Elsevier Adaptive Quizzing - Quiz Performance

10/12/21, 12:14 PM Elsevier Adaptive Quizzing - Quiz performance
Performance
Exit
Sherpath Quiz 1

Due
Sep 20, 2021 by 6:45 pm
Final Score
92%
23 out of 25 questions answered correctly

Completed on
Sep 20, 2021 6:36 pm
Incorrect
(2)
Which component is part of an effective postoperative hand-off report?

Select all that apply. One, some, or all responses may be correct.
Some correct answers were not selected
Type and extent of the surgical procedure
Preoperative and intraoperative respiratory function and dysfunction

Any health problems or pathophysiologic conditions
https://eaqng.elsevier.com/#/quizPerformance/20286429 1/19
When the next dose of antibiotics, cardiac drugs, and other medications are
due
Status of current vital signs, including temperature and oxygen saturation
Rationale
A postoperative hand-off report should include type and extent of the surgical
procedure; preoperative and intraoperative respiratory function and dysfunction; any
health problems or pathophysiologic conditions; when the next dose of antibiotics,
cardiac drugs, and other medications are due; and status of current vital signs,
including temperature and oxygen saturation.
p. 172
While preparing to initiate IV fluids for a patient with dehydration, the

nurse reviews the health care provider's (HCP's) prescriptions. Which
information would the nurse need to clarify?
Additives
Drug dose
Type of fluid
Infusion rate
Rationale
The prescription is missing the drug dose for the potassium chloride additive in the
bag. The prescription contains the type of additive (potassium chloride), the fluid type
of 0.9% sodium chloride, and the infusion rate of 80 mL/hr.
p. 278
Correct
(23)
Which question would the nurse ask the patient when completing the
preoperative assessment?
"What is your weight?"
"What is your occupation?"

"What type of insurance do you have?"
"What medications are you currently taking?"
Rationale
The nurse should ask the patient which current medications the patient is taking in the
preoperative assessment. The patient's occupation and insurance information are not
parts of the preoperative assessment. It would be more accurate to weigh the patient
on a scale than to ask the patient.
Test-Taking Tip: Identify option components as correct or incorrect. This may help you
identify a wrong answer.
p. 155
Which condition is the nurse concerned about for a patient who

received spinal anesthesia and is in the postoperative care unit with a
body temperature above 101°F, an inability to move the neck, and acute
confusion?
Meningitis
Chest infection
Postoperative sepsis
Surgical site infection
Rationale
Meningitis is a risk factor associated with spinal or epidural anesthesia. This condition
is manifested as temperature and mental status changes along with an inability to turn
the neck. Chest infection, postoperative sepsis, and surgical site infections are not
associated with mental status changes and an inability to turn the neck. Chest
infection and surgical site infections are generally the complications associated with
general anesthesia. Postoperative sepsis might occur because of failure of sterilizing
instruments during surgery or because of failure of sterilizing the surgical site.
p. 176
Which drug would be administered to reverse opioid-induced

respiratory depression?
Naloxone
Ketamine
Oxycodone
Gabapentin
Rationale
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression. Naloxone is administered slowly until the patient awakens and breathes
properly thereby reducing respiratory depression. Ketamine is a N-methyl-D-aspartate
(NMDA) antagonist used as an anesthetic to reduce pain perception. However, it is not
effective to reduce respiratory depression. Oxycodone is a mu opioid agonist given to
relieve pain caused by cancer. Gabapentin is an anticonvulsant used for treating
surgical pain as a part of postoperative treatment.
Test-Taking Tip: Identify option components as correct or incorrect. This may help you
identify a wrong answer.
p. 83
Which factor would the nurse consider when assessing a patient’s fluid
balance? Select all that apply. One, some, or all responses may be
correct.
Age
Height
Sex
Body fat
Cholesterol
Rationale
When assessing fluid balance, the nurse must consider the patient’s age, sex, and body
fat, as these three items can impact fluid balance within the body. Height and
cholesterol are not factors that affect fluid balance.
Test-Taking Tip: Be alert for details about what you are being asked to do. In this
question type, you are asked to select all options that apply to a given situation or
patient. All options likely relate to the situation, but only some of the options may
relate directly to the situation.
p. 243
Which hormone is responsible for maintaining fluid balance? Select all

that apply. One, some, or all responses may be correct.
Insulin
Glucagon
Aldosterone
Natriuretic peptide (NP)
Antidiuretic hormone (ADH)
Rationale
Aldosterone, NP, and ADH are the three hormones that are responsible for
maintaining fluid balance within the body. Insulin and glucagon are responsible for
maintaining blood glucose levels in the body, not fluid balance.
pp. 243-244
Upon identifying an issue with a patient’s hydration level, the nurse

contacts the health care provider using the SBAR model of
communication. Which statement would the nurse use to represent the
"R" step of the model?
The nurse records and reports the patient’s fluid and electrolyte levels and
urinary output.
The nurse relates the patient’s current condition and fluid intake and output
during the ICU stay.
The nurse reviews which fluid and electrolyte levels are cause for concern,
explaining the values are outside of the patient’s baseline.
The nurse reiterates the fluid and electrolyte expected values and suggests
that the health care provider order IV fluids for the patient.
Rationale
Reiterating (stating) the fluid and electrolyte normal values and suggesting that the
health care provider order IV fluids for the patient is part of the recommendation step
of the SBAR method of communication. Recording and reporting the patient’s fluid
and electrolyte levels and urinary output is part of the situation step of the SBAR
method of communication. Describing the patient’s condition and fluid intake and
output during the ICU stay is part of the background step of the SBAR method of
communication. Noting which fluid and electrolyte levels are cause for concern and
explaining that these are outside of the patient’s baseline is part of the assessment step
of the SBAR method of communication.
pp. 6-7
Which assessment is a priority to perform for a patient in the

postanesthesia care unit (PACU) who was given general anesthesia
during surgery?
Skin
Respiratory
Kidney or urinary
Wound
Rationale
The respiratory assessment is the most important assessment for the patient who was
given general anesthesia, moderate sedation, or has received sedative or opioid drugs.
Skin assessment, kidney or urinary assessment, and wound assessment can be done
after the patient's respiratory assessment has been performed and is all clear.
p. 173
Which hormone regulates fluid and electrolyte balance by preventing

water and sodium loss?
Antidiuretic
Thyrotropin
Aldosterone
Natriuretic peptide (NP)
Rationale
Aldosterone stimulates the nephrons to reabsorb sodium and water into the blood,
preventing sodium and water loss. NP hormone levels are altered in response to
increased blood volume and blood pressure. Antidiuretic hormone acts on the
collecting ducts of the kidney to normalize the blood osmolarity. Thyrotropin is a
thyroid-stimulating hormone that is released in response to low levels of the thyroid
hormone.
p. 244
Which medication mimics the effect of antidiuretic hormone (ADH) on

the body?
Insulin
Calcium
Potassium
Vasopressin
Rationale
Vasopressin is a medication that mimics the effects of ADH on the body to maintain
fluid balance within the body. Insulin is a medication that controls blood glucose levels
in the blood. Calcium and potassium are electrolytes that are impacted by fluid
balance; however, they are not administered to mimic the effect of ADH.
p. 243
Which electrolyte imbalance triggers aldosterone secretion to maintain

fluid balance within the body?
Decreased serum potassium levels
Decreased sodium levels in the extracellular fluid (ECF)

Increased serum glucose levels
Increased calcium levels in the extracellular fluid (ECF)
Rationale
Decreased sodium levels in the ECF trigger the secretion of aldosterone from the
adrenal cortex. The result is action on the kidney nephrons, triggering them to
reabsorb sodium and water from the urine back into the blood. This action increases
blood osmolarity and blood volume. This occurs most often in response to
hypotension as a result of low blood volume. Aldosterone would be secreted in
response to hyperkalemia (increased levels of serum potassium), not decreased serum
potassium levels (hypokalemia). Aldosterone secretion is not regulated by changes in
either serum glucose or extracellular calcium levels.
p. 244
Which electrolyte abnormality would the nurse anticipate when

reviewing laboratory data for a patient admitted with metabolic
acidosis?
Hyponatremia
Hypernatremia
Hypokalemia
Hyperkalemia
Rationale
Serum potassium (hyperkalemia) occurs during metabolic acidosis as the body

attempts to maintain pH by moving potassium ions from the cell in exchange with
hydrogen ions moving into the cell. Hypokalemia may occur as the cause of the
metabolic acidosis is corrected. Sodium concentrations (hypernatremia and
hyponatremia) are not affected in the buffering process of acid-base balance.
Test-Taking Tip: Avoid spending excessive time on any one question. Most questions
can be answered in 1 to 2 minutes.
pp. 269-270
A patient having continuous nasogastric (NG) suction after abdominal

surgery has become irritable and anxious with hyperreflexia,
tachycardia, and tachypnea. Which action by the nurse is correct?
Contact the health care provider to discuss administering IV bicarbonate.
Request an order to evaluate serum electrolytes and turning off the NG

suction.
Notify the Rapid Response Team because of increased cardiovascular
symptoms.
Suggest that the patient receive hypertonic IV fluids to replace electrolytes.
Rationale
Patients undergoing NG suction are at risk for metabolic alkalosis, which has central
nervous system and cardiovascular signs such as these. The nurse should request an
order for serum electrolytes to evaluate this and should disrupt the NG suction to
prevent increased alkalosis. Metabolic alkalosis would be increased with the
administration of bicarbonate. Until the patient's electrolyte levels are known, it is not
correct to administer IV electrolytes. Notifying the Rapid Response Team is not
indicated.
pp. 272-273
Which organ plays a major role in maintaining pH balance in the body?

Select all that apply. One, some, or all responses may be correct.
Lungs
Brain
Pancreas
Kidneys
Small intestines
Rationale
Blood pH represents a delicate balance between hydrogen ions (acid) and bicarbonate
anions (base), which is largely controlled by the lungs and kidneys. The lungs adjust
the blood pH by releasing or retaining hydrogen ions (acid), and the kidneys adjust the
blood pH by releasing or retaining bicarbonate anions (base). The liver plays a role in
metabolism, immunity, and clotting. The pancreas releases insulin for glucose
metabolism and enzymes for digestion. The brain plays a secondary role in
maintaining pH balance by sensing the need for alterations in acid or base levels and
sends appropriate signals to the kidneys and lungs. The small intestine is not involved
with regulating blood pH.
p. 266
For patients with fluid deficits, which primary collaborative intervention

would the nurse implement?
Fluid restriction
Diuretic therapy
Fluid replacement
Electrolyte replacement
Rationale
For patients with a fluid deficit, the primary collaborative intervention is fluid
replacement, either orally or parenterally. Fluid restriction and diuretic therapy are
interventions for fluid overload. Electrolyte replacement treats electrolyte deficits.
Test-Taking Tip: Do not worry if you select the same numbered answer repeatedly
because there usually is no pattern to the answers.
p. 39
Which action will the nurse take first for a patient whose blood gas test
results reveal a pH of 7.50, partial pressure of arterial oxygen (PaO 2) of
99 mm Hg, partial pressure of arterial carbon dioxide (PaCO 2) of 29,
and HCO 3 – of 22?
Provide oxygen support.
Call the health care provider.

Encourage the patient to slow his or her breathing rate.
Nothing; these results are within the normal range.
Rationale
The arterial blood gases (ABGs) indicate respiratory alkalosis, which is commonly
caused by hyperventilation; encouraging the patient to slow down his or her breathing
rate may help the patient return to normal breathing and may correct this abnormality.
The patient's PaO 2 is within normal limits and does not indicate oxygen support at
this time, but it is important for the nurse to assess the patient and not just look at the
numbers. This situation is not an emergency condition and does not require that the
health care provider be called. These findings are not within normal limits.
p. 490
A laboratory report for a patient shows the following results: pH 7.32;

bicarbonate 24 mEq/L; partial pressure of arterial oxygen (PaO 2) 77 mm

Hg; and partial pressure of arterial carbon dioxide (PaCO 2) 48 mm Hg.
These findings are consistent with which acid-base imbalance?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Rationale
In respiratory acidosis, there is a decrease in pH ( normal is 7.35 to 7.45), a normal
bicarbonate (normal is 21 to 28 mEq/L), a decrease in PaO 2 (normal is 80 to 100 mm
Hg), and an increase in PaCO 2 (normal is 35 to 45 mm Hg). The arterial blood gas
results of pH 7.32, bicarbonate 24 mEq/L, PaO 2 77mm Hg, and PaCO 2 48 mm Hg
reflect respiratory acidosis. In respiratory alkalosis, there is an increase in pH, a normal
bicarbonate, a normal PaO 2, and a decrease in PaCO 2. In metabolic alkalosis, there is
an increase in pH, an increase in bicarbonate, a normal PaO 2, and a normal PaCO 2.
In metabolic acidosis, there is a decrease in pH, a decrease in bicarbonate, a normal Pa
2, and a normal PaCO 2.
STUDY TIP: Answer every question. A question without an answer is the same as a
wrong answer. Go ahead and guess. You have studied for the test, and you know the
material well. You are not making a random guess based on no information. You are
guessing based on what you have learned and your best assessment of the question.
p. 270
The nurse obtains laboratory results for a patient that show the
following: pH 7.24; bicarbonate 20; partial pressure of arterial oxygen
(PaO 2) 82; and partial pressure of arterial carbon dioxide (PaCO 2) 35.
These findings are consistent with which acid-base imbalance?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Rationale
In metabolic acidosis, there is a decrease in pH (normal is 7.35 to 7.45), a decrease in
bicarbonate (normal is 21 to 28), a normal PaO 2 (normal is 80 to 100), and a normal or
decreased PaCO 2 (normal is 35 to 45). The arterial blood gas results of pH 7.24;
bicarbonate 20; PaO 2 82; and PaCO 2 35 reflect metabolic acidosis. In metabolic
alkalosis, there is an increase in pH, an increase in bicarbonate, a normal PaO 2, and a
normal PaCO 2. In respiratory alkalosis, there is an increase in pH, a normal
bicarbonate, a normal PaO 2, and a decrease in PaCO 2. In respiratory acidosis, there is
a decrease in pH, a normal bicarbonate, a normal PaO 2, and an increase in PaCO 2.
STUDY TIP: Record the information you find to be most difficult to remember on 3" ×
5" cards, and carry them with you in your pocket or purse. When you are waiting in
traffic or for an appointment, just pull out the cards, and review again. This "found"
time may add points to your test scores that you have lost in the past.
p. 272
Which ECG finding is consistent with hyperkalemia?

Absent T waves
Elevated P waves
Prolonged PR intervals
Shortened QRS complexes
Rationale
When hyperkalemia is present, an individual may show absent P waves, tall T waves,
prolonged PR intervals, and widened QRS complexes.
p. 255
Which finding is common with hypokalemia? Select all that apply. One,
some, or all responses may be correct.
Paresthesia
Bradycardia
Shallow respirations
Weak, thready pulse
Musculoskeletal weakness
Rationale
Common symptoms of hypokalemia include shallow respirations; weak, thready pulse;
and musculoskeletal weakness. Paresthesia and bradycardia are symptoms of
hyperkalemia.
pp. 254-256
The nurse is providing care to a patient who is experiencing severe

nausea, vomiting, and diarrhea. Which condition is the patient at risk
for developing? Select all that apply. One, some, or all responses may
be correct.
Dehydration
Hypertension
Hypokalemia
Hypercalcemia
Hypernatremia
Rationale
A patient who is experiencing severe nausea, vomiting, and diarrhea is at risk for
developing dehydration and electrolyte imbalances such as hypokalemia and
hypernatremia. The patient is at risk for hypotension not hypertension. The patient is
not at risk for developing hypercalcemia.
253,pp. 246
A patient reports painful muscle spasms in the lower legs at rest, a

tingling sensation in the hands and lips, and abdominal cramping and
diarrhea. Which disorder would the nurse suspect?
Hypocalcemia
Hypernatremia
Hypermagnesemia
Hypophosphatemia
Rationale
The primary symptoms of hypocalcemia are neuromuscular changes, specifically
painful muscle cramps, and paresthesia that may spread to the face, progressing to
tetany. Abdominal cramping and diarrhea may also occur. Muscle spasms in lower legs
at rest, a tingling sensation in the hands and lips, and abdominal cramping and
diarrhea are not primary characteristics of hypernatremia, hypermagnesemia, or
hypophosphatemia.
STUDY TIP: Laughter is a great stress reliever. Watching a short program that makes
you laugh, reading something funny, or sharing humor with friends helps decrease
stress.
p. 257
A nurse is caring for a group of patients who are all about to receive
transfusions. Which prescription requires correction?
Administer platelets with Ringer's lactate solution.
Transfuse white blood cells (WBCs) over 45 minutes.

Draw blood type and crossmatch before administering plasma.
Check vital signs every 15 minutes during transfusion of packed red blood
cells (PRBCs).
Rationale
Blood and blood products should be administered with normal saline, not Ringer's
lactate solution or dextrose in water, because of the risk for clotting or hemolysis.
WBCs should be administered slowly over 45 to 60 minutes. Vital signs should be
checked before, after, and every 15 minutes during the transfusion. Blood type and
crossmatch should be checked before administering a plasma transfusion because the
plasma contains the donor's ABO antibodies, which could react with the recipient's
blood.
p. 816
The nurse knows that a patient with a B-negative blood type can receive
which blood product?
O-negative
A-negative
AB-positive
B-positive
Rationale
A patient with B-negative blood can receive either type B-negative or type O-negative
blood. A patient with a negative Rh factor must also receive blood with a negative Rh
factor because of the potential for an infusion reaction to the Rh antigen. Receiving
either A-negative or AB-positive puts the patient at risk for a reaction, because the
patient has antibodies against the A antigen. Receiving B-positive blood puts the
patient at risk for an infusion reaction to the Rh factor.
p. 818

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10/12/21, 12:14 PM Elsevier Adaptive Quizzing - Quiz performance

Which component is part of an effective postoperative hand-off report?

Preoperative and intraoperative respiratory function and dysfunction

Status of current vital signs, including temperature and oxygen saturation

While preparing to initiate IV fluids for a patient with dehydration, the

information would the nurse need to clarify?

of 0.9% sodium chloride, and the infusion rate of 80 mL/hr.

"What is your occupation?"

"What medications are you currently taking?"

Which condition is the nurse concerned about for a patient who

Surgical site infection

Which drug would be administered to reverse opioid-induced

surgical pain as a part of postoperative treatment.

Which hormone is responsible for maintaining fluid balance? Select all

Antidiuretic hormone (ADH)

Upon identifying an issue with a patient’s hydration level, the nurse

Which assessment is a priority to perform for a patient in the

Which hormone regulates fluid and electrolyte balance by preventing

Natriuretic peptide (NP)

Which medication mimics the effect of antidiuretic hormone (ADH) on

Which electrolyte imbalance triggers aldosterone secretion to maintain

Decreased sodium levels in the extracellular fluid (ECF)

Increased calcium levels in the extracellular fluid (ECF)

Which electrolyte abnormality would the nurse anticipate when

Serum potassium (hyperkalemia) occurs during metabolic acidosis as the body

A patient having continuous nasogastric (NG) suction after abdominal

Request an order to evaluate serum electrolytes and turning off the NG

Which organ plays a major role in maintaining pH balance in the body?

For patients with fluid deficits, which primary collaborative intervention

Call the health care provider.

A laboratory report for a patient shows the following results: pH 7.32;

bicarbonate 24 mEq/L; partial pressure of arterial oxygen (PaO 2) 77 mm

Which ECG finding is consistent with hyperkalemia?

Shortened QRS complexes

The nurse is providing care to a patient who is experiencing severe

A patient reports painful muscle spasms in the lower legs at rest, a

Transfuse white blood cells (WBCs) over 45 minutes.

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