Foundations Chapter 38 Fluid Balance
13. Which of the following questions about fluid balance would be appropriate when conducting a health history for a patient? A) "Describe your usual urination habits." B) "Describe your problems with constipation." C) "How did you feel when your calcium was low?" D) "Do you eat fruits and vegetables each day?"
A) "Describe your usual urination habits."
5. A nurse monitoring the intake and output of fluids for a patient with severe diarrhea knows that normally how many mL of body fluids is lost via the gastrointestinal tract? A) 300 mL B) 1,000 mL C) 1,300 mL D) 2,600 mL
A) 300 mL
8. Which of the following descriptions best summarizes fluid homeostasis? A) Almost every body organ and system helps maintain homeostasis. B) The cardiovascular and renal systems primarily maintain homeostasis. C) Homeostasis is maintained through intra- and extracellular exchange. D) Homeostasis is maintained by the arterioles, capillaries, and venules.
A) Almost every body organ and system helps maintain homeostasis.
18. A physician writes an order to "force fluids." What will be the first action the nurse will take in implementing this order? A) Explain to the patient why this is needed. B) Tell the patient and family to increase oral intake. C) Decide how much fluid to increase each 8 hours. D) Divide the intake so the largest amount is at night.
A) Explain to the patient why this is needed.
6. A nurse explains the homeostatic mechanisms involved in fluid homeostasis to a student nurse. Which of the following statements accurately describe this process? Select all that apply. A) The kidneys selectively retain electrolytes and water and excrete wastes and excesses according to the body's needs. B) The cardiovascular system is responsible for pumping and carrying nutrients and water throughout the body. C) The thyroid gland secretes aldosterone, a mineralocorticoid hormone that helps the body conserve sodium, helps save chloride and water, and causes potassium to be excreted. D) The lungs regulate oxygen and carbon dioxide levels of the blood, which is especially crucial in maintaining acid-base balance. E) Thyroxine, released by the adrenal glands, increases blood flow in the body, leading to increased renal circulation and resulting in increased glomerular filtration and urinary output. F) The parathyroid glands secrete parathyroid hormone, which regulates the level of calcium and phosphorus.
A) The kidneys selectively retain electrolytes and water and excrete wastes and excesses according to the body's needs. B) The cardiovascular system is responsible for pumping and carrying nutrients and water throughout the body. D) The lungs regulate oxygen and carbon dioxide levels of the blood, which is especially crucial in maintaining acid-base balance. F) The parathyroid glands secrete parathyroid hormone, which regulates the level of calcium and phosphorus.
29. Which of the following patients would be the most likely candidate for the administration of total parenteral nutrition? A) a patient with severe pancreatitis C) a patient with hepatitis B B) a patient with a myocardial infarction D) a patient with mild malnutrition
A) a patient with severe pancreatitis
25. Cross-matching of blood is ordered for a patient before major surgery. What does this process do? A) determines compatibility between blood specimens B) determines a person's blood type C) predicts the amount of needed blood replacement D) specifies the donor and the recipient of the blood
A) determines compatibility between blood specimens
20. A nurse is administering a potassium supplement to a patient. What will the nurse do to disguise the taste and decrease gastric irritation? A) dilute it B) give it after meals C) mix it with food D) freeze it
A) dilute it
3. Based on knowledge of total body fluids, a nurse is especially watchful for a fluid volume deficit in an infant. Why would the nurse do this? A) Infants have less total body fluid and ECF than adults. B) Infants have more total body fluid and ECF than adults. C) Infants drink less fluid than adults. D) Infants lose more fluids through output than adults.
B) Infants have more total body fluid and ECF than adults.
14. A patient is taking a diuretic that increases her urinary output. What would be an appropriate nursing diagnosis on which to base a teaching plan? A) Impaired Skin Integrity C) Impaired Urinary Elimination B) Risk for Deficient Fluid Volume D) Urinary Retention
B) Risk for Deficient Fluid Volume
10. A home care patient is complaining of weakness and leg cramps. Per order, the nurse draws blood and requests a potassium level. What is the rationale for this request? A) The nurse is concerned that the patient's diet has caused sodium loss. B) The nurse recognizes these symptoms of hypokalemia. C) The patient is actively seeking increased attention. D) The patient had bananas and orange juice for breakfast.
B) The nurse recognizes these symptoms of hypokalemia.
27. A patient scheduled for surgery has arranged for an autologous transfusion. What type of blood transfusion is this? A) The patient's family members have been donors. B) The patient donates his or her own blood. C) The patient's blood has been rendered sterile. D) The patient will only need fluids, not blood.
B) The patient donates his or her own blood.
2. Which body fluid is the fluid within the cells, constituting about 70% of the total body water? A) extracellular fluid (ECF) C) intravascular fluid B) intracellular fluid (ICF) D) interstitial fluid
B) intracellular fluid
30. A nurse is initiating a peripheral venous access IV infusion ordered for a patient presurgically. In what position would the nurse place the patient to perform this skill? A) high Fowler's B) low Fowler's C) Sim's D) dorsal recumbent
B) low Fowler's
1. The student nurse studying fluid and electrolyte balance learns that which of the following is a function of water? Select all that apply. A) provide a medium for transporting wastes to cells and nutrients from cells B) provide a medium for transporting substances throughout the body C) facilitate cellular metabolism and proper cellular chemical functioning D) act as a buffer for electrolytes and nonelectrolytes E) help maintain normal body temperature F) facilitate digestion and promote elimination
B) provide a medium for transporting substances throughout the body C) facilitate cellular metabolism and proper cellular chemical functioning E) help maintain normal body temperature F) facilitate digestion and promote elimination
15. A nurse measures a patient's 24-hour fluid intake and documents the findings. To be an accurate indicator of fluid status, what must the nurse also do with the information? A) Compare the patient's intake with the normal range of adult fluid intake. B) Report the exact milliliter of intake to the physician's office nurse. C) Compare the total intake and output of fluids for the 24 hours. D) Ensure that the information is included in the verbal end-of-shift report.
C) Compare the total intake and output of fluids for the 24 hours.
24. A woman has had her left breast removed for cancer. She also had an axillary node dissection on the left during surgery. How would this affect placement of an intravenous line? A) Either arm may be used. C) The left arm should not be used. B) Neither arm should be used. D) The right arm should not be used.
C) The left arm should not be used.
11. A patient's PaCO2 is abnormal on an ABG report. Which of the following illnesses would most likely be the medical diagnosis? A) rheumatoid arthritis B) sexually transmitted infection C) chronic obstructive pulmonary disease D) infection of the bladder and ureters
C) chronic obstructive pulmonary disease
16. A nurse reads a complete blood count report for a patient who has been admitted to the hospital with fluid overload from late-stage kidney disease. What abnormal result would the nurse expect to find? A) increased white blood cells C) decreased hematocrit B) increased platelets D) increased hematocrit
C) decreased hematocrit
7. By what route do oxygen and carbon dioxide exchange in the lung? A) osmosis B) filtration C) diffusion D) active transport
C) diffusion
12. A patient has metabolic (nonrespiratory) acidosis. What type of respirations would be assessed? A) periods of apnea C) increased depth and rate B) decreased depth and rate D) alternating fast and slow
C) increased depth and rate
22. Which of the following locations might the nurse use to assess the condition of an insertion site for a central venous access device? A) below the sternum C) over the jugular vein B) over the fourth intercostal space D) the back of the hand
C) over the jugular vein
26. A patient asks a nurse if it is possible to contract a disease by donating blood. How would the nurse respond? A) "There is only a very small chance; I know you will be safe." B) "Although hepatitis is possible, AIDS is not." C) "If I were you, I would request special handling of my blood." D) "There is no way you can contract a disease by giving blood."
D) "There is no way you can contract a disease by giving blood."
4. What is the average adult fluid intake and loss in each 24 hours? A) 500 to 1,000 mL C) 1,500 to 2,000 mL B) 1,000 to 1,500 mL D) 1,500 to 3500 mL
D) 1,500 to 3500 mL
28. A patient is having a blood transfusion, but the fluid is dripping very slowly. The blood has been infusing for more than 4 hours. What should the nurse do next? A) Continue with the transfusion and document the drip rate. B) Report to the next shift the amount of blood left to infuse. C) Take and record vital signs more often. D) Discontinue the blood transfusion.
D) Discontinue the blood transfusion.
9. A nurse reads the laboratory report for a patient and notes that the patient has hyponatremia. What physical assessment would be made? A) Observe skin color and texture. C) Percuss lung density. B) Auscultate bowel sounds. D) Palpate skin of sternum.
D) Palpate skin of sternum.
23. A specially trained nurse has inserted a PICC line. What would be done next? A) Start administration of prescribed fluids. B) Explain the procedure to the patient and family. C) Place the patient on restricted oral fluids. D) Send the patient to the radiology department.
D) Send the patient to the radiology department.
21. A student is learning how to administer intravenous fluids, including accessing a vein. Although all of the following may occur, which is the most potentially harmful risk posed for the patient when accessing the vein? A) discomfort B) pain C) minor bleeding D) infection
D) infection
19. A patient has an order to restrict fluids. What is one comfort measure nurses can implement for this patient to alleviate a common problem? A) back rubs B) chewing gum C) hair care D) oral hygiene
D) oral hygiene
17. A patient has a decreased potassium level. What high-potassium foods would the nurse teach the patient to eat? A) lunch meat, salted nuts, whole milk C) carbonated beverages, beer, olives B) buttermilk, hard candy, spinach D) oranges, bananas, broccoli
D) oranges, bananas, broccoli
