Patho Ch. 24 -Fluid and Electrolyte Homeostasis and Imbalances

Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration. a. increased serum sodium b. decreased serum sodium c. increased serum potassium d. decreased serum potassium

b. decreased serum sodium

Osmoreceptors located in the hypothalamus control the release of a. angiotensin. b. atrial natriuretic peptide. c. aldosterone. d. vasopressin (antidiuretic hormone, ADH).

d. vasopressin (antidiuretic hormone, ADH).

Manifestations from sodium imbalances occur primarily as a result of a. cellular fluid shifts. b. vascular collapse. c. hyperosmolarity. d. hypervolemia.

a. cellular fluid shifts.

Effects of hypernatremia on the central nervous system typically include a. confusion. b. excitation. c. insomnia. d. hallucinations.

a. confusion.

Signs and symptoms of clinical dehydration include a. decreased urine output. b. increased skin turgor. c. increased blood pressure. d. decreased heart rate.

a. decreased urine output.

Decreased neuromuscular excitability is often the result of a. hypercalcemia and hypermagnesemia. b. hypomagnesemia and hyperkalemia. c. hypocalcemia and hypokalemia. d. hypernatremia and hypomagnesemia.

a. hypercalcemia and hypermagnesemia.

An increase in the resting membrane potential (hyperpolarized) is associated with a. hypokalemia. b. hyperkalemia. c. hypocalcemia. d. hypercalcemia.

a. hypokalemia.

The electrolyte that has a higher concentration in the extracellular fluid than in the intracellular fluid is _____ ions. a. sodium b. phosphate c. magnesium d. potassium

a. sodium

Clinical manifestations of extracellular fluid volume deficit include a. weak pulse, low blood pressure, and increased heart rate. b. thirst, dry mucous membranes, and diarrhea. c. confusion, lethargy, coma, and perhaps seizures. d. cardiac dysrhythmias, paresthesias, and muscle weakness.

a. weak pulse, low blood pressure, and increased heart rate.

Hyperaldosteronism causes a. ECV deficit and hyperkalemia. b. ECV excess and hypokalemia. c. hyponatremia and hyperkalemia. d. excessive water reabsorption without affecting sodium concentration.

b. ECV excess and hypokalemia.

Clinical manifestations of moderate to severe hypokalemia include a. muscle spasms and rapid respirations. b. muscle weakness and cardiac dysrhythmias. c. confusion and irritability. d. vomiting and diarrhea.

b. muscle weakness and cardiac dysrhythmias.

The person at highest risk for developing hypernatremia is a person who a. self-administers a daily tap water enema to manage a partial bowel obstruction. b. receives tube feedings because he or she is comatose after a stroke. c. has ectopic production of ADH from small cell carcinoma of the lung. id. s receiving IV 0.9% NaCl at a fast rate.

b. receives tube feedings because he or she is comatose after a stroke.

What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding? a. Too much sodium in the feedings b. Excess of feedings c .Inadequate water intake d. Kidney failure

c .Inadequate water intake

Which electrolyte imbalances cause increased neuromuscular excitability? a. Hypokalemia and hyperphosphatemia b. Hyperkalemia and hypophosphatemia c. Hypocalcemia and hypomagnesemia d. Hypercalcemia and hypermagnesemia

c. Hypocalcemia and hypomagnesemia

Clinical manifestations of severe symptomatic hypophosphatemia are caused by a. excess proteins. b. renal damage. c. deficiency of ATP. d. hypocalcemia.

c. deficiency of ATP.

Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with a. hyponatremia. b. hypocalcemia. c. hypophosphatemia. d. hypokalemia.

c. hypophosphatemia.

A known cause of hypokalemia is a. oliguric renal failure. b. pancreatitis. c. insulin overdose. d. hyperparathyroidism.

c. insulin overdose.

How do clinical conditions that increase vascular permeability cause edema? a. Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment b. By causing movement of fluid from the vascular compartment into the intracellular compartment, which leads to cell swelling c. Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

d. By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure

What is likely to lead to hyponatremia? a. Insufficient ADH secretion b. Excess aldosterone secretion c. Administration of intravenous normal saline d. Frequent nasogastric tube irrigation with water

d. Frequent nasogastric tube irrigation with water

What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? a. Bottled water, because he is so weak that he might choke on the fluid when he swallows, and water would be less damaging to the lungs than salty soup b. Bottled water, because it will rehydrate his cells c. Salty soup, because he needs nutrition as well as fluid d. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

d. Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid

Which change in a patient's assessment has the greatest urgency? a. Serum potassium concentration is decreasing; abdominal distention, but denies any difficulty breathing b. Serum calcium concentration is decreasing; reports constipation; is alert and denies any discomfort c. Serum calcium concentration is increasing; reports constipation; is alert and denies any discomfort d. Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

d. Serum potassium concentration is increasing; has developed cardiac dysrhythmias, but denies any difficulty breathing

A person who has hyperparathyroidism is likely to develop a. hypokalemia. b. hyperkalemia. c. hypocalcemia. d. hypercalcemia.

d. hypercalcemia.

A patient has a positive Chvostek sign. The nurse interprets this as a sign of a. hypercalcemia. b. hypermagnesemia. c. decreased neuromuscular excitability. d. increased neuromuscular excitability.

d. increased neuromuscular excitability.

Causes of hypomagnesemia include a. hyperphosphatemia. b. chronic alcoholism. c. oliguric renal failure. d. clinical dehydration.

b. chronic alcoholism.

Hypernatremia may be caused by a. decreased aldosterone secretion. b. decreased antidiuretic hormone secretion. c. compulsive water drinking. d. excessive dietary potassium.

b. decreased antidiuretic hormone secretion.

Signs and symptoms of extracellular fluid volume excess include a. tachycardia. b. increased serum sodium concentration. c. bounding pulse. d. increased hematocrit.

c. bounding pulse.

Clinical manifestations of hyponatremia include a. weak pulse, low blood pressure, and increased heart rate. b. thirst, dry mucous membranes, and diarrhea. c. confusion, lethargy, coma, and perhaps seizures. d. cardiac dysrhythmias, paresthesias, and muscle weakness.

c. confusion, lethargy, coma, and perhaps seizures.