Test Yourself: Fluid, Electrolytes, Acid-Base Imbalances, and Burns Practice Test

 

Grab a pen and paper and test yourself. Answers and rationale at the end of the exam. Good luck!

1.      Justin is brought to the E.R. after a barbeque grill accident. Based on the assessment of the physician, he sustained full thickness burns on his trunk, right upper extremities and right lower extremities. His wife asks what that means?

A.    Dermis is partially damaged

B.     Epidermis is damaged

C.     Epidermis and dermis are both damaged

D.    Epidermis, dermis, and subcutaneous tissue are damaged

 

2.      During the emergent phase of burns after thermal injury, what should be assessed?

A.    Hypokalemia and hypernatremia                             C. Hyperkalemia and hypernatremia

B.     Hypokalemia and hyponatremia                              D. Hyperkalemia and hyponatremia

 

3.      Which of the following is most characteristic of second degree burn?

A.    Reddening of the skin with moderate degree of pain

B.     Destruction of deep muscle layers with severe pain

C.     Destruction of superficial and deep skin layers with pain and blister formation

D.    Complete destruction & underlying tissue including bones

 

4.      Why should the nurse assess for symptoms of  hypovolemic shock associated with burns?

A.    The kidney compensates by increasing GFR

B.     Excessive blood loss through the burned area

C.     Sodium retention as a result of aldosterone mechanism

D.    Shift of protein and water out of intravascular compartment

 

5.      Which among the following medications is given to manage hyperkalemia?

A.    Polystyrene sulfonate                                                          C. Amphogel

B.     Magnesium sulfate                                                              D. Digitalis

 

6.      Prioritize the following emergency management of burns from highest to lowest priority, with 1 as the highest priority.

1.      Establish and maintain an airway

2.      Assess the associated injuries

3.      Establish an IV line with a large-gauge needle

4.      Remove the client from burn source

 

A.    1,4,2,3              B. 4,1,2,3                      C. 1,4,3,2                      D. 4,1,3,2

 

7.      Mrs. Simmons has just been admitted to the burn unit. Currently, she is evaluated for burns to her chest and upper legs. She complains of thirst and asks for a drink. What is the most appropriate nursing action?

A.    Give small glass of a clear liquid                              C. Keep her on NPO

B.     Give a small glass of full liquid                                D. Order a meal with extra liquids

 

8.      A 45-year old man is admitted for treatment of congestive heart failure. The physician orders an IV of 125 cc of normal saline per hour and central venous pressure readings every 4 hours. Sixteen hours after admission, the patient’s CVP is 18 cm H2O. What does this indicate?

A.    The patient has received enough fluid

B.     The patient’s fluid status remains unaltered

C.     The patient has received too much fluid

D.    The patient needs more fluid

 

9.      The physician orders for ABG determination and the results are pH-7.30, pCO2-38, HCO3-17 meq/L. What do these values suggest?

A.    Compensated respiratory alkalosis

B.     Uncomensated respiratory acidosis

C.     Compensated metabolic alkalosis

D.    Uncompensated metabolic acidosis

 

10.   The client receiving TPN complains of nausea, excessive thirst, and increased frequency of voiding. The nurse should assess which of the following next?

A.    Capillary blood glucose                                                       C. Urine output

B.     Serum BUN and creatinine                                                  D. Weight

 

11.   Which among the following best reflects the adequacy of fluid volume replacement in the early post burn period?

A.    Blood pressure, pulse rates, daily weights

B.     Quantity of urinary output and vital signs

C.     Hemoglobin and hematocrit levels

D.    Serum electrolytes

 

12.   Fifty four hours after deep partial thickness burns of the left leg and thigh, the client’s urine output increased from 1,000 to 2,300 cc/hour, serum sodium=136 meq/L, serum potassium=4 meq/L, and hematocrit=34%. What do these values indicate?

A.    Beginning of the interstitial to plasma fluid shift phase

B.     Renal failure

C.     Circulatory overload due to rapid IV infusion rate

D.    Hyponatremia

 

13.   The nurse is taking care of a client with full thickness burns to the lower half of the torso and lower extremities. During the emergent phase of injury, the primary nursing diagnosis would focus on which of the following?

A.    Ineffective airway clearance                                                C. Fluid volume deficit

B.     Impaired gas exchange                                                        D. Pain

 

14.   Which among the following patients are at most risk to develop metabolic alkalosis?

A.    A 32-year old post-abdominal surgery who has continuous nasogastric suction

B.     A 58-year old who has just experienced a stroke

C.     A 73-year old with altered level of consciousness who is unable to access water freely

D.    A 2-year old infant receiving isotonic sodium chloride IV solution

 

15.   Why are alkali burns more serious than acid burns?

A.    They are generally full thickness                             

B.     They produce liquefaction necrosis             

C.     They cause extensive damage to fascia and muscle

D.    They produce coagulation necrosis

 

16.   Which action is most important for the nurse to teach a client to reduce the risk for dehydration?

A.    Restricting sodium intake to no greater than 4 g per day

B.     Maintaining an oral intake of at least 1.5 to 2 liters per day

C.     Maintaining a daily oral intake of approximately equal to daily fluid loss

D.    Avoiding the use of glycerin suppositories to manage constipation

 

17.   Which assessment finding is most important for determining whether interventions for overhydration are effective?

A.    Serum sodium level of 133 mEq/L

B.     Weight loss and increased urine output

C.     Urine specific gravity change from 1.035 to 1.045

D.    Pulse pressure change from 40 mmHg to 200 mmHg

 

18.   Which client is at greatest risk for dehydration?

A.    The younger adult client with immobility

B.     The older adult client receiving hypotonic IV fluid

C.     The younger adult client receiving hypertonic IV fluid

D.    The older adult client with cognitive impairment

 

19.   Which among the following clients should the nurse be most alert for the development of overhydration?

A.    A 65-year old client who has diabetes mellitus and chronic hypertension

B.     A 45-year old client who self-meditates with sodium-containing antacids for indigestion

C.     A 75-year old  client receiving blood replacement therapy with 3 units of PRBC

D.    A 70-year old client 1 day post-operative from abdominal surgery who has an NGT to continuous suction

 

20.   Which question is most important for the nurse to ask the client who has been diagnosed with hypokalemia to identify a possible cause for the imbalance?

A.    “Do you use sugar substitutes or salt substitutes?

B.     “Do you use diuretics or laxatives?”

C.     “Have you or any member of your family been diagnosed with kidney disease?”

D.    “Have you ever noticed any changes in your pattern of bowel elimination during the last month?”

 

21.   What is the priority nursing intervention for a client with moderate to severe hypernatremia?

A.    Restricting fluid intake

B.     Initiating seizure precautions

C.     Weighing the client weekly at the same time of day

D.    Assessing pulse oximetry and respiratory status every hour

 

22.   What intervention is most important to teach the client who has hypercalcemia?

A.    “Avoid drinking coffee and other caffeinated beverages.”

B.     “Be sure to drink at least 3 liters of fluids each day.”

C.     “Do not eat or drink any dairy products.”

D.    “Take at least one 2-hour nap per day.”

 

23.   Which process or condition is likely to have resulted in the Arterial Blood Gas below?

pH=7.12, HCO₃=22 mEq/L, pCO₂=65 mmHg, PO₂=56 mmHg

A.    Diabetic ketoacidosis as a result of urinary tract infection in a person with emphysema

B.     Complete tracheal obstruction as result of aspirating a sausage

C.     Anxiety-induced hyperventilation

D.    Diarrhea for 36 hours

 

24.   Which set of arterial blood gas values represents fully compensated respiratory acidosis?

A.    pH=7.28, HCO₃=12 mEq/L, pCO₂=45 mmHg, PO₂=96 mmHg

B.     pH=7.32, HCO₃=17 mEq/L, pCO₂=25 mmHg, PO₂=98 mmHg

C.     pH=7.35, HCO₃=36 mEq/L, pCO₂=65 mmHg, PO₂=78 mmHg

D.    pH=7.48, HCO₃=12 mEq/L, pCO₂=35 mmHg, PO₂=85 mmHg

 

25.   A client with respiratory acidosis is receiving oxygen by nasal cannula at 10 lpm. Presently the RR is 8. What is the nurse’s appropriate action?

A.    Document the observation

B.     Change nasal cannula to an oxygen mask

C.     Place the client in a high Fowler’s position

D.    Decrease the oxygen flow rate

 

26.   The client has metabolic alkalosis as a result of excessive ingestion of a base-containing antacid and drinking more than 2L of milk daily as a home remedy for heartburn. Which electrolyte imbalance should the nurse expect to accompany this condition?

A.    Hyponatremia         B. Hypernatremia          C. Hypokalemia            D. Hyperkalemia

Elizabeth, 32 years old sustained burn injuries on her chest, abdomen, and upper extremities when fire broke in the office where she works.

27.   Which among the following should be done first in the E.R.?

A.    Remove clothes                                                      C. Assess for inhalation of heated air

B.     Start intravenous infusion                                        D. Evaluate total body surface area burned

 

28.   The physician diagnosed deep partial thickness burns. As the nurse of Elizabeth, which of the following characteristics of burned skin will you consider as consistent with the physician’s diagnosis?

A.    Red to gray with local edema                                   C. Dry, leathery, charred

B.     Mottled, non blanching red                                      D. Fluid filled blister, bright pink, waxy

 

29.   Which of the following symptoms if observed during the first 24 hours in the hospital would positively indicate paralytic ileus secondary to burn trauma?

A.    Hematemesis                                                          C. Negative bowel sounds

B.     Nausea and vomiting                                              D. Abdominal distention

 

30.   Continuous monitoring of the patient’s ABG was done. Results showed: pH=7.40, HCO₃=26 mEq/L, pCO₂=41 mmHg, PO₂=86 mmHg. What do these values mean?

A.    Respiratory Acidosis                                               C. Metabolic Acidosis

B.     Hypoxemia                                                             D. Normal

 

31.   You prepared a nursing care plan for the client. You have identified Abnormal fluid loss secondary to burn injury as a problem that needs to be addressed. Which among the following interventions will not solve this problem?

A.    Follow IV fluids resuscitation protocol

B.     Monitor hourly intake and output

C.     Maintain a warm environment

D.    Apply antimicrobial cream to burn

You are taking care of Tiana, 25 years old who was admitted due to dehydration.

32.   You are aware that a fluid loss may be considered when weight loss begins to exceed which of the following values?

A.    1 lb            B. 0.50 lb                                  C. 1 kg                         D. 1.5 kg

 

33.   Which of the following symptoms would you expect to assess in the patient?

A.    Bounding pulse                                                       C. Rales

B.     Tachycardia                                                            D. Bulging neck vein

 

34.   Tiana is scheduled to receive an isotonic solution. Which of the following solution is not isotonic?

A.    D5W                      B. 0.45% Saline                        C. LRS             D. 0.9% Saline

 

35.   Which of the following diagnoses applies to isotonic fluid volume deficit?

A.    Increased cardiac output                                          C. Decreased cardiac output

B.     Ineffective airway clearance                                    D. Altered urinary elimination

 

36.   A client diagnosed with SIADH complains of headache, weight, and nausea. Which of the following is an appropriate nursing diagnosis for this client?

A.    Deficient fluid volume related to decreased fluid intake

B.     Excess fluid volume related to increased water retention

C.     Deficient fluid volume related to excessive fluid loss

D.    Risk for injury related to fluid volume loss

 

37.   Based on the factors of age, gender, body type, which patient has the smallest percentage of total body water?

A.    Thin, 78-year old adult man                                     C. Thin 25-year old woman

B.     Obese 35-year old man                                            D. Obese 68-year old woman

 

38.   The patient’s blood osmolality is 306 mOsm/L. What manifestation do you expect to see in this patient?

A.    Increased urine output                                             C. Peripheral edema

B.     Thirst                                                                     D. Nausea

 

39.   On admission, the patient with pulmonary edema weighed 151 lbs, now the patient weighs 149 lbs. Assuming the patient weighed both times with the same clothing, same scale, and same time of the day, how many cc of fluid does the nurse estimate the patient has lost?

A.    500 cc                    B. 1,000 cc                   C. 2,000 cc                   D. 2,500 cc

 

40.   A nurse prepares to administer IV potassium as prescribed to a client with hypokalemia. Which if the following would not be a part of the nurse’s plan in regard to preparation and administration of potassium?

A.    Prepare to give the medication as an IV bolus

B.     Dilute in appropriate amount of normal saline

C.     Monitor the ECG when giving IV potassium

D.    Note the IV site for any signs of infiltration

 

41.   A nurse is assessing a client with suspected diagnosis of hypocalcemia. Which of the following assessments least likely indicates this condition?

A.    Lethargy                                                                 C. Hyperactive tendon reflexes

B.     Seizures                                                                  D. Positive Trousseau’s sign

 

42.   The nurse is taking care of a client diagnosed with stroke and has been bedridden for a month. His serum calcium is 13 mg/dL. Which of the following is the most appropriate action?

A.    Provide ROM exercises and encourage fluid intake

B.     Teach the client to drink milk and dairy products

C.     Place a tracheostomy at the bedside

D.    Administer calcium gluconate IM as ordered

 

43.   A client is receiving magnesium IV to correct serum Mg of 1.4 mEq/L. Which of the following assessments would alert the nurse to stop the infusion?

A.    Absent patellar reflex                                              C. Premature ventricular contractions

B.     Diarrhea                                                                 D. Increase in BP

 

44.   A client with renal failure enters the ER after skipping dialysis for 6 days. Which set of ABG would indicate that the client is in metabolic acidosis?

A. pH=7.52, HCO₃=26 mEq/L, pCO₂=25 mmHg, PO₂=87 mmHg

B. pH=7.41, HCO₃=30 mEq/L, pCO₂=49 mmHg, PO₂=82 mmHg

C. pH=7.25, HCO₃=18 mEq/L, pCO₂=47 mmHg, PO₂=80 mmHg

D. pH=7.48, HCO₃=32 mEq/L, pCO₂=35 mmHg, PO₂=76 mmHg

 

45.   The nurse is caring for a psychiatric patient who is continuously drinking tap water. The nurse monitors for which complication of hyponatremia?

A.    Proteinuria                                                             C. Pitting edema

B.     Increased  ICP                                                        D. GI Bleeding

 

46.   An older patient needs an oral potassium solution but is refusing it because it has a strong, unpleasant taste. What is the best strategy for the nurse to administer the drug?

A.    Tell the patient that failure to take the drug could result to serious heart problem

B.     Ask the patient’s preference of juice and mix the drug in small amount

C.     Mix the solution into food on the patient’s meal tray and encourage the patient to eat everything

D.    Offer the drug to the patient several times and document the patient’s refusal

 

47.   Which among the following patients is most likely to have respiratory alkalosis?

A.    Hypoxic patient                                                      C. Patient with panic attack

B.     Patient with body cast                                             D. Morbidly obese patient

 

48.   The nurse is caring for the patient who has 30% TBSA burn. During the 1^st 12-36 hours, the nurse carefully monitors the patient for which status changes related to capillary leak syndrome?

A.    Bradycardia and pitting edema                                 C. Tachycardia and hypotension

B.     Hypertension and decreased urine output                 D. Respiratory depression and crackles

 

49.   The nurse is caring for several patients on the burn unit who have sustained extensive tissue damage. The nurse should monitor for which electrolyte imbalance that is typically associated with the initial third spacing fluid shift?

A.    Hypercalcemia        B. Hypernatremia          C. Hypomagnesemia                 D. Hyperkalemia

 

50.   The nurse is reviewing the hemoglobin and hematocrit results for the patient recently admitted for a severe burn. Which result is most likely related to vascular dehydration?

A.    Hematocrit of 58%                                                  C. Hematocrit of 42%

B.     Hemoglobin of 14 g/dL                                           D. Hemoglobin of 10 g/dL

 

51.   The patient sustained a deep partial thickness burn over a large area of the body. What does the nurse tell the patient to expect to see?

A.    Blanching of the involved area                                 C. Eschar over the involved area

B.     Blistering over the involved area                              D. Superficial redness over involved area

 

52.   The nurse is caring for the patient brought to the E.R. after bending over the gas stove when it exploded in his face. What is the priority intervention for this patient?

A.    Initiate fluid resuscitation                                        C. Manage pain and discomfort

B.     Secure the airway                                                    D. Prevent infection

 

53.   The nurse is caring for a firefighter who was trapped for long period of time by burning debris. During the shift, the nurse notes progressive hoarseness, brassy cough and an increased difficulty swallowing. How does the nurse interpret these changes?

A.    Temporary discomfort that can be treated with sips of cold fluid

B.     Signs and symptoms of probable carbon monoxide poisoning

C.     Signs indicating pulmonary injury possible airway obstruction

D.    Expected findings considering mechanism of injury

 

54.   The nurse has reviewed report on the patient admitted for steam inhalation burns. The patient is alert and conversant but reports that his throat feels sore and raw. His wife says that he sounds hoarse compared to usual. Considering these assessment, which order is questionable?

A.    Continuous pulse oximetry                                      C. Intubation equipment at bedside

B.     VS and airway assessment every 8 hours                  D. O₂ @ 2 lpm to maintain O₂ sat >90%

 

55.   The nurse is caring for several patients on the burn unit. Which of these patients has the most acute need for cardiac monitoring?

A.    Older adult woman who spilled hot water over her legs while boiling noodles

B.     Teenager with facial burns that occurred when he threw gasoline on a campfire

C.     Young woman who was struck by lightning while jogging on the beach

D.    Middle aged woman who fell asleep while smoking and sustained burns on the chest

 

56.   What could be the possible etiology of the nursing diagnosis of risk for ineffective renal tissue perfusion among burn patients?

A.    Hypovolemia and myoglobin release

B.     Fluid overload and peripheral edema

C.     Prolonged resuscitation and hypoxia

D.    Direct blunt trauma to the kidneys

 

57.   The patient who lives in a rural community sustained severe burns during a house fire at 10 am. The paramedics started an IV at 11 am to start replacing the fluids. The patient was admitted at 1 pm. In calculating the fluid replacement, at what time is the fluid for the 1^st 8 hour period completed?

A.    6 pm                                  B. 7 pm                        C. 8 pm                        D. 9 pm

 

58.   What effect of fluid shifting does the nurse expect to see on the cardiac output of burn patients?

A.    An initial increase then normalize in 48 hours

B.     Decreased up to 48 hours after the burn

C.     Improved with fluid restriction

D.    Responsive to diuretics as evidenced by urinary output

 

59.   Which patient has the highest risk for a fatal burn injury?

A.    10-year old child                                                                 C. 45-year old woman

B.     32-year old man                                                                  D. 77-year old man

 

60.   Which among the following would the nurse anticipate the physician will order to prevent Curling’s Ulcer?

A.    NGT for tube feedings                                                         C. Abdominal assessment Q12

B.     H2 Blockers                                                                        D. Systemic Antibiotics

 

61.   While the operating room technician was operating the steam under pressure sterilizer, his face was exposed to the steam. Which of the following is a priority action?

A.    Wash the face with sterile ice cold water

B.     Wash the face with cool water

C.     Wash the face with soap and water

D.    Dry face with sterile water

 

62.   If clothing is on fire victim is running, which of the following is the best intervention to do?

A.    Stop the victim and remove clothing

B.     Roll the victim on the ground and wrap with blanket

C.     Wrap with blanket and roll on the ground with victim

D.    Stop victim and tell him to roll on the ground

 

63.   A disabled person on wheelchair asks the nurse what she will do in case her clothes catch fire. Which of the following is a correct response by the nurse?

A.    “Shout for help”                                                      C. “Drop to the ground and roll”

B.     “Stand and drop to the ground”                                D. “Cover yourself with blanket”

 

64.   Which among the following is a priority action in case of electrical burns?

A.    Remove victim with a dry non-conductive object

B.     Remove the victim from the electrical source

C.     Switch off the electrical source

D.    Wrap the victim with blanket

 

65.   In the pre-hospital period, pain in extensive burns is best handled with gentle and minimal handling. The degree of pain is described as which of the following?

A.    Directly proportional to the depth of burn injury

B.     Equal to the depth of burn injury

C.     Inversely proportional to the depth of the burn injury

D.    Increased as the depth of burn injury increases

 ANSWERS AND RATIONALE

1. .      D. All layers of the skin are damaged in full thickness burns.
2. D. Cells have been damaged causing potassium to leak out. The shifting of fluid causes sodium to be trapped on the edema fluids and some leak out of the body. This leads to hyperkalemia and hyponatremia.
3. C. Deep partial thickness with blister formation characterizes a 2^nd degree burn
4. D. Burn injuries cause a shift of fluids and electrolytes from the intravascular space to the interstitial space, resulting in hypovolemia and shock
5. A. Polystyrene sulfonate. Polystyrene sulfonate, also known as Kayexalate, is given to manage hyperkalemia by exchanging potassium ions for sodium ions in the intestines, which are then eliminated through the feces.
6. D. Always ensure patient is safe then establish patent airway. Then manage dehydration, after stabilizing assess further.
7. C. Keep her on NPO. During the emergent phase of burns, the client is at risk for developing edema in the airway and lungs, which can compromise breathing. Therefore, the client should be kept on NPO until the physician determines that it is safe to resume oral intake.
8. C. This CVP is increased, indicative of fluid overload. Normal range is 8-12 mmHg.
9.  D. The Pco2 is normal, HCO3 is decreased hence, acidic. The pH is also acidic. Therefore, no compensation and these values indicate an Uncompensated metabolic acidosis.
10. A. These are manifestations of hyperglycemia
11.   B. Among the choices, urine output and VS will be the most efficient assessment parameters during the initial stage of burns.
12. A. Increased urine output and decreased hematocrit are indicative that fluid has shifted back to the intravascular space. Low hematocrit indicates overhydration, since there is a lot of fluids in the intravascular space, this will in turn become urine thereby increasing urine output.
13.   C. Based on the situation, the data provided are only applicable to fluid volume deficit.
14.   A. The continuous suction eliminates HCl, therefore decreasing the acidity.
15. B. Alkali burns damages the skin by causing liquefaction. they dissolve and liquefy the affected tissues, leading to deeper penetration and damage. In contrast, acid burns typically cause coagulation necrosis, which creates a barrier that limits tissue penetration.
16. B. Maintaining an oral intake of at least 1.5 to 2 liters per day is the most important action for the nurse to teach a client to reduce the risk for dehydration. This ensures that the body has enough fluid to meet its needs and prevent dehydration.
17. B. Weight loss and increased urine output are the most important assessment findings for determining whether interventions for overhydration are effective. These indicate that excess fluid is being removed from the body.
18. C. By osmosis, this will cause fluids to shift from the intracellular space to extracellular space. Leading to cellular dehydration.
19. C. This is the only option where the client is receiving extra fluids through blood transfusion. Option A may have polyuria, Option B may experience vomiting, and Option D leads to loss of gastric fluids.
20. B. "Do you use diuretics or laxatives?" is the most important question for the nurse to ask the client who has been diagnosed with hypokalemia to identify a possible cause for the imbalance. Diuretics and laxatives can cause excessive potassium loss and lead to hypokalemia.
21.   B. Extremely high and low values of sodium may cause encephalopathy.
22. B. Hypercalcemia may cause nephrolithiasis. Hence, increase oral fluid intake.
23. B. The values are indicative of respiratory acidosis with hypoxemia. Implying that there is carbon dioxide retention and low oxygenation. Which can be seen among airway obstructions.
24. C. The bicarbonate (alkaline) and carbon dioxide (acidic) move toward the opposite direction, the pH also normalized.
25. B. Nasal cannula can only deliver up to 6 lpm.
26. C. When the blood has a high pH as in alkalosis, it will cause hydrogen ions inside the cell to exchange with potassium ions, thereby, causing hypokalemia.
27. C. Inhalation injury can compromise the airway due to edema.
28. D. Deep partial thickness is also referred to as 2^nd degree burns which is characterized by blisters also.
29. C. Absence of bowel sounds indicate ileus.
30. D. The values are within normal range.
31. D. This option will only prevent infection.
32. C.
33. B. Among the choices, tachycardia is indicative of dehydration as the body’s way of compensating
34.   B. This is hypotonic, anything below 0.9%.
35. C. Decreased cardiac output may happen with decreased blood volume
36. B. This condition causes excessive levels of antidiuretic hormone which cause retention of water.
37.   D. Adipose tissue holds little amount of water.
38. B. Normal serum osmolality is 275-295 mOsm/L. An increased levels indicate high levels of solute concentration or decreased fluid volume; hence, thirst is experienced.
39. B. 151-149 = 2 lbs convert to kg = 0.9 kg, 1 kg=1000 mL. Patient loss approximately 1,000 cc.
40. A. KCl is never pushed.
41.   A. In hypocalcemia, the neuromuscular system is hyperactive.
42. A. Encouraging exercise can help mobilize calcium and increasing OFI helps prevent nephrolithiasis.
43. A. Intracellular magnesium is critical for the functioning of Na-K pump. Therefore, with more magnesium in the intravascular space, this causes muscles to relax which may lead to loss of DTR.
44. C. HCO3 is low, PCO2 is high hence, acidic that’s why pH is low but the bicarbonate levels makes the blood more acidic. Therefore, these values indicate metabolic acidosis.
45. B. In hyponatremia, the intravascular space becomes hypotonic therefore, more fluids shift into the intracellular spaces including the brain cells therefore leading to increased ICP.
46. B. Mixing it with a preferred juice may help mask the unpleasant taste.
47. C. Patient having a panic attack hyperventilates which causes a lot of carbon dioxide to be eliminated.
48. C. These are indicative of shock.
49. D. During the initial stage, potassium leaks out of cells due to damage.
50. A. High hematocrit levels indicate dehydration.
51. B. Blistering is seen on 2^nd degree burns or deep partial thickness burns.
52. B. Burns on the face may put the patient at risk for inhalation injury as well as it may compromise the airway.
53. C. These manifestations are indicative of airway obstruction.
54. B. VS should be assed at least hourly and airway as frequently as possible.
55. C. Electrical burns may affect electrical pathways in the body including the cardiac system.
56. A. Loss of fluid decreases renal tissue perfusion. Burns also damages the muscles which causes release of myoglobin which may lodge into the kidneys thereby, compromising the circulation further.
57.  A. Since the client began sustaining the burns at 10 am.
58. B. There is loss of intravascular volume which causes decreases cardiac output.
59. 59.   D. Older adults are prone to dehydration. Therefore, they are at higher risk for mortality.
60. B. This will decrease HCl production.
61. C. To reduce inflammation
62.   D.
    
63. C. To stop the combustion process
64. C. Electric burns originates from a source which is electricity.
65.   C. The deeper the injury, the more nerves are damaged, hence there is decreased sensation.