Adult Nursing - Chapter 13: Fluid and Electrolytes: Balance and Disturbance - PrepU

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

- HCO3 - pH - PaCO2

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

- Tachycardia

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

- Tachycardia

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

- The client had a liver transplant 2 years ago.

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

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

A client was admitted to the hospital unit after 2 days of vomiting and diarrhea. The client's spouse became alarmed when the client demonstrated confusion and elevated temperature, and reported "dry mouth." The nurse suspects the client is experiencing which condition? - dehydration - hypervolemia - hypercalcemia - hyperkalemia

- dehydration

A client is taking spironolactone to control hypertension. The client's serum potassium level is 6 mEq/L. What is the nurse's priority during assessment? - respiratory rate - electrocardiogram (ECG) results - neuromuscular function - bowel sounds

- electrocardiogram (ECG) results

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

- increases the client's desire to consume fluid.

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 (3.08 mmol/L). Given this laboratory finding, the nurse should suspect that the - client's diet is lacking in calcium-rich food products. - malignancy is causing the electrolyte imbalance. - client has a history of alcohol abuse. - client may be developing hyperaldosteronism.

- malignancy is causing the electrolyte imbalance.

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? - evaporation - active transport - filtration - osmosis

- osmosis

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

- pH 7.48

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

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

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? - pH: 7.32, PaCO2: 40 mm Hg, HCO3-: 18 mEq/L - pH: 7.42, PaCO2: 45 mm Hg, HCO3-: 22 mEq /L - pH: 7.20, PaCO2: 65 mm Hg, HCO3-: 26 mEq/L - pH: 7.50, PaCO2: 30 mm Hg, HCO3-: 24 mEq/L

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

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: - respiratory alkalosis. - metabolic alkalosis. - metabolic acidosis. - respiratory acidosis.

- respiratory alkalosis.

Which factor increases blood urea nitrogen (BUN)? - Overhydration - Gastrointestinal bleeding - Decreased protein intake - Hypothermia

- Gastrointestinal bleeding

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 (2.9 mmol/L). Which statement made by the client indicates the need for further teaching? - "I will be sure to buy frozen vegetables when I grocery shop." - "I will take a potassium supplement daily as prescribed." - "I can use laxatives and enemas but only once a week." - "A good breakfast for me will include milk and a couple of bananas."

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

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

- 0.45% NaCl

Which solution is hypotonic? - 5% NaCl - 0.9% NaCl - Lactated Ringer solution - 0.45% NaCl

- 0.45% NaCl

The physician has prescribed a hypotonic IV solution for a patient. Which IV solution should the nurse administer? - 0.9% sodium chloride - 5% glucose in normal saline solution - 0.45% sodium chloride - 5% glucose in water

- 0.45% sodium chloride

Which is considered an isotonic solution? - 0.45% normal saline - Dextran in normal saline - 3% NaCl - 0.9% normal saline

- 0.9% normal saline

Below which serum sodium concentration might convulsions or coma occur? - 145 mEq/L (145 mmol/L) - 140 mEq/L (140 mmol/L) - 135 mEq/L (135 mmol/L) - 142 mEq/L (142 mmol/L)

- 135 mEq/L (135 mmol/L)

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 - 155 mEq/L (155 mmol/L) - 125 mEq/L (125 mmol/L) - 145 mEq/L (145 mmol/L) - 135 mEq/L (135 mmol/L)

- 155 mEq/L (155 mmol/L)

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: - 250 mOsm/kg. - 230 mOsm/kg. - 210 mOsm/kg. - 280 mOsm/kg.

- 280 mOsm/kg.

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

- A 52-year-old with diarrhea

A nurse correctly identifies a urine specimen with a pH of 4.3 as being which type of solution? - Alkaline - Neutral - Basic - Acidic

- Acidic

The nurse is correct to state that a client's body needs to have adequate nutrition to maintain energy. Which type of transport of dissolved substances requires adenosine triphosphate (ATP)? - Passive diffusion - Active transport - Facilitated diffusion - Osmosis

- Active transport

Which is the most common cause of symptomatic hypomagnesemia? - Burns - Sedentary lifestyle - Intravenous drug use - Alcoholism

- Alcoholism

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

- Arterial blood gas (ABG) analysis

Which is an insensible mechanism of fluid loss? - Breathing - Nausea - Urination - Bowel elimination

- Breathing

A patient complains of tingling in the fingers as well as feeling depressed. The nurse assesses positive Trousseau's and Chvostek's signs. Which decreased laboratory results does the nurse observe when the patient's laboratory work has returned? - Calcium - Magnesium - Phosphorus - Potassium

- Calcium

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

- Chest pain

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? - Hallucinations - Nausea - Confusion - Headache

- Confusion

You are caring for a 72-year-old client who has been admitted to your unit for a fluid volume imbalance. You know which of the following is the most common fluid imbalance in older adults? - Hypovolemia - Dehydration - Hypervolemia - Fluid volume excess

- Dehydration

A nurse reviews the results of an electrocardiogram (ECG) for a patient who is being assessed for hypokalemia. Which of the following would the nurse notice as the most significant diagnostic indicator? - Flat P wave - Widened QRS wave - Peaked T wave - Elevated U wave

- Elevated U wave

Before seeing a newly assigned client with respiratory alkalosis, a nurse quickly reviews the client's medical history. Which condition is a predisposing factor for respiratory alkalosis? - Type 1 diabetes mellitus - Myasthenia gravis - Extreme anxiety - Opioid overdose

- Extreme anxiety

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

- Fruits such as bananas and apricots

A nurse is caring for a client with metastatic breast cancer who is extremely lethargic and very slow to respond to stimuli. The laboratory report indicates a serum calcium level of 12.0 mg/dl, a serum potassium level of 3.9 mEq/L, a serum chloride level of 101 mEq/L, and a serum sodium level of 140 mEq/L. Based on this information, the nurse determines that the client's symptoms are most likely associated with which electrolyte imbalance? - Hypocalcemia - Hypokalemia - Hyperkalemia - Hypercalcemia

- Hypercalcemia

A nurse caring for a patient with metabolic alkalosis knows to assess for the primary, compensatory mechanism of: - Increased PaCO2. - Increased serum HCO3. - Decreased serum HCO3. - Decreased PaCO2.

- Increased PaCO2.

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? - Insensible fluid loss - Cardiovascular compromise - Summer allergies - Lung function

- Insensible fluid loss

Which sign suggests that a client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications? - Polyuria - Weight loss - Jugular vein distention - Tetanic contractions

- Jugular vein distention

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

- Light-headedness or paresthesia

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? - Metabolic alkalosis - Metabolic acidosis - Respiratory alkalosis - 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? - Respiratory acidosis - Respiratory alkalosis - Metabolic acidosis - Metabolic alkalosis

- 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? - Yes, along with the hypotonic IV. - Yes, this will correct the sodium deficit. - No, start with the sodium chloride IV. - No, sodium intake should be restricted.

- No, sodium intake should be restricted.

Which is a correct route of administration for potassium? - Subcutaneous - Oral - IV (intravenous) push - Intramuscular

- Oral

The calcium concentration in the blood is regulated by which mechanism? - Androgens - Adrenal gland - Parathyroid hormone (PTH) - Thyroid hormone (TH)

- Parathyroid hormone (PTH)

A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204 mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L; Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse identify as critical and report immediately? - Chloride - CO2 - Sodium - Potassium

- Potassium

Which electrolyte is a major cation in body fluid? - Phosphate - Potassium - Bicarbonate - Chloride

- 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? - Prepare for gastric lavage. - Obtain a urine specimen for drug screening. - Prepare to assist with ventilation. - Monitor the client's heart rhythm.

- Prepare to assist with ventilation.

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? - Slurred speech - Presence of Trousseau sign - Negative Chvostek sign - Muscle weakness

- Presence of Trousseau sign

A nurse is caring for a client admitted with a diagnosis of exacerbation of myasthenia gravis. Upon assessment of the client, the nurse notes the client has severely depressed respirations. The nurse would expect to identify which acid-base disturbance? - Metabolic acidosis - Metabolic alkalosis - Respiratory acidosis - Respiratory alkalosis

- Respiratory acidosis

A client comes to the emergency department with status asthmaticus. His respiratory rate is 48 breaths/minute, and he is wheezing. An arterial blood gas analysis reveals a pH of 7.52, a partial pressure of arterial carbon dioxide (PaCO2) of 30 mm Hg, PaO2 of 70 mm Hg, and bicarbonate (HCO3??') of 26 mEq/L. What disorder is indicated by these findings? - Metabolic alkalosis - Respiratory alkalosis - Metabolic acidosis - Respiratory acidosis

- Respiratory alkalosis

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? - Respiratory alkalosis - Respiratory acidosis - Metabolic acidosis - Metabolic alkalosis

- Respiratory alkalosis

A client was admitted to the 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 family? Select all that apply. - Drink caffeinated beverages to retain fluid. - Respond to thirst - Drink at least eight glasses of fluid each day. - Drink water as an inexpensive way to meet fluid needs. - Drink carbonated beverages to help balance fluid volume.

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

Which of the following electrolytes is the primary determinant of extracellular fluid (ECF) osmolality? - Potassium - Calcium - Sodium - Magnesium

- Sodium