Deck 25: Fluid, Electrolyte, and Acid-Base Balance

Question 1

The nurse points out that nonelectrolyte products of metabolism are as important to health as electrolytes. Nonelectrolytes include:

A) magnesium.
B) amino acids.
C) calcium.
D) phosphates.

Answer 1

amino acids.

Question 2

An isotonic state exists within a patient's body fluids when the solute concentration of:

A) interstitial fluid is less than the transcellular.
B) intracellular and extracellular fluid is equal.
C) intracellular fluid is greater than extracellular fluid.
D) extracellular fluid is lesser than intracellular fluid.

Answer 2

intracellular and extracellular fluid is equal.

Question 3

An anxious adult patient is experiencing a respiratory rate of 40 breaths/min. The most appropriate intervention that the nurse could do is to instruct the patient to:

A) sit up.
B) lie down.
C) breathe through a re-breather mask.
D) pant with mouth open.

Answer 3

breathe through a re-breather mask.

Question 4

A 10-month old infant has had watery green stool for 2 days and refuses the bottle. The nurse is aware that the primary concern for this baby is:

A) metabolic acidosis.
B) metabolic alkalosis.
C) weight loss.
D) diaper rash.

Question 5

For the accurate measurement to detect fluid retention, the nurse instructs the nursing assistants to measure the weight with the same scale:

A) each morning before breakfast after the patient has voided.
B) each day at noon before lunch, dressed in light clothing.
C) in between meals, dressed in light clothing after voiding.
D) just before bedtime, while the patient is in a hospital gown or pajamas.

Question 6

A nurse gets a positive Chvostek's sign on a young woman with bulimia who has been giving herself frequent enemas containing phosphate. The nurse anticipates a laboratory finding of:

A) sodium 140 mEq/L.
B) potassium 4.5 mEq/L.
C) magnesium 1.6 mEq/L.
D) calcium 6.5 mEq/L.

Question 7

The nurse is aware that small ions such as glucose, oxygen, and carbon dioxide redistribute themselves through semipermeable membranes by a process called:

A) diffusion.
B) osmosis.
C) blood pressure.
D) rehydration.

Question 8

The nurse is aware that an infant is more at risk for dehydration because the infant:

A) has kidneys that reabsorb water from the intravascular space.
B) has a larger body surface compared with body weight.
C) urinates more frequently.
D) has fat that absorbs water.

Question 9

The nurse is comparing sitting and standing vital signs for a patient who has been diagnosed with dehydration. The pulse rate has increased by 10 beats/min at 1 minute. The nurse then anticipates the blood pressure to show a(n):

A) increase of 5 mm Hg.
B) drop of 40 mm Hg.
C) drop of 20 mm Hg.
D) increase of 10 mm Hg.

Question 10

A patient with heart failure has gained 1.1 pounds over the last 24 hours. The nurse is aware that this weight gain represents a fluid retention of:

A) 0.25 L.
B) 0.5 L.
C) 1.0 L.
D) 2.0 L.

Question 11

A patient who is experiencing severe diarrhea is losing excessive bicarbonate ions. This patient is at risk for developing:

A) respiratory alkalosis.
B) respiratory acidosis.
C) metabolic alkalosis.
D) metabolic acidosis.

Question 12

A patient with healthy kidneys experiences metabolic alkalosis resulting from episodes of vomiting. The nurse takes into consideration that the kidneys can clear the alkaline substances and fully stabilize the patient's pH in approximately:

A) 3 to 5 minutes.
B) 12 to 24 hours.
C) 3 days.
D) 1 week.

Question 13

The patient who was admitted after vomiting for 3 days would show an abnormally low blood pressure because of a fluid shift from:

A) intracellular to the extracellular.
B) interstitial to intravascular.
C) intravascular to the interstitial.
D) interstitial to the intracellular.

Question 14

The nurse is aware that a more dynamic process that moves molecules into cells regardless of their electrical charge or concentration in the cell is:

A) filtration.
B) osmosis.
C) active transport.
D) hydrostatic pressures.

Question 15

A patient has been identified as having a dietary deficiency of vitamin D. The nurse understands that this patient is also at risk for having a deficiency of:

A) calcium.
B) magnesium.
C) sodium.
D) potassium.

Question 16

The nurse assesses that the patient has developed abdominal pain, urinary retention, and confusion. The nurse concludes these signs are the results of an inadequate supply of:

A) calcium (Ca2+).
B) sodium (NA+).
C) phosphates (PO43).
D) potassium (K+).

Question 17

The nurse explains that the dehydrated patient's urine is concentrated because:

A) renal tubules reabsorb more water and reduce urine output.
B) kidneys cease to function.
C) blood pressure drops.
D) the colon retains more fluid from the fecal waste.

Question 18

A patient drank a cup of coffee, a half glass of orange juice, and half a carton of milk with breakfast. Using common equivalents of food containers as a guide, the nurse notes on the intake column of the intake and output sheet that the patient consumed:

A) 360 mL.
B) 400 mL.
C) 420 mL.
D) 600 mL.

Question 19

A patient with a history of severe chronic obstructive pulmonary disease (COPD) is most likely to have:

A) respiratory alkalosis.
B) respiratory acidosis.
C) metabolic alkalosis.
D) metabolic acidosis.

Question 20

At the beginning of the shift, a patient's IV bag has 960 mL remaining. The IV fluid is running at 75 mL/hr. In 8 hours, there should be how many milliliters remaining in the IV bag?

A) 150
B) 360
C) 450
D) 600

Question 21

The primary care provider orders fluid restriction for a patient with severe fluid volume excess. When a patient is placed on a fluid restriction, the allowance of fluids should be:

A) greatest during the day shift.
B) greatest during the evening shift.
C) greatest during the night shift.
D) spaced in equal increments for all shifts.

Question 22

Based on the information provided, which of these measurements should be recorded on the output sheet? (Select all that apply.)

A) 250 mL nasogastric secretions
B) 200 mL diarrhea stool
C) 900 mL IV therapy
D) 650 mL urine from Foley catheter
E) 50 mL chest tube drainage
F) 240 mL milk

Question 23

The nurse is determining if I&O are within normal limits. Which of the following is an indication of a fluid imbalance?

A) Twenty-four hour I&O totals show 2 L negative output. Compare daily weight to see if there is a weight gain of 2 kg.
B) Shift I&O totals show a 2 L positive output. Compare the daily weights to see if there is a weight gain of 2 kg.
C) Shift I&O totals show a 4 L negative output. Compare daily weights to see if there is a zero weight loss.
D) Twenty-four hour I&O totals are equal. Compare daily weight to see if there is a negative weight loss.

Question 24

The nurse clarifies that the electrolytes include: (Select all that apply.)

A) sodium.
B) fatty acids.
C) potassium.
D) magnesium.
E) amino acids.
F) glucose.

Question 25

The nurse explains that water as a constituent of the body has the functions of: (Select all that apply.)

A) transportation of nutrients.
B) blood pressure regulation.
C) heat regulation.
D) removing waste from the cells.
E) assists with digestion of protein.

Question 26

The patient who is prescribed a diuretic for fluid volume excess is discharged home. The patient verbalizes understanding of his disease process when he says:

A) "I can put catsup on my scrambled eggs."
B) "I can snack on salted popcorn."
C) "I will snack on raisins."
D) "I will avoid apricots."

Question 27

The nurse caring for a frail 92-year-old dehydrated patient should add to the plan of care:

A) potential for over-hydration related to excessive thirst.
B) potential for diarrhea related to dehydration.
C) potential for pulmonary congestion related to excessive fluid intake.
D) potential for fall related to confusion.

Question 28

The nurse is aware that the patient who suffered a brain injury with cerebral edema will most likely receive a fluid that is:

A) isotonic.
B) hypertonic.
C) hypotonic.
D) enhanced with vitamin B.

Question 29

The nurse clarifies that when electrolytes are in solution, they break up and become ___________.

Question 30

The nurse assessing a newly admitted patient with marked edema from severe heart failure would anticipate that the patient would exhibit: (Select all that apply.)

A) a thready pulse.
B) concentrated urine.
C) hypertension.
D) weight gain.
E) crackles heard on auscultation.

Question 31

The nurse is caring for a patient for whom a dose of IV potassium has been ordered. Prior to hanging the potassium, the nurse should:

A) check urine output to be above 60 mL/hr.
B) check the dose with another licensed person.
C) confirm the IV fluid running is compatible with potassium.
D) start potassium with another venipuncture.

Question 32

A patient with a serum potassium value of less than 3.5 mEq/L is _________.