FLUID AND ELECTROLYTES
Hyponatremia most affects the cells of which body systems? Select all that apply. A. Cerebral B. Endocrine C. Respiratory D. Cardiovascular E. Neuromuscular
A, D, E
A patient has a serum magnesium level of 1.2 mEq/L. Which instruction by the nurse is appropriate? A. "Notify me if you have diarrhea." B. "I will be giving you an intramuscular injection of magnesium sulfate." C. "Your urine may become darker and more concentrated in appearance." D. "I will be administering a phosphorus supplement in addition to the magnesium supplement."
A
A patient has been having acute diarrhea for more than 24 hours from a viral infection. Which acid-base imbalance is most likely to manifest? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
A
A patient is admitted with chronic anemia. What physiologic imbalance does the nurse suspect the patient is at risk of developing? A. Acidosis B. Alkalosis C. Hypokalemia D. Ineffective ventilation
A
Deep and rapid breaths consistent with Kussmaul respirations are found in patients with which type of acid-base imbalance? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
A
Laboratory results report a patient's serum potassium at 5.6 mEq/L. What does the nurse immediately assess in the patient? A. Heart rate B. Bowel sounds C. Feet for paresthesias D. Level of consciousness
A
On the second day of caring for a patient with generalized edema, which change best reflects that the administered diuretic is effective? A. Weight loss of 6 pounds B. Respiratory rate decrease from 24 to 20 C. Urinary output decrease from 600 mL/8 hr to 200 mL/8 hr D. Blood pressure decrease from 138/88 to 126/78 mm Hg
A
The nurse is caring for a group of patients with acidosis. The nurse recognizes that Kussmaul respirations are consistent with which situation? A. Aspirin overdose B. Use of hydrochlorothiazide C. Administration of sodium bicarbonate D. Patient receiving mechanical ventilation
A
The primary health care provider prescribes intravenous administration of 100 mL of 20% glucose along with 20 units of insulin in a patient who is receiving furosemide therapy. What is the probable diagnosis of the patient? A. Hyperkalemia B. Hyperglycemia C. Hypernatremia D. Hypercalcemia
A
The student nurse is explaining body responses to alterations of fluid balance. Which statement made by the student requires correction? A. "Natriuretic peptides (NPs) are secreted by the kidneys to restore tissue perfusion." B. "The hypothalamus contains osmoreceptors that are sensitive to changes in blood osmolarity." C. "Antidiuretic hormone (ADH) is released from the posterior pituitary gland in response to changes in blood osmolarity." D. "Aldosterone is secreted by the adrenal cortex whenever sodium levels in the extracellular fluid are low."
A
What is the preferred diuretic used for patients with hypokalemia? A. Amiloride B. Furosemide C. Bumetanide D. Chlorothiazide
A
When planning care for a patient with hypercalcemia, which intervention does the nurse consider? A. Monitor cardiac rhythm for changes. B. Limit activities to protect against injury. C. Assess oxygen saturation levels every 4 hours. D. Avoid invasive procedures due to increased bleeding tendency
A
Which age-related change to fluid balance does the nurse anticipate when conducting a neurologic assessment for an older adult patient? A. Decreased thirst reflex B. Increased urine output C. Increased muscle mass D. Decreased sweat production
A
Which arterial blood gas laboratory values would be seen in metabolic alkalosis? A. pH 7.49, HCO 3 - 32 B. pH 7.28, CO 2 54 C. pH 7.53, CO 2 28 D. pH 7.31, HCO 3 - 18
A
Which assessment finding would cause the kidneys to secrete renin in order to increase blood pressure and maintain perfusion and fluid balance? A .Sodium 130 mEq/L B. PaO 2 98% on room air C. Blood pressure 130/82 mm Hg D. Heart rate of 88 beats per minute
A
Which electrolyte deficiency results in decreased depolarization in the excitable cells and increased cellular swelling? A. Sodium B. Calcium C. Potassium D. Magnesium
A
Which electrolyte imbalance does the nurse anticipate in association with a serum magnesium reading of 1.1 mEq/L? A. Calcium 7.8 mg/dL B. Sodium 149 mEq/L C. Potassium 5.7 mEq/L E. Phosphorus 2.6 mg/dL
A
A patient who recently experienced an anterior neck injury reports frequent and painful muscle spasms in the calf during sleep. Which condition does the nurse suspect in the patient? A. Hypokalemia B. Hypocalcemia C. Hyponatremia D. Hypophosphatemia
B
An older adult patient is admitted with dehydration. Which nursing assessment data identify that the patient is at risk for falling? A. Dry oral mucous membranes B. Orthostatic blood pressure changes C. Serum potassium level of 4.0 mEq/L D. Pulse rate of 72 beats/min and bounding
B
When caring for a group of patients at risk for respiratory acidosis, the nurse identifies which person as at highest risk? A. An athlete in training B. Patient who smokes cigarettes C. Person with uncontrolled diabetes D. Pregnant woman with hyperemesis gravidarum
B
When caring for a patient with kidney failure who has metabolic acidosis, which symptom does the nurse expect as evidence of the body's compensatory effort? A. Pallor and diaphoresis B. Rapid and deep respirations C. Bradycardia and bounding pulse D. Hypotension and weak, thready pulse
B
Which assessment findings would indicate decreased tissue perfusion stimulating the secretion of renin from the kidney tubular system? Select all that apply. A. High urine output B. Low blood volume C. Low blood oxygen D. High blood sodium E. High blood pressure
B, C
A patient is admitted with severe diabetic ketoacidosis. Arterial blood gas results reveal a pH of 7.21. What is this patient's acidosis most likely in response to? A. Anaerobic metabolism B. Excessive intake of insulin C. Excessive breakdown of fatty acids D. Excessive intake of alcoholic beverages
C
A patient receiving insulin and glucose infusion therapy for hyperkalemia now has a serum potassium level of 3.6 mEq/L. What is the nurse's first action? A. Stop the infusion immediately. B. Continue the infusion at the prescribed rate. C. Assess the patient's heart rate, rhythm, and respiratory status. D. Slow the infusion and increase the frequency of vital sign assessment.
C
The nurse is performing discharge dietary teaching for a patient with hyperkalemia. Which statement does the nurse include in the teaching? A. "You may use salt substitutes." B. "You don't need to restrict dairy products." C. "You may eat apples, strawberries, and peaches." D. "You may eat avocados, broccoli, and cantaloupe."
C
Which patient is at greatest risk for hypernatremia? A. 30-year-old on a low-salt diet B. 42-year-old receiving hypotonic fluids C. 54-year old who is sweating profusely D. 17-year-old with a serum blood glucose of 189 mg/dL
C
A patient admitted to the emergency department is having an acute episode of asthmatic bronchitis. The nurse notes the pH on the most recent arterial blood gas is 7.31. What is the most likely explanation for this finding? A. Acidosis in response to the presence of excessive ketoacids B. Alkalosis in response to the excessive loss of hydrogen ions C. Alkalosis in response to the excessive retention of bicarbonate D. Acidosis in response to the excessive retention of carbon dioxide
D
What is the major cause of death in patients diagnosed with hypokalemia? A. Stroke B. Renal failure C. Cardiac arrest D. Respiratory insufficiency
D
Which electrolyte abnormality does the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis? A. Hyponatremia B. Hypernatremia C. Hypokalemia D. Hyperkalemia
D
Which increased blood arterial level causes a compensatory increase in respiration rate? A. pH B. Lactate C. Bicarbonate D. Carbon dioxide
D
Which newly written prescription does the nurse administer first? A. Oral calcium supplements to a patient with severe osteoporosis B. Oral phosphorus supplements to a patient with acute hypophosphatemia C. Intravenous (IV) normal saline to a patient with a serum sodium of 132 mEq/L D. Oral potassium chloride (KCl) to a patient whose serum potassium is 3 mEq/L
D
Which organs play major roles in maintaining pH balance in the body? A. Lungs and liver B. Kidneys and brain C. Liver and pancreas D. Lungs and kidneys
D
Which person attending an all-day outdoor festival on a hot August day is at greatest risk for dehydration? A. 32-year-old man consuming alcoholic beverages B. 28-year-old woman with type 1 diabetes mellitus C. 68-year-old man who frequently wipes sweat from his forehead D. 72-year-old woman appearing to be at least 20 pounds overweight
D
What is a risk factor associated with tachypnea? A. Increased heart rate B. Increased urine output C. Increased blood volume D. Increased insensible water loss
D
Laboratory results for a patient with a large draining abdominal wound show a serum sodium decrease from 138 mEq/L to 131 mEq/L. What is the nurse's first action? A. Establish intravenous (IV) access. B. Assess for orthostatic hypotension. C. Assess the patient's respiratory status. D. Notify the provider of laboratory results
C
Which hormone regulates fluid and electrolyte balance by preventing water and sodium loss? A. Antidiuretic B. Thyrotropin C. Aldosterone D. Natriuretic peptide (NP)
C
A diabetic patient shows symptoms of diabetic ketoacidosis. What mechanism causes acidosis in this patient? A. Overproduction of hydrogen ions B. Underelimination of hydrogen ions C. Overelimination of bicarbonate ions D. Underproduction of bicarbonate ions
A
Which fruit will the nurse remove from the dietary tray of a patient with high potassium levels? A. Kiwi B. Berries C. Apricots D. Grapefruit
A
Which nursing action is recommended when providing care to a patient with hypokalemia? A. Question the continued administration of bumetanide. B. Administer prescribed oral potassium chloride before a meal or snack. D. Establish a peripheral IV, preferably in the hand, for administering IV potassium chloride. E. Obtain the prescribed vial of IV potassium chloride from the pharmacy and dilute before administration
A
When assessing patients for potential fluid imbalances, what factors does the nurse know affect the amount and distribution of body fluids? Select all that apply. A. Age B. Poverty C. Activity D. Gender E. Body fat F. Cognition
A, D, E
Which conditions can cause metabolic acidosis? Select all that apply. A. Diarrhea B. Liver failure C. Kidney failure D. Airway obstruction E. Respiratory depression
A, B, C
Which arterial blood gas reading does the nurse anticipate in a patient diagnosed with chronic obstructive pulmonary disease (COPD)? A. pH 7.33, PaO 2 65 mm Hg, PaCO 2 41 mm Hg, HCO 3 - 19 mEq/L B. pH 7.36, PaO 2 63 mm Hg, PaCO 2 52 mm Hg, HCO 3 - 32 mEq/L C. pH 7.48, PaO 2 82 mm Hg, PaCO 2 32 mm Hg, HCO 3 - 25 mEq/L D. pH 7.36, PaO 2 72 mm Hg, PaCO 2 30 mm Hg, HCO 3 - 18 mEq/L
B
Which electrolyte imbalance should be anticipated and monitored in a patient with hyperphosphatemia? A. Hypokalemia B. Hypocalcemia C. Hypernatremia D. Hypermagnesemia
B
The nurse is planning care for a 72-year-old resident of a long-term care facility who has a history of dehydration. Which action does the nurse delegate to unlicensed assistive personnel (UAP)? A. Choosing appropriate oral fluids B. Monitoring skin turgor for tenting C. Offering fluids to drink every hour D. Assessing oral mucosa for dryness
C
What history and assessment findings may be associated with hypocalcemia in a 22-year-old man? Select all that apply. A. Absent bowel sounds B. Tingling around the mouth C. Awakening at night with muscle spasms in the calf D. Decreased deep tendon reflexes without paresthesia E. Recent blunt trauma to the throat during a football game
B, C, E
Which foods will the nurse teach a patient with hyperkalemia to avoid? Select all that apply. A. Sugar B. Oranges C. Broccoli D. Cranberries E. Dairy products
B, C, E
The nurse is caring for a patient with metabolic alkalosis. What manifestations of metabolic alkalosis is the nurse likely to assess? Select all that apply. A. Decrease in heart rate B. Numbness around the mouth C. Increase in handgrip strength D. Presence of Kussmaul respiration E. Hyperactivity of deep tendon reflexes
B, E
When caring for a group of patients at risk for metabolic acidosis, the nurse identifies which person as at highest risk? A. An athlete in training B. Patient who smokes cigarettes C. Person with uncontrolled diabetes D. Pregnant woman with hyperemesis gravidarum
C
Which consequence of fluid overload may result in seizures, coma, and death? A. Decreased hematocrit B. Decreased hemoglobin C. Decreased serum proteins D. Decreased serum sodium and potassium levels
D
Which are common symptoms of hypokalemia? Select all that apply. A. Paresthesia B. Bradycardia C. Shallow respirations D. Weak, thready pulse E. Musculoskeletal weakness
C, D, E
Which conditions can cause metabolic alkalosis? Select all that apply. A. Diarrhea B. Liver failure C. Kidney failure D. Airway obstruction E. Respiratory depression
D, E
After a motor vehicle crash, the nurse is consoling a patient in the emergency department who is hysterical and hyperventilating after being notified of the death of a family member. What acid-base imbalance is this patient likely to develop? A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
D
The nurse instructs an older adult patient to increase intake of dietary potassium when the patient is prescribed which classification of drugs? A. Beta blockers B. Corticosteroids C. Alpha antagonists D. High-ceiling (loop) diuretics
D
When caring for a patient with hyponatremia, which intervention does the nurse implement? A. 2-gram sodium diet B. Administration of furosemide C. Intravenous administration of 0.45% normal saline D. Small-volume intravenous infusions of 3% normal saline
D
A patient with Crohn's disease reports numbness, tingling, and painful muscle contractions. After assessing the deep tendon reflexes of the patient, which intervention does the nurse perform next? A. Intravenous administration of sodium B. Intravenous administration of bicarbonate C. Intravenous administration of phosphorus D. Intravenous administration of magnesium sulfate
d