Answer to Question 1
Answer: B
Alkalosis increases binding of extracellular calcium to albumin, reducing ionized calcium levels. As a result, neuromuscular excitability increases, and manifestations similar to hypocalcemia develop. These manifestations include circumoral and distal extremity paresthesias. Rapid breathing is not reducing the amount of oxygen reaching the nerve endings. Excessive carbon dioxide would lead to acidosis. Respiratory alkalosis is not caused by an imbalance of serum potassium.
Answer to Question 2
Answer: C
A nurse is morally obligated to withhold food and fluids if it is determined to be more harmful to administer them than to withhold them. The nurse must also honor competent clients' refusal of food and fluids. This position is supported by the ANA's Code of Ethics for Nurses, through the nurse's role as a client advocate and through the moral principle of autonomy. Clients, not their families, should make decisions about their own health care and treatment. The physician may or may not be involved, but would not disregard the client's refusal. An ethics committee is usually considered when there is an ethical dilemma and more input is needed to make a decision. In this case, the client has made a decision and it should be honored.
