Textbook of Medical-Surgical Nursing

BRUNNER & SUDDARTH'S TEXTBOOK OF MEDICAL-SURGICAL NURSING 15TH EDITION HINKLE TEST BANK
B. Hypomagnesemia
C. Hypophosphatemia
D. Hypercalcemia
ANS: D
Rationale: The most common causes of hypercalcemia are malignancies and hyperparathyroidism.
Anorexia, nausea, vomiting, and constipation are common symptoms of hypercalcemia. Dehydration
occurs with nausea, vomiting, anorexia, and calcium reabsorption at the proximal renal tubule.
Abdominal and bone pain may also be present. Primary manifestations of hypernatremia are
neurologic and would not include abdominal pain and dehydration. Tetany is the most characteristic
manifestation of hypomagnesemia, and this scenario does not mention tetany. The client's presentation
is inconsistent with hypophosphatemia.
PTS: 1 REF: p. 250
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 10: Principles of Fluid and Electrolytes
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Apply
NOT: Multiple Choice
26. A medical nurse educator is reviewing a client's recent episode of metabolic acidosis with members of
the nursing staff. What should the educator describe about the role of the kidneys in metabolic
acidosis?
A. The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance.
B. The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.
C. The kidneys react rapidly to compensate for imbalances in the body.
D. The kidneys regulate the bicarbonate level in the intracellular fluid.
ANS: B
Rationale: The kidneys regulate the bicarbonate level in the ECF; they can regenerate bicarbonate ions
as well as reabsorb them from the renal tubular cells. In respiratory acidosis and most cases of
metabolic acidosis, the kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore
balance. In respiratory and metabolic alkalosis, the kidneys retain hydrogen ions and excrete
bicarbonate ions to help restore balance. The kidneys obviously cannot compensate for the metabolic
acidosis created by kidney disease. Renal compensation for imbalances is relatively slow (a matter of
hours or days).
PTS: 1 REF: p. 259
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 10: Principles of Fluid and Electrolytes
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
NOT: Multiple Choice
27. The nurse in the medical intensive care unit is caring for a client who is in respiratory acidosis due to
inadequate ventilation. Which diagnosis could the client have that could cause inadequate ventilation?
A. Endocarditis
B. Multiple myeloma
C. Guillain–Barré syndrome
D. Overdose of amphetamines
ANS: C
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