Question

The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

Answer 1

Correct Answers:

Requires nasogastric suction.

Rationale :

💉Clients with nasogastric suction are at high risk of potassium deficit because gastric fluids contain a large amount of potassium.

⚠️When gastric contents are removed, there is a direct loss of electrolytes including potassium, leading to hypokalemia.

🧪Other conditions such as Addison’s disease cause hyperkalemia rather than hypokalemia, so they are not risk factors for potassium deficit.

🩺Monitoring for hypokalemia is essential because it can cause dangerous cardiac dysrhythmias and muscle weakness.

📌Core Message

Clients with nasogastric suction lose large amounts of potassium through gastric fluid removal, making them highly prone to hypokalemia.

Answer 2

Correct Answers:

Positive Trousseau's sign.

Rationale :

🖐️A positive Trousseau’s sign is a classic finding in hypocalcemia, indicating increased neuromuscular excitability.

⚡This sign occurs when carpopedal spasm is elicited by inflating a blood pressure cuff on the arm.

🔎Other findings of hypocalcemia include muscle twitching and tetany, but the most specific diagnostic clinical indicator is Trousseau’s sign.

🩺Recognizing hypocalcemia signs is crucial since severe calcium deficits can result in laryngospasm and life-threatening complications.

📌Core Message

A positive Trousseau’s sign is the hallmark clinical finding of hypocalcemia due to increased neuromuscular excitability.

Answer 3

Correct Answers:

0.9% sodium chloride.

Rationale :

🩸When administering blood transfusions, the tubing must be primed only with 0.9% sodium chloride.

⚠️Other IV solutions such as dextrose or lactated Ringer’s can cause hemolysis or clotting by interacting with the blood.

💉Using the wrong solution may lead to red blood cell damage and inaccurate transfusion results.

🧾Therefore, normal saline is the only safe and recommended solution to use with PRBC transfusions.

📌Core Message

Only 0.9% sodium chloride is compatible and safe for priming tubing before PRBC transfusion to prevent hemolysis.

Answer 4

Correct Answers:

Restrict foods with protein.

Rationale :

👩🏻‍🤝‍🧑🏿Clients with calcium oxalate renal calculi should reduce intake of high-protein foods, as protein increases urinary calcium excretion.

🥩Excessive protein also contributes to urinary acidity, which promotes stone formation.

🥦A low-protein diet helps prevent recurrence of calcium oxalate stones and reduces stress on the kidneys.

📋Other options like low-calcium diets are outdated because calcium restriction can paradoxically increase stone risk.

📌Core Message

Clients with calcium oxalate renal calculi should limit protein intake to reduce urinary calcium excretion and prevent stone recurrence.

Answer 5

Correct Answers:

42 mL/h.

Rationale :

📊The IV order is 1000 mL over 24 hr.

🧮Calculation: 1000 mL ÷ 24 hr = 41.6 mL/hr.

✏️Rounded to the nearest whole number, the answer is 42 mL/hr.

⚠️Accurate IV calculation is critical to avoid fluid overload or underdosing.

📌Core Message

The correct infusion rate is 42 mL/hr based on dividing 1000 mL by 24 hours and rounding properly.

Answer 6

Correct Answers:

23

Rationale :

🧪The ordered dose is 30 mEq, and the supply is 20 mEq per 15 mL.

📊Set up proportion: 20 mEq ÷ 15 mL = 30 mEq ÷ X mL.

🧮Calculation: (30 × 15) ÷ 20 = 22.5, rounded to 23 mL.

⚕️Accurate dosage ensures safe administration and prevents overdose or underdose.

📌Core Message

The nurse administers 23 mL by proportion calculation to deliver the ordered 30 mEq potassium gluconate safely.

Answer 7

Correct Answers:

1.5

Rationale :

📊The order is 0.015 g, which equals 15 mg (since 1 g = 1000 mg).

💊The available supply is 10 mg tablets.

🧮Calculation: 15 mg ÷ 10 mg = 1.5 tablets.

⚕️Accurate conversion from grams to milligrams ensures safe medication administration.

📌Core Message

The correct dose is 1.5 tablets after converting 0.015 g to 15 mg and dividing by the 10 mg tablet strength.

Answer 8

Correct Answers:

135-145 mEq/L.

Rationale :

🧪The normal serum sodium range is 135–145 mEq/L, essential for fluid balance and nerve transmission.

⚡Deviations from this range lead to hyponatremia or hypernatremia, both of which can cause severe neurological symptoms.

📊This range is universally accepted as the reference standard for sodium values in clinical practice.

💉Monitoring sodium levels is critical in patients with fluid or electrolyte disturbances.

📌Core Message

The normal sodium value is 135–145 mEq/L, critical for maintaining fluid balance and nerve conduction.

Answer 9

Correct Answers:

Daily weight.

Rationale :

⚖️Daily weight is the most reliable indicator of fluid gain or loss because even small changes reflect fluid retention.

🧪One liter of fluid equals about 1 kg of weight, making this method highly accurate compared to others.

📋Other measures like intake and output can be inaccurate due to recording errors or insensible losses.

🩺Therefore, daily weights are the gold standard for monitoring fluid balance in acutely ill patients.

📌Core Message

Daily weight is the most accurate indicator of fluid changes because it directly reflects body fluid retention or loss.

Answer 10

Correct Answers:

Azotemia.

Rationale :

🧪Azotemia refers to the accumulation of urea and nitrogenous wastes in the blood due to renal insufficiency.

⚠️It is different from uremia, which refers to the clinical syndrome with symptoms caused by toxin buildup.

📋Azotemia is detected primarily by elevated BUN and creatinine levels.

🩺Early recognition of azotemia is essential to prevent progression to uremia and kidney failure.

📌Core Message

Azotemia is the term for excess urea and nitrogenous wastes in the blood resulting from renal insufficiency.

Med-Surg Urinary, Fluid and Electrolytes

No.

1 :
The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

2 :
The nurse is assessing a client with hypocalcemia. What clinical manifestation would the nurse expect to note in this client?

3 :
The client has an IV of dextrose 5% in 0.45% normal saline. The physician has ordered a transfusion of one unit of packed red blood cells (PRBCs). Before hanging the blood, the nurse will prime the blood tubing with which of the following solutions?

4 :
The nurse on a urology unit is caring for a client diagnosed with calcium oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide?

7 :
The physician's orders read: Give cortisone 0.015 grams every 8 hours orally. The pharmacy sends cortisone 10mg tablets. How many tablet(s) will the nurse give Instructions: Rounding: For adult clients, the answer should be rounded to the nearest tenth (mg, mcg, and m).

8 :
What is the normal value (NV) for sodium in the blood?

9 :
What is the most accurate indicator of fluid loss or gain in acutely ill patients?

10 :
What is the term for an excess of urea and other nitrogenous wastes in the blood as a result of kidney insufficiency?

Med-Surg Urinary, Fluid and Electrolytes

No.

1 : The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

2 : The nurse is assessing a client with hypocalcemia. What clinical manifestation would the nurse expect to note in this client?

3 : The client has an IV of dextrose 5% in 0.45% normal saline. The physician has ordered a transfusion of one unit of packed red blood cells (PRBCs). Before hanging the blood, the nurse will prime the blood tubing with which of the following solutions?

4 : The nurse on a urology unit is caring for a client diagnosed with calcium oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide?

7 : The physician's orders read: Give cortisone 0.015 grams every 8 hours orally. The pharmacy sends cortisone 10mg tablets. How many tablet(s) will the nurse give Instructions: Rounding: For adult clients, the answer should be rounded to the nearest tenth (mg, mcg, and m).

8 : What is the normal value (NV) for sodium in the blood?

9 : What is the most accurate indicator of fluid loss or gain in acutely ill patients?

10 : What is the term for an excess of urea and other nitrogenous wastes in the blood as a result of kidney insufficiency?

1 :
The nurse caring for a client reviews the medical record and determines the client is at risk for developing a potassium deficit because of which situation?

2 :
The nurse is assessing a client with hypocalcemia. What clinical manifestation would the nurse expect to note in this client?

3 :
The client has an IV of dextrose 5% in 0.45% normal saline. The physician has ordered a transfusion of one unit of packed red blood cells (PRBCs). Before hanging the blood, the nurse will prime the blood tubing with which of the following solutions?

4 :
The nurse on a urology unit is caring for a client diagnosed with calcium oxalate renal calculi. When planning this client's health education, what nutritional guidelines should the nurse provide?

7 :
The physician's orders read: Give cortisone 0.015 grams every 8 hours orally. The pharmacy sends cortisone 10mg tablets. How many tablet(s) will the nurse give Instructions: Rounding: For adult clients, the answer should be rounded to the nearest tenth (mg, mcg, and m).

8 :
What is the normal value (NV) for sodium in the blood?

9 :
What is the most accurate indicator of fluid loss or gain in acutely ill patients?

10 :
What is the term for an excess of urea and other nitrogenous wastes in the blood as a result of kidney insufficiency?