Textbook of Medical-Surgical Nursing

BRUNNER & SUDDARTH'S TEXTBOOK OF MEDICAL-SURGICAL NURSING 15TH EDITION HINKLE TEST BANK
ANS: D
Rationale: If hypermagnesemia is suspected, the nurse monitors the vital signs, noting hypotension and
shallow respirations. The nurse also observes for decreased DTRs and changes in the level of
consciousness. Kussmaul breathing is a deep and labored breathing pattern associated with severe
metabolic acidosis, particularly diabetic ketoacidosis (DKA), but also kidney disease. This type of
client is associated with decreased DTRs, not increased DTRs.
PTS: 1 REF: p. 254
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
33. A client's most recent laboratory results show a slight decrease in potassium. The health care provider
has opted to forgo drug therapy but has suggested increasing the client's dietary intake of potassium.
What should the nurse recommend?
A. Apples
B. Fish
C. Rice
D. Bananas
ANS: D
Rationale: Bananas are high in potassium. Apples, fish, and rice are not high in potassium.
PTS: 1 REF: p. 245
NAT: Client Needs: Physiological Integrity: Basic Care and Comfort
TOP: Chapter 10: Principles of Fluid and Electrolytes
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
NOT: Multiple Choice
34. The nurse is assessing the client for the presence of a Chvostek sign. Which electrolyte imbalance
would a positive Chvostek sign indicate?
A. Hypermagnesemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
ANS: C
Rationale: The nurse can induce Chvostek sign by tapping the client's facial nerve adjacent to the ear.
A brief contraction of the upper lip, nose, or side of the face indicates Chvostek sign. Both
hypomagnesemia and hypocalcemia may be indicated by a positive Chvostek sign.
PTS: 1 REF: p. 249
NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential
TOP: Chapter 10: Principles of Fluid and Electrolytes
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Understand
NOT: Multiple Choice
35. The intensive care unit nurse is caring for a client who experienced trauma in a workplace accident.
The client is reporting dyspnea because of abdominal pain. An arterial blood gas test reveals the
following results: pH 7.28, PaCO2 50 mm Hg, HCO3– 20 mEq/L. The nurse should recognize the
likelihood of which acid–base disorder(s)?
A. Respiratory acidosis only
B. Respiratory acidosis and metabolic alkalosis
C L I C K H E R E T O D O W N L O A D C O M P L E T E T E S T B A N K S