changes.

📌Magnesium 1.9 mEq/L is within the normal range (1.5–2.5 mEq/L).

📌Potassium 5.0 mEq/L is at the upper limit of normal (3.5–5.0 mEq/L) but acceptable.

📌Calcium 8.8 mg/dL is within the normal range (8.5–10.5 mg/dL).

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Answer 10

Correct Answers:

Increase in urine specific gravity

Rationale :

💧In dehydration, the kidneys conserve water by producing concentrated urine, which raises the urine specific gravity (>1.030).

💧Serum osmolarity and serum sodium usually increase, not decrease, due to fluid loss.

💧BUN also increases with dehydration because of reduced renal perfusion and concentration of nitrogenous wastes.

💧Since this patient has fever, pneumonia, and dehydration, the best expected finding is high urine specific gravity reflecting concentrated urine output.

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NUR 151

No.

2 :
The nurse is caring for an older adult patient who is receiving intravenous fluids at 150 mL/hr. Upon assessment, the nurse notes crackles, shortness of breath, and jugular vein distention. Based on this data, which complication of IV fluid therapy does the nurse anticipate?

3 :
The nurse is giving Magnesium Sulfate 4 GM in 50 mL IVPB for a low magnesium level. The infusion runs over 4 hours. How many mL/hr will this run? Input only numbers, round to the tenth if applicable.

4 :
The nurse is caring for a patient with a magnesium level of 3.2 mEq/L? Which assessment finding would the nurse expect to see?

5 :
The nurse is assessing a patient with a magnesium level of 1.2 mg/dL and expects which finding related to the lab value?

6 :
A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.1 mEq/L. The nurse should monitor the client for which of the following complications?

7 :
A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

8 :
A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

9 :
The nurse is caring for a patient in the pre-op area of the surgical suite. The nurse understands which of the following lab values needs called to the health care provider?

10 :
The nurse would expect to see which laboratory value in a patient with a fever, admitted with pneumonia and dehydration?

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NUR 151

No.

2 : The nurse is caring for an older adult patient who is receiving intravenous fluids at 150 mL/hr. Upon assessment, the nurse notes crackles, shortness of breath, and jugular vein distention. Based on this data, which complication of IV fluid therapy does the nurse anticipate?

3 : The nurse is giving Magnesium Sulfate 4 GM in 50 mL IVPB for a low magnesium level. The infusion runs over 4 hours. How many mL/hr will this run? Input only numbers, round to the tenth if applicable.

4 : The nurse is caring for a patient with a magnesium level of 3.2 mEq/L? Which assessment finding would the nurse expect to see?

5 : The nurse is assessing a patient with a magnesium level of 1.2 mg/dL and expects which finding related to the lab value?

6 : A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.1 mEq/L. The nurse should monitor the client for which of the following complications?

7 : A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

8 : A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

9 : The nurse is caring for a patient in the pre-op area of the surgical suite. The nurse understands which of the following lab values needs called to the health care provider?

10 : The nurse would expect to see which laboratory value in a patient with a fever, admitted with pneumonia and dehydration?

2 :
The nurse is caring for an older adult patient who is receiving intravenous fluids at 150 mL/hr. Upon assessment, the nurse notes crackles, shortness of breath, and jugular vein distention. Based on this data, which complication of IV fluid therapy does the nurse anticipate?

3 :
The nurse is giving Magnesium Sulfate 4 GM in 50 mL IVPB for a low magnesium level. The infusion runs over 4 hours. How many mL/hr will this run? Input only numbers, round to the tenth if applicable.

4 :
The nurse is caring for a patient with a magnesium level of 3.2 mEq/L? Which assessment finding would the nurse expect to see?

5 :
The nurse is assessing a patient with a magnesium level of 1.2 mg/dL and expects which finding related to the lab value?

6 :
A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.1 mEq/L. The nurse should monitor the client for which of the following complications?

7 :
A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as the cause of the client's low potassium level?

8 :
A nurse is caring for a client who had total thyroidectomy and a serum calcium level of 7.6 mg/dL. Which of the following findings should the nurse expect?

9 :
The nurse is caring for a patient in the pre-op area of the surgical suite. The nurse understands which of the following lab values needs called to the health care provider?

10 :
The nurse would expect to see which laboratory value in a patient with a fever, admitted with pneumonia and dehydration?