Nokea
The nurse is correct to state that a client's body needs to have adequate nutrition to maintain energy. Which type of transport of dissolved substances requires adenosine triphosphate (ATP)?
- A. Osmosis
- B. Passive diffusion
- C. Facilitated diffusion
- D. Active transport
Correct Answer: D
Rationale: Active transport requires the use of the body's energy molecule (ATP) to meet body needs for fluid and particle transport. Osmosis is the movement of body fluids through a semipermeable membrane that allows not all substances to pass through. Passive diffusion allows the movement of substances from an area of higher concentration to lower concentration. Facilitated diffusion has certain dissolved substances that require the assistance from a carrier module to pass through the semipermeable membrane.
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The nurse is reviewing client lab work for a critical lab value. Which value is called to the health care provider for additional prescriptions?
- A. Potassium: $5.8 \mathrm{mEq} / \mathrm{L}$
- B. Sodium: $138 \mathrm{mEq} / \mathrm{L}$
- C. Magnesium: $2 \mathrm{mEq} / \mathrm{L}$
- D. Calcium: $10 \mathrm{mg} / \mathrm{dL}$
Correct Answer: A
Rationale: Normal potassium level is 3.5 to $5.5 \mathrm{mEq} / \mathrm{L}$. Elevated potassium levels can lead to muscle weakness, paresthesias, and cardiac dysrhythmias.
The emergency department (ED) nurse is caring for a client with a possible acid- base imbalance. The physician has prescribed an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG?
- A. $\mathrm{PaO}_2$
- B. $\mathrm{PO}_2$
- C. Carbonic acid
- D. Bicarbonate
Correct Answer: D
Rationale: Arterial blood gas (ABG) results are the main tool for measuring blood $\mathrm{pH}, \mathrm{CO}_2$ content $\left(\mathrm{PaCO}_2\right)$, and bicarbonate. An acid-base imbalance may accompany a fluid and electrolyte imbalance. $\mathrm{PaO}_2$ and $\mathrm{PO}_2$ are not indications of acid-base imbalance. Carbonic acid levels are not shown in an ABG.
The nurse receives report that a client's $\mathrm{pH}$ level is 7.4. Which nursing action would be most appropriate?
- A. Call the health care provider with the report.
- B. Encourage the client to practice deep breathing.
- C. Finish the head-to-toe assessment.
- D. Obtain an ECG.
Correct Answer: C
Rationale: The nurse realizes that a $\mathrm{pH}$ level of 7.4 is within normal limits. No additional measures need obtained and the nurse would perform a usual head-to-toe assessment.
The nurse is documenting assessment findings of a client diagnosed with anasarca. Which nursing documentation best shows improvement in disease progression?
- A. Decreased abdominal girth
- B. Increased level of consciousness
- C. Weight maintenance
- D. Pulse rate decrease
Correct Answer: A
Rationale: Third-spacing is the translocation of fluid from the intravascular to intercellular space to tissue compartment. Anasarca is the general edema in the organ cavities such as the abdomen. Monitoring the abdominal girth provides data on the localization of the fluid in the interstitial space. A decrease in girth, in particular, notes improvement. Level of consciousness is not affected unless shock occurs. Weight remains the same as there is a shifting in fluid; pulse rate could fluctuate according to fluid movement.
The nurse is caring for a client prescribed a low sodium diet. Which food, identified as a client favorite, will the nurse discourage?
- A. A grilled chicken sandwich with mayonnaise
- B. A natural fruit salad with nuts
- C. A hot dog with ketchup
- D. A fresh grilled tuna entr?©e with fresh asparagus
Correct Answer: C
Rationale: Foods high in sodium include processed meats, such as hot dogs and cold cuts; fast foods; frozen meals; cheeses; soups and juices; and salted snack foods to name a few.