42. Laboratory Test Result pH 7.31 CO2

42. Laboratory Test Result pH 7.31 CO2 50 mmHg HCO3 23 mEq/L This patient is experiencing 1 2 and will need to be treated with 3 to improve their condition. 1 2 3 43. A client receiving sodium bicarbonate intravenously (IV) for correction of metabolic acidosis is experiencing cyanosis, decreased respirations, and an irregular pulse. Which of the following is the nurse’s priority action? A. Stop the infusion and notify the healthcare provider B. Increase the rate of the infusion C. Decrease the rate of the infusion D. Continue the infusion 44. A client has overdosed on aspirin. Which drug can the nurse anticipate giving to promote renal excretion of the drug? A. Potassium chloride B. Albumin 5% C. Sodium bicarbonate D. Naloxone (narcan) 45. A patient that presented with acute acidosis is receiving sodium bicarbonate. After a few hours, the nurse notices the patients respiration rate is slowing, and the patient is becoming irritable. The nurse recognizes this may be caused by A. Fluid volume overload B. a serum sodium of 142 mEq/L C. a metabolic alkalosis D. a serum potassium of 4.2 mEq/L 46. A client who takes potassium regularly has had an NG tube placed. To get the client their daily potassium dose, what is the best nursing action? A. Notify pharmacy a diluted liquid potassium solution will be needed B. Call the provider and request an IV push dose C. Hold the dose as the patients electrolytes may need adjusting due to the NG tube D. Crush the tablet and administer through the nasogastric tube followed by a 60 ml flush 47. The nurse is caring for a client receiving potassium chloride to raise the serum potassium level back into normal range. The nurse should call the provider for clarification for which of the following orders? A. 10 mEq potassium chloride IV push over 5 minutes ONCE. B. 40 mEq potassium chloride PO STAT. C. 20 mEq potassium chloride PO daily D. 20 mEq potassium chloride IV in 250 mL 0.9% NaCl, administer over 2 hours 48. Which should the nurse understand is a potential client outcome if potassium chloride (KCl) is administered intravenous (IV) push? A. Cardiac arrest B. Hypernatremia C. Respiratory distress D. Seizures 49. A client is receiving a potassium chloride replacement via an intravenous line. Which of the following is a priority nursing action? A. Dietary teaching on high potassium food choices. B. Monitoring urinary output every eight hours. C. Measuring the client’s temperature every four hours. D. Monitor the intravenous site for burning and infiltration. 50. Which order for intravenous potassium follows appropriate administration guidelines? A. 30 mEq of Potassium in 150 mL of NS over 3 hours IV via pump B. 60 mEq of Potassium in 50 mL of NS over 3 hours IV via pump C. 30 mEq of Potassium in 150 mL of NS over 1 hour IV via pump D. 20 mEq of Potassium in 50 mL of NS over 1 hour IV via pump 51. The nurse is caring for a client with orders for 1 liter 0.9% sodium chloride IV bolus. Which assessments should the nurse perform before and after administering this bolus? A. Inspect mucous membranes B. Auscultate lung sounds C. Auscultate heart sounds D. Palpate peripheral pulses 52. The nurse is taking care of a client who is complaining of pain and burning at the insertion site of an intravenous (IV) catheter. On visualization of the IV site, the nurse notes there is redness and swelling at the site as well. Which statements are true regarding this IV site? (Select all that apply.) A. This patient is experiencing extravasation at the IV site. B. This patient needs an IV catheter inserted in a new location. C. The nurse should remove the old IV catheter as soon as possible. D. This patient is experiencing infiltration at the IV site. E. Elevation of the affected extremity should be encouraged. 53. A patient receiving an intravenous (IV) infusion of an IV drug is complaining of pain and redness at the IV site. Which action should the nurse implement first? A. Place an ice pack on the IV site B. Elevate the affected arm C. Stop the infusion of the drug D. Assess the site for blanching 54. The nurse understands which is the primary purpose for intravenous fluid replacement for a client that has a burn injury? A. Antibiotic administration B. Maintain blood pressure C. Electrolyte replacement D. Administration of pain prescriptions 55. The nurse reviews the client’s lab values and notes the potassium level is 2.9 mEq/L. The nurse knows this is the condition of which of the following? A. Hypokalemia B. Hyponatremia C. Hypocalcemia D. Hypoglycemia 56. The nurse is caring for multiple clients on a nursing unit. To which patient would the nurse anticipate administering hypotonic fluids? A. A patient with a sodium electrolyte level of 150 mEq/L. B. A patient with excessive secretion of anti-diuretic hormone (ADH). C. A patient with a known infection and fever of 103.4 degrees F. D. A patient with a nasogastric tube attached to continuous wall suction. 57. Which are the nurse’s priority assessments of a client who has received a colloid solution? A. Blood pressure and urinary output B. Urinary output and temperature regulation C. Blood pressure and level of pain D. Neurological checks and nausea or vomiting 58. After evaluating a patient’s arterial blood gas readings, it is determined that the patient is in metabolic acidosis. Which of the following medications is the most appropriate option to administer? A. sodium bicarbonate B. clopidogrel C. darbepoietin alfa D. polystyrene sulfate 59. The nurse understands that the blood plasma pH should be between what, for the body to maintain homeostasis? A. 7.25 – 7.45 B.3.5 – 5.0 C.7.0 – 7.55 D. 7.35 – 7.45 60. 1 are IV solutions that contain electrolytes and other substances that closely mimic the body’s extracellular fluid. 1 61. The ____________ of a fluid is a measure of the number of dissolved particles or solutes in 1 kg of water. The nurse uses this information in determining if a particular IV solution is appropriate for a client. A.osmolality B. proteins C. electrolytes D. pregnancy class 62. The nurse is about to start an IV on a small elderly female patient who was admitted for a UTI per a new physician order for 0.9% normal saline at 100 ml/hr. Which of the following is not a priority concern for this client? A. Risk for fluid volume excess B. Risk for impaired skin integrity C. Risk for constipation D. Risk for electrolyte imbalance 63. By giving this type of solution, water moves from the plasma to the interstitial fluid, creating a decrease in plasma volume. A. hypotonic B. colloids C. hypertonic D. isotonic 64. Which of the following clients would an order of Dextran 40 IV be appropriate? A. A client with a UTI and severe dehydration B. A client who came in with severe burns over 50% of his body and a history of congestive heart failure C. A client on renal dialysis D. A client in hypovolemic shock due to severe hemorrhage after giving birth 65. The normal range for serum sodium is 1 mEq/L to 2 mEq/L. 1 66. The nurse is reviewing a client’s laboratory results. Based on the results below, how would the nurse anticipate intervening after calling to report the critical results? Laboratory Test Result Sodium 143 mEq/L Potassium 6.5 mEq/L Chloride 101 mEq/L Glucose 102 mg/dL A. Administration of intravenous insulin and intravenous dextrose. B. Preparation for administration of an intravenous hypotonic solution. C. Administration of subcutaneous insulin and intravenous dextrose. D. Preparation for initiation of one hemodialysis treatment. 67. A client has a serum sodium level of 125 mEq/L. Which prescription should the nurse anticipate? A. Encourage the patient to drink fluids. B. Administer normal saline intravenous (IV) C. Administer 0.45% NaCl D. Provide a diet high in NaCl. 68. Which of the following contain the lowest amount of sodium? A. 0.45% sodium chloride B. 3.0% sodium chloride C. Hypertonic saline D. 0.9% sodium chloride 69. Column A Column B 1. Hypotonic A. Shifts fluid out of vessel into cells to hydrate cells 2. Colloids B. Shifts fluid out of cells into vascular space to expand volume 3. Isotonic C. Plasma proteins that keep fluid within the vessels 4. Hypertonic D. No net fluid shift, maintains vascular expansion Match a number from column A with it’s definition in column B. (Please write your essay response on a separate piece of paper) 70. Which crystalloids listed below are intended to expand the circulating plasma volume without causing major fluid shifts between compartments? A. Lactated Ringer’s B. 0.9% sodium chloride C. 5% Albumin D. Plasma-Lyte 148 E. 2.5% dextrose in water SCIENCE HEALTH SCIENCE NURSING NURSING NUR103

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