Question

A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?

Answer 1

Correct Answers:

Potassium 2.9 mEq/L

Rationale :

🔺 Potassium 2.9 mEq/L is a critically low value and poses a risk for life-threatening cardiac dysrhythmias.

🔺 Furosemide is a loop diuretic that promotes renal potassium loss, increasing the risk for hypokalemia.

🔺 Signs of hypokalemia can include muscle weakness, arrhythmias, and ileus, making this a priority finding.

🔺 The other lab values are either normal or less immediately dangerous compared to severe hypokalemia.

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Answer 2

Correct Answers:

The client who has gastroenteritis and is febrile.

Rationale :

🖋️ Clients with gastroenteritis lose fluids through vomiting, diarrhea, and fever-induced insensible losses.

🖋️ Fever increases metabolic demands and evaporative fluid loss, contributing to fluid volume deficit.

🖋️ This client is at the highest risk of dehydration among the listed options.

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Answer 3

Correct Answers:

Other electrolyte disturbances.

Rationale :

▶️ Hypocalcemia often occurs alongside hypomagnesemia and hypoparathyroidism, making monitoring of other electrolytes essential.

▶️ Electrolyte imbalances are interrelated and can exacerbate neuromuscular symptoms.

▶️ Identifying concurrent disturbances helps guide effective treatment.

▶️ Drug toxicity and hypertension are not primary concerns in basic hypocalcemia assessment.

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Answer 4

Correct Answers:

Distended neck veins.

Rationale :

🎗️ Fluid volume overload causes increased venous return and right-sided heart strain, leading to jugular venous distension.

🎗️ Other signs may include pulmonary crackles, edema, and bounding pulses.

🎗️ Poor skin turgor and concentrated labs are associated with fluid deficit, not overload.

🎗️ Decreased urine output can occur in overload but is less specific than neck vein distention.

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Answer 5

Correct Answers:

Warm, flushed skin.

Rationale :

💎 In respiratory acidosis, CO₂ retention leads to vasodilation, manifesting as warm and flushed skin.

💎 Other signs include headache, confusion, and decreased respiratory drive.

💎 QRS widening and hyperreflexia are more common in other electrolyte imbalances or alkalosis.

💎 Understanding skin changes aids early recognition of acid-base imbalances.

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Answer 6

Correct Answers:

Respiratory acidosis.

Rationale :

🟥 A pH of 7.22 and PaCO₂ of 68 mm Hg indicate a primary respiratory acid-base disturbance.

🟥 The bicarbonate (HCO₃) level is normal, meaning no metabolic compensation has occurred.

🟥 A slow respiratory rate (7/min) causes CO₂ retention, the hallmark of respiratory acidosis.

🟥 Clinical signs can include confusion, dyspnea, and reduced oxygen saturation.

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Answer 7

Correct Answers:

Lethargy.
Circumoral paresthesia.
Bicarbonate excess.

Rationale :

🔷 Lethargy

🔷 In metabolic alkalosis, the elevated blood pH depresses the central nervous system, leading to symptoms like lethargy and confusion.

🔷 Reduced hydrogen ion concentration affects neuronal excitability, resulting in decreased mental alertness.

🔷 This is a common manifestation seen in clients with metabolic alkalosis due to prolonged vomiting or excessive bicarbonate intake.

🔷 Circumoral paresthesia

🔷 Tingling around the mouth occurs due to neuromuscular excitability, which is heightened in alkalotic states.

🔷 The alkalosis shifts calcium binding to albumin, decreasing ionized calcium and causing paresthesias.

🔷 Nurses should monitor for additional neuromuscular symptoms such as muscle cramps or tetany.

🔷 Bicarbonate excess

🔷 A defining laboratory marker of metabolic alkalosis is elevated serum bicarbonate (HCO₃⁻).

🔷 Excess bicarbonate increases the pH, disrupting acid-base homeostasis and causing systemic effects.

🔷 Identifying bicarbonate elevation helps confirm diagnosis and guides targeted treatment (e.g., fluid replacement, correcting underlying cause).

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Answer 8

Correct Answers:

Extracellular fluid deficit.

Rationale :

🪄 Severe burns cause plasma and fluid to leak into interstitial spaces, depleting extracellular fluid volume.

🪄 Hypovolemia from capillary permeability can result in shock if untreated.

🪄 The nurse must monitor fluid balance and ensure aggressive fluid resuscitation.

🪄 Burn injuries primarily disrupt vascular fluid volume, not intracellular fluid levels.

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Answer 9

Correct Answers:

Dysrhythmias.
Kussmaul respirations.
Weakness.

Rationale :

Kussmaul respirations

✍️ These are deep, rapid breathing patterns seen as a compensatory mechanism for metabolic acidosis.

✍️ The body attempts to exhale excess CO₂ to reduce acidity and raise the pH level.

✍️ This is commonly observed in diabetic ketoacidosis (DKA) and indicates the body is trying to correct the acidosis.

Weakness

✍️ In metabolic acidosis, the imbalance of hydrogen ions interferes with muscle contraction and cellular metabolism.

✍️ This leads to generalized muscle weakness and fatigue, which may progress to hypotonia.

✍️ Patients often report feeling drained or unable to perform daily activities due to energy deficit at the cellular level.

Dysrhythmias

✍️ Acidosis causes potassium to shift out of cells, leading to hyperkalemia, which increases the risk for cardiac arrhythmias.

✍️ The myocardium becomes more irritable, and conduction may be altered, especially in DKA or renal failure.

✍️ Continuous ECG monitoring is essential to detect life-threatening rhythm changes early.

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Answer 10

Correct Answers:

Normal saline.
Increased Vitamin D intake.

Rationale :

Normal saline

💎 Isotonic saline promotes renal excretion of excess phosphate by increasing glomerular filtration.

💎 It helps correct dehydration and supports renal clearance of electrolytes like phosphate in hyperphosphatemia.

💎 Hydration with saline is a frontline intervention to flush out phosphate especially in patients with intact kidney function.

Increased Vitamin D intake

💎 Vitamin D enhances calcium absorption, which indirectly suppresses parathyroid hormone (PTH) and reduces phosphate reabsorption.

💎 It aids in correcting secondary hyperparathyroidism often associated with chronic phosphate imbalance.

💎 The regulation of calcium and phosphate is tightly linked, and Vitamin D helps restore this balance.

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Custom Fluid &Electrolyte Exam-Summer 2023

No.

1 :
A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?

2 :
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

3 :
The nurse is caring for a patient diagnosed with hypocalcemia. What additional assessments should the nurse include when caring for this patient?

4 :
A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

5 :
A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

6 :
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, Pac02 68 mm Hg, Base excess -2, Pa02 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L.

7 :
A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).

8 :
The nurse is planning care for a patient with severe burns. What health problem should the nurse realize that this patient could develop?

10 :
A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.

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Custom Fluid &Electrolyte Exam-Summer 2023

No.

1 : A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?

2 : A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

3 : The nurse is caring for a patient diagnosed with hypocalcemia. What additional assessments should the nurse include when caring for this patient?

4 : A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

5 : A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

6 : A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, Pac02 68 mm Hg, Base excess -2, Pa02 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L.

7 : A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).

8 : The nurse is planning care for a patient with severe burns. What health problem should the nurse realize that this patient could develop?

10 : A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.

1 :
A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding?

2 :
A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

3 :
The nurse is caring for a patient diagnosed with hypocalcemia. What additional assessments should the nurse include when caring for this patient?

4 :
A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

5 :
A nurse is reviewing the arterial blood gas results for a client in the ICU who has kidney failure and determines the client has respiratory acidosis. Which of the following findings should the nurse expect?

6 :
A client is admitted to the emergency room with a respiratory rate of 7/min. Arterial blood gases (ABG) reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22, Pac02 68 mm Hg, Base excess -2, Pa02 78 mm Hg, Saturation 80%, Bicarbonate 26 mEq/L.

7 :
A nurse is caring for a client who has metabolic alkalosis. For which of the following clinical manifestations should the nurse monitor? (Select all that apply.).

8 :
The nurse is planning care for a patient with severe burns. What health problem should the nurse realize that this patient could develop?

10 :
A patient has a serum phosphate level of 4.7 mg/dL. Which treatments should the nurse expect to be prescribed for this patient? Select all that apply.