CPAN Fluid, Electrolyte and Acid-Base Balance

Question 1

A drowsy patient who received opioids has these ABGs: pH 7.30, PaCO2 55 mmHg, HCO3 24 mEq/L. What is the interpretation?

Accepted Answer

Uncompensated respiratory acidosis

Answer

A low pH with high PaCO2 shows respiratory acidosis. The normal HCO3 shows no metabolic compensation yet. This fits acute opioid-induced hypoventilation.

Question 2

What is the minimum acceptable hourly urine output for an adult postoperative patient?

Accepted Answer

0.5 mL/kg/hr

Answer

Urine output of at least 0.5 mL/kg/hr (about 30 mL/hr for most adults) indicates adequate kidney perfusion. Lower values suggest hypovolemia or acute kidney injury.

Question 3

Which ECG change is most typical of hyperkalemia?

Accepted Answer

Peaked, tall T waves

Answer

Tall, peaked T waves are the earliest classic ECG sign of hyperkalemia. As potassium rises further, the QRS widens. U waves and flat T waves suggest hypokalemia.

Question 4

After a TURP with hypotonic irrigation, a patient becomes confused and nauseated, with bradycardia and hypertension. Which electrolyte imbalance is most likely?

Accepted Answer

Dilutional hyponatremia

Answer

TURP syndrome happens when irrigation fluid is absorbed systemically, causing fluid overload and dilutional hyponatremia. Neurologic symptoms, bradycardia and hypertension follow.

Question 5

After a total thyroidectomy, tapping over the facial nerve makes the patient's facial muscles twitch. What should the nurse anticipate?

Accepted Answer

IV calcium gluconate

Answer

A positive Chvostek's sign indicates hypocalcemia, often from parathyroid injury or removal during thyroidectomy. The treatment is IV calcium replacement.

(CPAN) Certified Post Anesthesia Nurse Practice Test

(CPAN) Certified Post Anesthesia Nurse Practice Test

CPAN Fluid, Electrolyte and Acid-Base Balance