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Final Exam 2 Med su

Final Exam 2 Med Surge

Question	Answer
in the client with less than normal amounts of bicarbonate in blood and other extracellular fluids what response will the nurse anticipate	increase risk of acidosis
the nurse recognizes which response is an example of compensation for an acid base imbalance	increase of rate and depth of respirations when exercising
when a client has an arterial blood gas of 7.48, the nurse recognizes which action by the .....will help the ph go back to normal	release of hydrogen ions into the blood
when a client is NPO for 5 days and receiving 3L of crystalloid IV solution contain 5% dextrose daily what type of acid production could be expected to increase	ketoacids
in the client with hypoventilation which change in acid base would the nurse recognize as a compensatory response	increase arterial blood bicarbonate
in the client four minutes post cardiac arrest, the nurse correlates the largest source of excess hydrogen ions to which cause	cellular metabolism under anaerobic conditions leading to build up of lactic acid
the nurse recognizes that the lower levels of hgb affects acid base balance by which mechanism	decreases the ability to compensate for mild acidosis
the client has an arterial blood gas of 7.48 how will the nurse interpret the acid base status	the client has a deficit of blood hydrogen ion concentration
in the client of an arterial blood gas ph 7.42 what is the nurses interpretation of his or her acid base status	client has a normal blood hydrogen concentration because the pH is normal
the nurse monitors for which acid base balance in the client who has hypoxemia	excess carbon dioxide production acidosis
what acid base problem could result if a client is being mechanically ventilated is ventilated too high at a respiratory rate	acid deficient alkalosis
the nurse monitors for which acid base problem in the client lasix for hypertension	acid deficit secondary to metabolic alkalosis
the nurse correlates renal compensation for an acid base imbalance in which situation	hypoxemia from 4 days from pneumonia in an adult woman
the nurse determine which client at greatest risk for acidosis	the adult client with pneumonia
the nurse monitors for which acid base imbalance in a client who has acute pancreatitis	metabolic acidosis
the nurse assess acidosis for the client with which data	serum potassium level 6.5 and flaccid paralysis
the hand grasps of a client with acidosis has diminished sense the previous assessment one hour ago, what is the nurses best first action	assessing the clients rate and rhythm and depth of respirations
the client the following arterial blood gas results ph 7.12, HCO3 22, PCO2 65, PO2 56 , the nurse correlates these values to which clinical situation	complete tracheal obstruction related to an aspiration of a hot dog
which client will the nurse assess for potential metabolic acidosis	a young adult following carbohydrate free diet
the nurse interprets which arterial blood gas value as partially compensated metabolic acidosis	ph 7.32, bicarb 17 co2 25
the client has just experienced a 90 second grand mal seizure and has these arterial blood gas values ph 6.88, bicarb 22, co2 60 Po2 50, how will the nurse intervene	applying oxygen by mask or nasal cannula
the nurse teaches the client which intervention to decrease risk for development of metabolic acidosis	be sure to eat 3 well balance meals
the nurse recognizes which client most at risk for development for acute respiratory acidosis	a man undergoing a mechanical ventilation
the nurse correlates which condition to the following arterial blood gas values,ph 7.48, bicarb 22, co2 28, po2 98	anxiety induced hyperventilation
the nurse monitors for which acid base imbalance in client who is receiving 6 units of packed red blood cells for the past 6 hours secondary to blood loss in surgery	metabolic alkalosis
the nurse correlates which arterial blood gas values as consistent with fully compensated respiratory acidosis	ph 7.35 bicarb 36, co2 65 po2 78
the nurse recognizes which client as at greatest risk for alkalosis	an adult client with critical illness receiving total parenteral nutrition
which assessment finding should the nurse expect in a client with salicylates poisoning	increase rate and depth of respirations
in a client with prolonged fever the nurse correlates this to which acid base imbalance	fever increases the rate of metabolism causing a metabolic acidosis by increasing the rate of carbon dioxide production
which statement by the client indicates the need for further education regarding an increase risk metabolic alkalosis	I take sodium bicarb after every meal to prevent heartburn
the client with chronic respiratory acidosis is receiving oxygen by nasal cannula at 6L now has a respiratory rate at 8 breaths per minutes what is the nurses best action	oxygen therapy can inhibit respiratory effort eventually causing death
which acid base imbalance should the nurse be most alert for when providing care to a client who has several broken ribs	respiratory acidosis
the nurse prepares to administer bicarbonate intravenously to a client with which clinical manifestations	ph 7.28 bicarb 16 co2 45 po2 98 secondary to excessive diarrhea
the nurse assess for which electrolyte disorder in a client with metabolic alkalosis	hypokalemia
A family of client with a mixed respiratory and metabolic acidosis secondary to bronchitis and diabetic ketoacidosis asks the nurse whether the clients confusion is likely to be permanent, what is the nurses best response	The confusion should clear as soon as the oxygen and electrolytes become normal
The nurse indicates which statement in a discharge teaching in a client who is going home and continues to be at risk for the development of metabolic alkalosis	avoid excess use of antacids
The nurse monitors which electrolyte level in a client in any type of acid base imbalance	potassium
The nurse monitors for which electrolyte value in the client with acidosis	potassium 5.8
Prior to the administration of IV fluid it is most important for the nurse to obtain which information from the healthcare provider	specific type of IV fluid
Which IV order would the nurse question	infuse 0.9 normal saline and keep vein open
when assigning a client having IV therapy to a licensed LPN which instruction is most important for the RN to provide	Hang a designated IV solution if permitted by the institution
Which infusion device will the nurse select for the older client with a medical diagnosis of dehydration	Cassette pump
What action will the nurse take to prepare packed red blood cells through a Goshon catheter	Use a pump to infuse the blood
The RN assigns a new nurse to a client who is receiving chemotherapy through a IV extension set attached to a Huber needle, which information about disconnecting the Huber needle is most important for the RN to provide to this nurse	the rebound effect
After discontinuing a nontunneled percutaneouse central catheter it is most important for the nurse to record which information	length of the catheter
when assessing the client's peripheral IV site the nurse observes a red streak along the vein path and palpates 4 cm venous cord, what is the most accurate documentation of this finding	Grade 3 Phlebitis at IV site
Which information is most important to teach the client going home with PICC line	avoid carrying grandchildren with the arm that has the IV
A client is to receive 10 days of antibiotic therapy for eurosepsis the nurse should select which IV catheter to replace	Midline catheter
As a result to the of the client's admission to the hospital for excessive nausea and vomiting and BP of 80/50, the nurse selects the access device most appropriate for the designated purpose	20 gauge needle / catheter IV(dehydration)
To prevent infection when infusing a piggyback line which intervention is most important for the nurse	IV-Back priming
what is the initial action taken after completion of an intermittent medication administration through a Gushon catheter	Flush the line with normal saline
when examining a peripheral IV site the nurse observes a red streak along the length of the vein and the vein feels hard and cordlike,what is nurses next action	Removing catheter
when an IV pump alarms because of pressure what action will the nurse take first	Check for kink
the nurse is caring for 4 clients receiving IV therapy which client should the nurse assess first	Older adult with normal saline infusing
the client who is taking tunnel venus catheter inserted begins to complain of chest pain and difficulty breathing, what action will the nurse take first	Assist with insertion of a chest tube
the client who has just had a IV started in right cephalic vein tells the nurse that the wrist and hand below the IV site feels like “pins and needles” what is the nurses best action	discontinuing the IV and start it at another site
when changing the administration set of a central venous catheter it is most important for the nurse to carry out what intervention	Have the client hold his breath during the disconnection and reconnection
Home nurse administer IV med to the client reads in a chart that the PICC line in the clients lt arm has been in place for 4 weeks, IV is patent w good blood return and site is clean and free for manifestation of infiltrations, irritation and infection wh	Remain in months or even years
which assessment finding for client with PICC line requires immediate attention	Upper extremity swelling
when assessing a clients peripheral IV site the nurse notices edema and tenderness above the site what action will the nurse take first	STOP the infusion of IV fluids
What action should the nurse take to prevent an infection in the older patient receiving intravenous therapy	allow aseptic solutions to dry prior to dressing application
the nursing is caring for a client receiving epidural infusion for pain what action is has the highest priority	assessing respiratory rate
the nurse is caring for a client with radial arterial catheter, which assessment is of most concern	presence of ulnar pulse
5 days after start of intraperitneal therapy the patient is complaining of abdominal pain and feeling warm the nurse recognizes that the client is most likely exhibiting symptoms of which condition	Infection
Which client would be the best candidate to receive hypodermoclysis for intravenous therapy	clients receiving pain management
the nurse is caring for a client with an intraosseous catheter placed in the leg 20 hrs ago what assessment is of most concern	legs cold to touch
a client asks why the nurse signs the operative consent form under her signature as a witness what is the nurses best response	it confirms that you voluntarily signed the form
the nurse is caring for an older adult client with a history of emphysema who will be undergoing to surgery the following day, which nursing diagnosis is the highest priority for this client	Risk for Impaired gas exchange
the nurse is completing preoperative teaching for a client and it becomes apparent the client does not understand the surgery will be performed. what is the priority action of the nurse	notify the surgeon and note the findings in the clients chart
when the nurse brings a client preoperative medication the client response i dont need that i had a good nights sleep last night what is the nurses best response	the medication will help prevent complications during the surgery
the client receiving preoperative medication tells the nurse that she took all of her vitamins and herbs last night before going to bed, which one will the nurse report to the surgical team	garlic
the nurse reviews the clients lab results prior to surgery, which findings will the nurse report immediately	Prothrombin time is elevated (15.2)
the client is brought to the emergency department after a motorcycle accident the client has suffered a ruptured spleen, which type of surgery will the client have	emergent
the nurse has just finished preoperative teaching with female client who will be having surgery the following day, which statement by the client indicates that additional teaching is needed	I will wear my lucky earrings tomorrow during surgery
the nurse is performing preop teaching to client who will be having colon resection srugery the following day the surgeon ordered bowel preparation for the client to be taken that night which statement by the client indicates that additional teaching is	i will take my antibiotics with a glass of OJ tonight
the client is scheduled to have surgery in the 2 hrs tells the nurse during the admission interview the following information what information should the nurse be certain to communicate on the outside of the chart for the entire surgical team to know	client is hard of hearing
the client is undergoing palative surgery begin an abdominal tumor, the clients daughter asks what is the surgery to be considered palliative what is the nurses best response	the surgery will relieve the symptoms of the bowel obstruction and will not cure your father
20 minutes after the client receiving preoperative injection of Atropine and Versed, the client tells nurse that he must be allergic because mouth is dry and heart seems to be beating faster than normal, what is the nurses priority acton	ssess the clients pulse and blood pressure
the client under going preoperative assessment before an elective procedure tells the nurse that she has been taking 10 mg of prednisone daily for her rheumatoid arthritis what is the nurses best action	notify the surgeon and anesthesiologist
the preoperative client tells the nurse she has allergies to several substances which allergy presents the greatest potential problem considering the schedule of surgery	shrimp/shellfish

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