PrepU Fluid and Electrolytes

Which of the following solutions is hypotonic? a) 5% NaCl b) 0.9% NaCl c) 0.45% NaCl d) Lactated Ringer's solution

c) 0.45% NaCl

A patient is being treated in the ICU 24 hours after having a radical neck dissection completed. The patient's serum calcium level is 7.6 mg/dL. Which of the following physical examination findings is consistent with this electrolyte imbalance? a) Muscle weakness b) Negative Chvostek's sign c) Slurred speech d) Presence of Trousseau's sign

d) Presence of Trousseau's sign

Select all answer choices that apply. A client was admitted to your 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 his family? Select all that apply. a) Drink at least eight glasses of fluid each day. b) Drink carbonated beverages to help balance fluid volume. c) Drink water as an inexpensive way to meet fluid needs. d) Respond to thirst e) Drink caffeinated beverages to retain fluid.

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

An elderly client takes 40 mg of Lasix twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? a) Hypokalemia b) Hypernatremia c) Hypophosphatemia d) Hyperkalemia

a) Hypokalemia

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? a) Offer the client fluids frequently. b) Instruct the client to breathe into a paper bag. c) Administer ordered supplemental oxygen. d) Administer an ordered decongestant.

b) Instruct the client to breathe into a paper bag.

A 57-year-old homeless female with a history of alcohol abuse has been admitted to your hospital unitwith signs and symptoms of hypovolemia—minus the weight loss. She exhibits a localized enlargement of her abdomen. What condition could she be presenting? a) Anasarca b) Third-spacing c) Pitting edema d) Hypovolemia

b) Third-spacing

A 42-year-old client has chronic hypo natremia, which requires weekly blood labs to keep him from lapsing into convulsions or a coma. What is the level of serum sodium below which convulsions or coma can occur? a) 147 mEq/L b) 140 mEq/L c) 135 mEq/L d) 142 mEq/L

c) 135 mEq/L

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

f) HCO3 c) PaCO2 d) pH

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) A 52-year-old with diarrhea b) A 7-year-old with a fracture tibia c) A 72-year-old with a total knee repair d) A 65-year-old with a myocardial infarction

a) A 52-year-old with diarrhea

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? a) Insensible fluid loss b) Summer allergies c) Lung function d) Cardiovascular compromise

a) Insensible fluid loss

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? a) Respiratory alkalosis b) Respiratory acidosis c) Metabolic acidosis d) Metabolic alkalosis

d) Metabolic alkalosis

The calcium level of the blood is regulated by which mechanism? a) Adrenal gland b) Thyroid hormone (TH) c) Androgens d) Parathyroid hormone (PTH)

d) Parathyroid hormone (PTH)

The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea. What condition that exhibits blood values with a low pH and a low plasma bicarbonate concentration should the nurse assess for? a) Metabolic acidosis b) Respiratory acidosis c) Respiratory alkalosis d) Metabolic alkalosis

a) Metabolic acidosis

Which of the following is a correct route of administration for potassium? a) Oral b) Subcutaneous c) Intramuscular d) IV (intravenous) push

a) Oral

Translocation is a term used to describe the general movement of fluid and chemicals within body fluids. In every client's body, 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? a) Osmosis b) Evaporation c) Filtration d) Active transport

a) Osmosis

A client with a suspected overdose of an unknown drug is admitted to the emergency department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do first? a) Prepare to assist with ventilation. b) Prepare for gastric lavage. c) Monitor the client's heart rhythm. d) Obtain a urine specimen for drug screening.

a) Prepare to assist with ventilation.

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

a) Tachycardia

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)? a) Three ounces of light or dark meat chicken, 1 cup of spaghetti and a garden salad b) Three ounces of sliced ham, beets, and a salad c) A frozen, packaged low-fat dinner with a side salad d) Tomato juice, low-fat cottage cheese, and three slices of bacon

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

A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this client, the nurse's priority should be to assess her: a) electrocardiogram (ECG) results. b) bowel sounds. c) neuromuscular function. d) respiratory rate.

a) electrocardiogram (ECG) results.

A patient is ordered to receive hypotonic IV solution to provide free water replacement. Which of the following solutions will the nurse anticipate administering? a) 5% NaCl b) 0.45% NaCl c) Lactated Ringer's solution d) 0.9% NaCl

b) 0.45% NaCl

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? a) 5% dextrose in normal saline solution b) 0.45% sodium chloride c) 0.90% sodium chloride d) 5% dextrose in water

b) 0.45% sodium chloride

Below which serum sodium level may convulsions or coma can occur? a) 142 mEq/L b) 135 mEq/L c) 145 mEq/L d) 140 mEq/L

b) 135 mEq/L

The nurse is caring for a patient in the intensive care unit (ICU) following a saltwater near-drowning event. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen dry tongue, flushed skin, and peripheral edema. The nurse anticipated that the patient's serum sodium value would be which of the following? a) 125 mEq/L b) 155 mEq/L c) 145 mEq/L d) 135 mEq/L

b) 155 mEq/L

To evaluate a client for hypoxia, the physician is most likely to order which laboratory test? a) Sputum culture b) Arterial blood gas (ABG) analysis c) Red blood cell count d) Total hemoglobin

b) Arterial blood gas (ABG) analysis

Select all answer choices that apply. Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. a) Bradycardia b) Crackles in the lung fields c) Distended neck veins d) Shortness of breath e) Decreased blood pressure

b) Crackles in the lung fields c) Distended neck veins d) Shortness of breath

Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia? a) Hypermagnesemia b) Hypomagnesemia c) Hypercalcemia d) Hypervolemia

b) Hypomagnesemia

Which of the following are the insensible mechanisms of fluid loss? a) Bowel elimination b) Urination c) Breathing d) Nausea

c) Breathing

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

c) Chest pain

Select all answer choices that apply. Which of the following would be appropriate nursing interventions for a client with hypokalemia? Select all that apply. a) Administer the ordered Furosemide (lasix) 60 mg po. b) Monitor intake and output every shift. c) Offer a diet with fruit juices and citrus fruits. d) Administer the ordered Kayexalate enema. e) Administer the ordered potassium 40 mg IV push.

c) Offer a diet with fruit juices and citrus fruits. b) Monitor intake and output every shift.

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

c) Sodium

A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? a) Specific gravity of 1.02 b) Absence of protein c) Urine pH of 3.0 d) Absence of glucose

c) Urine pH of 3.0

A client admitted with acute anxiety has the following arterial blood gas (ABG) values: pH, 7.55; partial pressure of arterial oxygen (PaO2), 90 mm Hg; partial pressure of arterial carbon dioxide (PaCO2), 27 mm Hg; and bicarbonate (HCO3-), 24 mEq/L. Based on these values, the nurse suspects: a) metabolic alkalosis. b) respiratory acidosis. c) respiratory alkalosis. d) metabolic acidosis.

c) respiratory alkalosis.

Which of the following is the most common cause of symptomatic hypomagnesemia? a) IV drug use b) Sedentary lifestyle c) Burns d) Alcoholism

d) Alcoholism

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

d) Fruits such as bananas and apricots

Which set of arterial blood gas (ABG) results requires further investigation? a) pH 7.44, PaCO2 43 mm Hg, PaO2 99 mm Hg, and HCO3- 26 mEq/L b) pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L c) 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 d) pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L

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