fluid and electrolyte pre test questions

Lab chemistry results reveal a client's serum sodium is within normal range. Based on this finding , how would the nurse estimate the client's serum (plasma) osmolality?

270 to 29 mOsm/kg

The nurse evaluates that discharge teaching has been effective when the client with hypocalcemia states:

"I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."

Which of the following statements made by the nurse is correct when performing client education regarding oral potassium supplementation?

"Take your potassium tablet after you have eaten breakfast."

A client has a parenteral nutrition infusion of 25% dextrose. A student nurse asks the nurse why a peripherally inserted central catheter (PICC) was inserted. Which response by the nurse is most appropriate?

"The 25% dextrose is hypertonic and will be more rapidly diluted when given through a central line."

A patient arrives to the emergency department with gastritis and subsequent dehydration. The admitting nurse records the patient has been experiencing nausea and vomiting with diarrhea for the past several days. The doctor orders a continuous intravenous (IV) infusion. Which IV solution does the nurse anticipate administering?

0.9% saline solution

Which of the following clients is at highest risk for developing fluid volume deficit?

A 76-year-old client who has an NG tube to low suction following colon cancer surgery

A client who is taking a potassium-wasting diuretic for treatment of hypertension complains of generalized weakness. It is most appropriate for the nurse to take which action?

Ask the health care provider to order a basic metabolic panel.

A client comes to the clinic complaining of frequent, watery stools for the last 2 days. Which action should the nurse take first?

Check the client's blood pressure.

The nurse assesses a patient who has been hospitalized for 2 days. The patient has been receiving normal saline IV at 100 mL/hr, has a nasogastric tube to low suction, and is NPO. Which assessment finding would be a priority for the nurse to report to the health care provider?

Gradually decreasing level of consciousness (LOC)

Which of the following serum electrolyte imbalances would the nurse assess for in a client with a high fever and severe dehydration?

Hypernatremia and hypercholeremia

A 53-year-old homeless person is admitted with dehydration. Which type of intravenous (IV) fluid should be avoided when treating this patient?

Hypertonic fluid

A postoperative client who had surgery for a perforated gastric ulcer has been receiving nasogastric suction for 3 days. The client now has a serum sodium level of 127 mEq/L (127 mmol/L). Which prescribed therapy should the nurse question?

Infuse 5% dextrose in water at 125 mL/hr.

Intravenous (IV) potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take?

Infuse the KCl at a rate of 10 mEq/hour.

When administering 25% albumin to a client, the nurse can expect fluids to move from the:

Interstitial to intracellular space.

Which finding suggests to a nurse that a client has received too much magnesium sulfate?

Muscle weakness

An older client receiving iso-osmolar continuous tube feedings develops restlessness, agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately?

Na+ 154 mEq/L

A nurse is caring for a client with a suspected overdose of magnesium containing antacids and laxatives. On admission, the client's magnesium level was greater than 3mg/dl. Which signs and symptoms would a nurse expect to see? (Select all that apply).

Nausea and vomiting Hypotension Flushing

A client with renal failure has been taking aluminum hydroxide/magnesium hydroxide suspension at home for indigestion. The client arrives for outpatient hemodialysis and is unresponsive to questions and has decreased deep tendon reflexes. Which action should the dialysis nurse take first?

Notify the patient's health care provider.

A client who has been receiving diuretic therapy is admitted to the emergency department with a serum potassium level of 3.0 mEq/L. The nurse should alert the health care provider immediately that the patient is on which medication?

Oral digoxin 0.25 mg daily

Following a thyroidectomy, a patient complains of "a tingling feeling around my mouth." Which assessment should the nurse complete immediately?

Presence of the Chvostek's sign

Which of the following interventions is not warranted in planning care for a client with hypernatremia?

Restricting fluids to 1,200 ml daily

A nursing diagnosis that would be appropriate for a patient with calcium deficit would be

Risk for injury related to electrolyte imbalance, tetany, and seizure

During the admission process, the nurse obtains information about a patient through the physical assessment and diagnostic testing. Based on the data shown in the accompanying figure, which nursing diagnosis is appropriate?

Risk for injury: Seizures

After receiving change-of-shift report, which client should the nurse assess first? The client with

a serum magnesium level of 1.1 mEq/L who has tremors and hyperactive deep tendon reflexes

A nurse is teaching a group of athletes how to prevent excess fluid loss. The nurse tells them to consume fluids when they

are thirsty

A patient's phosphorous level is elevated. Which of the following electrolytes should you expect to be decreased?

calcium

A nurse in the outpatient clinic is caring for a client who has a magnesium level of 1.3 mg/dL. Which assessment would be most important for the nurse to make?

daily alcohol intake

An older adult client who is malnourished presents to the emergency department with a serum protein level of 5.2 g/dL. The nurse would expect which clinical manifestation?

edema

A client receives 3% NaCl solution for correction of hyponatremia. Which assessment is most important for the nurse to monitor for while the patient is receiving this infusion?

lung sounds

A client returned from the PACU with a nasogastric tube in place. The health care provider's order states "irrigate NG tube every 4 hours." Which solution is the best irrigant?

saline solution

The nurse is assessing a client with hypercalcemia. The nurse expects neuromuscular examination to show:

A positive Trousseau's sign.

A newly admitted client is diagnosed with hyponatremia. When making room assignments, the charge nurse should take which action?

Assign the client to a room near the nurse's station.

A client is admitted with dehydration. A nurse determines which of the following lab values are consistent with fluid volume deficit?

Serum osmolarity of 305 mOsm/kg

Lactated ringers solution has an osmolarity of 273. By administering this, a nurse knows that fluid will

Stay in the vascular space

A patient is admitted to the emergency department with severe fatigue and confusion. Laboratory studies are done. Which laboratory value will require the most immediate action by the nurse?

Serum calcium is 18 mg/dL.

When assessing a pregnant patient with eclampsia who is receiving intravenous (IV) magnesium sulfate, which finding should the nurse report to the health care provider immediately?

The patellar and triceps reflexes are absent.

A patient has a serum calcium level of 7.0 mEq/L. Which assessment finding is most important for the nurse to report to the health care provider?

The patient is experiencing laryngeal stridor.

A patient with lung cancer is receiving a 3% saline continuous IV infusion for syndrome of inappropriate diuretic hormone . Which assessment data will require the most rapid response by the nurse?

There are crackles audible throughout both lung fields.