Ch. 39 Prep U

A client is admitted to the facility after experiencing uncontrolled diarrhea for the past several days. The client is exhibiting signs of a fluid volume deficit. When reviewing the client's laboratory test results, which electrolyte imbalance would the nurse most likely find? a) Hypokalemia b) Hypomagnesemia c) Hyperchloremia d) Hypernatremia

Hypokalemia Intestinal secretions contain bicarbonate. For this reason, diarrhea may result in metabolic acidosis due to depletion of base. Intestinal contents also are rich in sodium, chloride, water, and potassium, possibly contributing to an ECF volume deficit and hypokalemia. Sodium and chloride levels would be low, not elevated.

When caring for a client who is on intravenous therapy, the nurse observes that the client has developed redness, warmth, and discomfort along the vein. Which of the following interventions should the nurse perform for this complication? a) Apply a warm compress. b) Elevate the client's head. c) Apply antiseptic and a dressing. d) Position the client on the left side.

a) Apply a warm compress.

The nurse is caring for elderly patients in a long-term care facility. What age-related alteration should the nurse consider when planning care for these patients? a) Cardiac volume intolerance b) An increased sense of thirst c) Increase in nephrons in the kidneys d) Increased renal blood flow

a) Cardiac volume intolerance

When providing care for a client who has a peripheral intravenous catheter in situ, the nurse should do what? a) Change the site every three to four days. b) Clean the insertion site daily using sterile technique. c) Insert the largest gauge possible to maximize flow and minimize the risk of occlusion. d) Flush the catheter every six hours with hypertonic solution if the IV is not in constant use.

a) Change the site every three to four days.

A client is taking a diuretic such as furosemide. When implementing client education, what information should be included? a) Decreased potassium levels b) Increased sodium levels c) Decreased oxygen levels d) Increased potassium levels

a) Decreased potassium levels

Choice Multiple question - Select all answer choices that apply. A nurse monitoring an IV infusion notes the signs and symptoms of a thrombus. What nursing interventions would the nurse perform? (Select all that apply.) a) Stop the infusion immediately. b) Place patient on left side in Trendelenburg position. c) Restart the IV at another site. d) Monitor vital signs and pulse oximetry. e) Apply warm compresses as ordered by the primary care provider. f) Rub or massage the affected area.

a) Stop the infusion immediately. e) Apply warm compresses as ordered by the primary care provider. c) Restart the IV at another site.

Major control over the extracellular concentration of potassium within the human body is exerted by: a) aldosterone. b) progesterone. c) albumin. d) testosterone.

a) aldosterone.

Potassium is needed for neural, muscle, and: a) cardiac function. b) optic function. c) auditory function. d) skeletal function.

a) cardiac function.

A client's most recent blood work indicates a K+ level of 7.2 mEq/L, a finding that constitutes hyperkalemia. For what signs and symptoms should the nurse vigilantly monitor? a) cardiac irregularities b) increased intracranial pressure (ICP) c) metabolic acidosis d) muscle weakness

a) cardiac irregularities

A decrease in arterial blood pressure will result in the release of: a) renin. b) thrombus. c) insulin. d) protein.

a) renin.

A physician has asked the nurse to use microdrip tubing to administer a prescribed dosage of IV solution to a client. What is the standard drop factor of microdrip tubing? a) 30 drops/mL b) 60 drops/mL c) 120 drops/mL d) 90 drops/mL

b) 60 drops/mL

Which nursing diagnosis would the nurse make based on the effects of fluid and electrolyte imbalance on human functioning? a) Constipation related to immobility b) Acute Confusion related to cerebral edema c) Pain related to surgical incision d) Risk for Infection related to inadequate personal hygiene

b) Acute Confusion related to cerebral edema

A nurse is providing care to a client with hypocalcemia. The nurse would monitor the client's laboratory test results for which imbalance? a) Hypermagnesemia b) Hyperphosphatemia c) Hyponatremia d) Hypokalemia

b) Hyperphosphatemia

A nurse is reviewing the client's serum electrolyte levels which are as follows: Sodium: 138 mEq/L Potassium: 3.2 mEq/L Calcium: 4.4 mEq/L Magnesium: 1.6 mEq/L Chloride: 100 mEq/L Phosphate: 1.8 mEq/L Based on these levels, the nurse would identify which imbalance? a) Hyponatremia b) Hypokalemia c) Hypermagnesemia d) Hypercalcemia

b) Hypokalemia

Because metabolism continually produces acids, maintenance of pH within these incredibly narrow limits depends on two processes: buffering and compensation. Which statement describes a function of buffering? a) The lungs, under the control of chemoreceptor areas in the brainstem respiratory center, are responsible for controlling the amount of carbon dioxide in the blood. b) It helps to prevent large changes in pH by absorbing or releasing H+ ions. c) The renal system excretes acids and bases from the body as needed. d) The kidneys influence the maintenance of the normal acid-base balance by changing the rate of excretion or retention of H+ and HCO3 ions.

b) It helps to prevent large changes in pH by absorbing or releasing H+ ions.

A client age 80 years, who takes diuretics for management of hypertension, informs the nurse that she takes laxatives daily to promote bowel movements. The nurse assesses the client for possible symptoms of: a) hypoglycemia. b) hypokalemia. c) hypothyroidism. d) hypocalcemia.

b) hypokalemia. The frequent use of laxatives and diuretics promotes the excretion of potassium and magnesium from the body, increasing the risk for fluid and electrolyte deficits.

The primary extracellular electrolytes are: a) phosphorous, calcium, and phosphate. b) sodium, chloride, and bicarbonate. c) potassium, phosphate, and sulfate. d) magnesium, sulfate, and carbon.

b) sodium, chloride, and bicarbonate.

Which of the following clients would be a candidate for total parenteral nutrition? a) A client with diabetic ketoacidosis b) A client receiving intravenous antibiotics c) A client with colitis and bloody diarrhea d) A postoperative appendectomy client

c) A client with colitis and bloody diarrhea

Which is a common anion? a) Potassium b) Magnesium c) Chloride d) Calcium

c) Chloride

Which is not a primary intracellular electrolyte? a) Potassium b) Sulfate c) Chloride d) Phosphate

c) Chloride

After surgery, a client is on IV therapy for the next 4 days. How often should the nurse change the IV tubing for this client? a) Every 24 hours b) Every 12 hours c) Every 72 hours d) Every 36 hours

c) Every 72 hours

During an assessment of an older adult client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. Which medical diagnosis may be responsible? a) Edema b) Circulatory overload c) Hypovolemia d) Hypervolemia

c) Hypovolemia

Potassium is essential for normal cardiac, neural, and muscle function and contractility of all muscles. Which is false about potassium? a) Aldosterone enhances renal excretion of potassium. b) A person loses approximately 30 mEq of potassium. c) Normal serum potassium ranges from 5.5 to 6.0 mEq/L. d) Insulin promotes the transfer of potassium from the extracellular fluid into skeletal muscle and liver cells.

c) Normal serum potassium ranges from 5.5 to 6.0 mEq/L. Normal serum potassium ranges from 3.5 to 5.0 mEq/L.

Choice Multiple question - Select all answer choices that apply. A nurse is teaching a client about his newly prescribed diuretic and how it affects his fluid and electrolyte balance. In addition to water, the nurse would explain that the drug also affects which electrolyte? Select all that apply. a) Calcium b) Phosphate c) Potassium d) Sodium e) Magnesium f) Chloride

c) Potassium d) Sodium e) Magnesium f) Chloride

Which statement most accurately describes the process of osmosis? a) Water shifts from high-solute areas to areas of lower solute concentration. b) Plasma proteins facilitate the reabsorption of fluids into the capillaries. c) Water moves from an area of lower solute concentration to an area of higher solute concentration. d) Solutes pass through semipermeable membranes to areas of lower concentration.

c) Water moves from an area of lower solute concentration to an area of higher solute concentration.

The nursing instructor hears students discussing fluid and electrolyte balance. Which statement would warrant further instruction? a) "The heart circulates water and nutrients through the body." b) "The lungs regulate metabolic acid-base disturbances by controlling carbon dioxide." c) "The lungs remove water though exhalation." d) "The kidneys store and release antidiuretic hormone to increase water retention."

d) "The kidneys store and release antidiuretic hormone to increase water retention." Explanation: The pituitary glands store and release antidiuretic hormone rather than the kidneys.

The nurse is caring for a male client who has a diagnosis of heart failure. Today's laboratory results show a serum potassium of 3.2 mEq/L. For what complications should the nurse be aware, related to the potassium level? a) Fluid volume excess b) Tetany c) Pulmonary embolus d) Cardiac dysrhythmias

d) Cardiac dysrhythmias

Mr. Jones is admitted to your unit from the emergency department with a diagnosis of hypokalemia. His laboratory results show a serum potassium of 3.2 mEq/L. For what manifestations will you be alert? a) Muscle weakness, fatigue, and constipation b) Diminished cognitive ability and hypertension c) Nausea, vomiting, and constipation d) Muscle weakness, fatigue, and dysrhythmias

d) Muscle weakness, fatigue, and dysrhythmias

Choice Multiple question - Select all answer choices that apply. The nurse is educating a client about the function of sodium in the body. What education points would the nurse make? Select all that apply. a) Sodium participates in the generation and transmission of nerve impulses. b) The normal extracellular concentration of sodium is 85 to 95 mEq/L. c) Sodium does not influence ICF volume. d) Sodium is the primary regulator of ECF volume e) Sodium is normally maintained in the body within a relatively narrow range, and deviations quickly result in serious health problems. f) The daily value of sodium cited on nutrition facts labels is 1,200 mg.

d) Sodium is the primary regulator of ECF volume e) Sodium is normally maintained in the body within a relatively narrow range, and deviations quickly result in serious health problems. a) Sodium participates in the generation and transmission of nerve impulses.

A nurse who has diagnosed a client as having "fluid volume excess" related to compromised regulatory mechanism (kidneys) may have been alerted by what symptom? a) nausea and vomiting b) fingerprinting over sternum c) muscle twitching d) distended neck veins

d) distended neck veins

A group of nursing students is reviewing information about body fluid and locations. The students demonstrate understanding of the material when they identify which of the following as a function of intracellular fluid? a) transportation of nutrients b) maintenance of blood volume c) removal of waste d) maintenance of cell size

d) maintenance of cell size