Fluid & Electrolyte Adaptive Quizzing

A large family that is struggling financially is instructed by the home health nurse about ways to increase their dietary intake of calcium. Which suggestion would the nurse make? A) collard greens or kale in one meal a day B) fruit-flavored yogurt every other day C) bread made with cornmeal each morning D) eight ounces (240mL) of milk with every meal

A) collard greens or kale in one meal a day Rationale: inexpensive and can be home-grown. That serving of milk exceeds the recommended amount for adults and is costly. Yogurt is costly. Bread products provide limited sources of calcium.

Which clinical manifestations indicate to the nurse that the client has an inadequate fluid volume? SELECT ALL THAT APPLY A) decreased urine B) hypotension C) dyspnea D) dry mucous membranes E) lung crackles F) poor skin turgor

A) decreased urine B) hypotension D) dry mucous membranes F) poor skin turgor

Which action will the urgent care clinic nurse anticipate taking for a 24-year-old client who is dehydrated after a long run and has a pulse of 103 and BP of 102/56 mmHg? A) offer oral fluids at frequent intervals B) give fluid boluses through nasogastric tube C) administer intravenous antiemetic medications D) insert a peripheral intravenous line for fluid infusion

A) offer oral fluids at frequent intervals

Which nursing assessment would be performed by a nurse before administering intravenous infusion of potassium chloride (KCl) 40 mEq in 100 mL of 5% dextrose and water to be infused over 2 hours? SELECT ALL THAT APPLY A) urinary output B) deep tendon reflexes C) last bowel movement D) arterial blood gas results E) last serum potassium level F) patency of the intravenous access

A) urinary output E) last serum potassium level F) patency of the intravenous access Rationale: To administer IV potassium, the urinary output must be normal. A patent IV access is essential because potassium is very irritating and painful to subcutaneous tissue.

Which action by the nurse will be MOST effective in determining whether fluid overload is improving when caring for a client who was admitted with heart failure? A) weighing the client B) monitoring the intake and output C) assessing the extent of pitting edema D) asking the client about subjective symptoms

A) weighing the client

When the health care provider prescribes a diet high in potassium for a client who is taking a daily diuretic, which foods will the nurse suggest that the client eat? SELECT ALL THAT APPLY A) corn B) banana C) strawberries D) cucumber salad E) baked potatoes with skins

B) banana E) baked potatoes with skins

Which process would the nurse consider when formulating a response to a client with acute kidney injury who states "Why am I experiencing twitching and tingling of my fingers and toes?" A) acidosis B) calcium depletion C) potassium retention D) sodium chloride depletion

B) calcium depletion Rationale: Hypocalcemia causes tetany (twitching and tingling of the extremities)

An older client is admitted to the hospital for rehydration therapy after 3 days of diarrhea. In addition to sodium, which electrolyte would the nurse be MOST concerned about? A) calcium B) chlorides C) potassium D) phosphates

C) potassium

A 4-year-old child is fluid-restricted to 600mL/24 hours. Which intervention would the nurse use to help the child cope with this limitation? A) dividing the fluids equally throughout the 24 hours B) allowing the child to drink fluids as desired until 600mL limit is reached C) providing the 600mL from 7:00AM to 7:00PM and then withholding fluids again until 7:00AM D) Offering the child at least 1 oz (30mL) of fluid, served in a 1-oz medicine cup, each waking hour

D) Offering the child at least 1 oz (30mL) of fluid, served in a 1-oz medicine cup, each waking hour

Which hormonal imbalance would the nurse suspect in a client who has low serum sodium levels? A) epinephrine B) glucagon C) calcitonin D) aldosterone

D) aldosterone

Tp prevent an adverse outcome while providing care for a client experiencing diarrhea, which client data would the nurse closely monitor? A) skin condition B) fluid and electrolyte balance C) food intake D) fluid intake and output

B) fluid and electrolyte balance

Which medication is unsafe to administer as an intravenous (IV) bolus? A) saline flush B) potassium chloride C) naloxone D) adenosine

B) potassium chloride Rationale: must be diluted and infused slowly through an IV pump

Which clinical finding would the nurse anticipate when admitting a client with an extracellular fluid volume excess? A) rapid, thready pulse B) distended jugular vein C) elevated hematocrit level D) increased serum sodium level

B) distended jugular vein Rationale: Because of fluid overload in the intravascular space, the neck veins become visibly distended

A client has been admitted with a diagnosis of intractable vomiting and can tolerate only sips of water. The initial blood works shows a sodium level of 122 mEq/L and a potassium level of 3.6 mEq/L. The client is likely experiencing which condition? A) hypernatremia B) hyponatremia C) hyperkalemia D) hypokalemia

B) hyponatremia Normal sodium level is 135-145

Which method is an efficient way to correct decreased serum chloride levels found in a client with an acute episode of ulcerative colitis? A) low-residual diet B) intravenous (IV) therapy C) oral electrolyte solution D) total parenteral nutrition (TPN)

B) intravenous (IV) therapy

Which signs of hypokalemia would the nurse monitor in the postoperative surgical client with a nasogastric tube attached to continuous low suction? SELECT ALL THAT APPLY A) irritability B) dysrhythmias C) muscle weakness D) abdominal cramps E) acidosis

B) dysrhythmias C) muscle weakness Rationale: Dysrhythmias are a sign of potassium depletion in cardiac muscles. Muscle weakness is a symptom of potassium depletion in skeletal muscles. Irritability and abdominal cramps are signs of hyperkalemia.

Which prescribed action will the nurse take FIRST when a client is admitted to the emergency department with reports of frequent loose, watery stools and anorexia during the past week with a blood pressure of 90/68 mmHg and pulse of 124? A) obtain blood and urine cultures B) start infusion of normal saline C) insert retention catheter D) transfer the client to ICU

B) start infusion of normal saline

Which intravenous fluid is a hypertonic solution? A) ringer solution B) 5% dextrose in water C) lactated ringer solution D) 5% dextrose in normal saline

D) 5% dextrose in normal saline

A client with end-stage renal disease receiving hemodialysis has a prescribed diet restricting proteins, sodium, and potassium. Which client statement indicates understanding of provided dietary instructions? A) "I should avoid using salt substitutes." B) "I should exclude meat from my diet." C) "I may not add seasoning to my food." D) "I may eat low-sodium canned vegetables."

A) "I should avoid using salt substitutes."

Which client would a nurse recognize as having an age-related impairment of the thirst mechanism when reviewing the laboratory reports of a group of older adult clients? A) serum sodium of 167 mEq/L B) serum sodium of 143 mEq/L C) serum sodium of 118 mEq/L D) serum sodium of 101 mEq/L

A) serum sodium of 167 mEq/L

Which electrolyte deficiency triggers the secretion of renin? A) sodium B) calcium C) chloride D) potassium

A) sodium

Which ion is the regulator of extracellular osmolarity? A) sodium B) potassium C) chloride D) calcium

A) sodium

Which explanation would the nurse include when teaching a client with heart failure about the reason for a low-sodium diet? A) body weight control B) decreased fluid retention C) lowering blood pressure D) prevention of hypernatremia

B) decreased fluid retention

The nurse advises a client receiving furosemide about potassium intake. Which fruits would the nurse encourage the client to eat? SELECT ALL THAT APPLY A) apple B) orange C) banana D) pineapple E) dried fruit

B) orange C) banana E) dried fruit

Which cation regulates intracellular osmolarity? A) sodium B) potassium C) calcium D) calcitonin

B) potassium

Which disease increases the risk for hyperkalemia? A) Crohn disease B) Cushing disease C) End-stage renal disease D) Gastroesophageal reflux disease

C) End-stage renal disease

The nurse instructs a client that, in addition to building bones and teeth, calcium is also important for which process? A) bile production B) blood production C) blood clotting D) digestion of fats

C) blood clotting

Which symptom would the nurse monitor for when caring for a client who has hyponatremia? A) increased urine output B) deep rapid respirations C) change in level of conciousness D) distended neck veins

C) change in level of conciousness

In which category of fluids would the nurse classify an intravenous solution of 0.45% sodium chloride? A) isotonic B) isomeric C) hypotonic D) hypertonic

C) hypotonic Rationale: Hypotonic solutions are less concentrated (contain less than 0.85 g of sodium chloride in each 100mL) than body fluids.

A client is admitted with severe diarrhea that resulted in hypokalemia. The nurse would monitor for which clinical manifestation of the electrolyte deficiency? SELECT ALL THAT APPLY A) diplopia B) skin rash C) leg cramps D) tachycardia E) muscle weakness

C) leg cramps E) muscle weakness

Which assessment finding indicates that sodium polystyrene sulfonate has been effective? A) control of diarrhea B) an increase in serum sodium level C) an increase in serum calcium level D) a decrease in serum potassium level

D) a decrease in serum potassium level

Which statement by a client receiving diuretic therapy indicates that the teaching about potassium supplements is understood? A) "I will report any abdominal distress" B) "I should use salt substitutes with my food." C) "The medication must be taken on an empty stomach" D) "The dosage is correct if my urine output increases"

A) "I will report any abdominal distress"

A client is diagnosed with parathyroid dysfunction. Which serum calcium concentration supports the diagnosis? A) 7.8 mg/dL B) 8.9 mg/dL C) 9.7 mg/dL D) 10.2 mg/dL

A) 7.8 mg/dL Rationale: hypocalcemia

The RN teaches a student nurse regarding the management of increased potassium levels in a client. Which action performed by the student nurse indicates effective learning? A) administering sodium polystyrene sulfonate B) instructing a client to increase potassium and sodium intake C) monitoring glucose levels hourly D) providing potassium-sparing diuretics

A) administering sodium polystyrene sulfonate Rationale: Administering potassium binding and excreting resin, such as sodium polystyrene sulfonate, can reduce the potassium levels

Which food would the nurse encourage a client to eat while receiving treatment to prevent hypokalemia? A) broccoli B) oatmeal C) fried rice D) canned carrots

A) broccoli

When teaching a client with hypertension about a 2-gram sodium diet, which foods would the nurse instruct the client to avoid? SELECT ALL THAT APPLY A) canned chili B) ground beef C) fresh salmon D) luncheon meat E) cooked broccoli

A) canned chili D) luncheon meat Rationale: Both of these options contain high sodium levels. Other options have low sodium levels.

A client is experiencing persistent vomiting, and serum electrolytes have been prescribed. The nurse would monitor which laboratory results? A) sodium and chloride levels B) bicarbonate and sulfate levels C) magnesium and protein levels D) calcium and phosphate levels

A) sodium and chloride levels Rationale: Sodium and chloride are lost with vomiting. Because sodium and chloride are parallel electrolytes, hyponatremia will accompany hypochloremia

Which intravenous (IV) solution would a nurse anticipate administering when caring for a client with a history of severe diarrhea for the past 3 days who is admitted for dehydration? A) 3% sodium chloride B) 0.9% sodium chloride C) 5% dextrose and 0.9% sodium chloride D) 5% dextrose and lactated ringer solution

B) 0.9% sodium chloride Rationale: Correct answer is an isotonic solution to quickly replace volume losses. 3% sodium chloride is a hypertonic solution. C & D may be appropriate to infuse after 0.9% sodium chloride

Which reason describes the purpose of restricting sodium for a client with hypertension? A) to chemically stimulate the loop of henle B) to diminish the thirst response of the client C) to prevent reabsorption of water in the distal tubules D) to cause fluid to move toward the interstitial compartment

C) to prevent reabsorption of water in the distal tubules Rationale: sodium absorbs water in the kidney's renal tubules. When intake of sodium is decreased, water is not reabsorbed and edema is reduced.

A pregnant client tells the nurse, "I'm sticking to my diet, and I don't eat anything containing salt." How would the nurse respond? A) "You're doing fine. Just keep up the good work." B) "A low-salt diet will protect you from getting swollen feet." C) "We now encourage pregnant women to increase their salt intake because of changes in the circulation." D) "Salt is necessary in your diet. Use a little when you're cooking, but avoid processed meats and canned foods with salt."

D) "Salt is necessary in your diet. Use a little when you're cooking, but avoid processed meats and canned foods with salt."

Which response would a nurse give to the daughter of an 80-year-old client admitted to the hospital with severe dehydration who asks how her mother could have become dehydrated? A) "The body's fluid needs decrease with age because of tissue changes." B) "Access to fluid may be insufficient to meet the daily needs of the older adults." C) "Memory declines with age, and the older adult may forget to ingest adequate amounts of fluid." D) "The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased."

D) "The thirst reflex diminishes with age, and the recognition of the need for fluid is decreased."

For an older adult client with dementia who developed dehydration as a result of vomiting and diarrhea, which assessment information BEST reflects the client's fluid balance? A) skin turgor B) intake and output results C) client's report about fluid intake D) blood lab results

D) blood lab results

Which assessment is necessary for the nurse to complete in a client with chronic kidney disease receiving loop diuretics? A) hemoglobin levels B) occurrence of nausea C) presence of constipation D) intake and output measurement

D) intake and output measurement

Which nursing action has the highest priority when a client with a history of heart failure arrives for a scheduled clinic appointment and has gained 6 lb? A) check for lower leg swelling B) notify the health care provider C) take the client's pulse rate D) listen to the client's breath sounds

D) listen to the client's breath sounds Rationale: Assess for fluid overload. Lung congestion associated with fluid overload would affect oxygenation, and the initial action of the nurse should be an assessment of lung sounds.

Which serum hormone level elevates in response to a client's total serum calcium concentration of 7.9 mg/dL? A) estrogen B) thyroxine C) growth hormone D) parathyroid hormone (PTH)

D) parathyroid hormone (PTH) Rationale: When serum calcium levels lower, secretion of PTH increases

An infant with a diagnosis of heart failure is being given furosemide twice a day. Which laboratory value would the nurse report to the health care provider? A) sodium of 140 mEq/L B) ionized calcium of 2.35 mEq/L C) chloride of 102 mEq/L D) potassium of 3.0 mEq/L

D) potassium of 3.0 mEq/L

Which reason would an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium be prescribed for a client with a nasogastric (NG) tube set to low intermittent suction? A) prevent constipation B) prevent dehydration C) prevent vomiting D) prevent electrolyte imbalance

D) prevent electrolyte imbalance

Which electrolyte has the potential to precipitate dysrhythmias and cardiac arrest in a client? A) serum sodium of 139 mEq/L B) serum chloride of 100 mEq/L C) serum calcium of 10.2 mg/dL D) serum potassium of 7.2 mEq/L

D) serum potassium of 7.2 mEq/L