Purdue Global Nu 144. Medical Surgical Nursing II Unit 9 Quiz

Question 1

Purdue Global Nu 144. Medical Surgical Nursing II Unit 9 Quiz. A nurse is caring for a client and recognizes that the client is at risk for hypovolemic shock in which of the following circumstances?

• The client is well-hydrated and receiving intravenous fluids
• The client experiences a traumatic injury and significant blood loss
• The client has a history of controlled hypertension
• The client is on a low-sodium diet for heart failure management

Question 2

A nurse is caring for a patient who is in the ED. The nurse assesses the patient and notes rapid respirations and a fruity odor on the patient’s breath. The provider diagnoses the client with DKA. Which acid-base imbalance is most likely occurring in this patient?

• Respiratory alkalosis
• Metabolic acidosis
• Respiratory acidosis
• Metabolic alkalosis

Question 3

A nurse educator is reviewing a client’s recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?

• The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance
• The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance
• The kidneys react rapidly to compensate for imbalances in the body
• The kidneys regulate the bicarbonate level in the intracellular fluid

Question 4

The nurse is evaluating a newly admitted client’s laboratory results, which include several values that are outside of reference ranges. Which of the following alterations would cause the release of antidiuretic hormone (ADH)?

• Increased serum osmolality
• Decreased serum potassium
• Decreased hemoglobin
• Increased platelets Purdue Global Nu 144. Medical Surgical Nursing II Unit 9 Quiz

Question 5 (0.5 points)

The nurse is caring for a client admitted to the medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. The nurse should assess for signs and symptoms of what imbalance?

• Hypercalcemia
• Metabolic acidosis
• Metabolic alkalosis
• Respiratory acidosis

Question 6

During assessment of a peripheral IV infusion, the nurse observes localized edema and swelling at the insertion site. The pump stopped working and it will not flush. This finding is most consistent with which IV therapy complication?

• Air emboli
• Phlebitis
• Infiltration
• Fluid overload

Question 7

The surgical nurse is caring for a client who is postoperative day 1 following a thyroidectomy. The client reports tingling in her lips and fingers. She states that she has an intermittent spasm in her wrist and hand, and she exhibits increased muscle tone. What electrolyte imbalance should the nurse first suspect?

• Hypophosphatemia
• Hypocalcemia
• Hypermagnesemia
• Hyperkalemia

Question 8

A nurse is caring for an elderly patient who has been avoiding drinking liquids to prevent the need to void at night. Which of the following actions should the nurse prioritize when addressing this patient’s concerns?

• Encourage the patient to continue limiting fluid intake during the evening
• Educate the patient on the importance of staying well-hydrated/come up with a hydration plan during the day
• Provide incontinence products for nighttime use
• Administer a diuretic medication to help the patient void during the daytime

Question 9

A client with hypertension has been prescribed hydrochlorothiazide. What nursing action will best reduce the client’s risk for electrolyte disturbances?

• Maintain a low-sodium diet
• Encourage the use of over-the-counter calcium supplements
• Ensure the client has sufficient potassium intake
• Encourage fluid intake

Question 11

The nurse is caring for a client who has a peripheral IV in place for fluid replacement. When caring for the client’s IV site, the nurse should

• ensure that anticoagulants are placed on hold for the duration of IV therapy Purdue Global Nu 144. Medical Surgical Nursing II Unit 9 Quiz
• ensure that the IV is not infusing with a pump
• ensure that the dressing is intact, no redness, leaking, or pain
• periodically remove hair from 2 cm around the IV site

Question 12

A nurse is caring for a patient who is hyperventilating. The patient’s blood gas analysis reveals a pH of 7.52, PaCO₂ of 28 mm Hg, and HCO₃⁻ of 24 mEq/L. Which of the following acid-base imbalances is most likely occurring in this patient?

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis

Question 13

A nurse is reviewing renal physiology with a newly graduated nurse while planning care for a client with chronic kidney disease. The nurse explains that kidney disease impairs the body’s ability to regulate acid-base balance. Which renal function is primarily responsible for this partial loss of pH regulation?

• The kidneys regulate and reabsorb carbonic acid to control blood pH
• The kidneys alter electrolyte levels to buffer excess acids
• The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH
• The kidneys combine carbonic acid and bicarbonate to stabilize blood pH

Question 14

The provider has ordered a solution of theophylline 500 mg in 250 mL of D5W to be infused at a rate of 750 mcg/minute. At what rate will the nurse set the IV pump?

• 22.5 mL/hr
• 25 mL/hr
• 25.5 mL/hr
• 26 mL/hr

Question 15

A doctor orders 1L of Normal Saline (NS) to be infused over 8 hours. The IV tubing has a drop factor of 10 gtt/mL. What is the drip rate in gtt/min?

• 12.5 gtt/min
• 20 gtt/min
• 21 gtt/min
• 22 gtt/min

Question 16

A nurse is caring for a group of older adult patients and is assessing them for the risk of dehydration. Which of the following factors or findings are indicative of potential dehydration risk in older adults? (Select all that apply)

• Decreased thirst sensation
• Headaches
• Taking diuretic medications
• Weight gain Purdue Global Nu 144. Medical Surgical Nursing II Unit 9 Quiz
• Dry, mucous oral mucosa
• non-tenting skin turgor

Question 17

The nurse is aware that clinical manifestations of hypermagnesemia include: (Select all that apply)

• Bradypnea
• Hypotension
• Tetany
• Increased tendon reflexes
• Decreased level of consciousness
• Abdominal pain

Question 18

Case Study Information – Mr. James Thompson, a 58-year-old male with a history of type 2 diabetes mellitus and chronic kidney disease, presents to the emergency department with nausea, vomiting, and generalized weakness. The patient reports that he has had poor oral intake for the past three days and has been urinating less frequently. On assessment, he appears lethargic, with dry mucous membranes, decreased skin turgor, and tachycardia (HR 110 bpm). Vital signs show BP 88/54 mm Hg and RR 24 breaths per minute. Laboratory results reveal serum sodium 152 mEq/L, potassium 5.8 mEq/L, BUN 48 mg/dL, creatinine 2.6 mg/dL, and arterial blood gases indicate pH 7.32, PaCO₂ 38 mm Hg, HCO₃⁻ 19 mEq/L.

What is most likely the patient’s condition? (Select 1)

• Hyponatremia with fluid overload
• Hypernatremia with fluid volume deficit
• Metabolic alkalosis
• Respiratory acidosis

Question 19

Case Study Information – Mr. James Thompson, a 58-year-old male with a history of type 2 diabetes mellitus and chronic kidney disease, presents to the emergency department with nausea, vomiting, and generalized weakness. The patient reports that he has had poor oral intake for the past three days and has been urinating less frequently. On assessment, he appears lethargic, with dry mucous membranes, decreased skin turgor, and tachycardia (HR 110 bpm). Vital signs show BP 88/54 mm Hg and RR 24 breaths per minute. Laboratory results reveal sodium 152 mEq/L, potassium 5.8 mEq/L, BUN 48 mg/dL, creatinine 2.6 mg/dL, and arterial blood gases indicate pH 7.32, PCO₂ 38 mm Hg, HCO₃ 19 mEq/L.

What are two priority interventions? (Select 2)

• Encourage oral intake of sodium-rich foods
• Initiate IV fluid replacement with hypotonic or isotonic solution
• Administer IV potassium chloride immediately
• Place on continuous cardiac monitoring