| 1. | The client is admitted to the unit with a potassium level of 2.4 mEq/L. The client with a potassium level of 2.4 meq/L would exhibit symptoms of:
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| A. | Peaked T waves | |
| B. | U waves | |
| C. | Muscle rigidity | |
| D. | Rapid respirations |
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| 2. | The client is admitted with hypokalemia. An IV of normal saline is infusing at 80 ml/hour with 10 mEq of KCl/hour. Prior to beginning the infusion, the nurse should:
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| A. | Check the sodium level. | |
| B. | Check the magnesium level. | |
| C. | Check the creatinine level. | |
| D. | Check the calcium level. |
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| 3. | The client is admitted to the labor and delivery unit with preeclampsia. An IV of magnesium sulfate is begun per pump. Which finding would indicate hypermagnesemia?
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| A. | Urinary output of 60 ml per hour | |
| B. | Respirations of 30 per minute | |
| C. | Absence of the knee-jerk reflex | |
| D. | Blood pressure of 150/80 |
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| 4. | The client presents to the unit with complaints of shortness of breath. A tentative diagnosis of respiratory acidosis related to pneumonia is made. Which finding would support this diagnosis?
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| A. | pH of 7.45, CO2 of 45, HCO3 of 26 | |
| B. | pH of 7.35, CO2 of 46, HCO3 of 27 | |
| C. | pH of 7.34, CO2 of 30, HCO3 of 22 | |
| D. | pH of 7.44, CO2 of 32, HCO3 of 25 |
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| 5. | The client with Cushing’s disease will most likely exhibit signs of:
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| A. | Hypokalemia | |
| B. | Hypernatremia | |
| C. | Hypocalcaemia | |
| D. | Hypermagnesemia |
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| 6. | The nurse is responsible for teaching the client regarding dietary choices to provide needed magnesium. Which food is a good source of magnesium?
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| A. | Apple | |
| B. | Spinach | |
| C. | Liver | |
| D. | Squash |
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| 7. | The client with hyperparathyroidism will exhibit signs of:
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| A. | Hypokalemia | |
| B. | Hyponatremia | |
| C. | Hypercalcemia | |
| D. | Hyperphosphatemia |
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| 8. | A client with metabolic acidosis associated with diabetes mellitus is admitted to the unit. A blood glucose of 250 mg/dl is present. Which symptom will most likely accompany ketoacidosis?
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| A. | Oliguria | |
| B. | Polydipsia | |
| C. | Perspiration | |
| D. | Tremors |
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| 9. | An elderly client is admitted to the unit with a temperature of 100.2°, urinary specific gravity of 1.032, and a dry tongue. The nurse should anticipate an order for:
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| A. | An antibiotic | |
| B. | An analgesic | |
| C. | A diuretic | |
| D. | An IV of normal saline |
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| 10. | Which diet selection contains the most potassium and should be removed from the tray of the client with renal failure?
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| A. | Peach | |
| B. | Baked potato | |
| C. | Marshmallows | |
| D. | Bread |
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| 1. | Answer B is correct. The normal potassium level is 3.5–5.5 mEq/dl. Answer A is incorrect because it indicates an elevated potassium level. Answer C is incorrect because the muscles will be flaccid with hypokalemia. Answer D is incorrect because the respirations will be shallow not rapid. |
| 2. | Answer C is correct. The client receiving potassium needs to be evaluated for renal function because regulation of potassium is primarily done within the kidneys. It is not necessary to check the sodium, magnesium, or calcium level prior to beginning potassium, so answers A, B, and D are incorrect. |
| 3. | Answer C is correct. The signs of toxicity to magnesium are oliguria (less than 30 ml/hour urinary output), respirations less than 12 per minute, and absence of the deep tendon reflexes. In answer A the urinary output is within normal limits. If it falls below 30, you should further evaluate for toxicity. In answer B if the respirations fall below 12, the infusion should be discontinued and oxygen support maintained. The blood pressure is within normal limits in answer D. |
| 4. | Answer B is correct. The client with respiratory acidosis will have a pH that is decreased and CO2 excretion will be inhibited due to the respiratory problems. The HCO3 will also be increased because the kidneys are the compensating organ. Answer A is alkalosis, answer C is metabolic acidosis, and answer D is compensated alkalosis. |
| 5. | Answer B is correct. The client with Cushing’s has hyperadrenal function. These clients retain sodium and water. They do not typically lose potassium or calcium or retain magnesium. |
| 6. | Answer B is correct. Dark green vegetables and legumes contain large amounts of magnesium. The other food choices do not provide significant sources of magnesium. |
| 7. | Answer C is correct. The client with hyperparathyoidism will have elevated calcium levels. Calcium is pulled from the bone into the serum. These clients frequently have renal calculi and osteoporosis. They do not have hypokalemia, hyponatremia, or hyperphosphatemia. They will have hypercalcemia and hypophosphatemia. |
| 8. | Answer B is correct. A blood glucose level of 250 mg/dl is elevated. Symptoms of hyperglycemia are polyuria, polydipsia, and polyphagia. The client will also have a decreased sensorium and tachypnea. Answers A, C, and D are all symptoms of hypoglycemia (testing technique: odd man out). |
| 9. | Answer D is correct. The client is hypovolemic and hyponatremic. The slight elevation in the temperature might be related to the dehydration. The normal specific gravity is 1.010–1.020; therefore, this finding shows urinary concentration. There is not enough data to support a need for an antibiotic, as in answer A, an analgesic as in B, or a diuretic as in C. |
| 10. | Answer B is correct. The skin of the potato contains large amounts of potassium, and potassium should be limited in the client with renal failure. A peach contains some potassium, but not as much as the baked potato, so answer A is incorrect. The marshmallows and bread contain minimal amounts of potassium, so answers C and D are incorrect. |
