Acid-Base

Which food is best for a patient with hypokalemia?

An 84-year-old patient being treated for a chronic obstructive pulmonary disorder (COPD) exacerbation starts to become disoriented after the evening meal and will not stay in bed. Which intervention does the nurse take first?

A patient with severe chronic obstructive pulmonary disorder (COPD) is receiving 3 liters per minute of oxygen via nasal canal. Which oxygen saturation indicates respiratory support is adequate?

The nurse is caring for a 48-year-old female diagnosed with acute kidney injury. Laboratory results reveal that the patient is experiencing mild hyperkalemia. Which independent nursing action is appropriate to manage the patient's hyperkalemia?

The nurse notes the patient being treated for chemical burns is hyperventilating. The nurse suspects which medication is the culprit of the patient's symptoms?

The patient has been prescribed lithium for treatment of bipolar disorder. Which instruction does the nurse include in teaching? 

The older adult patient is brought to the emergency department with sudden onset confusion, agitation, and hallucinations. The patient's past medical history is significant for type 2 diabetes managed with glyburide, anxiety managed with lorazepam, and insomnia managed with zolpidem. Upon assessment, the patient's heart rate and rhythm are regular, lungs are clear to auscultation, and bowel sounds are present. Vital signs are normal, with exception of a slightly elevated heart rate. Which is the most likely cause of the patient's symptoms?

The family practice nurse is reviewing telephone messages from patients. Which call is to be returned first?

The nurse is planning care for the patient with severe liver disease who has substantial ascites and peripheral edema. Which interventions are included in the care plan? 

The patient complains of heart palpitations. The nurse understands which lab result is responsible for the patient's symptoms?

The lab calls the nurse and reports an adult patient’s serum calcium of 5.9 mg/dL and serum potassium of 6.2 mEq/dL. Which action by the nurse is appropriate?

The nurse is caring for the patient with intestinal obstruction who is receiving total parenteral nutrition (TPN). The nurse reviews which lab results to ensure the patient is tolerating the infusion? Select all that apply. 

The 82-year-old patient presents to the emergency department with chest pain that started four hours ago. Vascular access is a challenge and the nurse is only able to draw enough blood for one test. The nurse sends the sample to the lab for which test?

The nurse is helping the nursing student to relate patient findings to pathophysiological concepts. Which findings, if selected by the nursing student as characteristics that prompt the kidneys to release renin, indicates a need for further teaching?

Which statement effectively summarizes the effect of the renin-angiotensin-aldosterone system?

There are four patients with hyperglycemia in the emergency department triage. One treatment room has become available. The patient with which additional symptom is moved into the available room first?

Which comorbidities increase the risk for refeeding syndrome in the chronically ill patient who is started on total parenteral nutrition (TPN)? Select all that apply.

The patient presents to the emergency department with abdominal pain, dehydration, a blood glucose level of 425 mg/dL. Blood testing reveals metabolic acidosis, hypokalemia, and ketones. The patient is alert and conversant, but in moderate distress. The nurse anticipates administering which medication?

Which is the most common symptom of the child with bronchiectasis?

The patient has been prescribed enalapril and spironolactone for the treatment of hypertension. The nurse is providing medication education to the patient regarding diet. Which food, if selected by the patient, indicates a need for further teaching?

The nurse receives report from the operating room regarding a postoperative craniotomy patient and recognizes the patient is at risk for which complications? Select all that apply.

The nurse is teaching a community health promotion class for older adults and includes a discussion on modifying which risks for hypertension?

The patient intubated in the intensive care unit has the following arterial blood gas results: pH 7.21 PCO2 51 PaO2 38 HCO3 16 Base Excess -7 Which action does the nurse take first?

Which arterial blood gas result is most indicative that the intubated and mechanically ventilated patient is ready to have the ventilator rate weaned?

The nurse is reviewing the lab results of a patient in the intensive care unit and finds the patient’s lactate to be 5.4 mmol/L. Which additional value is most responsible for this value?

The patient has hyperlactatemia. Which lab value concerns the nurse the most about the patient’s risk for long-term sequelae?

Following an accidental overdose of acetaminophen, the patient has a lactate level of 5.6 mmol/L. Which compensatory change in the patient will the nurse observe first?

The patient’s arterial blood gas and serum electrolyte results are as follows: pH 7.28, PCO2 = 32, PaO2 = 59, HCO3- = 16, SaO2 = 88%, Sodium = 149, Potassium 3.9, Chloride 112. Calculate this patient’s anion gap. Enter your answer using a whole number.

The patient with metabolic acidosis is determined to have an anion gap of 11 mmol/L. The nurse advocates for which additional lab test?

The 56-year-old intubated and sedated patient’s arterial blood gas results are as follows: pH = 7.25, PCO2 = 36, PaO2 = 50, HCO3- = 15, SaO2 = 86%. Other lab values are notable for a hemoglobin of 7.9 mg/dL, albumin of 2.5 g/dL, sodium of 152 mEq/L, potassium of 2.1 mEq/L, chloride of 118 mEq/L. Vital signs are notable for a heart rate of 118 bpm, blood pressure of 86/38 mmHg, temperature of 102°F, and pulse oximetry of 85% on room air. The nurse advocates for which order?

Following a motor vehicle accident, the unconscious patient presents with a respiratory rate of 28 and the following respiratory pattern: The nurse expects which acid-base derangement?

The patient with severely elevated intracranial pressure that has been well-controlled with medication and CSF drainage is intubated and sedated; the most recent arterial blood results are as follows: pH = 7.32, pCO2 = 35 mm Hg, PaO2 = 58, HCO3- = 16, Base excess = -7. The nurse advocates for which order to change ventilatory support?

What is the rationale for using hyperventilation as management for acute elevated intracranial pressure?

The patient who takes milk of magnesia every day is at risk for which electrolyte imbalance?

The patient returns from Mexico with severe diarrhea lasting 4 days. The nurse anticipates the serum electrolyte levels to reflect which imbalances? Select all that apply.

The patient has received an infusion of packed red blood cells for the treatment of anemia. The nurse anticipates which lab result following the transfusion?

The patient with a calcium level of 11.4 mEq/L is at risk for which life-threatening complication?

The nurse is reviewing a patient’s medications during discharge. Which further education can the nurse provide regarding spironolactone when the patient asks, “I thought that I took a furosemide pill for my water?”

Which patient characteristic prompts the nurse to hold the infusion of Lactated Ringer’s and contact the provider?

The patient has a phosphorus level of 5.2 mg/dL. Which additional lab value does the nurse anticipate in the patient related to the phosphorus level?

The patient who is NPO has an order to receive enemas until the intestines are devoid of stool. After 3 enemas, the patient is still passing a moderate amount of loose stool. Which action by the nurse is appropriate?

The nurse plans which intervention for the patient with toxic epidermal necrolysis?

The nurse is administering intravenous fluids to the patient with toxic epidermal necrolysis. Which parameters are most helpful to assess when determining the appropriate fluid rate for the patient?

The patient developed toxic epidermal necrolysis after receiving phenytoin for seizures. The nurse prioritizes nursing interventions to address which life-threatening comorbidities? Select all that apply.

During a well-child visit for the 4-month-old child, the nurse palpates hard nodules where each rib joins the sternum. The nurse reports this finding to the provider and requests which lab studies for this patient? Select all that apply.

The nurse is creating a presentation on rickets in the community. The nurse focuses on which group of individuals for this teaching?

The patient with kidney failure is scheduled to undergo the placement of a peritoneal dialysis catheter. Which instruction does the nurse give the patient?

The nurse is providing discharge teaching to the patient who will be discharged with a peritoneal dialysis catheter. Which statement indicates a need for further teaching?

The nurse is assessing the arteriovenous fistula in the patient’s right arm; it is without thrill or bruit. Which action does the nurse take next?

The patient found unresponsive in the park is determined to be in ventricular fibrillation. After cardiopulmonary resuscitation and defibrillation, the patient experienced return of spontaneous circulation. Initial survey upon arrival to the emergency department (ED) reveals a cachectic appearance and an edematous mass on the right forearm; upon palpation, the nurse palpates a thrill. The nurse is aware life-saving measures will have which aim?