Nokea
A nurse admits a client to the emergency department who reports nausea, vomiting, and epigastric pain that worsens when lying down. The provider suspects acute pancreatitis. Which of the following laboratory test results should the nurse expect to see?
- A. Increased serum amylase
- B. Decreased WBC count
- C. Increased serum calcium
- D. Decreased serum lipase
Correct Answer: A
Rationale: Serum amylase rises quickly in acute pancreatitis due to pancreatic inflammation.
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A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5 mg/kg/dose subcutaneously every 12 hours. The client weighs 245 lbs. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 167
Rationale: Calculation: 245 lbs ÷ 2.2 = 111.36 kg; 111.36 kg × 1.5 mg/kg = 167 mg
A nurse is reviewing the arterial blood gas (ABG) values of a client who has chronic kidney disease. Which of the following sets of values should the nurse expect?
- A. pH 7.25, HCO3- 19 mEq/L, PaCO2 30 mm Hg
- B. pH 7.50, HCO3- 20 mEq/L, PaCO2 32 mm Hg
- C. pH 7.55, HCO3- 30 mEq/L, PaCO2 31 mm Hg
- D. pH 7.30, HCO3- 26 mEq/L, PaCO2 50 mm Hg
Correct Answer: A
Rationale: The values indicate metabolic acidosis with compensatory respiratory alkalosis, typical in CKD due to impaired acid excretion.
A student nurse is reviewing clinical manifestations of chronic kidney disease. Which of the following findings are consistent with this diagnosis? (Select all that apply)
- A. Hypokalemia
- B. Anemia
- C. Hypertension
- D. Crackles in the lungs
- E. Lethargy
- F. Proteinuria
Correct Answer: B,C,E,F
Rationale: These reflect common CKD complications including erythropoietin deficiency, fluid overload, uremia, and glomerular damage.
A nurse is assessing a client and discovers the infusion pump with the client's total parenteral nutrition (TPN) solution is not infusing. The nurse should monitor the client for which of the following clinical manifestations?
- A. Fever and chills
- B. Hypertension and crackles
- C. Excessive thirst and urination
- D. Shakiness and diaphoresis
Correct Answer: D
Rationale: These are signs of hypoglycemia from sudden TPN interruption.
A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider immediately?
- A. Bubbling of the water in the water seal chamber with exhalation
- B. Crepitus in the area above and surrounding the insertion site
- C. Movement of the trachea toward the unaffected side
- D. Eyelets are not visible
Correct Answer: B
Rationale: Crepitus indicates subcutaneous emphysema, which requires immediate attention as it suggests air leaking into tissues.