Medical Surgical Nursing Chapter 17 Fluid, Electrolyte, and Acid-Base Imbalances-185 questions

2, 4, 5 It is especially important for the nurse to assess for which clinical manifestation(s) in a patient with primary hypoparathyroidism? Select all that apply

. 1 Anorexia 2 Easy fatigability 3 Depressed reflexes 4 Circumoral numbness 5 Positive Trousseau's sign

2, 3, 5 What does the nurse infer from a patient who reports abdominal cramping and diarrhea and has a serum potassium level of 6.8 mEq/L? Select all that apply

. 1 The patient is on insulin therapy. 2 The patient is on a potassium-sparing diuretic. 3 The patient is on β-adrenergic agonist therapy. 4 The patient is on an aldosterone receptor blocker. 5 The patient is on an angiotensin-converting enzyme inhibitor.

3 The student nurse is educating a patient regarding skin care management. What statement made by the student requires correction?

1 "Avoid extreme temperatures." 2 "Apply moisturizers even at night." 3 "Wash hands and legs frequently with soap." 4 "Change your position regularly while at rest."

1 A nurse is providing postoperative care for a patient. The primary health care provider assesses the patient and advises the nurse to stop all intravenous fluids except for continuous maintenance fluids. Which fluid will the nurse administer as a maintenance fluid?

1 0.45% NaCl 2 Lactated Ringer's solution 3 5% dextrose in 0.9% saline 4 25% albumin solution

2 The patient was admitted for a paracentesis to remove ascites fluid. Five liters of fluid were removed. What intravenous (IV) solution may be used to pull fluid into the intravascular space after the paracentesis?

1 0.9% sodium chloride 2 25% albumin solution 3 Lactated Ringer's solution 4 5% dextrose in 0.45% saline

1 Which phosphate level would the nurse be likely to find in the patient who has alcohol withdrawal symptoms?

1 1.4 mg/dL 2 2.4 mg/dL 3 3.8 mg/dL 4 4.8 mg/dL

2 The surgical-unit nurse notes that a patient has an intravenous (IV) prescription for 0.9% normal saline (NS) with 20 mEq KCl/L at 100 mL/hr. The nurse regulates the IV flow rate at how many drops (gtt) per minute, noting that the tubing has a drop factor of 10 drops/mL?

1 15 gtt/minute 2 17 gtt/minute 3 19 gtt/minute 4 21 gtt/minute

2 A patient reports weight gain, diarrhea, headache, nausea, and vomiting. The patient's blood pressure is 140/90 mm Hg. The patient's previous health records reveal primary hypoaldosteronism. Which medication may be beneficial for the patient? .

1 Amiloride 2 Conivaptan 3 Propranolol 4 Sodium polystyrene sulfonate

2 The nurse is caring for a patient admitted with heart failure. The morning laboratory results reveal a serum potassium level of 2.9 mEq/L. Which classification of medications should be withheld until consulting with the health care provider?

1 Antibiotics 2 Loop diuretics 3 Bronchodilators 4 Antihypertensives

1 While taking a patient's blood pressure, a nurse notices that a carpal spasm occurs. To diagnose a possible cause for the carpal spasm, the nurse should expect the primary health care provider to prescribe which level?

1 Calcium 2 Sodium 3 Potassium 4 Magnesium

1 Which treatment could be a possible reason for a cancer patient to have a serum phosphate level of 5.4 mg/dL?

1 Chemotherapy 2 Insulin therapy 3 Total parenteral nutrition 4 Phosphate-binding antacids

1 A patient is diagnosed with Cushing syndrome. What manifestation does the nurse anticipate while assessing this patient?

1 Dyspnea

1 A patient sustains a soft tissue injury to the ankle, and a large amount of edema develops. What nursing intervention will relieve edema associated with this injury?

1 Elevating the extremity

1 While caring for a patient who had a pituitary tumor removed, which finding should be reported immediately to the primary health care provider?

1 Excessive thirst 2 Calcium level of 8.6 mg/dL 3 Potassium level of 3.5 mEq/L 4 Urine output of 300 mL in eight hours

4 The nurse is preparing to administer intravenous (IV) potassium chloride (KCl) to a patient. Which action should the nurse perform to ensure the patient's safety?

1 Give KCl via IV push. 2 Add KCl to the hanging IV bag. 3 Give IV KCl in concentrated amounts. 4 Invert IV bags containing KCl several times

1 Which electrolyte changes can be identified by Trousseau's sign?

1 Hypocalcemia 2 Hypercalcemia 3 Hypermagnesemia 4 Hyperphosphatemia

3 Which electrolyte imbalance is associated with sickle cell anemia?

1 Increased calcium levels 2 Increased potassium levels 3 Increased phosphate levels 4 Increased magnesium levels

4 Which treatment strategy would be beneficial in a patient with a blood sodium level of 170 mEq/L who experiences intense thirst, agitation, and decreased alertness?

1 Intravenous furosemide 2 Intravenous cation-exchange resin 3 Intravenous phosphate-binding agent 4 Intravenous 0.45% sodium chloride saline solution

4 The nurse is caring for an older patient who is receiving intravenous (IV) fluids postoperatively. During the 8 AM assessment of this patient, the nurse notes that the IV solution, which was prescribed to infuse at 125 mL/hr, has infused 950 mL since it was hung at 4 AM. What is the priority nursing intervention?

1 Notify the health care provider and complete an incident report. 2 Slow the rate to keep the vein open until the next bag is due at noon. 3 Obtain a new bag of IV solution to maintain patency of the site. 4 Listen to the patient's lung sounds and assess respiratory status.

1 A patient has been treated successfully for dehydration. The nurse would expect:

1 Oral intake balances output. 2 Oral intake is less than output. 3 Oral intake is greater than output. 4 No significant difference in fluid balance.

1 A patient with blood pressure of 160/90 mm Hg has pedal edema. Which process of transport of molecules would be in action?

1 Osmosis

3 A patient is admitted with alcohol abuse. Laboratory data reveals a phosphate level of 1.8 mg/dL. Which assessment finding is consistent with this data?

1 Seizure activity 2 Diarrhea 3 Weakness 4 Tetany

4 The nurse preparing to administer a dose of potassium phosphate would hold the medication after noting which laboratory value?

1 Sodium 133 mEq/L 2 Magnesium 1.8 mEq/L 3 Potassium 5.2 mEq/L 4 Calcium 6.4 mg/dL

1 The nurse receives a health care provider's prescription to change a patient's intravenous (IV) from D5½ normal saline (NS) with 40 mEq KCl/L to D5NS with 20 mEq KCl/L. Which serum laboratory value on this same patient best supports the rationale for this IV prescription change?

1 Sodium 136 mEq/L, potassium 4.5 mEq/L 2 Sodium 145 mEq/L, potassium 4.8 mEq/L 3 Sodium 135 mEq/L, potassium 3.6 mEq/L 4 Sodium 144 mEq/L, potassium 3.7 mEq/L

2 The nurse finds that the patient with renal disease is irritable and has an irregular pulse. ECG changes suggest severe hyperkalemia. What should be the first nursing intervention?

1 Stop all sources of dietary potassium 2 Administer intravenous calcium gluconate 3 Administer ion-exchange resins 4 Administer intravenous insulin with glucose

1 A patient sustains multiple injuries in a motor vehicle accident and is hypovolemic due to hemorrhage. Blood transfusions are given to replace the lost blood. The nurse finds that the patient has now developed laryngeal stridor, dysphagia, and numbness and tingling around the mouth. What could be the reason for these new manifestations?

1 The patient has developed hypocalcemia 2 The patient has developed fluid overload 3 The patient has developed anemia 4 The patient has developed a hemolytic reaction

1 While caring for a patient with metastatic bone cancer, which clinical manifestations would alert the nurse to the possibility of hypercalcemia in this patient?

1 Weakness

1, 3, 4 When the nurse is caring for a patient with a central venous access device, which nursing interventions are important to maintain a safe, functioning device? Select all that apply.

1 Change the catheter dressing regularly. . 3 Change the injection caps at regular intervals. 4 Cleanse around the catheter insertion site.

3, 4, 5 A nurse is assessing a patient with hyperkalemia. Which changes in the electrocardiogram might the nurse find? Select all that apply.

1 Flattened T wave 2 Prolonged QRS 3 Loss of P wave 4 Tall, peaked T wave 5 ST segment depression

2, 3, 4 When administering intravenous (IV) potassium chloride (KCl) to a patient to correct hypokalemia, which interventions are important? Select all that apply.

1 IV KCl can be added to a hanging IV bag. 2 KCl should never be given via IV push or bolus. 3 KCl must always be diluted before administering. 4 IV site should be regularly assessed for infiltration. 5 IV KCl should be administered at a rate of 50 mEq/h.

2, 4, 5 The nurse finds polyuria, soft flabby muscles, and an irregular pulse in a patient who has a blood glucose level of 165 mg/dL and who is on is on intravenous dextrose therapy. Which changes are observed in the patient's electrocardiogram? Select all that apply.

1 Loss of P wave 2 Prolonged QRS 3 Peaked T waves 4 Presence of U wave 5 ST segment depression

1, 3, 4 A nurse has been caring for a patient with a high fever and diarrhea for the past five days. Which clinical manifestations suggest extracellular fluid volume deficit? Select all that apply.

1 Restlessness 2 Peripheral edema 3 Concentrated urine 4 Dry mucous membranes 5 Jugular venous distention

A nurse is teaching the nursing assistants the importance of performing accurate weighings. Which content should be included? Select all that apply.

1 Calibrate the scale before using 2 Weigh patient with same garments each day 3 Weigh the patient at the same time each day 6 If bed scale used, weigh with same number of linens on the bed

A nurse is caring for a patient who reports diarrhea and vomiting for the past five days. As a result, the patient has developed severe hypokalemia. The primary health care provider prescribes IV potassium chloride (KCl) treatment. How can the nurse ensure the safety of the patient when administering IV KCl? Select all that apply.

1 Continuously monitor cardiac function 2 Check hourly for the presence of phlebitis at the IV site 3 Monitor the urine output

On assessment, the nurse finds that a patient has a headache, increased blood pressure, peripheral edema, dyspnea, and jugular venous distention. The symptoms indicate excess fluid volume. Which causes of excess fluid volume might the nurse find in the patient? Select all that apply.

1 Heart failure 4 Long-term use of corticosteroids 5 Syndrome of inappropriate antidiuretic hormone (SIADH)

1, 3, 4 The dehydrated patient is receiving a hypertonic solution. What assessments must be done to avoid risk factors of these solutions? Select all that apply.

1 Lung sounds 3 Blood pressure (BP) 4 Serum sodium level

4 The nurse needs to add potassium chloride (KCl) 40 mEq to an intravenous (IV) solution of 0.9% sodium chloride. The multidose vial contains 10 mEq KCl in 5 mL of solution. How many milliliters of KCl should the nurse add to the IV bag?

1. 2 mL 2. 5 mL 3. 10 mL 4. 20 mL

4 The nurse needs to add potassium chloride 10 mEq to an intravenous (IV) of lactated Ringer's solution. Available are multidose vials containing 5 mEq KCl in 10 mL of solution. How many milliliters of KCl should be added to the IV bag?

1. 2 mL 2. 5 mL 3. 10 mL 4. 20 mL

2 Which statement made by the student nurse regarding the hypothalamic-pituitary regulation needs correction?

2 "Dry mouth is the measuring tool for fluid deficit."

2 The nurse is teaching a caregiver for an older adult patient with dementia about fluid balance maintenance at home. Which statement made by the caregiver indicates that he or she requires further education?

2 "I should provide fluids when the patient feels thirsty."

2 A patient has been admitted for dehydration. What is a priority nursing intervention? 2

2 Perform daily weights

3 The nurse is caring for a patient with fluid imbalance related to a deficit. Which action by the nurse provides comfort to the patient?

3 Helping the patient to apply moisturizer and use moisturizing soaps

A patient asks why the primary health care provider prescribed a b-type natriuretic peptide (BNP). Which response by the nurse is accurate?

3 It is a blood test that shows if there is excess fluid in the heart.

The nurse is caring for a patient diagnosed with heat stroke and with a urine output of 4000 mL per day. What is the most appropriate nursing action?

3 Administrating lactated Ringer's solution

3, 4, 5 A 71-year-old patient is admitted with nausea and vomiting. Which manifestations would the nurse assess to check for the presence of dehydration? Select all that apply.

3 Urine output 10 mL/hr 4 Tachycardia 5 Sunken eyes

4 When planning care for a patient with dehydration related to nausea and vomiting, the nurse would anticipate which fluid shift to occur because of the fluid volume deficit?

4 Fluid movement from the interstitial space into the blood vessels

4 The nurse is caring for a 92-year-old patient who has dehydration. The nurse would instruct the unlicensed assistive personnel (UAP) to report which finding?

4 Urine output of 350 mL in 24 hours

2000

A nurse is assessing a patient's weight in order to evaluate fluid volume status. The patient's weight on the day of admission was 60 kg. On day 2, the weight is 62 kg. What is the quantity of fluid retention in the patient? Record your answer using a whole number and no punctuation. _______ mL

3.5

A patient weighing 60 kg with diabetes mellitus is excreting 3500 mL of urine per day. What is the amount of weight lost by the patient in 24 hours? Record your answer using one decimal place. ____________ kg

24.0

A person weighing 100 kg has 40 L of intracellular fluid. What amount of intracellular fluid does a 60 kg individual have? Record your answer using one decimal place. ____________ L

8.6 Text Reference - p. 286

The nurse is recording a patient weight of 68 kg in the ward. How much interstitial fluid is estimated to be present there? Record your answer using one decimal place. ____________ L

2 Extracellular fluid accounts to one-third of the body water, and plasma represents 20 percent of the extracellular fluid. Therefore, a patient weighing 55 kg has 30.3 L of total body water and about 10 L of extracellular fluid, and plasma represents 20 percent of the extracellular fluid, which equals approximately 2 L.

What amount of plasma is present in the body of a patient who weighs 55 kg? Record your answer using two decimal places. ____________ L