Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 11 Fluids and Electrolytes^449



  1. When performing a neurological assessment on Ken, you notice that there
    is contraction of his facial muscle after tapping the facial nerve anterior to
    his ear. You recognize this as Chvostek’s sign. This is seen in:
    (a) hyponatremia.
    (b) hypokalemia.
    (c) hypocalcemia.
    (d) hypomagnesemia.

  2. Grace was diagnosed with hyperparathyroidism after a work-up to deter-
    mine the cause of her elevated calcium levels. The greatest concern in a
    patient with hypercalcemia would be:
    (a) cardiac arrhythmia and sinus arrest.
    (b) nausea and vomiting.
    (c) constipation and dehydration.
    (d) kidney stones and muscle weakness.

  3. Brendan has chronic obstructive pulmonary disease, causing a constant
    state of respiratory acidosis. He has a history of chronic trimethoprim and
    NSAID use, leading to hyperkalemia. Which of the following are associ-
    ated with hyperkalemia?
    (a) Irritability, circumoral paresthesia, muscle spasms, tetany, abdominal
    pain, laryngospasm, and prolonged QT intervals.
    (b) Muscle cramps, malaise, diminished deep tendon reflexes, anorexia,
    constipation, palpitations, and rhabdomyolysis.
    (c) Cardiac arrhythmia, nausea, vomiting, constipation, dehydration, kidney
    stones, muscle weakness, and sinus arrest.
    (d) Weakness, dizziness, abdominal distention, nausea, vomiting, diarrhea,
    palpitations, and cardiac arrhythmias.

  4. You are monitoring intravenous fluids for Tom who is currently being treated
    for metabolic acidosis. You monitor his signs and symptoms typical of meta-
    bolic acidosis which include:
    (a) elevated blood pressure, bradycardia, elevated respiratory rate, and mus-
    cle twitching.
    (b) hypotension, altered heart rate, elevated respiratory rate, and muscle
    weakness.
    (c) hypertension, tachycardia, slowed respiratory rate, and muscle spasms.
    (d) hypotension, hypoxia, irritability, and paresthesia.

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