Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider?
A. 10 mg/dL.
A BUN (Blood Urea Nitrogen) level of 10 mg/dL is within the normal range, indicating normal kidney function. There is no indication to report this value to the provider for a dehydrated client.
B. 18 mg/dL.
A BUN level of 18 mg/dL is within the normal range as well. This value does not suggest significant dehydration, so it is not necessary to report it to the provider in this context.
C. 13 mg/dL.
A BUN level of 13 mg/dL is also within the normal range, and similar to choices A and B, it does not indicate severe dehydration that requires immediate reporting to the provider.
D. 25 mg/dL.
A BUN level of 25 mg/dL is elevated, which may indicate dehydration, kidney dysfunction, or other issues affecting fluid balance. Since the client is dehydrated, this elevated value needs to be reported to the provider for further evaluation and appropriate intervention.
This question is an excerpt from Nurse Dive's nursing test bank - ATI custom Fluid and Electrolyte Exam Summer 2023 Proctored Exam. Take the full exam now
Full Explanation
25 mg/dL.
Choice A rationale:
A BUN (Blood Urea Nitrogen) level of 10 mg/dL is within the normal range, indicating normal kidney function. There is no indication to report this value to the provider for a dehydrated client.
Choice B rationale:
A BUN level of 18 mg/dL is within the normal range as well. This value does not suggest significant dehydration, so it is not necessary to report it to the provider in this context.
Choice C rationale:
A BUN level of 13 mg/dL is also within the normal range, and similar to choices A and B, it does not indicate severe dehydration that requires immediate reporting to the provider.
Choice D rationale:
A BUN level of 25 mg/dL is elevated, which may indicate dehydration, kidney dysfunction, or other issues affecting fluid balance. Since the client is dehydrated, this elevated value needs to be reported to the provider for further evaluation and appropriate intervention.
Similar Questions
A patient with fluid overload is prescribed furosemide (Lasix) 20 mg by mouth each day. What should the nurse include when teaching the patient about this medication? Select all that apply.
A. Expect urination to increase.
Furosemide is a loop diuretic that promotes diuresis, causing an increase in urine output. It is essential for the patient to expect this effect and understand that it helps in reducing fluid overload.
B. Expect to feel weak and dizzy.
Feeling weak and dizzy is not an expected effect of furosemide. It is more commonly associated with dehydration or excessive fluid loss, which can occur if the medication causes too much diuresis.
C. Take the medication before going to sleep.
Taking furosemide before going to sleep is not recommended because it can lead to nighttime diuresis, disrupting sleep and potentially causing electrolyte imbalances.
D. Report swelling of the face or hands.
Swelling of the face or hands may indicate an adverse reaction to furosemide or an underlying medical issue. The nurse should instruct the patient to report any such symptoms promptly.
E. Monitor body weight daily.
Monitoring body weight daily is crucial for patients on diuretic therapy to assess fluid status and response to treatment. Rapid weight gain may indicate worsening fluid overload, while significant weight loss may indicate excessive diuresis.
Full Explanation
A, D, and E.
Choice A rationale:
Furosemide is a loop diuretic that promotes diuresis, causing an increase in urine output. It is essential for the patient to expect this effect and understand that it helps in reducing fluid overload.
Choice B rationale:
Feeling weak and dizzy is not an expected effect of furosemide. It is more commonly associated with dehydration or excessive fluid loss, which can occur if the medication causes too much diuresis.
Choice C rationale:
Taking furosemide before going to sleep is not recommended because it can lead to nighttime diuresis, disrupting sleep and potentially causing electrolyte imbalances.
Choice D rationale:
Swelling of the face or hands may indicate an adverse reaction to furosemide or an underlying medical issue. The nurse should instruct the patient to report any such symptoms promptly.
Choice E rationale:
Monitoring body weight daily is crucial for patients on diuretic therapy to assess fluid status and response to treatment. Rapid weight gain may indicate worsening fluid overload, while significant weight loss may indicate excessive diuresis.
A nurse is caring for a client who is receiving an IV infusion of dextrose 10% in water. The nurse should monitor the client for which of the following adverse effects?
A. Hypokalemia.
Hypokalemia is not a direct adverse effect of dextrose 10% in water infusion. This solution does not contain potassium, and unless the patient already has low potassium levels or other contributing factors, it would not cause hypokalemia.
B. Hypercalcemia.
Hypercalcemia is unrelated to dextrose 10% in water infusion. The solution does not contain calcium, and it would not lead to an increase in serum calcium levels.
C. Hypovolemia.
Hypovolemia, or low blood volume, is not typically associated with dextrose 10% in water infusion. However, if administered rapidly in large amounts, it could potentially cause fluid overload leading to hypervolemia.
D. Hyperglycemia.
Hyperglycemia is a possible adverse effect of dextrose 10% in water infusion. The solution contains a high concentration of glucose, which can raise blood sugar levels if the body cannot adequately utilize or regulate the glucose. Regular monitoring of blood glucose levels is essential during such an infusion, especially in patients with diabetes or impaired glucose tolerance.
Full Explanation
Choice A rationale:
Hypokalemia is not a direct adverse effect of dextrose 10% in water infusion. This solution does not contain potassium, and unless the patient already has low potassium levels or other contributing factors, it would not cause hypokalemia.
Choice B rationale:
Hypercalcemia is unrelated to dextrose 10% in water infusion. The solution does not contain calcium, and it would not lead to an increase in serum calcium levels.
Choice C rationale:
Hypovolemia, or low blood volume, is not typically associated with dextrose 10% in water infusion. However, if administered rapidly in large amounts, it could potentially cause fluid overload leading to hypervolemia.
Choice D rationale:
Hyperglycemia is a possible adverse effect of dextrose 10% in water infusion. The solution contains a high concentration of glucose, which can raise blood sugar levels if the body cannot adequately utilize or regulate the glucose. Regular monitoring of blood glucose levels is essential during such an infusion, especially in patients with diabetes or impaired glucose tolerance.
The nurse is reviewing the health problems for a group of assigned patients. Which patient does the nurse recognize as being at increased risk for developing metabolic alkalosis?
A. Patient with bulimia.
Patients with bulimia are at increased risk for developing metabolic alkalosis due to recurrent vomiting, which leads to loss of hydrochloric acid from the stomach and results in an elevated blood bicarbonate level.
B. Patient with COPD.
Patients with COPD (Chronic Obstructive Pulmonary Disease) are at risk of developing respiratory acidosis, not metabolic alkalosis. In COPD, there is impaired lung function, leading to retention of carbon dioxide and increased levels of carbonic acid in the blood.
C. Patient with venous stasis ulcer.
Patients with venous stasis ulcers do not have a direct association with metabolic alkalosis.
D. Patient on dialysis.
Patients on dialysis can experience metabolic imbalances, but they are more likely to develop metabolic acidosis due to the inability of the kidneys to excrete acids effectively.
Full Explanation
Choice A rationale: Patients with bulimia are at increased risk for developing metabolic alkalosis due to recurrent vomiting, which leads to loss of hydrochloric acid from the stomach and results in an elevated blood bicarbonate level.
Choice B rationale: Patients with COPD are more likely to develop respiratory acidosis due to retention of carbon dioxide, not metabolic alkalosis.
Choice C rationale: Patients with venous stasis ulcers do not have a direct association with metabolic alkalosis.
Choice D rationale: Patients on dialysis are more likely to experience metabolic acidosis due to impaired kidney function and inability to excrete acid effectively.