Fluid & Electrolytes

Which food would a nurse instruct the client to include in the diet when being prescribed furosemide?

bananas

Which hormone aids in regulating intestinal calcium and phosphorous absorption?

glucocorticoids

Which action is characteristic of the hormone vasopressin?

helps produce concentrated urine

Which statement would the nurse use to respond to an older adult client who states, "I walk 2 miles [3.2 km] a day for exercise, but now that the weather is hot, I am worried about becoming dehydrated"?

"Fluids should be increased if the urine becomes darker."

Which statement would the nurse include when teaching about pneumaturia to a coworker?

"It is the passage of urine containing gas."

Which statement indicates the client with chronic kidney disease understands the purpose of using continuous ambulatory peritoneal dialysis (CAPD)?

"The treatment uses the peritoneum as a semipermeable membrane to clear toxins by osmosis and diffusion."

Which information would the nurse include in response to a client's questioning a protein-restricted dietary change required for acute kidney injury?

"This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys."

Which response would be given by a nurse providing discharge teaching to an older adult who was admitted to the hospital to be treated for dehydration when the client asks what to do about itchy, dry skin?

"Use a moisturizer on the skin daily to help reduce itching."

The client needs 8 mg of morphine sulfate to be given by injection. The vial on hand contains 10 mg of morphine per milliliter. How many milliliters will the nurse administer?

0.8 mL

Place the following nursing actions in the order for a client with esophageal varices prescribed a blood transfusion.

1. Check the client's vital signs. 2. Establish intravenous (IV) access with IV normal saline. 3. Verify the blood product with another nurse against the client's identification (ID) bracelet. 4.Monitor the client's vital signs and status according to agency policy

The provider has ordered endocrine testing for a client. Arrange the steps to be followed for the urine specimen collection in the correct sequence.

1. empty the bladder and discard the urine. 2. the timing for the urine collection begins after this specimen. 3. note the time. 4. empty bladder at the end of the timed period and add urine to the collection.

The nurse administers two units of packed red blood cells ([RBCs] 250 mL each), followed by 500 mL of 0.9% sodium chloride. How many mL of solution has infused?

1000 mL

A client with heart failure weighed 175 lb yesterday, and today's weight is 181 lb. How many milliliters of fluid has the client retained?

2700

An IV antibiotic in 50 mL of 0.9% sodium chloride needs to be administered over 20 minutes. The nurse will set the infusion pump to deliver how many milliliters per hour?

150 mL/hr

A client is to receive 2000 mL of intravenous (IV) fluid in 12 hours. The nurse will set the control device to deliver how many milliliters per hour?

167 mL/h

A client is to receive 125 mL of intravenous (IV) fluid every hour. The drop factor of the IV tubing is 10 gtt/mL. How many drops per minute will the nurse administer?

21 gtts/min

During an 8-hour shift a client drinks two 6-oz (180-mL) cups of tea and vomits 125 mL of fluid. Intravenous fluids absorbed equaled the urinary output. What is the client's fluid balance during this 8-hour period?

235 mL

Which gauge size would the nurse choose for a peripheral catheter insertion to administer saline to an infant?

24 gauge

Which length of time is the maximum that the nurse would allow an intravenous bag of solution to infuse?

24 hours

The nurse receives an order to prepare the solution for administering a cleansing enema to a 3-year-old child. Which is the volume of solution the nurse would prepare?

250-350 mL

Upon pressure application, which degree of edema would the nurse document for a 6-mm deep indentation?

3+

The nurse would assess for which electrolyte imbalance during the first 48 hours after a client has sustained a thermal injury?

hyperkalemia and hyponatremia

The client needs to receive 1 L of intravenous fluid every 8 hours. If the equipment delivers 15 drops/mL, the nurse will regulate the flow to deliver how many drops per minute?

31 drops/minute

During a 12-hour shift, a client has a 6-oz (180-mL) cup of tea and 360 mL of water. The client vomits 100 mL, and the instilled intravenous (IV) fluids equaled the urinary output. Which fluid balance would the nurse record for the 12-hour period?

440 mL

Which number would a nurse document as the client's fluid balance after an 8-hour shift where a client has a 6-oz (180-mL) cup of tea and 360 mL of water, vomits 100 mL, and the instilled intravenous (IV) fluids equaled the urinary output?

440 mL

IV fluid replacement of 7200 mL during the first 24 hours has been prescribed for a client with severe burns. Fifty percent of fluid replacement will be administered in the first 8 hours; then the remaining 50% given over the next 16 hours. How many mL/hr will the nurse infuse during the first 8 hours?

450 mL/hr

Which volume of solution would be prepared when the nurse receives an order to prepare a solution for administering a cleansing enema for an adolescent client?

500 to 750 mL

At 10:00AM the nurse hands a 1000-mL bag of 5% dextrose in water with 20 mEq of potassium chloride to be administered at 80 mL/h. At noon the health care provider prescribes a stat infusion of IV antibiotic of 100 mL to be administered via piggyback over 1 hr. How much longer than expected will it take the primary bag to empty if the nurse interrupts the primary infusion for infusion of the antibiotic?

60 minutes

One liter of 5% dextrose solution contains 50 grams of sugar. The nurse calculates that 3 L solution/day will supply approximately how many kilocalories?

600

Which percentage of total body water is found in a premature newborn?

85%

Which assessment finding indicates that sodium polystyrene sulfonate has been effective?

A decrease in serum potassium level

Which blood type must a person have to be a universal recipient?

AB

Which action would the nurse implement first for a client whose serum potassium level has increased to 5.8 mEq/L (5.8 mmol/L)?

Assess vital signs

Which goal would the nurse expect a client receiving treatment for bacterial cystitis to achieve before their discharge from the hospital?

Achieve relief of clinical symptoms and maintain kidney function

Which factor is the most probable cause for Conn syndrome in an adult client?

Adrenal adenoma

Which hormonal imbalance would the nurse suspect in a client who has low serum sodium levels?

Aldosterone

Administration of which medication in relation to which changes in fluid intake can help prevent complications related to uric acid nephropathy in a client with lymphosarcoma is receiving allopurinol and methotrexate?

Allopurinol and encouraging increased fluid intake

Which would the nurse assess for if unilateral injury of the laryngeal nerve was suspected, when caring for a client immediately after a subtotal thyroidectomy?

Ask the client to say what the current time is.

Which priority action will the nurse take after stopping an IV piggyback antibiotic of a client who became restless, flushed and began to wheeze shortly after initiation?

Assess the client's respiratory status

Which action would the nurse include in the plan of care for a client undergoing a transsphenoidal hypophysectomy? SATA

Assessing for clear nasal drainage Maintaining strict intake and output Increasing daily dietary fiber intake Elevating the head of the bed 30 degrees Instructing on the use of an incentive spirometer

A client with a diagnosis of malabsorption syndrome exhibits a symptom of spastic muscle spasms. Which electrolyte is responsible for this symptom?

Calcium

Which medication will the nurse expect the health care provider to prescribe to a client who had a thyroidectomy and is pale with spasms of the hand when taking the blood pressure?

Calcium

Which nutrient deficiency in the pregnant adolescent may result in decreased birthweight as a consequence of low bone mineral density in the fetus?

Calcium

A pregnant client with severe preeclampsia is receiving intravenous magnesium sulfate. Which item would the nurse keep at the bedside in case of magnesium sulfate toxicity?

Calcium gluconate

Which collecting structure is located at the end of the renal papilla?

Calyx

When a client who is taking a diuretic has been instructed to eat foods high in potassium, which fruit would the nurse suggest?

Cantaloupe

The diagnostic reports of a client who underwent a hypophysectomy indicate an intracranial pressure (ICP) of 20 mm Hg. Which action made by the client is responsible for the reported ICP?

bending over at the waist

Which action will the nurse take when caring for a client whose IV site is tender with erythema, warmth, and mild edema?

Change the IV site

A client who experienced extensive burns is receiving intravenous fluids to replace fluid loss. The nurse would monitor for which initial symptom of fluid overload?

Crackles in the lungs

Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder?

Cystic Fibrosis

Which action is the function of antidiuretic hormone (ADH)?

Decreases water loss in urine

For which reason would clients who receive intravenous (IV) fluids rather than total parenteral nutrition for gastrointestinal problems lose weight?

Deficient carbohydrate intake

Which concern when caring for a client prescribed furosemide 40 mg every day in conjunction with digoxin would prompt the nurse to ask the health care provider about potassium supplements?

Digoxin toxicity occurs rapidly in the presence of hypokalemia

Which conclusion would the nurse make about the assessment finding of a client's very pale-yellow-colored urine?

Dilute urine

Which clinical finding would the nurse anticipate when admitting a client with an extracellular fluid volume excess?

Distended jugular veins

Which action would the nurse include in the plan of care for a client admitted with heart failure who has gained 20 pounds in 3 weeks? SATA

Diuretics Low-salt diet Daily weight checks Fluid restriction Intake and output Oxygen administration

A 2-year-old child is admitted with gastroenteritis and dehydration. Intravenous fluids are prescribed. Which is the most appropriate site for the first intravenous insertion?

Dorsal metacarpals of the hand

Which factor would the nurse recognize as the cause when a client's IV infusion infiltrates?

Failure to secure the catheter adequately.

Which assessment finding of a client with heart failure would prompt the nurse to contact the health care provider? SATA

Fatigue orthopnea pitting edema dry hacking cough 4-pound weight gain

Which statement explains why metabolic acidosis develops with kidney failure?

Inability of the renal tubules to secrete hydrogen ions and conserve bicarbonate

Which statement regarding calcitonin is correct?

Its actions are opposite to that of parathyroid hormone.

Which part of the kidney produces the hormone bradykinin?

Juxtaglomerular cells of the arterioles

In which component of the nephron does furosemide decrease fluid reabsorption? SATA

Loop of henle Distal tubules Proximal tubules

Why would the nurse advise the client of a client who takes furosemide and digoxin for heart failure to drink a glass of orange juice every day?

Maintaining potassium levels

A client with hyperemesis gravidarum is receiving rehydration infusion therapy at home. Which is the priority nursing activity for the home health nurse?

Monitoring the client for signs of electrolyte imbalance

Which action will the nurse take in a client hospitalized for uncontrolled hypertension and chest pain on a daily diuretic for 2 days whose potassium level this morning is 2.7 mEq/L (2.7 mmol/L)?

Notify the healthcare provider that the potassium level is below normal

Which assessment finding in a client signifies a mild form of hypocalcemia?

Numbness around the mouth

The nurse is caring for a client with severe burns and determines that the client is at risk for hypovolemic shock. Which physiological finding supports the nurse's conclusion?

Plasma proteins moving out of the intravascular compartment

Which cation regulates intracellular osmolarity?

Potassium

Which laboratory result is important to communicate quickly to the health care provider?

Potassium 3.0 mEq/L

In which parts of the kidney are glucose and amino acids reabsorbed?

Proximal tubule

Which function would the nurse include when teaching a group of student nurses about the loop of Henle?

Reabsorption of sodium in the ascending limb

The nurse assesses bilateral +4 peripheral edema while assessing a client with heart failure and peripheral vascular disease. Which is the pathophysiological reason for the excessive edema?

Shift of fluid into the interstitial spaces

Which action would the nurse perform first when assessing if an intravenous (IV) infusion of a vesicant has extravasated?

Stop the infusion

A client is 36 hours after admission with severe burns and the nurse identifies the client's potassium level is 6.0 mEq/L (6.0 mmol/L). The nurse would recommend substituting current dietary fluids with which drink?

Tea

While providing care for a client with a second-degree left ankle sprain, the nurse raises the injured part above heart level. Which statement describes the rationale behind this nursing action?

To prevent further edema

Which client problem would the nurse expect to decrease in response to the administration of serum albumin intravenously to a client with ascites?

abdominal girth

When ammonia is excreted by healthy kidneys, which mechanism usually is maintained?

acid-base balance of the body

Which nursing intervention is appropriate when a client is first admitted with hyperglycemic hyperosmolar nonketotic syndrome (HHNS)?

administering fluid replacement

Which gland is affected in aldosteronoma?

adrenal cortex

The nurse administers vasopressin to a client and recalls that the medication is which type of hormone?

antidiuretic hormone

Which hormonal deficiency causes diabetes insipidus in a client?

antidiuretic hormone (ADH)

Which nursing assessment finding is consistent with fluid volume overload from high-flow intravenous (IV) fluid replacement therapy? Select all that apply. One, some, or all responses may be correct.

bounding pulse prescence of dependent edema neck vein distention in the upright position

Which complication would a nurse try to avoid by slowly administering a parenteral preparation of potassium?

cardiac arrest

The nurse is evaluating the effectiveness of a treatment for a client with excessive fluid volume. Which clinical finding indicates that treatment was successful?

clear breath sounds

Which finding during peritoneal dialysis would the nurse act on as a sign of infection?

cloudy return of dialysate

Which component of the client's nephron acts as a receptor site for the antidiuretic hormone to regulate water balance?

collecting ducts

Which clinical finding leads the nurse to conclude that an IV has infiltrated rather than caused inflammation?

coolness

Which pressure change does the nurse determine to be the cause of edema for a client with albuminuria?

decrease in plasma colloid oncotic pressure

Which action is the function of the antidiuretic hormone (ADH)?

decreases water loss in urine

Which medication can cause diabetes insipidus?

demeclocycline

When evaluating fluid loss for a client with burns, which relationship between a client's burned body surface area and fluid loss would the nurse consider?

directly proportional

Which factor must the nurse determine to adjust the drip rate when administering intravenous (IV) fluids to be delivered at 80 mL/h?

drops per milliliter delivered by the infusion set

Which component of the client's nephron delivers blood from the glomerulus into the peritubular capillaries or the vasa recta?

efferent arteriole

How would the nurse respond to a client admitted for dehydration who has an IV infusion of normal saline is started at 125 mL/h and one hour later begins screaming, "I can't breathe!"?

elevate the head of the client's bed and obtain vital signs

Which disease increases the risk of hyperkalemia?

end-stage renal disease

While assessing a client with dehydration, the nurse notices diminished skin elasticity. Which portion of the nurse's hand would the nurse use to perform this assessment?

fingertips

To prevent an adverse outcome while providing care for a client experiencing diarrhea, which client data would the nurse closely monitor?

fluid and electrolyte balance

Which condition is a possible cause of pitting edema on the dorsum of the foot?

fluid and electrolyte imbalance

Which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema?

hypokalemia

Which complication would the nurse suspect when the cardiac monitor shows the appearance of a U wave in a client being treated with intravenous fluids and insulin for diabetic ketoacidosis when the client develops peripheral paresthesias and shortness of breath?

hypokalemia

Which condition would a nurse monitor for in a client who is prescribed bumetanide?

hypokalemia

Which manifestations are exhibited with syndrome of inappropriate secretion of antidiuretic hormone (SIADH)?

hyponatremia and decreased urine output

Which clinical manifestation occurs in a client with vasopressin deficiency?

hypotension

In which category of fluids would the nurse classify an intravenous solution of 0.45% sodium chloride?

hypotonic

Which type of shock would the nurse monitor for in a client with a ruptured abdominal aortic aneurysm?

hypovolemic

Which symptom indicates that a client with inhalation anthrax is in the fulminant stage?

hypoxia

Which physiological alteration would be expected with a higher-than-normal red blood cell count?

increased blood viscosity

Which molecule excessively accumulates in the blood to precipitate the signs and symptoms associated with a diabetic coma?

ketones as a result of rapid fat breakdown, causing acidosis

Which intervention would the nurse implement for a client with a ureteral calculus? Select all that apply. One, some, or all responses may be correct

monitoring intake and output straining the urine at each voiding administering the prescribed analgesic

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide?

muscle weakness

Which clinical finding would the nurse associate with hypokalemia?

muscle weakness,

Which hormone regulates blood levels of calcium?

parathyroid hormone (PTH)

Which laboratory value may indicate hyperfunction of the adrenal gland in a client?

potassium: 2.9 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?

prevent electrolyte imbalance

Which action is promoted by vasopressin?

reabsorption of water

Which information in the response of a client receiving peritoneal dialysis indicates understanding of the purpose of the procedure?

removing toxins and metabolic wastes

For a client admitted with metabolic acidosis, which two body systems would the nurse assess for compensatory changes?

respiratory and urinary

Based on an ECG, a client is suspected to have hypokalemia. Which test will be used to confirm hypokalemia?

serum potassium level

Which diagnostic test will the nurse use to confirm the diagnosis when hypokalemia is suspected?

serum potassium level

The nurse pulls up on the client's skin and releases it to determine whether the skin returns immediately to its original position. Which parameter is the nurse assessing?

skin turgor

Which answer would a nurse give to a client receiving a hemodialysis treatment who asks which substances are being removed?

sodium

Which dietary restriction will the nurse expect to be included in the plan for a client with left ventricular failure?

sodium

Which electrolyte deficiency triggers the secretion of renin?

sodium

Which action will a nurse take first when caring for a client reporting chest pain, difficulty breathing, and feeling cold twenty minutes after an infusion of packed red blood cells begins?

stop the transfusion

When providing care for a client with diarrhea, in which clinical indicator would the nurse anticipate a decrease?

tissue turgor

A child who has a history of a 5-lb weight gain in 1 week and periorbital edema is admitted with a diagnosis of acute glomerulonephritis. How can the nurse obtain the most accurate information on the status of the child's edema?

weighing daily