A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

167 mEq/L

142 mEq/L

136 mEq/L

116 mEq/L

Answer and Explanation

The Correct Answer is D

Rationale:

A. 167 mEq/L: This indicates hypernatremia, which is typically associated with fluid volume deficit due to water loss, not fluid overload.

B. 142 mEq/L: This is a normal sodium level and does not indicate fluid imbalance on its own.

C. 136 mEq/L: Also within the normal reference range (135–145 mEq/L) and does not signal fluid excess.

D. 116 mEq/L: This level represents severe hyponatremia, commonly seen in fluid volume excess. In conditions like heart failure or renal failure, water retention can dilute serum sodium. The patient’s symptoms (dyspnea, crackles, and edema) are consistent with fluid overload and dilutional hyponatremia.

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Correct Answer is A

Explanation

Rationale:

A. This is an early and potentially serious sign of cardiac involvement in hypokalemia. It can lead to life-threatening arrhythmias such as ventricular tachycardia or fibrillation. Continuous cardiac monitoring is essential in patients with low potassium levels.

B. Muscle cramps – Common in hypokalemia due to muscle cell irritability, but not immediately life-threatening like cardiac effects.

C. Fatigue is a general symptom of hypokalemia, but nonspecific and not as critical as ECG changes.

D. Decreased bowel sounds – Reflects reduced smooth muscle activity (hypokalemia can slow GI motility), but this is also less critical than cardiac dysrhythmias.

A. normal ABG B. metabolic acidosis C. metabolic alkalosis D. respiratory acidosis

Correct Answer is C

Explanation

Rationale:
A. Normal ABG would have pH between 7.35–7.45, PaCO₂ between 35–45 mmHg, and HCO₃⁻ between 22–26 mEq/L. This ABG is not fully normal.
B. Metabolic acidosis is characterized by low pH and low HCO₃⁻, which is not the case here.
C. Metabolic alkalosis shows elevated HCO₃⁻ (30 mEq/L) and a near-normal but slightly alkalotic pH (7.44). The elevated PaCO₂ (48 mmHg) suggests partial respiratory compensation.
D. Respiratory acidosis would have a low pH and high PaCO₂, which doesn't match this ABG.

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A nurse is caring for a client who has dyspnea, crackles, and 3+ bilateral pitting pedal edema. Which of the following serum sodium levels should the nurse identify as an indication of fluid volume excess?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Use Case Study to answer the following questions. Exhibits Which of the following assessment findings is most concerning in a patient with hypokalemia?

Correct Answer is A

Explanation

Interpret the following ABG: pH 7.44, PaCo2 48mmHg, HCO3 30 Meq/L

Correct Answer is C

Explanation

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