RN Physiological Adaptation 1 — Questions and Answers
Question 1: A patient presents with Kussmaul respirations, fruity breath odor, and blood glucose of 520 mg/dL. Which condition does the nurse suspect?
- Hypoglycemia
- Diabetic ketoacidosis (DKA) (Correct answer)
- Hyperosmolar hyperglycemic state
- Respiratory alkalosis
Correct answer: Diabetic ketoacidosis (DKA)
DKA presents with Kussmaul respirations (deep, rapid breathing to compensate for metabolic acidosis), fruity breath from ketones, and markedly elevated blood glucose.
Question 2: Which electrolyte imbalance is most commonly associated with prolonged vomiting?
- Hyperkalemia
- Hypernatremia
- Hypokalemia (Correct answer)
- Hypercalcemia
Correct answer: Hypokalemia
Prolonged vomiting causes loss of hydrochloric acid and potassium, leading to hypokalemia and metabolic alkalosis.
Question 3: A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L. The nurse's priority intervention is to:
- Administer oral potassium supplements
- Prepare for cardiac monitoring (Correct answer)
- Encourage increased dietary potassium
- Administer a potassium-sparing diuretic
Correct answer: Prepare for cardiac monitoring
Hyperkalemia at 6.8 mEq/L poses a life-threatening cardiac risk; continuous cardiac monitoring must be initiated immediately.
Question 4: A patient post-thyroidectomy develops tingling around the mouth and muscle cramps. The nurse should check which lab value first?
- Serum sodium
- Serum calcium (Correct answer)
- Serum potassium
- Serum glucose
Correct answer: Serum calcium
Parathyroid glands may be inadvertently removed during thyroidectomy, causing hypocalcemia with characteristic perioral tingling and muscle cramps (Chvostek's and Trousseau's signs).
Question 5: Which assessment finding indicates successful treatment of fluid volume deficit in a dehydrated patient?
- Urine output of 15 mL/hour
- Heart rate of 110 bpm
- Urine specific gravity of 1.030
- Blood pressure of 110/70 mmHg with moist mucous membranes (Correct answer)
Correct answer: Blood pressure of 110/70 mmHg with moist mucous membranes
Adequate blood pressure with moist mucous membranes indicates restored fluid volume, whereas low urine output, tachycardia, and high specific gravity suggest ongoing deficit.
Question 6: A nurse caring for a patient in the oliguric phase of acute kidney injury expects which finding?
- Urine output greater than 400 mL/day
- Elevated BUN and creatinine (Correct answer)
- Decreased serum potassium
- Metabolic alkalosis
Correct answer: Elevated BUN and creatinine
The oliguric phase is characterized by urine output less than 400 mL/day and accumulation of waste products, resulting in elevated BUN and creatinine.
RN Physiological Adaptation 1
A patient presents with Kussmaul respirations, fruity breath odor, and blood glucose of 520 mg/dL.
Which condition does the nurse suspect?