NRG 301 Lec Midterms Quiz#1

An elderly woman presents with vomiting for 3 days, poor skin turgor, and orthostatic hypotension. Labs: Na+ 150, BUN 32, Cr 1.1, urine SG 1.038. Which fluid should the nurse expect to administer first?

• D5W at 100 mL/hr

• 3% NaCl 250 mL bolus

• Lactated Ringer’s 500 mL bolus

• 0.45% NS with potassium

A patient with SIADH secondary to lung cancer is receiving D5W at 100 mL/hr. He is drowsy and confused. Na+ = 119, urine output = 100 mL/12 hr. Which intervention is the priority?

• Administer oral salt tablets

• Continue D5W infusion

• Switch to hypertonic saline 3% NaCl

• Give furosemide to promote water excretion

A nurse is caring for a patient postoperatively receiving LR. After 6 hours, the patient develops SOB and 3+ edema. Vitals: BP 156/92, HR 112. What is the nurse’s first action?

• Slow the IV rate to 50 mL/hr

• Elevate HOB and apply oxygen

• Administer PRN antihypertensive

• Prepare to give albumin

A patient with DKA is on an insulin drip. His potassium was 5.2 mEq/L on admission. Four hours later, he reports weakness. ECG: flat T waves. What should the nurse anticipate?

• Hyperkalemia due to acidosis

• Hypokalemia due to insulin therapy

• Worsening acidosis due to potassium loss

• Hypoglycemia with stable potassium

A nurse is teaching a student about fluid compartments. Which statement by the student indicates understanding?

• Extracellular fluid is two-thirds of total body water.

• Transcellular fluid holds most of the potassium in the body.

• Muscle mass increases total body water percentage.

• Fat tissue stores more water than lean tissue.

A patient is receiving IV fluids post-op and suddenly becomes restless and hypertensive with JVD and crackles.

• Stop the IV infusion

• Apply oxygen and raise HOB

• Continue fluids and reassess in 30 minutes

• Notify provider and prepare for diuretics

A 78-year-old is admitted from a nursing home with poor PO intake. Labs: Na+ 132, BUN 36, Cr 1.2. BP 88/52, HR 122. Which order would the nurse question?

• IV NS 500 mL bolus

• D5W at 150 mL/hr for maintenance

• Monitor weights and I&O

• Trend serum electrolytes

A patient is receiving furosemide. He complains of muscle cramps and palpitations. ECG: U waves. Labs: K+ 2.8, Mg2+ 1.4. Which intervention is priority?

• Encourage high-potassium foods

• Administer IV KCl with cardiac monitoring

• Stop loop diuretic permanently

• Give kayexalate

A nurse is assessing a patient with suspected fluid volume deficit. Which findings support this diagnosis? (Select all that apply)

• A. Orthostatic hypotension

• B. Jugular venous distention

• C. Dry mucous membranes

• D. Bilateral crackles

• E. Decreased urine output

A patient on magnesium sulfate develops drowsiness, RR 10/min, and absent reflexes. What is the nurse’s priority action?

• Call rapid response

• Reassess every 15 minutes

• Stop the infusion and give calcium gluconate

• Administer oxygen and continue infusion