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Michael’s College
NCM 102
Name:____________________________________________________________
2. Before administering packed red blood cells, the nurse must flush the client’s
I.V. line. Which solution should the nurse use to flush the line?
c. Dextrose 5% in water
a. Hypercalcemia
b. Hyperphosphatemia
c. Hypokalemia
d. Hypernatremia
5. When assessing a client’s I.V. insertion site, the nurse notes normal color and
temperature at the site and no swelling. However, the I.V. solutions haven’t
infused at the ordered rate; the flow rate is slow even with the roller clamp
wide open. When the nurse lowers the I.V. fluid bag, no blood returns to the
tubing. What should the nurse do first?
a. Discontinue the I.V. infusion at that site and restart it in the other arm.
c. Check the tubing for kinks and reposition the client’s wrist and elbow.
c. Low-fat milk
d. Creamed corn
7. The physician prescribes a loop diuretic for a client. When administering this
drug, the nurse anticipates that the client may develop which electrolyte
imbalance?
a. Hypervolemia
b. Hypokalemia
c. Hyperkalemia
d. Hypernatremia
8. Which of the following type of solutions, when administered I.V., would cause
a shift of fluid from body tissues to the bloodstream?
a. Hypotonic
b. Isotonic
c. Sodium chloride
d. Hypertonic
9. Which type of solution raises serum osmolarity and pulls fluid from the
intracellular and interstitial compartments into the intravascular
compartment?
a. Isotonic
b. Hypertonic
c. Electrotonic
d. Hypotonic
10.While preparing to start a stat I.V. infusion, the nurse notices that the ground
on the infusion pump’s plug is broken. What should the nurse do first?
a. Use the pump as is because the physician has ordered the medication
stat.
b. Obtain another pump from central supply to use for the infusion.
c. Tape the broken ground to the plug and use the pump.
11.While performing rounds, a nurse finds that a client is receiving the wrong I.V.
solution. The nurse’s initial response should be to:
d. Wait until the next bottle is due and then change to the proper solution.
12.The nurse is caring for a client with Congestive Heart Failure. On assessment,
the nurse finds the client complaining of dyspnea and that rales are heard on
auscultation. The nurse suspects fluid volume excess. Which additional would
the nurse expect if fluid volume excess is present?
b. Weight loss
d. Hypotension
13.A client with Congestive Heart Failure is assessed by the nurse. Upon
reviewing the chart, it is determined that his weight increased by 4.5 pounds.
The nurse estimates that the client has gained how many liters of fluid?
a. 3
b. 1
c. 2
d. 0.5
14.A nurse reads a doctor’s progress notes in the client’s chart which states
“insensible fluid loss approximately 800 mL.” The nurse understands that this
fluid loss may occur through:
b. Urinary output
c. Wound drainage
d. The skin
15.A nurse is administering IVF as ordered to a patient who sustained second-
degree burns. In evaluating the adequacy of fluid resuscitation, the nurse
understands that the most reliable indicator for fluid adequacy is the:
a. Blood pressure
b. Mental status
c. Urine output
d. Peripheral pulses
16.The nurse receives the following endorsements. She is certain that which
patient is at most risk for the development of fluid volume deficit?
b. Chovstek’s Sign
18.The nurse reviews the laboratory report of a patient with fluid volume deficit.
Which of the following laboratory findings will support this condition?
b. Creatinine of 1 mg/dl
c. Sodium of 140 mEq/L
d. Hematocrit of 58%
a. Monitor urinary pH
20.The nurse notes that the client’s I.V. insertion site is red, swollen, and warm
to the touch. Which action should the nurse take first?
22.The physician orders the nurse to prepare an isotonic solution. Which of the
following IV solution would the nurse expect the intern to prescribe?
a. 5% dextrose in water
23.The nurse is making initial rounds on the nursing unit to assess if the
condition of assigned clients. The nurse notes that the client’s IV site is cool,
pale, and swollen and the solution is not infusing. The nurse concludes that
which of the following complications has been experienced by the client?
a. Infection
b. Phlebitis
c. Infiltration
d. Thrombophlebitis
24.A nurse reviews the client’s electrolyte laboratory report and notes that the
potassium level is 3.2 mEq/L. Which of the following would the nurse note on
the electrocardiogram as a result of the laboratory value?
a. U waves
b. Absent P waves
c. Elevated T waves
d. Elevated ST segment
b. Isotonic solution
c. Hypertonic solution
d. Hypotonic solution
d. Urethral catheterization
27.Which of the following is not true with regards to the informed consent?
29.A nurse is assigned to care for a group of clients. On review of the client’s
medical records, the nurse determined that which client is at risk for excess
fluid volume?
30.A nurse is assigned to care for a group of clients. On review of the client’s
medical records, the nurse determines that which client is at risk for deficient
fluid volume?
31.Which of the following nursing interventions is correct for clients receiving I.V.
therapy?
Carina, 17 years old, is admitted to the hospital with a diagnosis of acute renal
failure
32.Kayexalate was prescribed by the doctor for the patient. The nurse
understands that in Carina’s condition, this medication is given to treat:
a. Cardiac complication
b. Uremia
c. Edema
d. Hyperkalemia
33.The doctor ordered for a 24 hour urine specimen. Which action of the nurse is
correct?
a. Monitor and record the patient’s intake and output for the next 24 hours
b. In the next 24 hours, bring the fresh voided urine of the patient after
every urination to the laboratory for examination.
c. Provide the patient with water only to drink in the next 24 hours.
34.When the doctor orders for sterile urine specimen, which would be an
appropriate action of the nurse:
c. The nurse performs perineal hygiene then collects the midstream urine.
d. The nurse should remind the doctor that a sterile specimen cannot be
collected because normal flora is always present in the genital tract.
35.Which of the following is the most important action in assessing fluid status
of Carina?
c. Weigh daily
a. Hyperkalemia
b. Falling hair
37.Laboratory blood test results revealed that the patient developed acute
hyperclacemia. The nurse should:
a. Institute bedrest
38.What finding in the patient’s history could have probably contributed to the
development of SIADH?
d. History of TB
a. Hyponatremia
b. Polyuria
c. Polydipsia
40. After the lungs, the kidneys work to maintain body pH. The best explanation
of how kidneys accomplish regulation of pH is that they
b. Secrete ammonia
d. Decrease sodium ions, hold on to hydrogen ions, and then secrete sodium
bicarbonate
41.Of the following blood gas values, the one the nurse would expect to see in
the client with acute renal failure is
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