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Kardex

Practice

Physiological Adaptation

1. A 74-year-old on a medical unit received 2 L of IV 0.9 percent sodium chloride over 4 hours. The practical nurse now hears new fine crackles at both bases, sees jugular venous distention, and notes a bounding radial pulse. This cluster is most consistent with which problem?

Physiological Adaptation

2. Which findings support fluid volume overload? (Select all that apply.)

Select all that apply.

Physiological Adaptation

3. A 74-year-old on a medical unit received 2 L of IV 0.9 percent sodium chloride over 4 hours. The practical nurse now hears new fine crackles at both bases, sees jugular venous distention, and notes a bounding radial pulse. This cluster is most consistent with which problem?

Physiological Adaptation

4. A 62-year-old with gastroenteritis has a heart rate of 118/min, a blood pressure of 88/56 mm Hg, dry oral mucosa, and 20 mL of dark concentrated urine in 2 hours. Which fluid problem do these findings indicate?

Physiological Adaptation

5. A 81-year-old in long-term care has a serum sodium of 122 mmol/L and new confusion. The practical nurse should recognize that severe hyponatremia most directly threatens which complication?

Physiological Adaptation

6. A 70-year-old with poor oral intake has dry sticky mucosa, intense thirst, and a serum sodium of 156 mmol/L. Which problem do these findings indicate?

Physiological Adaptation

7. After thyroid surgery, a 44-year-old develops perioral tingling. Tapping the facial nerve in front of the ear produces ipsilateral facial twitching. Which electrolyte problem does this sign support?

Physiological Adaptation

8. A 59-year-old on a loop diuretic reports leg cramps. The monitor description is a regular rhythm with flattened T waves and prominent U waves. Which electrolyte imbalance is most likely?

Physiological Adaptation

9. A 52-year-old has a pleural chest tube to water-seal drainage. The water in the water-seal chamber rises with inspiration and falls with expiration, and there is no continuous bubbling in that chamber. How should the practical nurse interpret the water movement?

Physiological Adaptation

10. While assessing a water-seal chest drainage system, the practical nurse sees continuous bubbling in the water-seal chamber. Suction is not applied. What does continuous water-seal bubbling most likely indicate?