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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 24

Question 1 Type: MCMA The nurse practitioner conducts education for home-health nurses who care for geriatric patients. Many of the patients abuse laxatives, so the nurse practitioner focuses the education on problems that can be caused by chronic laxative use. The nurse practitioner evaluates that learning has occurred when the nurses make which statement s!" #ote$ Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. &The kidneys and '( tract keep electrolytes in narrow balance, where they must be.& 2. &)lectrolytes carry electricity in the body and must stay in balance.& 3. &The electrolytes can be replaced by eating the right foods.& 4. &The most important electrolytes are sodium, potassium, and magnesium.& 5. &*axatives can lower the level of potassium, necessary for proper heart function.& Corre t Ans!er: +,,,-,. "ationa#e 1$ %mall, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible conse/uence of hypokalemia. *evels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and '( tract. As electrolytes are lost due to normal excretory functions, they must be replaced by ade/uate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium. "ationa#e 2$ %mall, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible conse/uence of hypokalemia. *evels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and '( tract. As electrolytes are lost due to normal excretory functions, they must be replaced by ade/uate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium. "ationa#e 3$ %mall, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible conse/uence of hypokalemia. *evels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and '( tract. As electrolytes are lost due to normal excretory functions, they must be replaced by ade/uate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium.
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"ationa#e 4$ %mall, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible conse/uence of hypokalemia. *evels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and '( tract. As electrolytes are lost due to normal excretory functions, they must be replaced by ade/uate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium. "ationa#e 5$ %mall, inorganic molecules possessing a positive or negative charge are called electrolytes. These ions are able to conduct electricity. Chronic use of laxatives can result in fluid imbalance and hypokalemia. Cardiac arrest is a possible conse/uence of hypokalemia. *evels of electrolytes in body fluids are maintained within very narrow ranges, primarily by the kidneys and '( tract. As electrolytes are lost due to normal excretory functions, they must be replaced by ade/uate intake, otherwise electrolyte imbalances will result. The most important electrolytes are sodium, potassium, and calcium, not magnesium. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0-0 Question 2 Type: MC%A The patient is receiving sodium bicarbonate intravenously (4! for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. 5hat is the nurse6s priority action" 1. (ncrease the rate of the infusion and continue to assess the patient for symptoms of acidosis. 2. 7ecrease the rate of the infusion and continue to assess the patient for symptoms of alkalosis. 3. Continue the infusion8 the patient is still in acidosis. 4. %top the infusion and notify the physician8 the patient is in alkalosis. Corre t Ans!er: 0 "ationa#e 1$ The patient receiving sodium bicarbonate is prone to alkalosis8 monitor for cyanosis, slow respirations, and irregular pulse. The patient6s symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, C#% depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis. "ationa#e 2$ The patient receiving sodium bicarbonate is prone to alkalosis8 monitor for cyanosis, slow respirations, and irregular pulse. The patient6s symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, C#%
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depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis. "ationa#e 3$ The patient receiving sodium bicarbonate is prone to alkalosis8 monitor for cyanosis, slow respirations, and irregular pulse. The patient6s symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, C#% depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis. "ationa#e 4$ The patient receiving sodium bicarbonate is prone to alkalosis8 monitor for cyanosis, slow respirations, and irregular pulse. The patient6s symptoms indicate alkalosis so infusion must be stopped and the physician notified. The patient is not in acidosis, symptoms of acidosis include lethargy, confusion, C#% depression leading to coma, and a deep, rapid respiration rate that indicates an attempt by the lungs to rid the body of excess acid. The patient is not in acidosis, so the infusion must be stopped, not increased. The infusion must be stopped, not decreased, as the patient is in alkalosis. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0-: Question 3 Type: MCMA The nurse cares for a patient in the critical care setting who was severely burned. The wife of the patient asks the nurse, &5hy does he need those intravenous infusions (4s!"& 5hat is are! the best response s! by the nurse that indicates the primary reason for intravenous infusions (4s! with a burned patient" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. &%o we have an open line for resuscitation in case his heart stops.& 2. &%o he can receive his antibiotics.& 3. &%o we can keep his blood pressure stable.& 4. &%o we can be sure he keeps enough blood volume.& 5. &%o we can rapidly administer his pain medications.&
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Corre t Ans!er: -,0 "ationa#e 1$ #et loss of fluids from the body can result in dehydration and shock. (ntravenous (4! fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (4! fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (4! fluid replacement. Administration of analgesics is not a primary reason for intravenous (4! fluid replacement. "ationa#e 2$ #et loss of fluids from the body can result in dehydration and shock. (ntravenous (4! fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (4! fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (4! fluid replacement. Administration of analgesics is not a primary reason for intravenous (4! fluid replacement. "ationa#e 3$ #et loss of fluids from the body can result in dehydration and shock. (ntravenous (4! fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (4! fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (4! fluid replacement. Administration of analgesics is not a primary reason for intravenous (4! fluid replacement. "ationa#e 4$ #et loss of fluids from the body can result in dehydration and shock. (ntravenous (4! fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (4! fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (4! fluid replacement. Administration of analgesics is not a primary reason for intravenous (4! fluid replacement. "ationa#e 5$ #et loss of fluids from the body can result in dehydration and shock. (ntravenous (4! fluid therapy is used to maintain blood volume and support blood pressure. Antibiotic therapy is not a primary reason for intravenous (4! fluid replacement. Cardiac resuscitation is not a primary reason for intravenous (4! fluid replacement. Administration of analgesics is not a primary reason for intravenous (4! fluid replacement. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0-+ Question 4 Type: MC%A The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema. The nurse hangs a bag of a hypotonic solution. 5hat will the priority assessment by the nurse include" 1. ;eadache, irritability, and decreasing level of consciousness 2. #ausea, pro<ectile vomiting, and pinpoint pupils 3. Confusion, hallucinations, and agitation 4. ;ypertension, headache, and nausea
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Corre t Ans!er: + "ationa#e 1$ A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. ;eadache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. ;ypertension and nausea are not classical signs of cerebral edema. 3ro<ectile vomiting and pinpoint pupils are not classical signs of cerebral edema. "ationa#e 2$ A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. ;eadache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. ;ypertension and nausea are not classical signs of cerebral edema. 3ro<ectile vomiting and pinpoint pupils are not classical signs of cerebral edema. "ationa#e 3$ A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. ;eadache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. ;ypertension and nausea are not classical signs of cerebral edema. 3ro<ectile vomiting and pinpoint pupils are not classical signs of cerebral edema. "ationa#e 4$ A hypotonic solution will cause a fluid shift out of the plasma into the tissues and cells in the intracellular compartment. This will increase cerebral edema. ;eadache, irritability, and decreasing level of consciousness are signs of cerebral edema. Confusion, hallucinations, and agitation are not classical signs of cerebral edema. ;ypertension and nausea are not classical signs of cerebral edema. 3ro<ectile vomiting and pinpoint pupils are not classical signs of cerebral edema. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-, Question 5 Type: MC%A The patient is dehydrated, but has a normal blood pressure. The new medical intern orders normal serum albumin intravenously (4! for this patient. 5hat is the best evaluation by the nurse regarding this order" 1. (t is a correct and valid order. 2. The intern should have ordered .= dextrose in normal saline. 3. The intern should have ordered 2.0.= #aCl. 4. The intern should have ordered 2.>= #aCl.
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Corre t Ans!er: "ationa#e 1$ 2.0.= #aCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. ;ypotonic solutions are indicated for patients who are dehydrated with normal blood pressure. #ormal serum albumin is a hypertonic solution8 the patient re/uires a hypotonic solution .= dextrose in normal saline is a hypertonic solution8 the patient re/uires a hypotonic solution. 2.>= #aCl is an isotonic solution, the patient re/uires a hypotonic solution. "ationa#e 2$ 2.0.= #aCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. ;ypotonic solutions are indicated for patients who are dehydrated with normal blood pressure. #ormal serum albumin is a hypertonic solution8 the patient re/uires a hypotonic solution .= dextrose in normal saline is a hypertonic solution8 the patient re/uires a hypotonic solution. 2.>= #aCl is an isotonic solution, the patient re/uires a hypotonic solution. "ationa#e 3$ 2.0.= #aCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. ;ypotonic solutions are indicated for patients who are dehydrated with normal blood pressure. #ormal serum albumin is a hypertonic solution8 the patient re/uires a hypotonic solution .= dextrose in normal saline is a hypertonic solution8 the patient re/uires a hypotonic solution. 2.>= #aCl is an isotonic solution, the patient re/uires a hypotonic solution. "ationa#e 4$ 2.0.= #aCl is a hypotonic solution. This will cause fluid to shift from plasma to the tissues and cells in the intravascular compartment. ;ypotonic solutions are indicated for patients who are dehydrated with normal blood pressure. #ormal serum albumin is a hypertonic solution8 the patient re/uires a hypotonic solution .= dextrose in normal saline is a hypertonic solution8 the patient re/uires a hypotonic solution. 2.>= #aCl is an isotonic solution, the patient re/uires a hypotonic solution. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0-Question , Type: MC%A The patient has been running in a long-distance marathon on a very warm day. The patient complains of di99iness and nausea, and is taken to the hospital where she becomes lethargic. The serum sodium level is +,. m)/1*. 5hat will be the best plan of the nurse" 1. 3repare to encourage the patient to drink fluids. 2. 3repare to administer normal saline intravenous (4!. 3. 3repare to administer 2.0.= #aCl.
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4. 3repare to provide a diet high in #aCl. Corre t Ans!er: , "ationa#e 1$ ;yponatremia is a serum sodium level less the +-. m)/1*. ;yponatremia caused by sodium loss may be treated with intravenous (4! fluids containing salt, such as normal saline. 2.0.= #aCl is a hypotonic solution and will further lower the serum sodium. The patient re/uires intravenous (4! fluids at this point, not oral fluids. The patient re/uires intravenous (4! fluids at this point, not foods high in #aCl. "ationa#e 2$ ;yponatremia is a serum sodium level less the +-. m)/1*. ;yponatremia caused by sodium loss may be treated with intravenous (4! fluids containing salt, such as normal saline. 2.0.= #aCl is a hypotonic solution and will further lower the serum sodium. The patient re/uires intravenous (4! fluids at this point, not oral fluids. The patient re/uires intravenous (4! fluids at this point, not foods high in #aCl. "ationa#e 3$ ;yponatremia is a serum sodium level less the +-. m)/1*. ;yponatremia caused by sodium loss may be treated with intravenous (4! fluids containing salt, such as normal saline. 2.0.= #aCl is a hypotonic solution and will further lower the serum sodium. The patient re/uires intravenous (4! fluids at this point, not oral fluids. The patient re/uires intravenous (4! fluids at this point, not foods high in #aCl. "ationa#e 4$ ;yponatremia is a serum sodium level less the +-. m)/1*. ;yponatremia caused by sodium loss may be treated with intravenous (4! fluids containing salt, such as normal saline. 2.0.= #aCl is a hypotonic solution and will further lower the serum sodium. The patient re/uires intravenous (4! fluids at this point, not oral fluids. The patient re/uires intravenous (4! fluids at this point, not foods high in #aCl. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ 3lanning (earnin& +ut ome: ,0-. Question Type: MC%A The patient has a potassium level of ..> m)/1*. The nurse is administering glucose and insulin. The patient6s wife says, &;e doesn6t have diabetes, why is he getting insulin"& 5hat is the best response by the nurse" 1. &(nsulin will cause his extra potassium to go into his cells and lower the blood level.& 2. &(nsulin lowers his blood sugar levels and this is how the extra potassium is excreted.& 3. &(nsulin is safer than giving laxatives such as ?ayexalate.& 4. &(nsulin will help his kidneys excrete the extra potassium.& Corre t Ans!er: +
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"ationa#e 1$ %erum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. 'iving insulin to decrease serum potassium levels is not considered a safer method than giving ?ayexalate. (nsulin does not promote renal excretion of potassium. %erum potassium is lowered by entering the cells8 this is not controlled by serum glucose. "ationa#e 2$ %erum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. 'iving insulin to decrease serum potassium levels is not considered a safer method than giving ?ayexalate. (nsulin does not promote renal excretion of potassium. %erum potassium is lowered by entering the cells8 this is not controlled by serum glucose. "ationa#e 3$ %erum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. 'iving insulin to decrease serum potassium levels is not considered a safer method than giving ?ayexalate. (nsulin does not promote renal excretion of potassium. %erum potassium is lowered by entering the cells8 this is not controlled by serum glucose. "ationa#e 4$ %erum potassium levels may be temporarily lowered by administering glucose and insulin, which cause potassium to leave the extracellular fluid and enter cells. 'iving insulin to decrease serum potassium levels is not considered a safer method than giving ?ayexalate. (nsulin does not promote renal excretion of potassium. %erum potassium is lowered by entering the cells8 this is not controlled by serum glucose. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0-+2 Question . Type: MC%A The physician has ordered ammonium chloride for the patient. 5hat will be a primary assessment of the nurse during administration" 1. The patient6s level of orientation 2. The patient6s blood pressure 3. The patient6s renal status 4. The patient6s liver status Corre t Ans!er: "ationa#e 1$ The nurse must closely monitor the patient6s renal status during the administration of ammonium chloride, because the excretion of this drug depends on normal kidney function. Although important, blood pressure is not a primary assessment for a patient receiving ammonium chloride. Although important, liver status
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is not a primary assessment for a patient receiving ammonium chloride. Although important, the level of orientation is not a primary assessment for a patient receiving ammonium chloride. "ationa#e 2$ The nurse must closely monitor the patient6s renal status during the administration of ammonium chloride, because the excretion of this drug depends on normal kidney function. Although important, blood pressure is not a primary assessment for a patient receiving ammonium chloride. Although important, liver status is not a primary assessment for a patient receiving ammonium chloride. Although important, the level of orientation is not a primary assessment for a patient receiving ammonium chloride. "ationa#e 3$ The nurse must closely monitor the patient6s renal status during the administration of ammonium chloride, because the excretion of this drug depends on normal kidney function. Although important, blood pressure is not a primary assessment for a patient receiving ammonium chloride. Although important, liver status is not a primary assessment for a patient receiving ammonium chloride. Although important, the level of orientation is not a primary assessment for a patient receiving ammonium chloride. "ationa#e 4$ The nurse must closely monitor the patient6s renal status during the administration of ammonium chloride, because the excretion of this drug depends on normal kidney function. Although important, blood pressure is not a primary assessment for a patient receiving ammonium chloride. Although important, liver status is not a primary assessment for a patient receiving ammonium chloride. Although important, the level of orientation is not a primary assessment for a patient receiving ammonium chloride. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-@ Question / Type: MC%A The patient receives dextran 02 'entran 02!. The patient experiences tachycardia, dyspnea, and a cough. 5hat is the best evaluation by the nurse" 1. The drug caused an interaction with another drug the patient receives. 2. The patient experienced impending kidney failure. 3. The patient is allergic to the drug. 4. The drug was infused too rapidly. Corre t Ans!er: 0 "ationa#e 1$ Aluid overload will be caused by a rate of infusion that is too rapid. %igns of fluid overload include tachycardia, peripheral edema, distended neck veins, dyspnea, and cough. An allergy would be manifested by
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urticaria. There is no information in the /uestion that the patient is receiving another drug. The patient6s symptoms do not indicate kidney failure. "ationa#e 2$ Aluid overload will be caused by a rate of infusion that is too rapid. %igns of fluid overload include tachycardia, peripheral edema, distended neck veins, dyspnea, and cough. An allergy would be manifested by urticaria. There is no information in the /uestion that the patient is receiving another drug. The patient6s symptoms do not indicate kidney failure. "ationa#e 3$ Aluid overload will be caused by a rate of infusion that is too rapid. %igns of fluid overload include tachycardia, peripheral edema, distended neck veins, dyspnea, and cough. An allergy would be manifested by urticaria. There is no information in the /uestion that the patient is receiving another drug. The patient6s symptoms do not indicate kidney failure. "ationa#e 4$ Aluid overload will be caused by a rate of infusion that is too rapid. %igns of fluid overload include tachycardia, peripheral edema, distended neck veins, dyspnea, and cough. An allergy would be manifested by urticaria. There is no information in the /uestion that the patient is receiving another drug. The patient6s symptoms do not indicate kidney failure. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0-B Question 10 Type: MC%A The physician orders potassium chloride ?C*! intravenous (4! for the patient. The nurse administers this drug intravenous (4! push. 5hat will be the most likely outcome for this patient" 1. The patient will most likely experience cardiac arrest. 2. The patient will not experience adverse effects if the push was given slowly. 3. The patient will most likely experience tissue necrosis at the in<ection site. 4. The patient will most likely experience renal failure. Corre t Ans!er: + "ationa#e 1$ 3otassium chloride ?C*! must never be administered intravenous (4! push, as bolus in<ections can overload the heart and cause cardiac arrest. 3otassium chloride must never be administered via intravenous (4! push, even if slowly, as cardiac arrest may result. Cardiac failure, not renal failure, is the most likely outcome of administering potassium chloride intravenous (4! push. Although tissue necrosis may occur, this is not the primary concern.
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"ationa#e 2$ 3otassium chloride ?C*! must never be administered intravenous (4! push, as bolus in<ections can overload the heart and cause cardiac arrest. 3otassium chloride must never be administered via intravenous (4! push, even if slowly, as cardiac arrest may result. Cardiac failure, not renal failure, is the most likely outcome of administering potassium chloride intravenous (4! push. Although tissue necrosis may occur, this is not the primary concern. "ationa#e 3$ 3otassium chloride ?C*! must never be administered intravenous (4! push, as bolus in<ections can overload the heart and cause cardiac arrest. 3otassium chloride must never be administered via intravenous (4! push, even if slowly, as cardiac arrest may result. Cardiac failure, not renal failure, is the most likely outcome of administering potassium chloride intravenous (4! push. Although tissue necrosis may occur, this is not the primary concern. "ationa#e 4$ 3otassium chloride ?C*! must never be administered intravenous (4! push, as bolus in<ections can overload the heart and cause cardiac arrest. 3otassium chloride must never be administered via intravenous (4! push, even if slowly, as cardiac arrest may result. Cardiac failure, not renal failure, is the most likely outcome of administering potassium chloride intravenous (4! push. Although tissue necrosis may occur, this is not the primary concern. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0-B Question 11 Type: MC%A The physician orders potassium chloride ?C*! for the patient who has a nasogastric #'! tube. 5hat will the nurse plan to do prior to the administration of this drug" 1. 7ilute the drug prior to administration through the nasogastric #'! tube. 2. Alush the nasogastric #'! tube with Coca-Cola before and after administration. 3. Alush the nasogastric #'! tube with normal saline before and after administration. 4. There is no particular preparation prior to administration. Corre t Ans!er: + "ationa#e 1$ *i/uid forms of potassium chloride ?C*! must be diluted prior to administration through a nasogastric #'! tube to decrease gastrointestinal '(! distress. There is a preparation8 the drug must be diluted to decrease gastrointestinal '(! distress. Alushing the tube with Coca-Cola is an outdated practice, and should not be done. Alushing the tube before and after administration of the drug is important, but the drug must still be diluted to decrease gastrointestinal '(! distress.
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"ationa#e 2$ *i/uid forms of potassium chloride ?C*! must be diluted prior to administration through a nasogastric #'! tube to decrease gastrointestinal '(! distress. There is a preparation8 the drug must be diluted to decrease gastrointestinal '(! distress. Alushing the tube with Coca-Cola is an outdated practice, and should not be done. Alushing the tube before and after administration of the drug is important, but the drug must still be diluted to decrease gastrointestinal '(! distress. "ationa#e 3$ *i/uid forms of potassium chloride ?C*! must be diluted prior to administration through a nasogastric #'! tube to decrease gastrointestinal '(! distress. There is a preparation8 the drug must be diluted to decrease gastrointestinal '(! distress. Alushing the tube with Coca-Cola is an outdated practice, and should not be done. Alushing the tube before and after administration of the drug is important, but the drug must still be diluted to decrease gastrointestinal '(! distress. "ationa#e 4$ *i/uid forms of potassium chloride ?C*! must be diluted prior to administration through a nasogastric #'! tube to decrease gastrointestinal '(! distress. There is a preparation8 the drug must be diluted to decrease gastrointestinal '(! distress. Alushing the tube with Coca-Cola is an outdated practice, and should not be done. Alushing the tube before and after administration of the drug is important, but the drug must still be diluted to decrease gastrointestinal '(! distress. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ 3lanning (earnin& +ut ome: ,0-B Question 12 Type: MC%A The patient has overdosed on aspirin. (n the emergency department, the physician orders sodium bicarbonate. A family member says to the nurse, &( thought that was for stomach ulcers.& 5hat is the best response by the nurse" 1. &(t will prevent excessive bleeding from the stomach.& 2. &(t will change the p; of the blood to neutrali9e the aspirin.& 3. &(t will change the urine so the kidneys can get rid of the aspirin /uickly.& 4. &(t will help the liver break down the aspirin more /uickly.& Corre t Ans!er: "ationa#e 1$ %odium bicarbonate makes the urine more basic, which aids in the renal excretion of acidic drugs such as aspirin. %odium bicarbonate is not given to prevent bleeding when a patient has overdosed on aspirin. %odium bicarbonate is not given to neutrali9e blood p; when a patient has overdosed on aspirin. %odium bicarbonate is not given to enhance liver en9ymes when a patient has overdosed on aspirin.
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"ationa#e 2$ %odium bicarbonate makes the urine more basic, which aids in the renal excretion of acidic drugs such as aspirin. %odium bicarbonate is not given to prevent bleeding when a patient has overdosed on aspirin. %odium bicarbonate is not given to neutrali9e blood p; when a patient has overdosed on aspirin. %odium bicarbonate is not given to enhance liver en9ymes when a patient has overdosed on aspirin. "ationa#e 3$ %odium bicarbonate makes the urine more basic, which aids in the renal excretion of acidic drugs such as aspirin. %odium bicarbonate is not given to prevent bleeding when a patient has overdosed on aspirin. %odium bicarbonate is not given to neutrali9e blood p; when a patient has overdosed on aspirin. %odium bicarbonate is not given to enhance liver en9ymes when a patient has overdosed on aspirin. "ationa#e 4$ %odium bicarbonate makes the urine more basic, which aids in the renal excretion of acidic drugs such as aspirin. %odium bicarbonate is not given to prevent bleeding when a patient has overdosed on aspirin. %odium bicarbonate is not given to neutrali9e blood p; when a patient has overdosed on aspirin. %odium bicarbonate is not given to enhance liver en9ymes when a patient has overdosed on aspirin. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0-B Question 13 Type: MC%A The patient receives normal serum albumin. 5hat are the priority assessments by the nurse" 1. Clood pressure and urinary output 2. Drinary output and pupil response 3. Clood pressure and level of pain 4. Drinary output and nausea or vomiting Corre t Ans!er: + "ationa#e 1$ 7uring fluid replacement therapy, the nurse must assess for fluid volume deficit and fluid volume excess. This is commonly done by assessment of blood pressure and urinary output. *evel of pain is not a priority assessment. 3upil response is not a priority assessment. #ausea or vomiting is not the priority assessment. "ationa#e 2$ 7uring fluid replacement therapy, the nurse must assess for fluid volume deficit and fluid volume excess. This is commonly done by assessment of blood pressure and urinary output. *evel of pain is not a priority assessment. 3upil response is not a priority assessment. #ausea or vomiting is not the priority assessment.

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"ationa#e 3$ 7uring fluid replacement therapy, the nurse must assess for fluid volume deficit and fluid volume excess. This is commonly done by assessment of blood pressure and urinary output. *evel of pain is not a priority assessment. 3upil response is not a priority assessment. #ausea or vomiting is not the priority assessment. "ationa#e 4$ 7uring fluid replacement therapy, the nurse must assess for fluid volume deficit and fluid volume excess. This is commonly done by assessment of blood pressure and urinary output. *evel of pain is not a priority assessment. 3upil response is not a priority assessment. #ausea or vomiting is not the priority assessment. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-> Question 14 Type: MC%A 5hat is a priority outcome when a patient receives dextran 02 'entran 02!" 1. The patient will immediately report any ototoxicity. 2. The patient will immediately report any diarrhea. 3. The patient will immediately report any hiccoughs. 4. The patient will immediately report any itching or flushing. Corre t Ans!er: 0 "ationa#e 1$ A small percentage of patients are allergic to dextran 02 'entran 02!, with urticaria being the most common sign. The most important outcome is for the patient to report any allergic symptoms. 7iarrhea is not a sign of an allergic reaction so is not the priority. Etotoxicity is not a sign of an allergic reaction so is not the priority. ;iccoughs are not a sign of an allergic reaction so are not the priority. "ationa#e 2$ A small percentage of patients are allergic to dextran 02 'entran 02!, with urticaria being the most common sign. The most important outcome is for the patient to report any allergic symptoms. 7iarrhea is not a sign of an allergic reaction so is not the priority. Etotoxicity is not a sign of an allergic reaction so is not the priority. ;iccoughs are not a sign of an allergic reaction so are not the priority. "ationa#e 3$ A small percentage of patients are allergic to dextran 02 'entran 02!, with urticaria being the most common sign. The most important outcome is for the patient to report any allergic symptoms. 7iarrhea is not a sign of an allergic reaction so is not the priority. Etotoxicity is not a sign of an allergic reaction so is not the priority. ;iccoughs are not a sign of an allergic reaction so are not the priority. "ationa#e 4$ A small percentage of patients are allergic to dextran 02 'entran 02!, with urticaria being the most common sign. The most important outcome is for the patient to report any allergic symptoms. 7iarrhea is not a
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sign of an allergic reaction so is not the priority. Etotoxicity is not a sign of an allergic reaction so is not the priority. ;iccoughs are not a sign of an allergic reaction so are not the priority. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0-+2 Question 15 Type: MC%A The nurse provides group education to active adolescents about sodium replacement after exercising outdoors. 5hat is the best information to include" 1. ;ave extra salt with your breakfast on days you exercise outdoors. 2. (t is best to avoid exercising outdoors in the summer. 3. Fou should take one salt tablet for every , hours spent outside. 4. 5ater is the best fluid replacement after exercising. Corre t Ans!er: 0 "ationa#e 1$ ;eat-related problems can be best avoided by consuming ade/uate amounts of water. %alt tablets can increase the risk of hypernatremia. There is no need to avoid exercising as long as enough water is consumed to avoid dehydration. (ncreasing salt intake prior to exercising is not necessary. "ationa#e 2$ ;eat-related problems can be best avoided by consuming ade/uate amounts of water. %alt tablets can increase the risk of hypernatremia. There is no need to avoid exercising as long as enough water is consumed to avoid dehydration. (ncreasing salt intake prior to exercising is not necessary. "ationa#e 3$ ;eat-related problems can be best avoided by consuming ade/uate amounts of water. %alt tablets can increase the risk of hypernatremia. There is no need to avoid exercising as long as enough water is consumed to avoid dehydration. (ncreasing salt intake prior to exercising is not necessary. "ationa#e 4$ ;eat-related problems can be best avoided by consuming ade/uate amounts of water. %alt tablets can increase the risk of hypernatremia. There is no need to avoid exercising as long as enough water is consumed to avoid dehydration. (ncreasing salt intake prior to exercising is not necessary. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity
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C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0-> Question 1, Type: MC%A (ntravenous therapy would be indicated if 1. hypertension were present. 2. fluid intake were greater than ,.22 m*1day. 3. intake and output were deregulated. 4. constipation were present. Corre t Ans!er: "ationa#e 1$ ;ypertension would not re/uire (4 therapy. "ationa#e 2$ Aluid intake of ,.22 m*1day is the average intake for adults. "ationa#e 3$ (ntake and output imbalance would re/uire (4 therapy to treat dehydration or shock and correct fluid imbalance. "ationa#e 4$ Constipation might indicate lack of fluid, but would not re/uire (4. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstanding C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ 3lanning (earnin& +ut ome: ,0-+ Question 1Type: MC%A Esmolality and tonicity are not changed when movement of fluids and solution are 1. hypotonic. 2. hypertonic. 3. isotonic.
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4. oncotic. Corre t Ans!er: "ationa#e 1$ 7ecreased osmolity, waters moves to fluid and cells, hypotonics. "ationa#e 2$ (ncreased osmolity, water moves from cells is hypertonic. "ationa#e 3$ (sotonic does not net fluid change. "ationa#e 4$ Encotic refers to a blood product to treat shock. $#o%a# "ationa#e: Co&niti'e (e'e#: Gemembering C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-, Question 1. Type: MC%A )lectrolytes are essential for many body functions, and re/uire a 1. wide level range. 2. low level range. 3. narrow level range. 4. high level range. Corre t Ans!er: "ationa#e 1$ *evels of electrolytes are maintained within a very narrow range. "ationa#e 2$ *evels of electrolytes are maintained within a very narrow range. "ationa#e 3$ *evels of electrolytes are maintained within a very narrow range. "ationa#e 4$ *evels of electrolytes are maintained within a very narrow range. $#o%a# "ationa#e: Co&niti'e (e'e#: Gemembering C#ient )eed: 3hysiological (ntegrity
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C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-0 Question 1/ Type: MC%A ;yponatremia is marked by a serum sodium level less than 1. +-@ m)/1m*. 2. +02 m)/1m*. 3. +-. m)/1m*. 4. +0. m)/1m*. Corre t Ans!er: "ationa#e 1$ +-@ is normal. "ationa#e 2$ +02 is normal. "ationa#e 3$ +-. indicates a hyponatremia state. "ationa#e 4$ #ormal serum sodium range is +-.H+0. m)/1*. $#o%a# "ationa#e: Co&niti'e (e'e#: Gemembering C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-: Question 20 Type: MC%A 5hich of the following is a sign of hypokalemia" 1. Constipation 2. ;ypertension 3. Muscle weakness 4. 5eight gain
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Corre t Ans!er: "ationa#e 1$ 7iarrhea, not constipation, will occur. "ationa#e 2$ ;ypertension is usually not a sign of hypokalemia. "ationa#e 3$ Muscle weakness can occur, since muscle fibers are very sensitive to changes in potassium. "ationa#e 4$ 5eight gain is usually not a sign of hypokalemia. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstanding C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-@ Question 21 Type: MC%A Cuffers are chemicals that help maintain normal body 3h. The two primary buffers in the body are 1. sodium and calcium ions. 2. sodium and bicarbonate ions. 3. bicarbonate and phosphate ions. 4. potassium and phosphate ions. Corre t Ans!er: "ationa#e 1$ %odium and calcium are not buffers. "ationa#e 2$ %odium is not a buffer in maintaining normal body 3h. "ationa#e 3$ Cicarbonate and phosphate are the two primary buffers of 3h balances. "ationa#e 4$ 3otassium and phosphate are not the two primary buffers. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstanding C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment
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(earnin& +ut ome: ,0-B Question 22 Type: MC%A 3otential causes for respiratory alkalosis include 1. hypotension. 2. hypertension. 3. hypoventilation. 4. hyperventilation. Corre t Ans!er: 0 "ationa#e 1$ ;ypotension is unrelated. "ationa#e 2$ ;ypertension is unrelated. "ationa#e 3$ ;ypoventilation is associated with respiratory acidosis. "ationa#e 4$ ;yperventilation occurs with respiratory alkalosis. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstanding C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0-+2 Question 23 Type: MCMA The nurse is caring for a group of patients on a medical-surgical unit. Aor which patients would the nurse anticipate the need for intravenous fluid therapy to correct fluid depletion" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. A patient suffering from constipation 2. A patient exhibiting nausea and vomiting following a surgical procedure
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3. A patient with a severe burn 4. A patient with congestive heart failure with edema to the lower extremities and rales 5. A patient with uncontrolled diabetic ketoacidosis Corre t Ans!er: ,,-,. "ationa#e 1$ A patient who is suffering from constipation will not need intravenous fluid due to fluid depletion. A patient with diarrhea may re/uire intravenous fluid due to fluid depletion. "ationa#e 2$ A patient exhibiting nausea and vomiting may re/uire intravenous fluid to avoid dehydration. "ationa#e 3$ A patient with a severe burn will often re/uire intravenous fluid due to fluid depletion that occurs from fluid shifts. "ationa#e 4$ A patient with congestive heart failure retains fluid and will be on fluid restrictions. "ationa#e 5$ A patient with uncontrolled diabetic ketoacidosis often re/uires intravenous fluid administration for fluid depletion. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: 3harmacological and 3arenteral Therapies )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0., Question 24 Type: A(C A seasoned nurse is caring for a patient receiving intravenous fluid therapy for dehydration. The nurse knows that the osmolarity or tonicity of a fluid causes water to move to a different compartment. The nurse is caring for a patient who weighs 02 kg. The osmolality of the body fluids for this patient is between ++,222 and IIIII milliosmoles. Standard Text: Corre t Ans!er: ++,B22 "ationa#e $ The normal osmolality of body fluids ranges from ,@. to ,>. milliosmoles per kilogram mEsm1kg!. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: 3hysiological Adaptation )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation
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(earnin& +ut ome: ,0.Question 25 Type: MCMA The nurse is reviewing the tonicity of the different intravenous fluids on the medical-surgical unit in preparation for an in-service presentation. 5hich fluids are considered to be isotonic and appropriate in the treatment of fluid loss due to a surgical procedure" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. .= dextrose in lactated ringers 2. 2.>= sodium chloride #%! 3. 2.0.= sodium chloride 4. *actated Gingers 5. .= dextrose in water Corre t Ans!er: ,,0,. "ationa#e 1$ This is a hypertonic solution and is not appropriate for the treatment of fluid loss due to a surgical procedure. "ationa#e 2$ This is an isotonic solution and is appropriate for the treatment of fluid loss due to a surgical procedure. "ationa#e 3$ This is a hypotonic solution and is not appropriate in the treatment of fluid loss due to a surgical procedure. "ationa#e 4$ This is an isotonic solution that is appropriate to treat fluid loss caused by a surgical procedure. "ationa#e 5$ This is an isotonic solution that is appropriate to treat fluid loss caused by a surgical procedure. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: 3harmacological and 3arenteral Therapies )ursin&/*nte&rated Con epts: #ursing 3rocess$ Assessment (earnin& +ut ome: ,0.0 Question 2,
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Type: MCMA The nurse is caring for a patient with severe electrolyte imbalances that have occurred as a result of kidney failure. The nurse knows that this patient is at risk for what disorders as a result of this electrolyte imbalance" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. Aluid retention 2. Muscle spasms 3. Aractures 4. ;igh cholesterol 5. 7epression Corre t Ans!er: +,,,"ationa#e 1$ )lectrolytes are responsible for membrane permeability and water balance. An electrolyte imbalance, especially too much sodium, can result in fluid retention. "ationa#e 2$ )lectrolytes are essential for muscle contractions. An imbalance in electrolytes can result in muscle spasms. "ationa#e 3$ )lectrolytes are essential for bone growth and remodeling and may place a patient at risk for fractures, especially when there is an imbalance of calcium. "ationa#e 4$ There is no indication that electrolyte imbalances result in high cholesterol. "ationa#e 5$ There is no indication that electrolyte imbalances result in depression. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: Geduction of Gisk 3otential )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0.. Question 2Type: MCMA The nurse is caring for a patient with a p; of @.-,. 5hich medications would be appropriate to administer to a patient with this condition"
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Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. Eral bicarbonate 2. %odium chloride 3. Citrate salts 4. 3otassium chloride 5. Ammonium chloride Corre t Ans!er: +,"ationa#e 1$ Eral bicarbonate is an agent used to treat acidosis. "ationa#e 2$ %odium chloride is an agent used to treat alkalosis. "ationa#e 3$ Citrate salts are an agent used to treat acidosis. "ationa#e 4$ 3otassium chloride is an agent used to treat alkalosis. "ationa#e 5$ 3otassium chloride is an agent used to treat alkalosis. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: 3harmacological and 3arenteral Therapies )ursin&/*nte&rated Con epts: #ursing 3rocess$ (mplementation (earnin& +ut ome: ,0.@ Question 2. Type: MCMA The nurse is preparing to administer normal serum albumin 3lasbumin! to a patient with an albumin level of -., g1d*.The nurse knows that 3lasbumin is classified as Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: %elect all that apply. 1. a blood product. 2. a colloid.
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3. a crystalloid. 4. a vitamin. 5. an electrolyte. Corre t Ans!er: +,, "ationa#e 1$ 3lasbumin is an albumin product. Albumin is considered a blood product. "ationa#e 2$ 3lasbumin is an albumin product. Albumin is considered a colloid. "ationa#e 3$ 3lasbumin is an albumin product. Albumin is not considered a crystalloid. "ationa#e 4$ 3lasbumin is an albumin product. Albumin is not considered a vitamin. "ationa#e 5$ 3lasbumin is an albumin product. Albumin is not considered an electrolyte. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy9ing C#ient )eed: 3hysiological (ntegrity C#ient )eed Su%: 3harmacological and 3arenteral Therapies )ursin&/*nte&rated Con epts: #ursing 3rocess$ )valuation (earnin& +ut ome: ,0.>

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