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Which rationale supports the nurse's assessment of a patient's magnesium level?
- A. The electrolyte is the most abundant intracellular cation present in the body.
- B. The electrolyte may cause extracellular fluid overload.
- C. Magnesium may affect neuromuscular excitability and contractility.
- D. The patient is at risk for hypotension when the levels of magnesium decrease.
Correct Answer: C
Rationale: Magnesium plays a crucial role in neuromuscular excitability and contractility. Abnormal magnesium levels can lead to neuromuscular symptoms such as muscle weakness, tremors, and spasms, and affect cardiac function.
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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 characterized by a high pH (>7.45) and a low PaCO2 (<35 mm Hg). The data in option D (pH = 7.52, PaCO2 = 24 mm Hg) indicates respiratory alkalosis.
The nurse is teaching a patient about the administration of liquid iron supplements. Which response by the patient indicates the need for additional teaching?
- A. I will take my iron supplement with a straw.
- B. I will take my iron supplement at bedtime.
- C. I will take my iron supplement along with meals.
- D. I will take my iron supplement along with orange juice.
Correct Answer: C
Rationale: Taking iron supplements with meals decreases absorption, indicating a need for further teaching; iron should be taken on an empty stomach or with vitamin C.
Which laboratory report finding would support the nurse's conclusion that a patient has thalassemia major? Select all that apply.
- A. Increased bilirubin levels.
- B. Increased reticulocyte level.
- C. Increased mean corpuscular volume.
- D. Increased total iron-binding capacity.
Correct Answer: A,B,D
Rationale: Increased bilirubin, reticulocyte levels, and total iron-binding capacity are seen in thalassemia major due to hemolysis, bone marrow response, and increased iron absorption.
Which acid-base mechanism would the kidney use to buffer a patient's acidosis (serum pH <7.35)? Select all that apply.
- A. Eliminating excess H+.
- B. Excreting excess water.
- C. Eliminating excess CO2.
- D. Reabsorbing additional HCO3-.
- E. Reabsorbing additional sodium ions.
Correct Answer: A,D
Rationale: The kidneys buffer acidosis by eliminating excess hydrogen ions (H+) and reabsorbing additional bicarbonate ions (HCO3-) to neutralize acid and raise pH.
A patient who smokes reports chest pain while at rest. Which condition would the nurse suspect the patient is experiencing?
- A. Silent ischemia.
- B. Angina decubitus.
- C. Prinzmetal angina.
- D. Chronic stable angina.
Correct Answer: C
Rationale: Prinzmetal angina, also known as variant angina, typically occurs at rest due to coronary artery spasms, which aligns with the patient's symptoms of chest pain at rest.