NACE Physiological Adaptation 4

Question 1

A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which ECG change should the nurse anticipate first?

Accepted Answer

Peaked T waves

Answer

Peaked T waves are the earliest ECG manifestation of hyperkalemia, preceding widened QRS and other changes.

Question 2

A patient post-thyroidectomy develops tingling around the mouth and carpopedal spasms. Which lab value should the nurse check immediately?

Accepted Answer

Serum calcium

Answer

Hypocalcemia due to inadvertent parathyroid removal causes tetany symptoms including perioral tingling and carpopedal spasms.

Question 3

Which compensatory mechanism occurs in a patient with metabolic acidosis?

Accepted Answer

Kussmaul respirations to blow off CO2

Answer

Kussmaul respirations (deep, rapid breathing) are the respiratory compensation for metabolic acidosis, eliminating CO2 to raise pH.

Question 4

A patient in hypovolemic shock has a BP of 80/50 mmHg and HR of 128 bpm. Which physiological response explains the tachycardia?

Accepted Answer

Baroreceptor-mediated sympathetic activation

Answer

Decreased arterial pressure reduces baroreceptor stretch, triggering sympathetic nervous system activation that increases heart rate.

Question 5

A patient with SIADH has a serum sodium of 118 mEq/L. Which symptom is most concerning?

Accepted Answer

Seizures and altered consciousness

Answer

Severe hyponatremia causes cerebral edema, leading to seizures and altered consciousness, which are life-threatening neurological complications.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test