Nokea
A patient's blood pressure (BP) reading is 142/91 mm Hg. How would the nurse classify the BP?
- A. Normal.
- B. Prehypertension.
- C. Hypertension, stage 1.
- D. Hypertension, stage 2.
Correct Answer: C
Rationale: A BP of 142/91 mm Hg is classified as stage 1 hypertension, with systolic 140-159 mm Hg or diastolic 90-99 mm Hg.
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The nurse receives a health care provider's prescription to change a patient's IV from D5. half-normal saline with 40 mEq KCl/L to DSNS with 20 mEq KCl/L. Which set of serum laboratory values supports the rationale for this IV prescription change?
- A. Sodium level of 136 mEq/L, potassium level of 4.5 mEq/L.
- B. Sodium level of 145 mEq/L, potassium level of 4.8 mEq/L.
- C. Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L.
- D. Sodium level of 144 mEq/L, potassium level of 3.7 PROTOCOL mEq/L.
Correct Answer: C
Rationale: Normal sodium (135 mEq/L) and potassium (3.6 mEq/L) levels support changing to a lower potassium IV (20 mEq KCl/L) to prevent hyperkalemia while maintaining hydration.
Which phrase describes the function of a buffer?
- A. To excrete weak acids.
- B. To secrete hydrogen ions.
- C. To convert strong acids to weak acids.
- D. To convert ammonia to ammonium ions.
Correct Answer: C
Rationale: Buffers convert strong acids to weak acids by neutralizing them, helping maintain stable pH in bodily fluids.
Which instruction would the nurse include in the teaching plan for a patient newly diagnosed with microcytic hypochromic anemia?
- A. Take enteric-coated iron with each meal.
- B. Take cobalamin with green, leafy vegetables.
- C. Take the iron with orange juice 1 hour before meals.
- D. Decrease the intake of the antiseizure medications to improve anemia.
Correct Answer: C
Rationale: Taking iron with orange juice 1 hour before meals enhances absorption due to vitamin C, optimal for treating microcytic hypochromic anemia.
The nurse recognizes that patients with von Willebrand disease are at risk for prolonged bleeding times for which reason?
- A. Adequate platelet production.
- B. Deficiency in intrinsic clotting system factor.
- C. Impairment of the thrombin fibrinogen reaction.
- D. Variable factor VIII deficiencies and platelet dysfunction.
Correct Answer: D
Rationale: Von Willebrand disease involves variable factor VIII deficiencies and platelet dysfunction, leading to prolonged bleeding times due to impaired clot formation.
Which arterial blood gas (ABG) data corresponds with a patient's clinical manifestations of respiratory alkalosis?
- A. pH = 7.46, PaCO2 = 44 mm Hg, PaO2 = 95 mm Hg, and HCO3 = 36 mEq/L.
- B. pH = 7.27, PaCO2 = 70 mm Hg, PaO2 = 80 mm Hg, and HCO3 = 26 mEq/L.
- C. pH = 7.30, PaCO2 = 35 mm Hg, PaO2 = 70 mm Hg, and HCO3 = 20 mEq/L.
- D. pH = 7.52, PaCO2 = 24 mm Hg, PaO2 = 85 mm Hg, and HCO3 = 24 mEq/L.
Correct Answer: D
Rationale: Respiratory alkalosis is indicated by a high pH (7.52) and low PaCO2 (24 mm Hg), as seen in option D, with normal HCO3 indicating no metabolic compensation.