Nokea
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.
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The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration?
- A. Cool and pale skin
- B. Crackles in the lung fields
- C. Distended jugular veins
- D. Dark, concentrated urine
Correct Answer: D
Rationale: Dehydration indicates a fluid volume deficit. Dark, concentrated urine indicates a lack of fluid volume. Adding more fluid would dilute the urine. The other options indicate fluid excess.
The nurse on a surgical unit is caring for a client recovering from recent surgery with the placement of a nasogastric tube to low continuous suction. Which acid-base imbalance is most likely to occur?
- A. Respiratory alkalosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Metabolic acidosis
Correct Answer: B
Rationale: Metabolic alkalosis results in increased plasma $\mathrm{pH}$ because of an accumulated base bicarbonate or decreased hydrogen ion concentration. Factors that increase base bicarbonate include excessive oral or parenteral use of bicarbonate- containing drugs, a rapid decrease in extracellular fluid volume and loss of hydrogen and chloride ions as with gastric suctioning. Acidotic states are from excess carbonic acid and hydrogen ions in the system. Respiratory alkalosis results from a carbonic acid deficit that occurs when rapid breathing releases more $\mathrm{CO}_2$ than necessary.
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 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.
The nurse is caring for a client with multiple organ failure and in metabolic acidosis. Which pair of organs is responsible for regulatory processes and compensation?
- A. Kidney and liver
- B. Heart and lungs
- C. Lungs and kidney
- D. Pancreas and stomach
Correct Answer: C
Rationale: The lungs and kidneys facilitate the ratio of bicarbonate to carbonic acid. Carbon dioxide is one of the components of carbonic acid. The lungs regulate carbonic acid levels by releasing or conserving $\mathrm{CO}_2$ by increasing or decreasing the respiratory rate. The kidneys assist in acid-base balance by retaining or excreting bicarbonate ions.