Fluid and Elecrolytes Remediation, Fluid & Electrolyte Balance PrepU ch.10 (Unit 1 exam)

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 can use laxatives and enemas but only once a week." "I will be sure to buy frozen vegetables when I grocery shop." "A good breakfast for me will include milk and a couple of bananas." "I will take a potassium supplement daily as prescribed."

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

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

0.45% NaCl

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

0.9% normal saline

When fluid intake is normal, the specific gravity of urine should be: 1.000 Less than 1.010 Greater than 1.025 1.010 to 1.025

1.010 to 1.025

When fluid intake is normal, the specific gravity of urine should be 1.000. less than 1.010. greater than 1.025. 1.010 to 1.025.

1.010 to 1.025.

At which serum sodium concentration might convulsions or coma occur? 142 mEq/L (142 mmol/L) 145 mEq/L (145 mmol/L) 130 mEq/L (130 mmol/L) 140 mEq/L (140 mmol/L)

130 mEq/L (130 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 135 mEq/L (135 mmol/L) 155 mEq/L (155 mmol/L) 125 mEq/L (125 mmol/L) 145 mEq/L (145 mmol/L)

155 mEq/L (155 mmol/L)

A client who is semiconscious presents with restlessness and weakness. The nurse assesses a dry, swollen tongue; body temperature of 99.3 °F; and a urine specific gravity of 1.020. What is the most likely serum sodium value for this client? 110 mEq/L 145 mEq/L 130 mEq/L 165 mEq/L

165 mEq/L

A patient is admitted with severe vomiting for 24 hours as well as weakness and "feeling exhausted." The nurse observes flat T waves and ST-segment depression on the electrocardiogram. Which potassium level does the nurse observe when the laboratory studies are complete? 5.5 mEq/L 3.5 mEq/L 4.5 mEq/L 2.5 mEq/L

2.5 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? Hallucinations Headache Confusion Nausea

275-300 mOsm/kg

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. 210 mOsm/kg. 280 mOsm/kg. 230 mOsm/kg.

280 mOsm/kg.

A patient has a gastric sump tube attached to low intermittent suction. The nurse empties the suction collection chamber and records an output of 320 mL for this 8-hour shift. The record shows that the tube had been irrigated with 20 mL of normal saline twice this shift. What would be the actual output of the gastric sump tube?

280mL

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

A 52-year-old with diarrhea

Which of the following measurable urine outputs indicates the client is maintaining adequate fluid intake and balance? A patient with a minimal urine output of 20 mL/hour A patient with a minimal urine output of 50 mL/hour A patient with a minimal urine output of 30 mL/hour A patient with a minimal urine output of 10 mL/hour

A patient with a minimal urine output of 30 mL/hour

Vomiting results in which of the following acid-base imbalances? A)Metabolic alkalosis B)Respiratory acidosis C)Respiratory alkalosis D)Metabolic acidosis

A)Metabolic alkalosis

A client is admitted to the hospital with systolic left-sided heart failure. The nurse knows to look for which assessment finding for this client? A)Pulmonary congestion B)Pedal edema C)Jugular venous distention D)Nausea

A)Pulmonary congestion

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

Acidic

After a thyroidectomy, the client develops a carpopedal spasm while the nurse is taking a BP reading on the left arm. Which action by the nurse is appropriate? Administer an oral calcium supplement as ordered. Administer a sedative as ordered. Start administering oxygen at 2 L/min via a cannula. Administer IV calcium gluconate as ordered.

Administer IV calcium gluconate as ordered.

A client with excess fluid volume and hyponatremia is in a comatose state. What are the nursing considerations concerning fluid replacement? Restrict fluids and salt for 24 hours. Correct the sodium deficit rapidly with salt. Monitor the serum sodium for changes hourly. Administer small volumes of a hypertonic solution.

Administer small volumes of a hypertonic solution.

Which of the following is the primary hormone for the long-term regulation of sodium balance?

Aldosterone

The nurse is reviewing lab work on a newly admitted client. Which diagnostic stud(ies) confirms the nursing problem statement of dehydration. Select all that apply. Electrolyte imbalance An elevated hematocrit level Absence of ketones in urine Low protein level in the urine A low urine specific gravity

An elevated hematocrit level Electrolyte imbalance

A client has returned to the postsurgical unit from the PACU after an above-the-knee amputation of the right leg. Results of the nurse's initial postsurgical assessment were unremarkable but the client has called out. The nurse enters the room and observes copious quantities of blood at the surgical site. What should be the nurse's initial action? Apply sterile gauze. Elevate the residual limb. Call the surgeon. Apply a tourniquet.

Apply a tourniquet.

What intervention is a priority when treating a client with HIV/AIDS? Monitoring skin integrity Assessing neurologic status Assessing fluid and electrolyte balance Monitoring psychological status

Assessing fluid and electrolyte balance

A client who is blind is admitted for treatment of gastroenteritis. What does the nurse recognize as the highest priority for this client? A)Risk for injury B)Fluid volume deficit C)Limited mobility D)Activity intolerance

B)Fluid volume deficit

Which clinical finding should a nurse look for in a client with chronic renal failure? A)Hypotension B)Uremia C)Metabolic alkalosis D)Polycythemia

B)Uremia????

The nurse is caring for a client after cardiac surgery. What laboratory result will lead the nurse to suspect possible renal failure? A)an hourly urine output of 50 to 70 mL B)a serum BUN of 70 mg/dL C)a serum creatinine of 1.0 mg/dL D)a urine specific gravity reading of 1.021

B)a serum BUN of 70 mg/dL

The Emergency Department (ED) nurse is caring for a client with a possible acid-base imbalance. The physician has ordered an arterial blood gas (ABG). What is one of the most important indications of an acid-base imbalance that is shown in an ABG? Bicarbonate PO2 Carbonic acid PaO2

Bicarbonate

The nurse is reviewing the client's urinalysis results. The finding that is most suggestive of dehydration of the client is: Protein 15 mg/dL Bright yellow urine Specific gravity 1.035 Creatinine 0.7 mg/dL

Bright yellow urine

A nurse is preparing a client with Crohn's disease for a barium enema. What should the nurse do the day before the test? A)Serve the client his usual diet. B)Serve dairy products. C)Encourage plenty of fluids. D)Order a high-fiber diet.

C)Encourage plenty of fluid

A client reports 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 client's laboratory work has returned? Calcium Phosphorus Iron Potassium

Calcium

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse informs the client that the physician will order diuretic therapy and restrict fluid and sodium intake to treat the disorder. If the client doesn't comply with the recommended treatment, which complication may arise? Cerebral edema Hypovolemic shock Severe hyperkalemia Tetany

Cerebral edema

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 Jaundice Slow pulse

Chest pain

Which electrolyte is a major anion in body fluid? Calcium Chloride Potassium Sodium

Chloride

Which electrolyte is a major anion in body fluid? Calcium Chloride Sodium Potassium

Chloride

An adult client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and lethargy. The nurse reconciles the client's medication list and notes that salt tablets had been prescribed. What would the nurse do next? Consider sodium restriction with discontinuation of salt tablets. Continue to monitor client with another appointment. Be prepared to administer a sodium chloride IV. Be prepared to administer a lactated Ringer's IV.

Consider sodium restriction with discontinuation of salt tablets.

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis? A)Bacteremia B)Proteinuria C)Hematuria D)Azotemia

D)Azotemia

The nurse identifies which symptom as a characteristic of right-sided heart failure? A)Cough B)Pulmonary crackles C)Jugular vein distention (JVD) D)Dyspnea

D)Dyspnea

When the postcardiac surgery client demonstrates restlessness, nausea, weakness, and peaked T waves, the nurse reviews the client's serum electrolytes, anticipating which abnormality? A)Hypomagnesemia B)Hyponatremia C)Hypercalcemia D)Hyperkalemia

D)Hyperkalemia

On the third day after a partial thyroidectomy, a client exhibits muscle twitching and hyperirritability of the nervous system. When questioned, the client reports numbness and tingling of the mouth and fingertips. Suspecting a life-threatening electrolyte disturbance, the nurse notifies the surgeon immediately. Which electrolyte disturbance most commonly follows thyroid surgery? A)Hyponatremia B)Hyperkalemia C)Hypermagnesemia D)Hypocalcemia

D)Hypocalcemia

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. Crackles in the lung fields Decreased blood pressure Distended neck veins Shortness of breath Bradycardia

Distended neck veins Crackles in the lung fields Shortness of breath

Which of the following is a clinical manifestation of fluid volume excess (FVE)? Select all that apply. Shortness of breath Bradycardia Distended neck veins Decreased blood pressure Crackles in the lung fields

Distended neck veins Crackles in the lung fields Shortness of breath

The nurse is caring for a client in heart failure with signs of hypervolemia. Which vital sign is indicative of the disease process? Subnormal temperature Rapid respiration Low heart rate Elevated blood pressure

Elevated blood pressure

Which laboratory result does the nurse identify as a direct result of the client's hypovolemic status with hemoconcentration? Low white blood count Low urine specific gravity Abnormal potassium level Elevated hematocrit level

Elevated hematocrit level

A client with acute pericarditis is exhibiting distended jugular veins, tachycardia, tachypnea, and muffled heart sounds. The nurse recognizes these as symptoms of what occurrence?

Excess pericardial fluid compresses the heart and prevents adequate diastolic filling.

A client with a traumatic brain injury has developed increased intracranial pressure resulting in diabetes insipidus. While assessing the client, the nurse expects which of the following findings?

Excessive urine output and decreased urine osmolality

A nurse is caring for an adult client with numerous draining wounds from gunshots. The client's pulse rate has increased from 100 to 130 beats per minute over the last hour. The nurse should further assess the client for which of the following? Respiratory acidosis Metabolic alkalosis Altered blood urea nitrogen (BUN) value Extracellular fluid volume deficit

Extracellular fluid volume deficit

A client is brought to the ED with burns exceeding 20% of total body surface area. Which is the primary nursing intervention in the care of this client

Fluid resuscitation

Immediately after a burn injury, electrolytes need to be evaluated for a major indicator of massive cell destruction, which is:

Hyperkalemia.

An elderly client diagnosed with diarrhea is taking digoxin. Which electrolyte imbalance should the nurse be alert to?

Hypokalemia

An elderly client takes 40 mg of furosemide twice a day. Which electrolyte imbalance is the most serious adverse effect of diuretic use? Hyperkalemia Hypophosphatemia Hypokalemia Hypernatremia

Hypokalemia

The nurse identifies which of the following as a potential cause of premature ventricular complexes (PVCs)?

Hypokalemia

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

Hypothalamus

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

Hypothalamus

A nurse is assessing a client who is receiving total parenteral nutrition (TPN). Which finding suggests that the client has developed hyperglycemia? Diaphoresis Decreased appetite Cheyne-Stokes respirations Increased urine output

Increased urine output

Which intervention is most appropriate for a client with an arterial blood gas (ABG) of pH 7.5, a partial pressure of arterial carbon dioxide (PaCO2) of 26 mm Hg, oxygen (O2) saturation of 96%, bicarbonate (HCO3-) of 24 mEq/L, and a PaO2 of 94 mm Hg? Administer an ordered decongestant. Offer the client fluids frequently. Instruct the client to breathe into a paper bag. Administer ordered supplemental oxygen.

Instruct the client to breathe into a paper bag.

The nurse is caring for a geriatric client in the home setting. Due to geriatric changes decreasing thirst, the nurse is likely to see a decrease in which fluid location which contains the most body water? Extracellular fluid Intracellular fluid Interstitial fluid Intravascular fluid

Intracellular fluid

A large volume of intravenous fluids is being administered to an elderly client who experienced hypovolemic shock following diarrhea. The nurse is evaluating the client's response to treatment and notes the following as a sign of an adverse reaction: Vesicular breath sounds Jugular venous distention Decreased pulse rate to 110 beats/minute Positive increase in the fluid balance ratio

Jugular venous distention

With which condition should the nurse expect that a decrease in serum osmolality will occur? Uremia Influenza Kidney failure Hyperglycemia

Kidney failure

Which of the following is the preferred IV fluid for burn resuscitation?

Lactated Ringer's (LR)

A physician orders an isotonic I.V. solution for a client. Which solution should the nurse plan to administer? Lactated Ringer's solution Half-normal saline solution 10% dextrose in water 5% dextrose and normal saline solution

Lactated Ringer's solution

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

Light-headedness or paresthesia

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? Sucrose Liquids Iron and zinc Gluten

Liquids

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

Magnesium

The client's lab values are sodium 166 mEq/L, potassium 5.0 mEq/L, chloride 115 mEq/L, and bicarbonate 35 mEq/L. What condition is this client likely to have, judging by anion gap? Respiratory acidosis Metabolic alkalosis Respiratory alkalosis Metabolic 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 Metabolic acidosis Respiratory alkalosis Metabolic alkalosis

Metabolic alkalosis

Which is the preferred route of administration for potassium? IV (intravenous) push Intramuscular Oral Subcutaneous

Oral

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

Parathyroid hormone (PTH)

A patient is prescribed digitalis preparations. Which of the following conditions should the nurse closely monitor when caring for the patient? Potassium levels Vasculitis Enlargement of joints Flexion contractures

Potassium levels

The nurse is reviewing client lab work for a critical lab value. Which value is called to the physician for additional orders? Magnesium:2 mEq/L Sodium: 138 mEq/L Potassium: 5.8 mEq/L Calcium: 10 mg/dL

Potassium: 5.8 mEq/L

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? Provide oral care every 2-3 hours. Teach the client about increased fluid intake. Monitor for signs and symptoms of dehydration. Assess the client's weight daily for trends.

Provide oral care every 2-3 hours.

Which of the following fluid or electrolyte changes occur in the emergent/resuscitative phase? Potassium deficit Increased urinary output Reduction in blood volume Sodium excess

Reduction in blood volume

A client with herpes simplex virus (HSV) encephalitis is receiving acyclovir. To ensure early intervention, the nurse monitors laboratory values and urine output for which type of adverse reactions? Renal Musculoskeletal Integumentary Hepatic

Renal

A client reports nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes as pale and dry. The client has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which is the priority nursing intervention? Initiate oral rehydration therapy at 100 mL/kg of oral rehydration solution over 4 hours. Request an order from the physician for IV rehydration therapy. Assess vital signs every 15 minutes. Obtain stool specimen for analysis.

Request an order from the physician for IV rehydration therapy.

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. Respond to thirst Drink water as an inexpensive way to meet fluid needs. Drink alcoholic beverages to help balance fluid volume. Drink at least eight glasses of fluid each day. Drink caffeinated beverages to retain fluid.

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

A client is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Laboratory results reveal serum sodium level 130 mEq/L and urine specific gravity 1.030. Which nursing intervention helps prevent complications associated with SIADH? Administering vasopressin as ordered Restricting sodium intake to 1 gm/day Elevating the head of the client's bed to 90 degrees Restricting fluids to 800 ml/day

Restricting fluids to 800 ml/day

The nurse is caring for a patient with a diagnosis of hyponatremia. Which nursing intervention is appropriate to include in the plan of care for this patient? Select all that apply. Encouraging the intake of low-sodium liquids Restricting tap water intake Monitoring neurologic status Encouraging the use of salt substitute instead of salt Assessing for symptoms of nausea and malaise

Restricting tap water intake Monitoring neurologic status Assessing for symptoms of nausea and malaise

When describing the functions of the skin to a group of nursing students, which skin layer would the instructor include as having the capacity to absorb water? Stratum germinativum Stratum corneum Stratum lucidum Stratum granulosum

Stratum corneum

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

Tachypnea Weakness Lethargy

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

Tachypnea Lethargy Weakness

A client seeks medical attention for an acute onset of severe thirst, polyuria, muscle weakness, nausea, and bone pain. Which health history information will the nurse report to the health care provider? Works as a customer service representative Ingests alcohol occasionally Takes high doses of vitamin D Follows a high-fiber eating plan

Takes high doses of vitamin D

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

The client had a liver transplant 2 years ago

The nurse is caring for a client with essential hypertension. The nurse reviews lab work and assesses kidney function. Which action of the kidney would the nurse evaluate as the body's attempt to regulate high blood pressure? The kidney retains sodium and excretes water. The kidney retains water and excretes sodium. The kidney excretes sodium and water. The kidney retains sodium and water.

The kidney excretes sodium and water.

Which hormones are secreted by the posterior lobe of the pituitary gland? Select all that apply. Oxytocin Follicle-stimulating hormone (FSH) Vasopressin Thyroid-stimulating hormone (TSH) Luteinizing hormone (LH)

Vasopressin Oxytocin

The nurse is discussing basic cardiac hemodynamics and explains preload to the client. What nursing intervention will decrease preload? increasing activity sustained elevation of the client's legs administration of a vasodilating drug (as ordered by a health care provider) application of antiembolic stockings

administration of a vasodilating drug (as ordered by a health care provider)

A nurse is providing client teaching about the body's plasma pH and the client asks the nurse what is the major chemical regulator of plasma pH. What is the best response by the nurse? renin-angiotensin-aldosterone system bicarbonate-carbonic acid buffer system sodium-potassium pump ADH-ANP buffer system

bicarbonate-carbonic acid buffer system

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

increased breathing effort and weight gain.

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

increases the client's desire to consume fluid.

A client who complains of an "acid stomach" has been taking baking soda (sodium bicarbonate) regularly as a self-treatment. This may place the client at risk for which acid-base imbalance? respiratory acidosis metabolic alkalosis metabolic acidosis respiratory alkalosis

metabolic alkalosis

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? osmosis filtration evaporation active transport

osmosis

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. pH HCO3 PaCO2 K+ Glucose Na+

pH HCO3 PaCO2

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

pH 7.48

A client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis? pH, 7.35; PaCO2 40 mm Hg pH, 7.25; PaCO2 50 mm Hg pH, 7.40; PaCO2 35 mm Hg pH, 7.5; PaCO2 30 mm Hg

pH, 7.25; PaCO2 50 mm Hg

A nurse is monitoring a client being evaluated who has a potassium level of 7 mEq/L (mmol/L). Which electrocardiogram changes will the client display? peaked T waves prolonged T waves elevated ST segment shortened PR interval

peaked T waves

Retention of which electrolyte is the most life-threatening effect of renal failure?

potassium

The nurse is caring for a client after cardiac surgery. What is the most immediate concern for the nurse? bilateral rales and rhonchi weight gain of 6 ounces serum glucose of 124 mg/dL potassium level of 6 mEq/L

potassium level of 6 mEq/L

A client is admitted to the ED after a near-drowning accident. The client is diagnosed with saltwater aspiration. The nurse will observe the client for several hours to monitor for symptoms of pulmonary edema. hyponatremia. hypothermia. head injury.

pulmonary edema.

A client with chronic renal failure has a serum potassium level of 6.8 mEq/L. What should the nurse assess first?

pulse

One of the roles of the nurse in caring for clients with chronic kidney disease is to help them learn to minimize and manage potential complications. This would include:

restricting sources of potassium.

The nurse is reviewing the laboratory results for a client with heart failure. Which laboratory value will the nurse report to the health care provider? sodium 148 mEq/L magnesium 2.5 mg/dL calcium 9.8 mg/dL potassium 3.9 mEq/L

sodium 148 mEq/L