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Phillips’s Manual of I.V. Therapeutics: Evidence-Based Practice for Infusion Therapy 7th Edition Test Bank Full ACCESS Test Bank From Link Below https://nursylab.com/products/phillipss-manual-of-i-v-therapeu tics-evidence-based-practice-for-infusion-therapy-7th-edition-t est-bank/ TestBank Directly From The publisher, 100% Verified Answers. COVERS ALL CHAPTERS. Download Immediately
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Chapter 1: Professional Practice Concepts for Infusion Therapy Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with gastroenteritis. The client is
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combative and resists the nurse’s efforts to start the I.V. Which action by the nurse would result in an intentional tort? a. Failure to document the client’s combativeness b. Refusing to wear gloves while starting the I.V. c. Failure to report the client’s combativeness to a physician d. Starting an I.V. on a coherent client against the client’s wishes 2. A nurse who is caring for clients understands that he or she should provide care that meets at least
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the minimum standards of practice for nursing. Which phrase regarding standards of practice is most accurate? a. Standards of practice focus on the care provider and define needed activities and behaviors. b. Standards of practice focus on the recipient of care and describe the outcomes of care. c. Standards of practice are written laws enacted by the legislature. d. Standards of practice are the result of the performance of a function or process.
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Multiple Response Identify one or more choices that best complete the statement or answer the question. 1. A nurse is caring for multiple clients in a rehabilitation facility. During the shift, the nurse notes that
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several medical devices are not functioning properly. According to the Safe Medical Devices Act, which problems should be reported to the U.S. Food and Drug Administration (FDA)? SELECT ALL THAT APPLY. a. Outdated medication b. Misleading packaging c. Cracked or leaking I.V. solution bag d. Defective infusion pump tubing 2. A new infusion clinic is being started. The nursing supervisor of the new clinic must conform to
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specific standards of practice when developing nursing policies and procedures for the new program. To which organizational standards of practice must the nurse manager adhere? SELECT ALL THAT APPLY. a. Centers for Disease Control and Prevention (CDC) guidelines b. Infusion Nurses Society (INS) standards c. American Medical Association (AMA) standards d. Oncology Nursing Society (ONS) standards
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3. A staff nurse is serving on a hospital’s quality-assurance task force. On which quality-assurance
models is the task force most likely to focus? SELECT ALL THAT APPLY. a. Standards of care
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b. Standards of practice c. Performance improvement d. Continuous quality improvement ____
4. A nurse is planning for the discharge of a hospitalized client. The nurse reviews the client’s plan of
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care to determine whether all client outcomes were achieved. Which methods should the nurse use to evaluate the client’s outcomes? SELECT ALL THAT APPLY. a. Collect data to determine whether standards were met. b. Identify controllable or uncontrollable variables. c. Determine the cause of the problem by comparing actual care with established standards. d. Re-evaluate to determine whether corrective action is effective and improvement in service is obtained. e. Contact The Joint Commission (JCAHO) Web site for standards. 5. While caring for a client, a nurse administers an incorrect dose of medication, causing the client to
6. When nurses provide care to clients, nursing actions are governed by established standards of
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become ill. The nurse reports the incident to the nurse manager on the unit. The nurse manager then notifies risk management. Which risk-management strategies should be used by the nurse in this situation? SELECT ALL THAT APPLY. a. Documentation b. Physical assessment c. Unusual occurrence reports d. Professional liability insurance
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nursing care, as well as both state and federal laws. Which are sources of law? SELECT ALL THAT APPLY. a. Constitution b. Statutes c. State Nurse Practice Acts d. Joint Commission standards 7. A new infusion clinic is being started. The nursing supervisor of the new clinic must conform to
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specific standards of practice when developing nursing policies and procedures for the new program. To which organizational standards of practice must the nurse manager adhere? SELECT ALL THAT APPLY. a. Centers for Disease Control and Prevention (CDC) guidelines b. Infusion Nurses Society (INS) standards c. American Medical Association (AMA) standards d. Oncology Nursing Society (ONS) standards
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Chapter 1: Professional Practice Concepts for Infusion Therapy Answer Section MULTIPLE CHOICE
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Intentional torts include assault and battery, false imprisonment, using restraints as a form of false imprisonment, defamation of character, and breach of confidentiality. Reference: Cockburn, T., & Madden, B. (2006). Intentional torts claims in medical cases. J Law Med, 13(3), 311–335.
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Standards of practice are criteria for measuring performance against the optimal achievable degree of clinical excellence. These standards are formulated to communicate expectations of nursing practice. Agencies are influential in developing standards of practice.
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MULTIPLE RESPONSE 1. ANS: B, C, D
KEY: Cognitive Level: Application
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Misleading packaging, cracked or leaking I.V. solutions bags, and defective infusion pump tubing should all be reported to the FDA because these problems indicate product integrity issues. Ensuring that medical devices in domestic commercial distribution are safe and effective for their intended purposes is a professional responsibility. Outdated medication should be discarded and reported to the facility pharmacy. Reference: U.S. Food and Drug Administration, MedWatch. (2005). Voluntary reporting by health professionals. Retrieved from www.fda.gov/medwatch/report/hcp.htm March 11, 2013.
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The nurse manager must adhere to the guidelines of the CDC, INS, and ONS. The AMA does not provide guidelines for nursing standards of practice. Reference: The Joint Commission
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PTS: 1 3. ANS: A, C, D
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The task force is most likely to focus on standards of practice, performance improvement, and continuous quality improvement. These quality-assurance models focus on the recipients of care. Standards of practice focus on the provider, and define the activities and behaviors needed to achieve patient outcomes. Reference: Phillips, L. (2010). Manual of I.V. therapeutics: Evidence-based infusion therapy (5th ed.). Philadelphia, PA: F.A. Davis.
PTS: 1 4. ANS: A, B, C, D
KEY: Cognitive Level: Application
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Methods used to collect and determine outcomes for clients parallel the nursing process. Collection, identification, problem solving, and re-evaluation are part of the nursing process. TJC is a nonprofit organization that accredits health-care facilities and works to improve client care and safety. Reference: Ackley, B., & Ladwig, G. (2011). Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis, MO: Mosby/Elsevier. KEY: Cognitive Level: Application
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A complete written account of care given to the client, written unusual occurrence reports, and professional liability insurance to protect the nurse are risk-management strategies. Reference: Alexander, M., & Webster, H. K. (2010). Legal issues of infusion nursing. In M. Alexander, A. Corrigan, L. Gorski, J. Hankins, & R. Perucca (Eds.), Infusion nursing: An evidence-based approach (pp. 49–59). St. Louis, MO: Saunders Elsevier. KEY: Cognitive Level: Application
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The constitution, statutes, and state Nurse Practice Acts all provide laws that govern nursing practice. The Joint Commission, along with the American Nurses Association and specialty organizations, establishes standards of nursing care. Reference: Alexander, M., & Webster, H. K. (2010). Legal issues of infusion nursing. In M. Alexander, A. Corrigan, L. Gorski, J. Hankins, & R. Perucca (Eds.), Infusion nursing: An evidence-based approach (pp. 49–59). St. Louis, MO: Saunders Elsevier. KEY: Cognitive Level: Application
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The nurse manager must adhere to the guidelines of the CDC, INS, and ONS. The AMA does not provide guidelines for nursing standards of
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practice. https://nursylab.com/products/phillipss-manual-of-i-v-therapeutics-evidence-based-practice-for-infusion-therapy-7th-edition-test-bank Reference: The Joint Commission. (www.nursylab.com 26.
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Chapter 2: Infection Prevention and Occupational Risks Multiple Choice Identify the choice that best completes the statement or answers the question. 1. During a hospital orientation, a newly hired nurse learns that infectious waste must be incinerated as
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mandated by the Environmental Protection Agency (EPA). The nurse understands that the main focus of the EPA is on: a. risk-assessment strategies. b. performance-improvement strategies. c. quality management. d. occupational safety. 2. A healthy individual comes in contact with a rhinovirus while out in the community. Which actions
3. A nurse is teaching a client who is immunosuppressed about ways to help the client to avoid
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constitute the first line of nonspecific defense mechanisms against the invading infection? a. Phagocytosis and a complement cascade b. Leukocytes and proteins c. Physical and chemical barriers d. Immune system and phagocytes
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infections. The nurse teaches the client that the purpose of the immune system is to provide: a. the body with antigens. b. a way to inhibit the formation of antibodies to antigens. c. a way for the organism to move from the source to the host. d. the body with a way to recognize and destroy invading antigens. 4. A nurse is caring for a hospitalized client who has a health-care–associated infection. The nurse
5. A hospitalized client has acquired an infusion-related infection. Which is the most appropriate
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understands that the links in the chain of infection consist of: a. organism, inflammation, and infection. b. disease, the organism, and the host. c. agent, the host, and transmission. d. host, signs, and symptoms.
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intervention for a nurse to implement when caring for a client who has an infusion-related infection? a. Monitoring for signs and symptoms of sepsis b. Monitoring for dysrhythmias c. Use of full-barrier protection d. Educating the client on good hand hygiene techniques
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6. A client with active tuberculosis (TB) is admitted to a hospital. A nurse implements
transmission-based precautions when caring for the client because the nurse is concerned about the dissemination of the disease. Which statement best describes dissemination? a. The movement of an organism from source to the host b. Produced within or caused by factors within the organism c. The replication of organisms in the tissue of the host d. The movement of microorganisms from an individual into the immediate
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environment ____
7. A nurse on an intensive care unit is caring for a febrile client with a central venous catheter whose
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Multiple Response Identify one or more choices that best complete the statement or answer the question.
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blood pressure is steadily dropping. The nurse suspects septicemia. Which microorganism is responsible for most cases of septicemia related to infusion? a. Mycobacterium b. Yersinia c. Coagulase-negative staphylococci d. Salmonella
1. A nurse teaches a client newly diagnosed with HIV about the immune system. Which organs should
the nurse include when discussing the client’s immune system? SELECT ALL THAT APPLY. Thymus Bone marrow Heart Lungs
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2. A new client diagnosed with AIDS is being seen in a hospital clinic. Which characteristics should a
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a. b. c. d.
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nurse anticipate when assessing a client with immunosuppression? SELECT ALL THAT APPLY. a. Frequent infections b. Infections that are more severe than usual c. Incomplete response to treatment d. Leukocyte count of 5,000 to 10,000 3. A nurse is caring for a client who has an I.V. access. With which sources of contamination should
4. A nurse is preparing to initiate I.V. therapy on a client admitted with dehydration. Which
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the nurse be concerned when attempting to reduce the client’s risk of infection? SELECT ALL THAT APPLY. a. Skin b. Air c. Entry ports d. Mucous membranes
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precannulation antiseptic agents are acceptable for the nurse to use, according to the Infusion Nurses Society’s Standards of Practice, to cleanse the client’s skin? SELECT ALL THAT APPLY. a. 70% isopropyl alcohol b. Povidone-iodine c. 2% chlorhexidine gluconate d. Hydrogen peroxide
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5. A new client, diagnosed with AIDS, is being seen in a hospital clinic. Which characteristics should a
nurse anticipate when taking the health history of a client with immunosuppression? SELECT ALL THAT APPLY. a. Frequent infections b. Infections that are more severe than usual
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c. Incomplete response to treatment d. Infections that are usually from common sources ____
6. A nurse teaches a client, newly diagnosed with HIV, about the immune system. Which organs
7. A physician writes an order for a nurse to begin administering I.V. fluids to a client diagnosed with
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should the nurse include when discussing the client’s immune system? SELECT ALL THAT APPLY. a. Thymus b. Bone marrow c. Heart d. Lungs
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hepatitis A. While implementing this order, to which occupational risks is the nurse exposed? SELECT ALL THAT APPLY. a. Latex allergy b. Chemical exposure c. Needlestick injuries d. Back injury 8. A nurse is preparing to administer I.V. chemotherapy for a client diagnosed with cancer. Which are
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potential occupational risks associated with I.V. therapy? SELECT ALL THAT APPLY. a. Falls b. Latex allergy c. Chemical exposure d. Needlestick injuries 9. A home-care nurse provides education regarding basic infection control to the parents of a child with
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HIV infection. Which instructions should be included in the nurse’s education? SELECT ALL THAT APPLY. a. Carefully wash all fresh fruits and vegetables. b. Wash bottles, nipples, and pacifiers in the dishwasher. c. Immediately discard any unused food and formula. d. Cleanse the inside of the nipple of the bottle with salt and rinse well if it becomes slimy.
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Chapter 2: Infection Prevention and Occupational Risks Answer Section MULTIPLE CHOICE
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The EPA is one agency that performs risk assessment. Risk assessment takes different approaches depending on what information is available. Some assessments look back to try to assess effects after an event. Other assessments look forward to anticipate effects before a new product is approved for use. Reference: U.S. Environmental Protection Agency. (2009). Hospital/medical/infectious waste incinerators. Retrieved from www.epa.gov/ttn/atw/129/hmiwi/rihmiwi.html, March 10, 2013. KEY: Cognitive Level: Application
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The first lines of defense for healthy human hosts, to protect themselves from environmental microbes, are the physical (skin, mucous membrane, epiglottis, respiratory tract cilia, and sphincter) and chemical barriers (tears, gastric acidity, and vaginal secretions). Mechanical barriers also provide a line of defense. KEY: Cognitive Level: Application
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Appropriate immune response occurs when the immune system recognizes and destroys invading antigens. KEY: Cognitive Level: Application
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The nurse understands that the client’s infection results from interaction between an infectious agent and a susceptible host. This interaction, called transmission, occurs by means of contact between the agent and the host. Three interrelated factors—the agent, the host, and transmission—represent the chain of infection. Reference: Siegel, J. D., Rhinehart, E., Jackson, M., et al. (2007). Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings. Retrieved from www.cdc.gov/ncidod/dhq/pdf/isolation2007.pdf KEY: Cognitive Level: Application
Sepsis is a serious complication of infusion therapy. Signs and symptoms, such as fluctuating fever, profuse sweating, nausea and vomiting, abdominal pain, tachycardia, and hypotension, should be reported immediately to the physician.
PTS: 1 6. ANS: D
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Dissemination is a shedding of microorganisms. Cultures of air samples, surfaces, and objects reveal dissemination or shedding of microorganisms. PTS: 1
KEY: Cognitive Level: Application
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7. ANS: C
KEY: Cognitive Level: Application
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Infusion-related septicemia and fungemia are more likely than cannula-related infections to culminate in frank shock and are often unrecognized. Most infusion-related septicemia is by gram-negative bacilli introduced by intrinsic or extrinsic contamination. Yersinia and Salmonella can occur in contaminated blood products, and Mycobacterium has been found in infections related to central venous catheters.
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The nurse should include the thymus, bone marrow, and lungs when teaching the client about his or her immune system. The thymus and bone marrow are primary organs of the immune system. The lungs are a secondary organ of the immune system. The heart does not contribute to the immune response.
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The nurse should anticipate that the client experiences frequent infections, has infections that are more severe than usual, and usually has an incomplete response to therapy. The normal white cell count is 5,000 to 10,000. The nurse should expect to see an increased white cell count in an immunocompromised client with an infection. PTS: 1 3. ANS: A, B, C
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Microorganisms gain entry via the skin, via air entering into the closed system, and via entry points into the administration set, such as the junction between the administration set and the catheter hub. Mucous membranes would not be a source of contamination during I.V. therapy. Reference: O’Grady, N. P., Alexander, M., Burns, L. A., et al; Healthcare Practices Advisory Committee. (2011). Guidelines for prevention of intravascular catheter related infections, 2011. American Journal of Infection Control, 39(4 Suppl.), S1–S34. KEY: Cognitive Level: Knowledge
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Cleansing the insertion site reduces the potential for infection by minimizing the amount of microorganisms on the skin. The Centers for Disease Control and Prevention (2009) now recommends 2% chlorhexidine gluconate as the solution of choice for infusion therapy preparation. Reference: O’Grady, N. P., Alexander, M., Burns, L. A., et al; Healthcare Practices Advisory Committee. (2011). Guidelines for prevention of intravascular catheter related infections, 2011. American Journal of Infection Control, 39(4 Suppl.), S1–S34.
PTS: 1 5. ANS: A, B, C
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The nurse should anticipate a history of frequent infections, infections that are more severe than usual, and incomplete response to treatments. These clients often present with unusual infections or infections with opportunistic infectious agents.
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Reference: Phillips, L. D., & Gorski, L. (pg). Infusion-related infection control and occupational risks. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis. PTS: 1 6. ANS: A, B, D
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The nurse should discuss the thymus, bone marrow, and lungs when teaching the client about his or her immune system. The organs and cells involved in the immune system form a complex when antigens and immune system cells are constantly moving through the lymphatic system and organs and blood circulation. The heart is not an organ directly responsible for immune function. Both the thymus and bone marrow are primary immune organs, whereas the lungs are secondary immune organs.
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Reference: Phillips, L. D., & Gorski, L. (pg). Infusion-related infection control and occupational risks. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis. KEY: Cognitive Level: Application
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Latex allergy, chemical exposure, and needlestick injuries are directly related to the initiation of infusion therapy. Back injuries are associated with lifting and moving clients and with poor body mechanics. Reference: Phillips, L. D., & Gorski, L. (pg). Infusion-related infection control and occupational risks. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis. KEY: Cognitive Level: Application
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The nurse providing infusion therapy is at risk for latex and chemical exposure in the process of delivering infusion therapy. Needlestick injury risk is highest with the hollow-bore needles, such as with over-the-needle catheters. Falls are a risk for clients. Reference: Phillips, L. D., & Gorski, L. (pg). Infusion-related infection control and occupational risks. In Manual of I.V. therapeutics: Evidence-based infusion therapy (6th ed.). Philadelphia, PA: F.A. Davis. PTS: 1 12. ANS: A, B, D
KEY: Cognitive Level: Application
The parents should be instructed to carefully wash all fruits and vegetables; wash bottles, nipples, and pacifiers in the dishwasher; and cleanse the inside of the bottle nipple with salt if it becomes slimy. The parents should also be instructed to cover and refrigerate unused food and formula, and to discard unused refrigerated food or formula after 24 hours. Reference: Phillips, L. D., & Gorski, L. (
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Chapter 3: Fundamentals of Fluid and Electrolyte Balance Multiple Choice Identify the choice that best completes the statement or answers the question. 1. A nurse is assessing an older adult client who is disoriented to time and place. The nurse notes that
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2. A nurse prepares to assess a client who has been vomiting for several days. For which signs of fluid
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the client’s eyes are sunken, the mouth is coated, the tongue has an extra longitudinal furrow, and the client’s lips are cracked. The client’s hand vein filling takes more than 5 seconds; tenting is apparent over the sternum; and the vital signs are BP 110/60 mm Hg, pulse 62, and respiratory rate of 12. Based on these assessment findings, which fluid or electrolyte imbalance should the nurse suspect? a. Sodium excess b. Magnesium deficit c. Fluid volume deficit d. Fluid volume excess
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volume deficit (FVD) should the nurse assess? a. Bounding pulse, decreased blood pressure, and moist crackles b. Dyspnea, jugular vein distention, and sternum fingerprinting c. Increased pulse rate, decreased blood pressure, and poor skin turgor d. Increased respiratory rate; warm, moist skin; and decreased body temperature 3. A nurse assesses a client who has moist crackles (rales) in the lung bases, an increased respiratory
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rate, dyspnea, and 3+ edema of the ankles. Which is the most accurate nursing diagnosis for this client? a. Fluid volume deficit b. Fluid volume excess c. Impaired tissue integrity d. Altered tissue perfusion, renal 4. A nurse analyzes a client’s laboratory report that shows a serum potassium level of 5.7 mEq/L.
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5. A nurse notes that a client admitted with renal failure has a serum phosphorus level of 7.0 mg/dL.
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Which client’s laboratory report is the nurse most likely reviewing? a. The client with ulcerative colitis b. The client with Cushing’s syndrome c. The client who has overused laxatives d. The client who has sustained a traumatic burn Which medication should a nurse expect to be prescribed for this client? Calcium gluconate Calcium chloride Calcitonin (Calcimar) Aluminum hydroxide gel (Amphojel)
a. b. c. d.
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6. A nurse is caring for a client with an ileostomy. Which acid-base imbalance will this client most
likely experience? a. Metabolic alkalosis b. Metabolic acidosis
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Phillips’s Manual of I.V. Therapeutics: Evidence-Based Practice for Infusion Therapy 7th Edition Test Bank Full ACCESS Test Bank From Link Below https://nursylab.com/products/phillipss-manual-of-i-v-therapeu tics-evidence-based-practice-for-infusion-therapy-7th-edition-t est-bank/ TestBank Directly From The publisher, 100% Verified Answers. COVERS ALL CHAPTERS. Download Immediately
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