Prep U Fluid and Electrolytes
The nurse is caring for a client in the intensive care unit (ICU) following a near-drowning event 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 (155 mmol/L) b) 145 mEq/L (145 mmol/L) c) 135 mEq/L (135 mmol/L) d) 125 mEq/L (125 mmol/L)
a) 155 mEq/L
The nurse is caring for a client with a serum sodium concentration of 113 mEq/L (113 mmol/L). The nurse should monitor the client for the development of which condition? a) Confusion b) Headache c) Nausea d) Hallucinations
a) confusion
You are caring for a new client on your unit who is third-spacing fluid. You know to assess for what type of edema? a) Generalized b) Dependent c) Brassy d) Pitting
a) generalized
Which is the preferred route of administration for potassium? a) Oral b) Subcutaneous c) IV (intravenous) push d) Intramuscular
a) oral
Which electrolyte is a major cation in body fluid? a) Potassium b) Chloride c) Bicarbonate d) Phosphate
a) potassium
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
A client is diagnosed with hypocalcemia and the nurse is teaching the client about symptoms. What symptom would the nurse include in the teaching? a) tingling sensation in the fingers b) polyuria c) flank pain d) hypertension
a) tingling sensation in the fingers
A nurse can estimate serum osmolality at the bedside by using a formula. A patient who has a serum sodium level of 140 mEq/L would have a serum osmolality of: a) 210 mOsm/kg. b) 280 mOsm/kg. c) 230 mOsm/kg. d) 250 mOsm/kg.
b) 280 mOsm/kg.
The nurse is caring for a 72-year-old client who has been admitted to the unit for a fluid volume imbalance. The nurse knows which of the following is the most common fluid imbalance in older adults? a) Hypervolemia b) Dehydration c) Fluid volume excess d) Hypovolemia
b) dehydration
A client is being treated in the ICU 24 hours after having a radical neck dissection completed. The client's serum calcium concentration is 7.6 mg/dL (1.9 mmol/L). Which physical examination finding is consistent with this electrolyte imbalance? a) Negative Chvostek sign b) Presence of Trousseau sign c) Slurred speech d) Muscle weakness
b) presence of a trousseau sign
A nurse reviews the arterial blood gas (ABG) values of a client admitted with pneumonia: pH, 7.51; PaCO2, 28 mm Hg; PaO2, 70 mm Hg; and HCO3--, 24 mEq/L. What do these values indicate? a) Metabolic alkalosis b) Respiratory alkalosis c) Metabolic acidosis d) Respiratory acidosis
b) respiratory alkalosis
A nurse is reviewing a report of a client's routine urinalysis. Which value requires further investigation? a) Absence of glucose b) Specific gravity of 1.02 c) Urine pH of 3.0 d) Absence of protein
c) urine pH of 3.0
The calcium concentration in the blood is regulated by which mechanism? a) Thyroid hormone (TH) b) Adrenal gland c) Androgens d) Parathyroid hormone (PTH)
d) Para-TH
A client with hypervolemia asks the nurse by what mechanism the sodium-potassium pump will move the excess body fluid. What is the nurse's best answer? a) Free flow b) Passive elimination c) Passive osmosis d) Active transport
d) active transport
A client with emphysema is at a greater risk for developing which acid-base imbalance? a) metabolic acidosis b) metabolic alkalosis c) respiratory alkalosis d) chronic respiratory acidosis
d) chronic respiratory acidosis
A client has been diagnosed with an intestinal obstruction and has a nasogastric tube set to low continuous suction. Which acid-base disturbance is this client at risk for developing? a) Respiratory acidosis b) Respiratory alkalosis c) Metabolic acidosis d) Metabolic alkalosis
d) metabolic alkalosis
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: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L b) pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L c) pH: 7.40, PaCO2: 40 mm Hg, HCO3-: 24 mEq /L d) pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L
d) pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L
The nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease (COPD) and is experiencing respiratory acidosis. The client asks what is making the acidotic state. What does the nurse identify as the result of the disease process that causes the fall in pH? a) The lungs are unable to breathe in sufficient oxygen. b) The lungs are unable to exchange oxygen and carbon dioxide. c) The lungs have ineffective cilia from years of smoking. d) The lungs are not able to regulate carbonic acid levels.
d) the lungs are not able to regulate carbonic acid levels
