Fluid and Electrolyte Quiz (2.1)

A nurse is caring for an infant with gastroenteritis and diarrhea. What should the nurse evaluate to determine the magnitude of the infant's fluid loss? A) Tissue turgor B) Hematocrit value C) Moistness of mucous membranes D) Weight compared with prior weight

4

A 6-month-old infant weighing 15 lb (6.8 kg) is admitted with a diagnosis of dehydration. A prescription for oral rehydration therapy 4 mL/kg electrolyte replacement over 4 hours is made. What is the approximate amount of fluid that the infant should ingest during the 4 hours? A) 28 mL B) 32 mL C) 38 mL D) 42 mL

A

A client with a hemoglobin level of 6.2 g/dL (62 mmol/L) is receiving packed red blood cells. Twenty minutes after the infusion starts, the client complains of chest pain, difficulty breathing, and feeling cold. What is the first action the nurse should take? A) Stop the transfusion. B) Notify the healthcare provider. C) Provide several warm blankets. D) Slow down the rate of infusion.

A

The nurse is preparing to administer an intravenous piggyback antibiotic that has been newly prescribed. Shortly after initiation, the client becomes restless and flushed and begins to wheeze. The nurse determines that the appropriate priority action will be to stop the antibiotic infusion and then do what? A) Notify the physician immediately about the client's condition. B) Take the client's blood pressure. C) Obtain the client's pulse oximetry. D) Assess the client's respiratory status.

D

Which hormonal deficiency causes diabetes insipidus in a client? A) Prolactin B) Thyrotropin C) Luteinizing hormone (LH) D) Antidiuretic hormone (ADH)

D

A client with a history of heart failure and atrial fibrillation reports a nine-pound (four kilogram) weight gain in the last two weeks. Which factor does the nurse consider as the most likely cause of this sudden weight gain? A) Fluid retention B) Urinary retention C) Renal insufficiency D) Abdominal distention

A

A nurse is caring for a client with heart failure. The healthcare provider prescribes a 2-gram sodium diet. What should the nurse include when explaining how a low-salt diet helps achieve a therapeutic outcome? A) Allows excess tissue fluid to be excreted B) Helps to control the volume of food intake and thus weight C) Aids the weakened heart muscle to contract and improves cardiac output D) Assists in reducing potassium accumulation that occurs when sodium intake is high

A

What does a nurse identify as the priority short-term goal for a toddler with dehydration caused by diarrhea? A) Improvement of fluid balance B) Continuation of an antidiarrheal diet C) Preservation of perianal skin integrity D) Retention of weight appropriate for height

A

A client has been admitted with a diagnosis of intractable vomiting and can only tolerate sips of water. The initial blood work shows a sodium level of 122 mEq/L (122 mmol/L) and a potassium level of 3.6 mEq/L (3.6 mmol/L). Based on the lab results and symptoms, what is the client experiencing? A) Hypernatremia B) Hyponatremia C) Hyperkalemia D) Hypokalemia

B

A client is admitted with severe burns. The nurse is caring for the client 36 hours after the client's admission and identifies the client's potassium level of 6.0 mEq/L (6.0 mmol/L). Which drink will the nurse recommend be included in the client's diet? A) Milk B) Tea C) Orange juice D) Tomato juice

B

A client with the diagnosis of bulimia nervosa, purging type, is admitted to the mental health unit after an acute episode of bingeing. Which clinical manifestation is most important for the nurse to assess? A) Weight gain B) Dehydration C) Hyperactivity D) Hyperglycemia

B

A man who has 40% of the body surface area burned is admitted to the hospital. Fluid replacement of 7200 mL during the first 24 hours has been prescribed. Fifty percent of fluid replacement should be administered in the first 8 hours; then the remaining 50% given over the next 16 hours. What does the nurse calculate the hourly intravenous (IV) fluid to be for the first 8 hours of fluid replacement therapy? Record your answer using a whole number. ___ mL/hr A) 500 B) 450 C) 750 D) 3600

B

A nurse is caring for a 9-month-old infant with severe dehydration. What does the nurse expect to note while completing a physical assessment of this infant? A) Frothy stools B) Weak, rapid pulse C) Pale, copious urine D) Bulging anterior fontanel

B

A nurse is caring for a client who is receiving an intravenous (IV) infusion. What should the nurse do first if the IV infusion infiltrates? A) Elevate the IV site. B) Discontinue the infusion. C) Attempt to flush the tubing. D) Apply a warm, moist compress

B

An electrocardiogram (ECG) is performed before a client is to have a cardiac catheterization, and hypokalemia is suspected. What does the nurse expect the primary healthcare provider to prescribe to confirm the presence of hypokalemia? A) A complete blood count B) A serum electrolyte level C) An arterial blood gas panel D) An x-ray film of long bones

B

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder? A) Cerebral palsy B) Cystic fibrosis C) Muscular dystrophy D) Multiple sclerosis

B

What is the action of vasopressin? A) Promotes sodium reabsorption B) Reabsorbs water into the capillaries C) Promotes tubular secretion of sodium D) Stimulates bone marrow to make red blood cells

B

What is the priority nursing action in the care of a young child with severe diarrhea? A) Measuring daily urine output B) Maintaining fluid and electrolyte balance C) Replacing the lost calories with high-fiber foods D) Promoting perianal skin integrity by bathing often

B

While caring for a client with a second-degree left ankle sprain, a nurse raises the injured part above heart level. What is the reason behind this nursing intervention? A) To promote bone density B) To prevent further edema C) To reduce pain perception D) To increase muscle strength

B

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action should the nurse take next? A) Send another blood sample to the lab to retest the serum potassium level B) Notify the healthcare provider that the potassium level is above normal C) Notify the healthcare provider that the potassium level is below normal D) No action is required because the potassium level is within normal limits

C

A nurse is administering serum albumin intravenously to a client with ascites. In response to this therapy, what does the nurse expect to decrease? A) Confusion B) Urinary output C) Abdominal girth D) Serum ammonia level

C

A nurse is caring for a postoperative client who has a nasogastric (NG) tube set to low intermittent suction. The nurse recalls that the primary reason that an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium has been prescribed is to prevent which complication? A) Constipation B) Dehydration C) Electrolyte imbalance D) Nausea and vomiting

C

Which type of drug-induced hormonal imbalance is likely to be observed in the client undergoing treatment with demeclocycline? A) Acromegaly B) Diabetes mellitus C) Diabetes insipidus D) Cushing's syndrome

C

At 10 AM the nurse hangs a 1000-mL bag of D5W with 20 mEq of potassium chloride to be administered at 80 mL/hr. At noon the healthcare provider prescribes a stat infusion of an intravenous (IV) antibiotic of 100 mL to be administered via piggyback over 1 hour. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion to use the circulatory access for the secondary infusion of the antibiotic? A) Quarter hour B) Half hour C) Three quarters of an hour D) 1 hour

D

What is the percentage of total body water in a premature newborn? A) 55% B) 65% C) 75% D) 85%

D