Textbook of Medical-Surgical Nursing

BRUNNER & SUDDARTH'S TEXTBOOK OF MEDICAL-SURGICAL NURSING 15TH EDITION HINKLE TEST BANK
C. Respiratory alkalosis and metabolic acidosis
D. Respiratory acidosis and metabolic acidosis
ANS: D
Rationale: Clients can simultaneously experience two or more independent acid–base disorders. This
client has a pH value below normal, a PCO2 value above 45 mm HG, and a HCO3– value of less than
22 mEq/L, which is indicative of both respiratory acidosis and metabolic acidosis.
PTS: 1 REF: p. 262
NAT: Client Needs: Physiological Integrity: Physiological Adaptation
TOP: Chapter 10: Principles of Fluid and Electrolytes
KEY: Integrated Process: Nursing Process
BLM: Cognitive Level: Analyze
NOT: Multiple Choice
MULTIPLE RESPONSE
36. A client with hypokalemia is to receive intravenous (IV) potassium replacement. Which action should
the nurse take when administering potassium intravenously? Select all that apply.
A. Administer potassium by IV push.
B. Assess blood urea nitrogen (BUN) and serum creatinine prior to potassium administration.
C. Monitor complete blood count during potassium infusion.
D. Follow the facility policy for infusion of potassium.
E. Report a reduced urinary output to the health care provider.
ANS: B, D, E
Rationale: Potassium should be administered by an infusion pump and should never be given by IV
push to avoid rapid replacement. Because potassium is excreted by the kidneys, BUN, serum
creatinine, and urinary output should be assessed prior to and during administration of IV potassium.
Abnormal laboratory results or decreased or absent urinary output should be reported to the health care
provider. Because potassium administration does not affect blood cells, the complete blood count does
not need to be monitored during administration of potassium. The nurse should check facility policy
on the administration of IV potassium to ensure safe care.
PTS: 1 REF: p. 245
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: Apply
NOT: Multiple Response
37. A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in
older adults. Which factors contribute to this phenomenon? Select all that apply.
A. Decreased kidney mass
B. Increased conservation of sodium
C. Increased total body water
D. Decreased renal blood flow
E. Decreased excretion of potassium
ANS: A, D, E
Rationale: Dehydration in older adults is common as a result of decreased kidney mass, decreased
glomerular filtration rate, decreased renal blood flow, decreased ability to concentrate urine, inability
to conserve sodium, decreased excretion of potassium, and a decrease of total body water.
PTS: 1 REF: p. 233 NAT: Client Needs: Health Promotion and Maintenance
TOP: Chapter 10: Principles of Fluid and Electrolytes
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