Deck 42: Pharmacotherapy of Fluid, Electrolyte, and Acid-Base Balance Disorders

Question 1

When planning care, the nurse anticipates that which of the following patients will most likely require intravenous fluid replacement?
1)A patient diagnosed with anaphylactic shock
2)A patient diagnosed with congestive heart failure
3)A patient diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)
4)A patient with a minor burn to the left arm

Answer 1

1

Question 2

When a nurse administers a hypotonic intravenous solution to a patient, water will:
1)Move by osmosis from the plasma compartment to the interstitial compartment.
2)Move by diffusion from the plasma compartment to the interstitial compartment.
3)Move by osmosis from the interstitial compartment to the plasma compartment.
4)Move by diffusion from the interstitial compartment to the plasma compartment.

Answer 2

1

Question 3

The nurse is aware that body fluids are exchanged between the:
1)Intracellular and extracellular compartments.
2)Interstitial and extracellular compartments.
3)Intravascular and extracellular compartments.
4)Intravascular and interstitial compartments.

Answer 3

1

Question 4

A patient being treated long-term with oral sodium bicarbonate should be monitored for which acid-base imbalance?
1)Respiratory acidosis
2)Respiratory alkalosis
3)Metabolic acidosis
4)Metabolic alkalosis

Question 5

A patient who was ordered to receive 100 mL of 3% normal saline solution received 1,000 ml of 3% normal saline.The nurse should closely monitor this patient's:
1)Blood pressure.
2)Capillary refill.
3)Skin integrity.
4)Coagulation profile.

Question 6

When infusing 3% NaCl solutions, the nurse should continuously check for:
1)Signs of pulmonary edema.
2)Signs of depression.
3)Hyponatremia.
4)Signs of thirst.

Question 7

A patient is ordered to have a hypertonic intravenous solution administered.Administration of this solution will most likely cause:
1)The plasma to have less solutes than the interstitial fluid.
2)No fluid shift.
3)The plasma to have more solutes than the interstitial fluid.
4)A shift of fluid from the vascular space to the interstitial space.

Question 8

A nurse is caring for a patient with a serum potassium level of 6.9 mEq/L.The nurse planning care is aware that which body system will be most profoundly affected by this value?
1)The genitourinary system
2)The respiratory system
3)The hematological system
4)The cardiovascular system

Question 9

A patient has a serum sodium level of 157 mEq/L.The patient must be monitored closely for changes in:
1)Level of consciousness.
2)Thirst level.
3)Daily weight.
4)Muscle pain.

Question 10

The nurse is reviewing a patient's lab values, which indicate normal serum osmolality.Which intravenous solutions will not cause a fluid shift in this patient?
1)Hypotonic solutions
2)Isotonic solutions
3)Hypertonic solutions
4)Colloids

Question 11

A nursing instructor asks a student at which point it is appropriate to treat hyponatremia.The student correctly responds by stating:
1)"When serum levels fall below 145 mEq/L."
2)"When serum levels fall below 140 mEq/L."
3)"When serum levels fall below 155 mEq/L."
4)"When serum levels fall below 130 mEq/L."

Question 12

When treating fluid imbalances, the ultimate goal of the health care team is to:
1)Administer intravenous fluids.
2)Diagnose and correct the underlying cause of the disorder.
3)Keep patients normothermic.
4)Maintain normal vital signs.

Question 13

A nurse would question which of the following orders?
1)Administer potassium chloride 20 mEq, by mouth, once.
2)Infuse potassium chloride 40 mEq, IV push over one minute, once.
3)Administer potassium chloride, 20 mEq diluted in 90 mL juice, by mouth once.
4)Infuse potassium chloride 40 mEq in 250 mL NaCl, over four hours, once.

Question 14

A patient has a severe fluid and electrolyte imbalance.The nurse is aware that in order for the body to move large molecules and molecules with electrical charges, which two processes are required?
1)Osmosis and diffusion
2)Osmosis and active transport
3)Diffusion and active transport
4)Active transport and facilitated osmosis

Question 15

A nurse is evaluating a patient's serum osmolality.Which of the following solutes is not factored into this value?
1)Sodium
2)Glucose
3)Urea
4)Water

Question 16

A patient has vomited several times, and continues to be nauseated.To correct mild hypovolemia, the nurse plans to:
1)Ask the patient to drink eight ounces of water every hour.
2)Administer a hypotonic crystalloid.
3)Ask the patient to drink eight ounces of an electrolyte solution every 30 minutes for four hours.
4)Administer an isotonic crystalloid.

Question 17

A patient has a serum potassium of 2.5 mEq/L.While reviewing the patient's medical administration record, which medication does the nurse suspect might have contributed to this imbalance?
1)Metoprolol
2)Aspirin
3)Hydrochlorothiazide
4)Acetaminophen

Question 18

A patient diagnosed with diabetes insipidus is suffering from severe hypernatremia.The nurse anticipates the use of which type of intravenous solution?
1)An isotonic crystalloid
2)A hypotonic crystalloid
3)Albumin
4)A hypertonic crystalloid

Question 19

A patient with long-standing hepatic cirrhosis might receive which intravenous solution to correct hypoproteinemia?
1)Packed red cells
2)Whole blood
3)Dextrose 5%
4)Albumin

Question 20

A patient is ordered to receive a transfusion of fresh frozen plasma (FFP).The nurse plans her care based on the knowledge that this will:
1)Rehydrate cells.
2)Replace intravascular volume.
3)Dehydrate cells.
4)Cause fluid to shift out of the intravascular space.

Question 21

The nurse would question administering sodium bicarbonate to which patient?
1)A patient on continuous nasogastric suctioning
2)A patient diagnosed with metabolic acidosis
3)A patient in chronic renal failure
4)A patient taking methotrexate

Question 22

The nurse would be most concerned about administering which blood product to a patient?
1)Whole blood
2)Fresh frozen plasma
3)Albumin
4)Packed red cells

Question 23

A nurse is providing patient teaching to a patient prescribed to take potassium tablets.Which patient teaching information should be included?
1)Avoid salt substitutes.
2)Licorice helps alleviate the bad taste of the potassium tablets.
3)Allow potassium tablets to dissolve completely in the mouth.
4)Add lots of potassium-rich foods to your diet.

Question 24

The nurse is assessing a patient being treated with 3% normal saline solution.Which of the following assessment findings should be reported to the physician immediately?
1)Presence of auscultated rhonchi
2)Temperature of 100.1°F
3)Presence of auscultated crackles
4)Blood pressure of 146/92

Question 25

Nurses must administer sodium bicarbonate with caution to patients with hypertension to avoid:
1)Retention of fluid.
2)Unexpected diuresis.
3)Metabolic acidosis.
4)Respiratory acidosis.

Question 26

A patient is being treated with ammonium chloride.The nurse evaluates that effective patient and family teaching is done when the patient's wife states:
1)"I will report sleepiness right away."
2)"The IV infusion is going to be painful."
3)"This medication should make him a little shaky."
4)"Confusion will be normal for a day or so."

Question 27

The nurse is preparing to administer a D5W infusion to a patient.The nurse explains to a graduate nurse that:
1)"This medication is isotonic in its container, but when infused, the solution becomes hypotonic."
2)"This medication is hypertonic, and will cause fluid to shift from the extravascular space into the vascular space."
3)"This medication is hypotonic, and will cause fluid to shift from the intravascular space into the interstitial and intracellular spaces."
4)"This is a colloid, and will increase the patient's blood pressure."

Question 28

A patient is receiving an infusion of magnesium sulfate.The physician should be notified immediately if which of the following is observed?
1)A blood pressure of 90/60
2)Pain at the IV site
3)A respiratory rate of 9 breaths per minute
4)A pulse rate of 99 beats per minute

Question 29

Which of the following is not an indication for the use of potassium chloride?
1)Preventing hypokalemia
2)Treatment of mild alkalosis
3)Treatment of peptic ulcer disease
4)Treatment of hypokalemia

Question 30

A patient is scheduled to have a parenteral dose of magnesium sulfate.The nurse tests patellar reflexes and determines them to be absent.The nurse should:
1)Administer the drug as ordered, this is a normal finding.
2)Administer the drug after placing the patient on a cardiac monitor.
3)Hold the medication and notify the physician.
4)Hold the medication for one hour, then reassess.

Question 31

A nurse is scheduled to administer a potassium supplement to a patient.Which action should the nurse take prior to administration of the drug?
1)Check the patient's potassium level from the morning labs.
2)Place the patient in a low Fowler's position.
3)Tell the patient that the infusion will burn.
4)Ask the patient why she is taking the medication.