An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Hyperkalemia

Hyponatremia

Fluid volume excess

Hypernatremia

Answer and Explanation

The Correct Answer is B

Choice A: Hyperkalemia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood potassium level is too high. This can happen in patients who have renal failure, acidosis, or excessive potassium intake. Hyperkalemia can cause muscle weakness, cardiac arrhythmias, and paralysis.

Choice B: Hyponatremia is an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too low. This can happen in patients who have watery diarrhea, which causes the loss of sodium and water from the body. Hyponatremia can cause abdominal and muscle cramping, nausea, confusion, and seizures.

Choice C: Fluid volume excess is not an imbalance that this patient is demonstrating, because this condition occurs when the body retains more ﬂuid than it excretes. This can happen in patients who have heart failure, kidney failure, or excessive ﬂuid intake. Fluid volume excess can cause edema, distended neck veins, and crackles in the lungs.

Choice D: Hypernatremia is not an imbalance that this patient is demonstrating, because this condition occurs when the blood sodium level is too high. This can happen in patients who have dehydration, diabetes insipidus, or excessive sodium intake. Hypernatremia can cause thirst, dry mucous membranes, agitation, and coma.

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Correct Answer is D

Explanation

Choice A: Anticipating the administration of intravenous sodium bicarbonate is incorrect because this would increase the pH and worsen the alkalosis. Sodium bicarbonate is used to treat metabolic acidosis, not respiratory alkalosis.

Choice B: Preparing to start an intravenous ﬂuid bolus using isotonic ﬂuids is incorrect because this would not aﬀect the pH or the PaCO2. Isotonic ﬂuids are used to treat ﬂuid volume deficit, not respiratory alkalosis.

Choice C: Immediately administering oxygen via a mask and monitoring oxygen saturation is incorrect because this would decrease the respiratory drive and increase the PaCO2. Oxygen therapy is used to treat hypoxemia, not respiratory alkalosis.

Choice D: Encouraging the patient to breathe in and out slowly into a paper bag is correct because this would increase the PaCO2 and lower the pH. Rebreathing carbon dioxide is a common treatment for respiratory alkalosis caused by hyperventilation.

A. Sodium 155 mEq/L B. Hematocrit 44% C. Urine specific gravity 1.035 D. BUN 19 mg/dL

Correct Answer is C

Explanation

Choice A: Sodium 155 mEq/L is correct because it indicates hypernatremia, or high sodium level, which can occur in ﬂuid volume deficit due to dehydration, excessive sweating, or diuretic therapy. Sodium is an electrolyte that regulates ﬂuid balance and osmotic pressure in the body. The normal range of sodium is 135 to 145 mEq/L.

Choice B: Hematocrit 44% is incorrect because it is within the normal range of hematocrit, which is the percentage of red blood cells in the blood. Hematocrit can reﬂect the oxygen-carrying capacity and viscosity of the blood. The normal range of hematocrit is 37% to 47% for females and 42% to 52% for males.

Choice C: Urine specific gravity 1.035 is correct because it indicates a high urine concentration, which can occur in ﬂuid volume deficit due to decreased urine output and increased solute excretion. Urine specific gravity is a measure of the density of urine compared to water. The normal range of urine specific gravity is 1.005 to 1.030.

Choice D: BUN 19 mg/dL is incorrect because it is within the normal range of BUN, which stands for blood urea nitrogen, and is a measure of the amount of nitrogen in the blood that comes from urea, a waste product of protein metabolism. BUN can reﬂect the kidney function and hydration status of the client. The normal range of BUN is 7 to 20 mg/dL.

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An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient who is anxious and dizzy following a traumatic experience. The arterial blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, and HCO3 24. Which intervention should the nurse expect to be prescribed to correct this problem?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory results of a client who has ﬂuid volume deficit. The nurse would expect which of the following findings?

Correct Answer is C

Explanation

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