LS 1 Week 4 Chapter 13 Fluid and Electrolytes: Balance and Disturbance

The nurse is caring for a client diagnosed with bulimia. The client is being treated for a serum potassium concentration of 2.9 mEq/L. Which statement made by the client indicates the need for further teaching? a. "I can use laxatives and enemas but only once a week" b. I will be sure to buy frozen vegetables when I grocery shop" c. A good breakfast for me will include milk and a couple of bananas" d. "I will take a potassium supplement daily as prescribed?

a. "I can use laxatives and enemas but only once a week"

Below which serum sodium concentration might convulsions or coma occur? a. 135 mEq/L b. 142 mEq/L c. 140 mEq/l d. 145 mEq/L

a. 135 mEq/L

Hypokalemia can cause which symptom to occur? a. Excessive thirst b. Increased release of insulin c. Decreased sensitivity to digitalis d. Production of concentrated urine

a. Excessive Thirst

Which factor increases blood urea nitrogen (BUN)> a. Gastrointestinal bleeding b. Overhydration c. Hypothermia d. Decreased Protein

a. Gastrointestinal bleeding

A client experiencing a severe anxiety attack and hyperventilating presents to the emergency department. The nurse would expect the client's pH value to be a. 7.35 b. 7.50 c. 7. 45 d. 7.30

b. 7.50

When evaluating arterial blood gases (ABGs), which value is consistent with metabolic alkalosis? a. HCO 21 mEq/L b. O saturation 95% c. PaCO 36 d. pH 7.48

d. pH 7.48

The nurse caring for a client in the intensive care unit (ICU) following a near-drowning even in saltwater. The client is restless, lethargic, and demonstrating tremors. Additional assessment findings include swollen and dry tongue, flushed skin, and peripheral edema. The nurse anticipates that the client's serum sodium value would be a. 155 mEq/L b. 145 mEq/L c. 125 mEq/L d. 134 mEq/L

a. 155 mEq/L

The normal serum value for potassium is a. 3.5-5.0 mEq/L (3.5-5.0 mmol/L) b. 96-106 mEq/L (96-106 mmol/L) c. 8.5-10.5 mEq/L (2.13-2.63 mmol/L) d. 135-145 mEq/L (135-145 mmol/L)

a. 3.5-5.0 mEq/L (3.5-5.0 mmol/L)

When caring for a client who has risk factors for fluid and electrolyte imbalances, which assessment finding is the highest priority for the nurse to follow up? a. Irregular heart rate b. Weight loss of 4 lb c. Mild confusion d. Blood Pressure 96/53

a. Irregular heart rate

The nurse is caring for a client with severe diarrhea. The nurse recognizes that the client is at risk for developing which acid-base imbalance? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory acidosis

a. Metabolic acidosis

The calcium concentration in the blood is regulated by which mechanism? a. Parathyroid Hormone (PTH) b. Androgens c. Thyroid Hormone (TH) d. Adrenal gland

a. Parathyroid Hormone (PTH)

Which electrolyte is a major cation in body fluid? a. Potassium b. Chloride c. Phosphate d. Biocarbonate

a. Potassium

A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client serum calcium concentration is 7.6 mg/dL. Which physcial examination finding is consistent with this electrolyte imbalance? a. Presence of Trousseau b Slurred speech c. Negative Chvostek sign d. Muscle weakness

a. Presence of Trousseau

The nurse is caring for a client who was admitted with fluid volume excess (FVE). Which nursing assessments should the nurse include in the ongoing monitoring of the client? Select all that apply a. Skin assessment for edema and turgor b. Nutritional status and diet c. Intake and output, urine volume, color d. Strength testing for muscle wasting e. Blood pressure, heart rate, rhythm

a. Skin assessment for edema and turgor c. Intake and output, urine volume, color e. Blood pressure, heart rate, rhythm

A client with cancer is being treated on the oncology unit for bilateral breast cancer. The client is undergoing chemotherapy. The nurse notes the client's serum calcium concentration is 12.3 mg/dL. Given this laboratory finding, the nurse should suspect that the a. malignancy is causing the electrolyte imbalance b. client may be developing hyperaldosteronism c. client's diet is lacking in calcium-rich food products d. client has a history of alcohol abuse

a. malignancy is causing the electrolyte imbalance

The nurse is analyzing the arterial blood gas (ABG) results of a client diagnosed with severe pneumonia. Which of the following ABG results indicates respiratory acidosis? a. pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L b. pH:7.32, PaCO2: 40mm Hg, HCO3-: 18 mEeq/L c. pH: 7.42, PaCO2: 45 mmHg, HCO3-: 22 mEq/L d. pH: 7.50, PaCO2: 30 mmHg, HCO3-: 24 mEq/L

a. pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L

Which is considered an isotonic solution? a. Dextran in normal saline b. 0.9% Normal Saline c. 3% NaCl d. 0.45% Normal Saline

b. 0.9% Normal Saline

The nurse is caring for a patient with a metabolic acidosis (pH7.25). Which of the following values is uesful to the nurse in determining wheter the cause of the acidosis is due to acid gain or to biocarbonate loss? a. Bicorbonate level b. Anion gap c. Serum sodium level d. PaCo2

b. Anion gap

The nurse is caring for a client with a serum sodium concentration of 113 mEq/L. The nurse should monitor the client for the development of which condition? a. Hallucinations b. Confusion c. Nausea d. Headache

b. Confusion

The nurse is caring for a client with a serum potassium concentration of 6.0 mEq/L. The client is order to recieve oral sodium polystyrene sulfonate and furosemide. What other order should the nurse anticipate giving? a. Change the lactated Ringer solution to 3% saline b. Discontinue the intravenous lactated Ringer solution c. Increase the rate of the intravenous lacted Ringer solution d. Change the Lactated Ringer solution to 2.5% dextrose

b. Discontinue the intravenous lactated Ringer solution

The nurse is assessing a client for local complications of intravenous therapy. Which local complications? Select all that apply a. Infection b. Extravasation c. Hematoma d. Phlebitis e. Air embolism

b. Extravasation c. Hematoma d. Phlebitis e. Air embolism

The nurse is assigned to care for a client with a serum phosphorus concentration of 5.0 mg/dL. The nurse anticipates that the client will also experience which electrolyte imbalance? a. Hypermagnesemia b. Hypocalcemia c. Hyperchloremia d. Hyponatremia

b. Hypocalcemia

Which could be a potential cause of respiratory acidosis? a. Hyperventilation b. Hypoventilation c. Vomiting d. Diarrhea

b. Hypoventilation

Which condition might occur with respiratory acidosis? a. Decreased blood pressure b. Increased intracranial pressure c. Mental alertness d Decreased pulse

b. Increased intracranial pressure

A client with a magnesium concentration of 2.6 mEq/L is being treated on a medical-surgical unit. Which treatment should the nurse anticipate will be used? a. Dialysis b. Intravenous furosemide c. Fluid restriction d. Oral magnesium oxide

b. Intravenous furosemide

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

b. Oral

The nurse is analyzing the electrocardiographic (ECG) rhythm tracing of a client experiencing hypercalemia. Which ECG change is typically assoicated with this electrolyte imbalance? a. Prolonged QT intervals b. Prolonged PR intervals c. Peaked T waves d. Elevated ST segments

b. Prolonged PR intervals

The nurse is caring for a client diagnosed with hyperchloremia. which are signs and symptoms of hyperchloremia? Select all that apply a. Hypotension b. Tachypnea c. Lethargy d. Weakness e. Dehydration

b. Tachypnea c. Lethargy d. Weakness

Oncotic pressure refers to the a. amount of pressure needed to stop the flow of water by osmosis b. osmotic pressure exerted by proteins c. excretion of substances such as glucose through increased urine output. d. number of dissolved particles contained in a unit of fluid

b. osmotic pressure exerted by proteins

Which solution is hypotonic? a. Lactated Ringer Solution b. 5% NaCl c. 0.45% NaCl d. 0.9% NaCl

c. 0.45% NaCl

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

c. Alcoholism

Which is an insensible mechanism of fluid loss? a. Nausea b. Bowel elimination c. Breathing d. Urination

c. Breathing

Which electrolyte is a major anion in body fluid? a. Sodium b. Potassium c. Chloride d. Calcium

c. Chloride

The nurse is caring for a client undergoing alcohol withdrawal. Which serum laboratory value should the nurse monitor most closely? a. Calcium b. Phosphorus c. Magnesium d. Potassium

c. Magnesium

Early signs of hypervolemia include a. decrease in blood pressure b. moist breath sounds c. increased breathing effort and weight gain d. thirst

c. increased breathing effort and weight gain

Clients diagnosed with hypervolemia should avoid sweet or dry food because it a. can lead to weight gain b. obstructs water elimination c. increases the client's desire to consume fluid d. can cause dehydration

c. increases the client's desire to consume fluid

Which arterial blood gas (ABG) result would the nurse anticipate for a client with a 3-day history of vomiting? a. pH: 7.45, PaCO2: 32 mm Hg, HCO3-: 21 b. pH: 7.34, PaCo2: 60 mm Hg, HCO3-: 34 c. pH: 7.55, PaCo2: 60 mm Hg, HCO3-: 28 d. pH: 7.28, PaCO2: 25 mm Hg, HCO3-: 15

c. pH: 7.55, PaCo2: 60 mm Hg, HCO3-: 28

The nurse is instructing a client with recurrent hyperkalemia about following a potassium-restricted diet. Which statement by the client indicates the need for additional instruction? a. "Bananas have a lot of potassium in them; I'll stop buying them" b. "I'll drink cranberry juice with my breakfast instead of coffee" c. "I need to check to see whether my cola beverages has potassium in it" d. "I will not salt my food; instead I'll use salt subsititue"

d. "I will not salt my food; instead I'll use salt subsititue"

A client is to receive hypotonic IV solution in order to provide free water replacement. Which solution does the nurse anticipate administering? a. Lactated Ringer Solution b. 0.9% NaCl c. 5% NaCl d. 0.45% NaCl

d. 0.45% NaCl

What percentage of potassium excreted daily leaves the body by way of the kidneys? a. 40 b. 60 c. 20 d. 80

d. 80

Which statement accurately reflects a rule of thumb on which the nurse may rely in assessing a client's fluid balance? a. Minimal intake of 2 L/day b. Minimal urine output of 50 mL/hour c. Minimal urine output of 10 mL/hour d. Minimal intake of 1.5 L/day

d. Minimal intake of 1.5 L/day

A nurse is caring for a client with acute renal failure and hypernatremia. In this case ,which action can be delegated to the nursing assistant? a. Teach the client about increased fluid intake b. Assess the client weight daily for trends c. Monitor for signs and symptoms of dehydration d. Provide oral care every 2-3 hours

d. Provide oral care every 2-3 hours

The nurse is participating in the care of a client who had a peripherally inserted central catheter (PICC) placed in the right arm. After catheter placement, the nurse should complete which action? a. Assess the client's blood pressure (BP) on the right arm b. Obtain written consent for the procedure c. Administer the prescribed IV fluids d. Send the client for a chest x-ray

d. Send the client for a chest x-ray

Which condition leads to chronic respiratory acidosis in older adults? a. Overuse of sodium bicarbonate b. Decreased renal function c. Erratic meal patterns d. Thoracic skeletal change

d. Thoracic skeletal change