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Pharmacology 5th Edition McCuistion Kee Hayes Test Bank

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Pharmacology 5th Edition McCuistion Kee Hayes Test Bank

ISBN-13: 978-0721639277

ISBN-10: 0721639275

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Pharmacology 5th Edition McCuistion Kee Hayes Test Bank

ISBN-13: 978-0721639277

ISBN-10: 0721639275

 

 

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Free Nursing Test Questions:

 

Kee: Pharmacology, 5th Edition

Chapter 15: Fluid and Electrolyte Replacement

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A client’s serum osmolality is 270 mOsm/kg. His body fluid osmolality is:
1. iso-osmolar.
2. hypo-osmolar.
3. hyperosmolar.
4. normosmolar.

 

 

ANS:   2

Normal osmolality is 275 to 295 mOsm/kg. This client is therefore hypo-osmolar.

 

DIF:    Cognitive level: Analysis                   REF:    p. 236

TOP:    Nursing process: Analysis

 

  1. A client’s serum chemistry is serum sodium 142 mEq/L, blood urea nitrogen (BUN) 15 mg/dL, and glucose 90 mg/dL. His body fluid osmolality is:
1. iso-osmolar.
2. hypo-osmolar.
3. hyperosmolar.
4. None of the above

 

 

ANS:   1

To calculate osmolality, use the equation:

2 (serum Na) + BUN/3 + glucose/18

2 (142) + 15/3 + 90/18 = 294 mOsm/kg, or iso-osmolality

 

DIF:    Cognitive level: Analysis                   REF:    p. 236

TOP:    Nursing process: Analysis

 

  1. A client’s serum chemistry is serum sodium 146 mEq/L, BUN 24 mg/dL, glucose 90 mg/dL. Her serum osmolality is:
1. 275 mOsm/kg.
2. 285 mOsm/kg.
3. 295 mOsm/kg.
4. 305 mOsm/kg.

 

 

ANS:   4

To calculate osmolality, use the equation:

2 (serum Na) + BUN/3 + glucose/18

2 (146) + 24/3 + 90/18 = 305 mOsm/kg

 

DIF:    Cognitive level: Analysis                   REF:    p. 235

TOP:    Nursing process: Analysis

 

 

  1. A client received 3 L of D5W. With continuous use of 5% dextrose in water, the intravenous (IV) fluids become:
1. isotonic.
2. hypotonic.
3. hypertonic.
4. megatonic.

 

 

ANS:   2

D5W is isotonic, but when the dextrose is metabolized in the human body, it becomes hypotonic.

 

DIF:    Cognitive level: Comprehension        REF:    p. 235

TOP:    Nursing process: Analysis

 

  1. A client is ordered to receive lactated Ringer’s solution. This is what type of IV solution?
1. Lipid
2. Crystalloid
3. Colloid
4. Blood product

 

 

ANS:   2

This is a crystalloid solution.

 

DIF:    Cognitive level: Comprehension        REF:    p. 236

TOP:    Nursing process: Analysis

 

  1. A client in severe shock is ordered to receive dextran as a volume expander. This type of fluid is known as a:
1. lipid.
2. crystalloid.
3. colloid.
4. blood product.

 

 

ANS:   3

Dextran is a colloid.

 

DIF:    Cognitive level: Comprehension        REF:    p. 236

TOP:    Nursing process: Analysis

 

 

  1. A nurse is calculating a client’s daily fluid needs. The client weighs 85 kg. The daily fluid requirement would be approximately:
1. 1700 mL.
2. 2000 mL.
3. 2550 mL.
4. 3000 mL.

 

 

ANS:   3

Fluids for adults may be calculated as 30 mL/kg/day: 30 x 85 = 2550 mL.

 

DIF:    Cognitive level: Application              REF:    p. 237

TOP:    Nursing process: Analysis

 

  1. A client with a history of vomiting presents to the emergency department with a serum potassium level of 3 mEq/L. The client’s serum potassium level indicates:
1. normal serum potassium value.
2. hypokalemia.
3. hyperkalemia.
4. hypocalcemia.

 

 

ANS:   2

Normal serum K is 3.5 to 5.3 mEq/L.

 

DIF:    Cognitive level: Analysis                   REF:    p. 238

TOP:    Nursing process: Analysis

 

  1. Which of the following physician orders would the nurse question when administering IV fluids with potassium chloride (KCl)?
1. Inject IV KCl directly into the IV tubing.
2. Check for infiltration because potassium is irritating to subcutaneous tissues.
3. Check for phlebitis because potassium is irritating to the veins.
4. Check for adequate urinary output (kidney dysfunction can cause potassium retention that may lead to hyperkalemia).

 

 

ANS:   1

KCl should never be directly injected, but must be diluted in order to not cause venous or tissue damage, or more serious effects of a large bolus, such as cardiac standstill. The other options are correct.

 

DIF:    Cognitive level: Application              REF:    p. 238

TOP:    Nursing process: Intervention/Implementation

 

 

  1. A client is ordered to receive KCl tablets. The nurse should instruct the client to take KCl:
1. daily with sips of water.
2. before breakfast.
3. at bedtime; fluid intake is not necessary.
4. with 4 ounces or more of fluid, or at mealtime.

 

 

ANS:   4

KCl should be well diluted to avoid gastric upset and improve absorption.

 

DIF:    Cognitive level: Application              REF:    p. 238

TOP:    Nursing process: Intervention/Teaching

 

  1. A client is taught to take his potassium because a medication he is on can cause hypokalemia. A drug group that can cause hypokalemia is:
1. potassium-sparing diuretics.
2. potassium-wasting diuretics.
3. beta blockers.
4. narcotics.

 

 

ANS:   2

These drugs cause the body to lose potassium.

 

DIF:    Cognitive level: Application              REF:    p. 240

TOP:    Nursing process: Intervention/Teaching

 

  1. A client’s serum potassium level is 5.4 mEq/L. An intervention that may correct this type of potassium imbalance is:
1. to restrict foods containing potassium.
2. IV sodium bicarbonate (NaHCO3).
3. insulin and glucose administration.
4. to administer sodium polystyrene sulfonate (Kayexalate) and sorbitol.

 

 

ANS:   1

Mild hyperkalemia may be treated with dietary restriction of potassium-rich foods.

 

DIF:    Cognitive level: Application              REF:    p. 238

TOP:    Nursing process: Intervention/Implementation

 

 

  1. A client’s serum potassium is 6.9 mEq/L. An effective method to correct this severe hypokalemia would be:
1. to restrict foods containing potassium.
2. to administer IV sodium bicarbonate (NaHCO3).
3. insulin and glucose administration.
4. to administer sodium polystyrene sulfonate (Kayexalate) and sorbitol.

 

 

ANS:   4

This is considered severe hypokalemia and requires aggressive treatment with Kayexalate and sorbitol. These increase the body’s excretion of potassium.

 

DIF:    Cognitive level: Application              REF:    p. 240

TOP:    Nursing process: Intervention/Implementation

 

  1. In monitoring a client on potassium supplements, the nurse observes for signs and symptoms of hyperkalemia, which include:
1. oliguria, tachycardia, and later bradycardia.
2. soft, flabby muscles.
3. abdominal distention.
4. blurred vision and loss of hearing.

 

 

ANS:   1

These are the signs of hyperkalemia.

 

DIF:    Cognitive level: Application              REF:    p. 240

TOP:    Nursing process: Assessment

 

  1. A nurse is teaching a client about ways to avoid hypocalcemia. Dietary recommendations indicate that the vitamin that is necessary for calcium absorption is:
1. vitamin A.
2. vitamin B.
3. vitamin D.
4. vitamin E.

 

 

ANS:   3

Vitamin D enhances the absorption of calcium in the body.

 

DIF:    Cognitive level: Application              REF:    p. 244

TOP:    Nursing process: Intervention/Teaching

 

 

  1. A client’s serum calcium level is 3.7 mEq/L. The nurse correctly interprets that this level is:
1. low.
2. Normal.
3. high.
4. dangerously high.

 

 

ANS:   1

The appropriate range for serum calcium is 4.5 to 5.6 mEq/L.

 

DIF:    Cognitive level: Analysis                   REF:    p. 244

TOP:    Nursing process: Analysis

 

  1. A client is receiving D5  NSS via a peripheral IV. The client is prescribed to receive calcium gluconate. The nurse knows that calcium should not be mixed with saline solution. The appropriate response for the nurse is to:
1. ask the health care provider about changing the IV solution to 5% dextrose in water (D5W), because saline encourages calcium loss.
2. not give the medication because it is the wrong solution.
3. report the health care provider immediately to the supervisor because of the wrong solution.
4. change the IV solution to D5W and report it later to the health care provider.

 

 

ANS:   1

This is the correct action to take when administering IV calcium.

 

DIF:    Cognitive level: Application              REF:    p. 246

TOP:    Nursing process: Intervention/Implementation

 

  1. Tetany symptoms result from severe calcium deficit. The nurse checks for symptoms of tetany. Which of the following is not associated with tetany?
1. Twitching of the mouth and numbness of the fingers
2. Muscle weakness
3. Carpopedal spasms
4. Laryngeal spasm

 

 

ANS:   2

Muscle weakness is not characteristic of tetany; the other symptoms are.

 

DIF:    Cognitive level: Application              REF:    p. 244

TOP:    Nursing process: Assessment

 

 

  1. The group of drugs that contains magnesium and if taken in excess can cause hypermagnesemia includes:
1. laxatives and steroids.
2. laxatives and antacids.
3. antacids and antibiotics.
4. antacids and steroids.

 

 

ANS:   2

Laxatives and antacids may contain magnesium and have the potential for misuse in clients.

 

DIF:    Cognitive level: Comprehension        REF:    p. 248

TOP:    Nursing process: Analysis

 

  1. A client in congestive heart failure is noted to gain 17 pounds in the 2 weeks since the last appointment. The nurse is aware that this represents an approximate fluid retention volume of:
1. 5 L.
2. 7 L.
3. 10 L.
4. 15 L.

 

 

ANS:   2

1 L of fluid weighs one kg; therefore 17 lb = 7.7 kg. Thus 7 L is the closest answer.

 

DIF:    Cognitive level: Application              REF:    p. 237

TOP:    Nursing process: Assessment

 

  1. Which of the following signs and symptoms may be noted in a client with overhydration?
1. Bradycardia
2. Hypotension
3. Pulmonary congestion
4. Weight loss

 

 

ANS:   3

Pulmonary congestion is a sign of fluid overload. Hypotension and weight loss are associated with dehydration and shock. Bradycardia may be due to longtime hypoxia and hypoxemia, but this is a very late sign.

 

DIF:    Cognitive level: Application              REF:    p. 237

TOP:    Nursing process: Assessment

 

 

  1. A postoperative client enters the postanesthesia care unit and blood studies are done. The client’s serum potassium level is 2.9 mEq/L. The nurse should:
1. institute seizure precautions.
2. monitor ECG readings.
3. draw liver enzyme levels.
4. elevate the head of the bed.

 

 

ANS:   2

That level of potassium puts the client at risk for cardiac dysrhythmias. The nurse must monitor for cardiac irregularities.

 

DIF:    Cognitive level: Analysis                   REF:    p. 238

TOP:    Nursing process: Assessment

 

  1. Which of the following symptoms would alert the nurse to the diagnosis of Deficient fluid volume?
1. Weight gain
2. Tachycardia
3. Moist mucous membranes
4. Urine output >600 mL/day

 

 

ANS:   2

Tachycardia is a compensatory mechanism for hypovolemia; the other symptoms are consistent with appropriate hydration or overhydration.

 

DIF:    Cognitive level: Analysis                   REF:    p. 237

TOP:    Nursing process: Analysis

 

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