Question

What is the normal range of serum calcium in adults?

Answer 1

Correct Answers:

8.50 to 10.50 mg/dL

Rationale :

The normal serum calcium range in adults is approximately 8.5 to 10.5 mg/dL. Calcium is essential for neuromuscular activity, cardiac function, and bone health. Values below or above this range may indicate hypocalcemia or hypercalcemia, both of which require clinical attention.

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Answer 2

Correct Answers:

Metabolic acidosis, uncompensated

Rationale :

A pH of 7.33 (acidic) with a normal PaCO₂ (40 mm Hg) and decreased HCO₃⁻ (20 mEq/L) indicates metabolic acidosis without respiratory compensation. This is common in diabetic ketoacidosis (DKA), where the kidneys cannot neutralize excess ketones.

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Answer 3

Correct Answers:

Active transport

Rationale :

Active transport requires cellular energy (ATP) to move substances against a concentration gradient. Unlike diffusion, osmosis, or filtration, this mechanism is used to move ions like sodium and potassium where higher concentration already exists.

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Answer 4

Correct Answers:

Glucose

Rationale :

Electrolytes are charged particles like sodium, potassium, and magnesium. Glucose is a nonelectrolyte—it does not dissociate into ions in solution. It plays a critical role in energy metabolism but does not conduct electricity in fluid.

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Answer 5

Correct Answers:

Elderly patient with fever and nausea and vomiting

Rationale :

Among the listed options, the elderly patient with fever, nausea, and vomiting is at the highest risk for dehydration. Older adults have a diminished thirst sensation and decreased total body water content, making them more vulnerable to fluid volume deficits. Additionally, gastrointestinal losses from vomiting and insensible fluid loss due to fever further compound the risk. Aging also results in a decline in renal concentrating ability, impairing the body’s ability to conserve water efficiently. Without prompt recognition and fluid replacement, dehydration in elderly clients can rapidly progress to hypotension, electrolyte imbalance, or acute kidney injury. Therefore, close monitoring and early intervention are essential for this population.

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Answer 6

Correct Answers:

Metabolic alkalosis

Rationale :

The client’s arterial blood gas (ABG) values show a pH of 7.6, PaCO₂ of 40 mm Hg, and HCO₃⁻ of 32 mEq/L. The elevated pH indicates alkalosis, and the PaCO₂ being within the normal range (35–45 mm Hg) rules out a respiratory origin. The increased HCO₃⁻ confirms a metabolic cause, as bicarbonate is a base that helps buffer excess hydrogen ions. When HCO₃⁻ levels are high in the setting of alkalosis, the diagnosis is metabolic alkalosis. This condition can result from factors such as vomiting, nasogastric suctioning, or excessive bicarbonate intake, all of which lead to hydrogen ion loss or bicarbonate retention.

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Answer 7

Correct Answers:

135 to 145 mEq/L

Rationale :

The normal serum sodium level in adults ranges from 135 to 145 mEq/L. Sodium is the primary extracellular electrolyte that regulates fluid volume, osmotic pressure, acid-base balance, and neuromuscular function. Deviations below this range may lead to hyponatremia, characterized by confusion, seizures, and muscle weakness. Conversely, values above this range indicate hypernatremia, presenting with symptoms such as intense thirst, dry mucous membranes, and neurological deficits. Maintaining sodium within the normal range is critical to cellular hydration and physiological stability.

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Answer 8

Correct Answers:

Dry mucous membranes
Intense thirst

Rationale :

In hypernatremia, the serum sodium level is elevated, leading to a hyperosmolar state in which water shifts out of cells, causing cellular dehydration. The body responds with mechanisms such as thirst and reduced secretions to conserve water. Clinical signs include dry mucous membranes due to decreased salivary secretion and intense thirst as the hypothalamus triggers fluid intake behavior. Other symptoms may include lethargy, confusion, or irritability in severe cases.

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Answer 9

Correct Answers:

Kussmaul's respirations

Rationale :

Kussmaul respirations are characterized by deep, rapid, and labored breathing and are a compensatory response to metabolic acidosis, most notably diabetic ketoacidosis (DKA). This breathing pattern allows for excess carbon dioxide to be expelled, reducing blood acidity. It is distinct from other abnormal respiratory patterns such as Cheyne-Stokes (periodic breathing with apnea), Biot's (irregular), or bradypnea (slow breathing). Recognizing Kussmaul's respirations is crucial in identifying underlying metabolic imbalances and initiating prompt treatment to prevent complications like coma. This pattern is often observed in clients with uncontrolled diabetes who present in a state of acidosis.

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Answer 10

Correct Answers:

Potassium level of 3.0 mEq/L

Rationale :

In respiratory alkalosis (pH 7.50 and PaCO₂ 30 mm Hg), a common secondary imbalance is hypokalemia due to potassium shifting into the intracellular space in exchange for hydrogen ions. A potassium level of 3.0 mEq/L is below the normal range (3.5–5.0 mEq/L) and may manifest as muscle weakness, arrhythmias, or fatigue. This occurs because alkalosis causes increased cellular uptake of potassium as the body attempts to buffer the elevated pH. Monitoring and correcting serum potassium is essential to prevent cardiac complication. Nurses should assess for ECG changes and symptoms of hypokalemia in any client with alkalosis.

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RN Fundamental Exam Chapter 25

No.

1 : What is the normal range of serum calcium in adults?

2 : Lena Mason, who has diabetes, is admitted in a stuporous condition. Her blood gases show a pH of 7.33, PaC02 of 40 mm Hg, and HC03- of 20 mEq/L. What type of acid-base imbalance does this patient have?

3 : Which transport mechanism involves cellular energy?

4 : The nurse points out that electrolytes are essential for health. Nonelectrolytes include:

5 : Which patient is at the highest risk for dehydration?

6 : A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABGs are:

pH 7.6

PaC02 40 mm Hg

HC03 32 mEq/L

Which of the following acid-base conditions should the nurse identify the client is experiencing?

7 : What is the normal range of serum sodium in adults?

8 : The nurse is caring for a client with leukemia and notes that the client has poor skin turgor and flat neck and hand veins. The nurse suspects hypernatremia. Which sign/symptom would the nurse expect to note in this client if hypernatremia is present?

9 : The nurse observed that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, and rapid respirations.

How would the nurse document this observation in the medical record?

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RN Fundamental Exam Chapter 25

No.

1 : What is the normal range of serum calcium in adults?

2 : Lena Mason, who has diabetes, is admitted in a stuporous condition. Her blood gases show a pH of 7.33, PaC02 of 40 mm Hg, and HC03- of 20 mEq/L. What type of acid-base imbalance does this patient have?

3 : Which transport mechanism involves cellular energy?

4 : The nurse points out that electrolytes are essential for health. Nonelectrolytes include:

5 : Which patient is at the highest risk for dehydration?

6 : A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABGs are:pH 7.6PaC02 40 mm HgHC03 32 mEq/LWhich of the following acid-base conditions should the nurse identify the client is experiencing?

7 : What is the normal range of serum sodium in adults?

8 : The nurse is caring for a client with leukemia and notes that the client has poor skin turgor and flat neck and hand veins. The nurse suspects hypernatremia. Which sign/symptom would the nurse expect to note in this client if hypernatremia is present?

9 : The nurse observed that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, and rapid respirations.How would the nurse document this observation in the medical record?

6 : A nurse is reviewing the arterial blood gas (ABG) results of a client. The client's ABGs are:

pH 7.6

PaC02 40 mm Hg

HC03 32 mEq/L

Which of the following acid-base conditions should the nurse identify the client is experiencing?

9 : The nurse observed that a client with diabetic ketoacidosis is experiencing abnormally deep, regular, and rapid respirations.

How would the nurse document this observation in the medical record?