Saunders Chapter 11: Fluid and Electrolyte NCLEX Questions

Saunders Chapter 11: Fluid and Electrolyte NCLEX Questions

ScienceMedicineNursing RN-in-training299Teacher Save Fluid and Electrolytes NCLEX Quest...33 terms Alex_Hassiepen Preview Fluid & Electrolyte NCLEX Practice ...145 terms ngreen14Preview Saunders Fluid & Electrolyte Practic...35 terms sdelacruz89Preview Med Su 10 terms kwa The RN is assessing a 70-year-old client admitted to the unit with severe dehydration. Which finding requires immediate intervention by the nurse?

• Client behavior that changes from anxious to lethargic
• Deep furrows on the surface of the tongue
• Poor skin turgor with tenting remaining for 2 minutes after the skin is pinched
• Urine output of 950 mL for the past 24 hours

a A client with diarrhea for 3 days and inability to eat or drink well is brought to the emergency department (ED) by her family. She states she has been taking her diuretics for congestive heart failure (CHF). What nursing actions are indicated at this time? Select all that apply.

• Place the client on bed rest.
• Evaluate the electrolyte levels.
• Administer the ordered diuretic.
• assess for orthostatic hypotension.
• initiate cardiac monitoring

a, b, d, e

A client with hypokalemia has a prescription for parenteral potassium chloride (KCl). Which of these interventions does the nurse use to safely administer KCl? Select all that apply.

• Use a potassium infusion prepared by a registered pharmacist.
• Assess for burning or redness during infusion.
• Infuse at a rate of no more than 10 mEq per hour.
• Administer only through a central venous catheter.
• Administer by IV push only during cardiac arrest.

a, b, c The nurse is caring for a client who is receiving a loop diuretic for treatment of heart failure. Which of these actions will be included in the plan of care? Select all that apply.

• Assess daily weights.
• Encourage consumption of citrus fruits.
• Weigh the client weekly.
• Monitor serum potassium.
• Discourage intake of spinach.
• Monitor for bradycardia.

a, b, d The nurse is teaching a client who is taking a potassium-sparing diuretic about precautions while taking this medication. Which of these does the nurse teach the client to avoid or use cautiously? Select all that apply.

• Apples
• Bananas
• ACE inhibitors
• Grapes
• Salt substitute

b, c, e The nurse is assessing a client with a sodium level of 118 mEq/L (118 mmol/L). Which activity takes priority?

• Monitoring urine output
• encouraging sodium rich fluids and foods throughout the day
• instructing the client not to ambulate without assistance
• assessing deep tendon reflexes

c The nurse is infusing 3% saline for a client with syndrome of inappropriate secretion (SIADH). Which of these complications does the nurse report to the primary care provider?

• Peripheral edema
• Crackles ½ way up the lung fields
• Serum osmolarity of 294 mOsm/kg (294 mmol/kg)
• Urine output of 1300 mL over 24 hours

b

A client is brought to the emergency department for increasing weakness and muscle twitching. The laboratory results include a potassium level of 7.0 mEq/L (7.0 mmol/L). Which assessments does the nurse make?

• History of liver disease
• Use of salt substitute
• Use of an ACE inhibitor
• Potassium-sparing diuretics
• Prescription for insulin

b, c, d A client with hypermagnesemia is seen in the emergency department (ED). Which of these interventions is most appropriate?

• Monitor for hyperactive reflexes
• prepare for endotracheal intubation
• Institute teaching on avoiding magnesium rich foods
• Place the client on a cardiac monitor

d The nurse is caring for an older adult with hypernatremia. Which of these interventions does the nurse perform first?

• Restrict the client's intake of sodium
• Administer a diuretic
• Monitor the serum osmolarity
• Encourage fluid intake

d The rapid response team (RRT) is called to the bedside of a client with heart rate of 38 beats per minute and a potassium level of 7.0 mEq/L (7.0 mmol/L). For which medication will the nurse anticipate a prescription?

• Insulin
• atropine
• Sodium polystyrene sulfonate (Kayexalate)
• potassium phosphate

a A client is admitted to the hospital with dehydration secondary to influenza and vomiting. The provider orders an intravenous (IV) potassium replacement for potassium level of 2.7 mEq/L (2.7 mmol/L). Which of these best practice techniques does the nurse include when administering this medication?

a) Ensuring that the concentration is no greater than 1?9?mEq/10?9?mL of solution

b) Use a vein in the hand for better flow

c) Use an IV pump to deliver the medication

d) Check IV access for blood return after the infusion

e) Push the medication over 5 minutes

a, c

The nurse is caring for a client who takes furosemide (Lasix) and digoxin (Lanoxin). The client's potassium (K+) level is 2.5 mEq/L (2.5 mmol/L).Which additional assessment will the nurse make?

a) Heart rate

b) Blood pressure (BP)

c) Increases in edema

d) Sodium level

a Furosemide (Lasix) has been ordered for a client with heart failure, shortness of breath, and 3+ pitting edema of the lower extremities. Which assessment finding indicates to the nurse that the medication has been effective?

a) The client's potassium level is 5.1 mEq/L (5.1 mmol/L).

b) The client's heart rate is 101 beats per minute.

c) The client is free from adventitious breath sounds.

d) The client has experienced a weight gain of 1 pound (0.5 kg).

c The nurse is discussing safety when administering bumetanide with a nursing student. The nurse recognizes that the student understands side effects of this medication when the student makes which statement?

• "The client's PT and INR may be prolonged while taking this medication."
• "The client may develop hypoglycemia during treatment."
• "Inverted T waves and a U wave may appear on the ECG."
• "I need to tell the client to avoid salt substitutes."

c The nurse is caring for a client who is receiving intravenous (IV) magnesium sulfate. Which assessment parameter is critical?

a) Monitoring 24-hour urine output

b) Asking the client about feeling depressed

c) Assessing the blood pressure hourly

d) Monitoring the serum calcium levels

c After receiving change-of-shift report, which client does the RN assess first?

a) A client with nausea and vomiting who complains of abdominal cramps

b) A client with a nasogastric (NG) tube who has dry oral mucosa and is complaining of thirst

c) A client receiving intravenous (IV) diuretics whose blood pressure is 88/52 mm Hg

d) A client with normal saline infusing at 150 mL/hr whose hourly urine output has been averaging 75 mL

c