Medsurg - Chapter 13: Fluid and Electrolytes: Balance and Disturbance

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

Alcoholism

The nurse is instructing a patient with recurrent hyperkalemia about following a potassium-restricted diet. Which of the following patient statements indicates the need for additional instruction? a) "Bananas have a lot of potassium in them, I'll stop buying them." b) "I need to check if my cola beverage has potassium in it." c) "I will not salt my food, instead I'll use salt substitute." d) "I'll drink cranberry juice with my breakfast instead of coffee."

"I will not salt my food, instead I'll use salt substitute."

Which of the following is considered an isotonic solution? a) 3% NaCl b) 0.9% normal saline c) 0.45% normal saline d) Dextran in NS

0.9% normal saline

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

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) Chest pain c) Slow pulse d) Jaundice

Chest pain

A client presents with anorexia, nausea and vomiting, deep bone pain, and constipation. The following are the client's laboratory values. Na + 130 mEq/L K + 4.6 mEq/L Cl - 94 mEq/L Mg ++ 2.8 mg/dL Ca ++ 13 mg/dL Which of the following alterations is consistent with the client's findings? a) Hyperkalemia b) Hyponatremia c) Hypermagnesemia d) Hypercalcemia

Hypercalcemia

Oral intake is controlled by the thirst center, located in which of the following cerebral areas? a) Hypothalamus b) Cerebellum c) Thalamus d) Brainstem

Hypothalamus

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

Insensible fluid loss

A client hospitalized for treatment of a pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis? a) Nausea or vomiting b) Abdominal pain or diarrhea c) Hallucinations or tinnitus d) Light-headedness or paresthesia

Light-headedness or paresthesia

A client has the following arterial blood gas (ABG) values: pH, 7.12; partial pressure of arterial carbon dioxide (PaCO2), 40 mm Hg; and bicarbonate (HCO3-), 15 mEq/L. These ABG values suggest which disorder? a) Metabolic acidosis b) Respiratory alkalosis c) Metabolic alkalosis d) Respiratory acidosis

Metabolic acidosis

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

Metabolic alkalosis

A 64-year-old client is brought in to the clinic with thirsty, dry, sticky mucous membranes, decreased urine output, fever, a rough tongue, and lethargy. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? a) No, sodium intake should be restricted. b) No, start with the sodium chloride IV. c) Yes, this will correct the sodium deficit. d) Yes, along with the hypotonic IV.

No, sodium intake should be restricted.

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

Parathyroid hormone (PTH)

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) Monitor the client's heart rhythm. b) Prepare to assist with ventilation. c) Obtain a urine specimen for drug screening. d) Prepare for gastric lavage.

Prepare to assist with ventilation.

Which of the following arterial blood gas results would be consistent with metabolic alkalosis? a) pH 7.26 b) Serum bicarbonate of 21 mEq/L c) pH 7.30 d) Serum bicarbonate of 28 mEq/L

Serum bicarbonate of 28 mEq/L

A nurse is conducting an initial assessment on a client with possible tuberculosis. Which assessment finding indicates a risk factor for tuberculosis? a) The client has never traveled outside of the country. b) The client works in a health care insurance office. c) The client sees his physician for a check-up yearly. d) The client had a liver transplant 2 years ago.

The client had a liver transplant 2 years ago.

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

it increases the patient's desire to consume fluid.

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

pH 7.48

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 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3- 18 mEq/L c) pH 7.35, PaCO2 40 mm Hg, PaO2 91 mm Hg, and HCO3- 22 mEq/L d) 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

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

The nurse is caring for a patient diagnosed with hyperchloremia. Signs and symptoms of hyperchloremia include which of the following? Select all that apply. a) Tachypnea b) Hypotension c) Dehydration d) Lethargy e) Weakness

• Tachypnea • Weakness • Lethargy


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