Physiological Adaptation1. 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?A. Circulating fluid volume overload with pulmonary congestionB. Acute fluid volume deficit with poor perfusion rather than the overload cluster shown hereC. Isolated hyponatremia without a volume changeD. Hypocalcemic tetany from rapid infusionCheck
Physiological Adaptation2. Which findings support fluid volume overload? (Select all that apply.)Select all that apply.A. New crackles in the lung basesB. Jugular venous distentionC. Pitting peripheral edemaD. Bounding peripheral pulsesE. Dry sticky oral mucosaF. Oliguria with concentrated dark urineCheck
Physiological Adaptation3. 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?A. Circulating fluid volume overload with pulmonary congestionB. Acute fluid volume deficit with poor perfusion rather than the overload cluster shown hereC. Isolated hyponatremia without a volume changeD. Hypocalcemic tetany from rapid infusionCheck
Physiological Adaptation4. 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?A. Fluid volume overload with pulmonary edemaB. Hypercalcemia with kidney stonesC. Fluid volume deficitD. Chronic stable heart failure at dry weightCheck
Physiological Adaptation5. 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?A. Painless hematuria from bladder stonesB. Seizure activity from cerebral swellingC. Bounding pulses from circulating overloadD. Trousseau sign from low ionized calciumCheck
Physiological Adaptation6. 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?A. Hypocalcemia with laryngeal spasmB. Fluid overload with pink frothy sputumC. Hypokalemia with flattening of T wavesD. Water deficit with hypernatremiaCheck
Physiological Adaptation7. 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?A. Hypocalcemia with neuromuscular irritabilityB. Hypernatremia from free-water loss after thyroid surgery when calcium is the issueC. Hyperkalemia with peaked T wavesD. Fluid overload with sacral edemaCheck
Physiological Adaptation8. 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?A. Hyperkalemia with peaked T wavesB. Hypernatremia with thirst onlyC. HypokalemiaD. Hypocalcemia with Chvostek signCheck
Physiological Adaptation9. 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?A. The tube is occluded and must be stripped forcefully when tidaling alone is still presentB. Tidaling is the expected fluctuation with respirationC. The client needs immediate clamping of both tubesD. Continuous leak is proven by any water movementCheck
Physiological Adaptation10. 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?A. Expected tidaling onlyB. Normal suction-control function on water sealC. That the collection chamber is full and should be emptied into a sinkD. An air leak in the system or from the pleural spaceCheck