Nokea
Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would the nurse interpret the results?
- A. Respiratory acidosis with no compensation
- B. Metabolic alkalosis with a compensatory alkalosis
- C. Metabolic acidosis with no compensation
- D. Metabolic acidosis with a compensatory respiratory alkalosis
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A patient with diabetes insipidus is admitted to the intensive care unit after a motor vehicle accident that resulted in head trauma and damage to the pituitary gland. Diabetes insipidus can occur when there is a decreased production of which of the following?
- A. ADH
- B. Estrogen
- C. Aldosterone
- D. Renin
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The woman seems confused and has poor skin turgor, and she states that 'she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.' The nurse explains to the woman that:
- A. She will need to have her medications adjusted and be readmitted to the hospital for a complete workup.
- B. Limiting fluids can create imbalances in the body that can result in confusion; maybe we need to adjust the timing of your fluids.
- C. It is normal to be a little confused following surgery and it is safe not to urinate at night.
- D. Confusion following surgery is common in the elderly due to loss of sleep.
Correct Answer: B
Rationale: The correct answer is B. In elderly patients, fluid deficits can lead to confusion and cognitive impairment. Limiting fluids can disrupt the body's balance, leading to such symptoms. Adjusting the timing of fluids can help maintain hydration without causing nighttime interruptions. Choices A, C, and D are incorrect because they do not address the underlying issue of fluid imbalance causing confusion. Choice A suggests unnecessary hospital readmission and medication adjustments. Choice C incorrectly normalizes confusion post-surgery and suggests it is safe not to urinate at night, which can exacerbate the issue. Choice D inaccurately attributes confusion to sleep loss rather than fluid imbalance.
A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?
- A. Tell the patient to rest more often.
- B. Tell the patient to stop taking the digoxin, and call the physician.
- C. Call the physician, report the symptoms, and request to draw a blood sample to determine the patient's potassium level.
- D. Tell the patient to avoid foods that contain caffeine.
Correct Answer: C
Rationale: Furosemide is a potassium-wasting diuretic. A low potassium level may cause weakness and palpitations. Telling the patient to rest more often won't help the patient if she's hypokalemic. Digoxin isn't causing the patient's symptoms, so she doesn't need to stop taking it. The patient should probably avoid caffeine, but this wouldn't resolve potassium depletion.
What would be the best initial nursing actions prior to inserting an IV?
- A. Have the patient wash the hands.
- B. Prepare the IV insertion site with povidone iodine.
- C. Verify the order for IV therapy.
- D. Identify a suitable vein.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
The renin and angiotensin systems help to maintain the balance of sodium and water in the body. What other functions do these systems serve?
- A. Regulating hemoglobin levels
- B. Maintaining a healthy blood volume
- C. Releasing platelets when tissues are injured
- D. Lowering blood volumes
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.