Fluid and Electrolyte Practice Quiz

The community health nurse is performing a home visit to an 80-year-old client recovering from hip surgery. The nurse notes that the client seems uncharacteristically confused at times and has dry mucous membranes. When asked about fluid intake, the client states, "I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response? "I will need to have your medications adjusted, so you will need to be readmitted to the hospital for a complete workup." "It is normal to be a little confused following surgery, and it is safe not to urinate at night." "Confusion and bladder issues are a normal consequence of aging, so I am not too concerned." "Limiting your fluids can create imbalances that can result in confusion, so let's try adjusting the timing of your fluids."

"Limiting your fluids can create imbalances that can result in confusion, so let's try adjusting the timing of your fluids."

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? 0.45% sodium chloride 5% glucose in normal saline solution 5% glucose in water 0.9% sodium chloride

0.45% sodium chloride

Which is considered an isotonic solution? 0.45% normal saline 3% NaCl 0.9% normal saline Dextran in normal saline

0.9% normal saline

The weight of a client with congestive heart failure is monitored daily and entered into the medical record. In a 24-hour period, the client's weight increased by 2 lb. How much fluid is this client retaining? 500 ml 1250 ml 1 L 1500 ml

1 L

The nurse knows which is the normal serum value for potassium? 8.5-10.5 mg/dL (2.13-2.63 mmol/L). 135-145 mEq/L (135-145 mmol/L). 96-106 mEq/L (96-106 mmol/L). 3.5-5.0 mEq/L (3.5-5.0 mmol/L).

3.5-5.0 mEq/L (3.5-5.0 mmol/L).

The nurse is caring for four clients on a medical unit. The nurse is most correct to review which client's laboratory reports first for an electrolyte imbalance? A 72-year-old with a total knee repair A 65-year-old with a myocardial infarction A 52-year-old with diarrhea A 7-year-old with a fracture tibia

A 52-year-old with diarrhea

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? Alkaline Acidic Neutral Basic

Acidic

Which of the following is the most common cause of symptomatic hypomagnesemia in the United States? Alcoholism Inflammatory bowel disease Loss of gastric acid Intestinal resection

Alcoholism

The nurse is reviewing lab work on a newly admitted client. Which of the following diagnostic studies confirm the nursing diagnosis of Deficient Fluid Volume? Select all that apply. Electrolyte imbalance A low urine specific gravity Absence of ketones in urine An elevated hematocrit level Low protein level in the urine

An elevated hematocrit level Electrolyte imbalance

A group of nursing students are studying for a test over acid-base imbalance. One student asks another what the major chemical regulator of plasma pH is. What should the second student respond? Renin-angiotensin-aldosterone system Bicarbonate-carbonic acid buffer system Sodium-potassium pump ADH-ANP buffer system

Bicarbonate-carbonic acid buffer system

Which is an insensible mechanism of fluid loss? Breathing Nausea Urination Bowel elimination

Breathing

When a client's ventilation is impaired, the body retains which substance? Nitrous oxide Oxygen Carbon dioxide Sodium bicarbonate

Carbon dioxide

Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical manifestation associated with air embolism? Slow pulse Chest pain Jaundice Hypertension

Chest pain

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? Headache Nausea Hallucinations Confusion

Confusion

A client was admitted to the unit with a diagnosis of hypovolemia. When it is time to complete discharge teaching, which of the following will the nurse teach the client and family? Select all that apply. Drink at least eight glasses of fluid each day. Respond to thirst Drink caffeinated beverages to retain fluid. Drink carbonated beverages to help balance fluid volume. Drink water as an inexpensive way to meet fluid needs.

Drink at least eight glasses of fluid each day. Drink water as an inexpensive way to meet fluid needs. Respond to thirst

The physician has prescribed a peripheral IV to be inserted before the client goes for computed tomography. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter? Have the client briefly hold his arm over his head before insertion. Leave the tourniquet on for at least 3 minutes. Consider potential effects on the client's mobility when selecting a site. Choose a hairless site if available.

Consider potential effects on the client's mobility when selecting a site.

The nurse is caring for a client with laboratory values indicating dehydration. Which clinical symptom is consistent with the dehydration? Crackles in the lung fields Distended jugular veins Cool and pale skin Dark, concentrated urine

Dark, concentrated urine

Baroreceptors in the left atrium and in the carotid and aortic arches respond to changes in the circulating blood volume and regulate sympathetic and parasympathetic neural activity as well as endocrine activities. Sympathetic stimulation constricts renal arterioles, causing what effect? Decrease in the reabsorption of sodium Decrease in the release of aldosterone Decrease in glomerular filtration Increase of filtration in the Loop of Henle

Decrease in glomerular filtration

The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults? Dehydration Fluid volume excess Hypovolemia Hypervolemia

Dehydration

Which nerve is implicated in the Chvostek's sign? Hypoglossal Optic Facial Spinal accessory

Facial

A patient with a diagnosis of colon cancer has undergone a bowel resection with the creation of an ileostomy. The patient's ileostomy output has been unexpectedly high in the 2 days since surgery, and the patient's most recent blood work indicates a K+ level of 2.7 mEq/L. This potassium level should prompt the nurse to assess for which of the following physical manifestations? Shortness of breath, rales, and peripheral edema Fatigue, cramps, and weakness Dysphagia, tetany, and emotional lability Confusion and decreased level of consciousness

Fatigue, cramps, and weakness

The nurse is caring for a client who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). The plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the client's health? Nutritional status Calcium balance Fluid volume status Potassium balance

Fluid volume status

What foods can the nurse recommend for the patient with hypokalemia? Nuts and legumes Fruits such as bananas and apricots Green, leafy vegetables Milk and yogurt

Fruits such as bananas and apricots Sources of potassium include fruit juices and bananas, melon, citrus fruits, fresh and frozen vegetables, lean meats, milk, and whole grains (Crawford & Harris, 2011b).

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? Hypocalcemia Hypercalcemia Hyperkalemia Hypokalemia

Hypercalcemia

A client presents with muscle weakness, tremors, slow muscle movements, and vertigo. The following are the client's laboratory values:Na+ 134 mEq/LK+ 3.2 mEq/LCl- 111 mEq/LMg++ 1.1 mg/dLCa++ 8.4 mg/dLIdentify which of the following alterations is consistent with the client's findings. Hypomagnesemia Hyponatremia Hypocalcemia Hypokalemia

Hypomagnesemia

A fluid volume deficit can be caused by either dehydration or hypovolemia. What is the distinction between the two? In hypovolemia all fluid compartments have decreased volumes. In dehydration intracellular fluid volume is depleted. In hypovolemia only blood volume is low. In dehydration only blood volume is low.

In hypovolemia only blood volume is low.

While assessing a client's peripheral IV site, the nurse observes edema and coolness around the insertion site. How should the nurse document this observation? Infiltration Air embolism Phlebitis Fluid overload

Infiltration

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? Respiratory alkalosis Metabolic alkalosis Metabolic acidosis Respiratory acidosis

Metabolic acidosis

The nurse is assessing residents at a summer picnic at the nursing facility. The nurse expresses concern due to the high heat and humidity of the day. Although the facility is offering the residents plenty of fluids for fluid maintenance, the nurse is most concerned about which? Summer allergies Lung function Cardiovascular compromise Insensible fluid loss

Insensible fluid loss

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? Half-normal saline solution Lactated Ringer's solution 5% dextrose and normal saline solution 10% dextrose in water

Lactated Ringer's solution

Your client has a diagnosis of hypervolemia. What would be an important intervention that you would initiate? Teach client behaviors that decrease urination. Limit sodium and water intake. Give medications that promote fluid retention. Assess for dehydration.

Limit sodium and water intake

A client in the emergency department reports that he has been vomiting excessively for the past 2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and bicarbonate (HCO3-) of 42 mEq/L. Based on these findings, the nurse documents that the client is experiencing which type of acid-base imbalance? Metabolic alkalosis Respiratory acidosis Metabolic acidosis Respiratory alkalosis

Metabolic alkalosis

A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/l (145 mmol/L). Should the nurse start salt tablets when caring for this client? Yes, along with the hypotonic IV. Yes, this will correct the sodium deficit. No, sodium intake should be restricted. No, start with the sodium chloride IV.

No, sodium intake should be restricted.

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? Yes, this will correct the sodium deficit. Yes, along with the hypotonic IV. No, sodium intake should be restricted. No, start with the sodium chloride IV.

No, sodium intake should be restricted.

Which is a correct route of administration for potassium? Oral IV (intravenous) push Intramuscular Subcutaneous

Oral

The calcium concentration in the blood is regulated by which mechanism? Androgens Thyroid hormone (TH) Parathyroid hormone (PTH) Adrenal gland

Parathyroid hormone (PTH)

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? CO2 Sodium Potassium Chloride

Potassium

Which electrolyte is a major cation in body fluid? Bicarbonate Potassium Phosphate Chloride

Potassium

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? Sodium: 138 mEq/L Potassium: 5.8 mEq/L Calcium: 10 mg/dL Magnesium:2 mEq/L

Potassium: 5.8 mEq/L

A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 24 mm Hg. Which condition does the ABG reflect? Metabolic acidosis Respiratory alkalosis Metabolic alkalosis Respiratory acidosis

Respiratory acidosis

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings? Respiratory alkalosis Respiratory acidosis Metabolic acidosis Metabolic alkalosis

Respiratory alkalosis

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? Serum bicarbonate of 28 mEq/L pH 7.26 PaCO2 less than 35 mm Hg Serum bicarbonate of 21 mEq/L

Serum bicarbonate of 28 mEq/L

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? Potassium Calcium Sodium Magnesium

Sodium

To compensate for decreased fluid volume (hypovolemia), the nurse can anticipate which response by the body? Tachycardia Vasodilation Bradycardia Increased urine output

Tachycardia

A 73-year-old man comes into the emergency department (ED) by ambulance after slipping on a small carpet in his home. The patient fell on his hip with a resultant fracture. He is alert and oriented; his pupils are equal and reactive to light and accommodation. His heart rate is elevated, he is anxious and thirsty, a Foley catheter is placed, and 40 mL of urine is present. What is the nurse's most likely explanation for the low urine output? The man is experiencing symptoms of heart failure and is releasing atrial natriuretic peptide that results in decreased urine output. The man likely has a traumatic brain injury, lacks antidiuretic hormone (ADH), and needs vasopressin. The man is having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output. The man urinated prior to his arrival to the ED and will probably not need to have the Foley catheter kept in place.

The man is having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output.

Treatment of FVE involves dietary restriction of sodium. Which of the following food choices would be part of a low-sodium diet, mild restriction (2 to 3 g/day)? Three ounces of sliced ham, beets, and a salad Tomato juice, low-fat cottage cheese, and three slices of bacon Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad A frozen, packaged low-fat dinner with a side salad

Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad

A client has a serum calcium level of 7.2 mg/dl (1.8 mmol/L). During the physical examination, the nurse expects to assess: Homans' sign. Trousseau's sign. Hegar's sign. Goodell's sign.

Trousseau's sign.

What does the nurse understand is the primary method by which fluid volume is regulated? Urine excretion Breathing Bowel elimination Perspiration

Urine excretion

A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition? dehydration hypervolemia hyperkalemia hypercalcemia

dehydration

A client with severe hypervolemia is prescribed a loop diuretic and the nurse is concerned with the client experiencing significant sodium and potassium losses. What drug was most likely prescribed? hydrochlorothiazide metolazone furosemide spironolactone

furosemide

Clients diagnosed with hypervolemia should avoid sweet or dry food because it obstructs water elimination. can cause dehydration. increases the client's desire to consume fluid. can lead to weight gain.

increases the client's desire to consume fluid.

A client recovering from an acute asthma attack experiences respiratory alkalosis. The nurse measures a respiratory rate of 46 breaths/minute, a heart rate of 110 beats/minute, a blood pressure of 162/90 mm Hg, and a temperature of 98.6° F (37° C). To help correct respiratory alkalosis, the nurse should: administer antibiotics as ordered. insert a nasogastric tube (NG) as ordered. instruct the client to breathe into a paper bag. administer acetaminophen as ordered.

instruct the client to breathe into a paper bag.

Fluid and electrolyte balance is maintained through the process of translocation. What specific process allows water to pass through a membrane from a dilute to a more concentrated area? osmosis evaporation filtration active transport

osmosis

To confirm an acid-base imbalance, it is necessary to assess which findings from a client's arterial blood gas (ABG) results? Select all that apply. Na+ Glucose pH HCO3 K+ PaCO2

pH PaCO2 HCO3

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? HCO 21 mEq/L PaCO 36 O saturation 95% pH 7.48

pH 7.48

Which set of arterial blood gas (ABG) results requires further investigation? pH 7.44, PaCO2 43 mm Hg, PaO2 99 mm Hg, and HCO3- 26 mEq/L pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L pH 7.38, partial pressure of arterial carbon dioxide (PaCO2) 36 mm Hg, partial pressure of arterial oxygen (PaO2) 95 mm Hg, bicarbonate (HCO3-) 24 mEq/L pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L

pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?

pH, 7.25; PaCO2 50 mm Hg

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L pH: 7.42, PaCO2: 45 mm Hg, HCO3-: 22 mEq /L pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L pH: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L

pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L

A client who is being treated for pneumonia reports sudden shortness of breath. An arterial blood gas (ABG) is drawn, yielding the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect? respiratory alkalosis metabolic acidosis respiratory acidosis metabolic alkalosis

respiratory acidosis