Nursing Elites

1. A nurse evaluates the following arterial blood gas values in a client: pH 7.48, PaO2 98 mm Hg, PaCO2 28 mm Hg, and HCO3 22 mEq/L. Which client condition should the nurse correlate with these results?

• A. Diarrhea and vomiting for 36 hours
• B. . Anxiety-induced hyperventilation
• C. Chronic obstructive pulmonary disease (COPD)
• D. Diabetic ketoacidosis and emphysema

Correct answer: B

Rationale:

2. What fluid is found in spaces between the cells?

• A. Intracellular fluid
• B. Interstitial fluid
• C. Plasma
• D. Electrolyte

Correct answer: B

Rationale: The correct answer is B, Interstitial fluid. Interstitial fluid is the fluid that surrounds and occupies the spaces between cells, providing them with nutrients and removing waste. Choices A, C, and D are incorrect because intracellular fluid refers to fluid inside cells, plasma refers to the liquid component of blood, and electrolyte refers to substances that dissociate into ions in solution, affecting fluid balance but not specifically found in spaces between cells.

3. A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?

• A. Tell the patient to rest more frequently.
• B. Advise the patient to discontinue digoxin and contact the physician.
• C. Contact the physician, report the symptoms, and request a blood sample to determine the patient's potassium level.
• D. Instruct the patient to avoid caffeine-containing foods.

Correct answer: C

Rationale: The correct action for the nurse to take is to contact the physician, report the patient's symptoms, and request a blood sample to determine the patient's potassium level. Furosemide, a potassium-wasting diuretic, can lead to hypokalemia, causing weakness and palpitations. Therefore, checking the potassium level is crucial in this situation. Simply telling the patient to rest more frequently won't address the underlying issue of potassium depletion. While digoxin can cause adverse effects, in this case, the symptoms are more likely related to furosemide-induced potassium loss. Instructing the patient to avoid caffeine-containing foods may be beneficial in general, but it wouldn't directly address the potassium depletion that needs urgent attention.

4. The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance does a positive Chvostek's sign indicate?

• A. Hypermagnesemia
• B. Hypomagnesemia
• C. Hypocalcemia
• D. Hyperkalemia

Correct answer: C

Rationale: Chvostek's sign is characterized by a brief contraction of the upper lip, nose, or side of the face and is indicative of hypocalcemia, making choice C the correct answer. Hypomagnesemia (choice B) is associated with Trousseau's sign, not Chvostek's sign. Hypermagnesemia (choice A) is not related to Chvostek's sign. Hyperkalemia (choice D) is not typically associated with Chvostek's sign; instead, it may present with muscle weakness and cardiac arrhythmias.

5. What is the fluid inside the cell called?

• A. Plasma
• B. Intracellular fluid
• C. Interstitial fluid
• D. Plasma and intracellular fluid

Correct answer: B

Rationale: The correct answer is 'Intracellular fluid.' Intracellular fluid refers to the fluid contained within the cells, constituting a significant portion of the body's total water content. Choices A, C, and D are incorrect. Plasma is the liquid component of blood outside the cells, interstitial fluid is the fluid surrounding cells in tissues, and the combination of plasma and intracellular fluid is not the specific term for the fluid inside the cell.

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