Deck 8: Fluid and Electrolyte Imbalances

Question 1

When assessing a patient with metabolic acidosis, which concept should the nurse keep in mind?

A) The kidney response is to retain HCO^3-.
B) The kidney response is to excrete HCO^3- or conserve H⁺.
C) The kidney response is to decrease acid excretion in the urine and decrease HCO^3- production.
D) The kidney response is to Increase CO².

Answer 1

The kidney response is to retain HCO^3-.

Question 2

When reviewing the laboratory values of a patient, which value would prompt the nurse to notify the physician?

A) Serum sodium 140 mEq/L
B) Serum chloride 100 mEq/L
C) Serum potassium 3.0 mEq/L
D) Serum phosphorous 2.0 mEq/L

Answer 2

Serum potassium 3.0 mEq/L

Question 3

During an assessment, the nurse notes that a patient has 2 mm pitting edema in his ankles. In the medical record, the nurse grades this edema as:

A) 1+
B) 2+
C) 3+
D) 4+

Answer 3

1+

Question 4

Which manifestation would the nurse expect in a 3-month-old with diarrhea?

A) Bulging fontanels
B) Swollen tongue
C) Dry diaper for 2 hours
D) No tears when crying

Question 5

Which manifestation would the nurse expect to find in a patient with fluid volume deficit?

A) Postural hypotension
B) Taut skin
C) Low urine specific gravity
D) Weight gain

Question 6

Which nursing intervention would the nurse expect to implement in a patient with isotonic fluid excess?

A) Provide a 2- to 4-gram sodium diet.
B) Encourage fluid intake.
C) Monitor intake and output.
D) Position the patient flat in bed.

Question 7

When assessing the cardiovascular status of a patient with hypernatremia, the nurse would expect which manifestation?

A) Bradycardia
B) Flat jugular veins
C) Hypertension
D) Peripheral edema

Question 8

When a patient with hypoparathyroidism reports numbness and tingling, the nurse should suspect which electrolyte imbalance?

A) Hyperchloremia
B) Hypernatremia
C) Hypophosphatemia
D) Hypocalcemia

Question 9

Which assessment finding would alert the nurse that a patient who is vomiting has developed hypochloremia?

A) Slow, shallow respirations
B) Polydipsia
C) Poor skin turgor
D) Decreased urine output

Question 10

Which nursing intervention should be included in the nursing plan of care for a patient with hepatic impairment and hypochloremia?

A) Administer ammonium chloride.
B) Discontinue a loop diuretic and change to another class of drug.
C) Infuse a hypotonic saline solution.
D) Encourage intake of low-chloride foods.

Question 11

Which statement by a patient receiving a thiazide diuretic indicates to the nurse that the patient needs more instruction?

A) "I may need to take a potassium supplement."
B) "I should avoid foods high in potassium."
C) "I will need to have my potassium level checked periodically."
D) "I should report any undue weakness or fatigue."

Question 12

Which response should the nurse make when a patient receiving intravenous potassium complains of burning at the infusion site?

A) "Let me check the IV site and make sure there are no complications."
B) "Don't worry, the burning goes away with time."
C) "It's normal for the insertion site to be red and warm."
D) "I'll check back with you in 2 hours and see if it still burns."

Question 13

The nurse is administering intravenous (IV) magnesium to a patient with hypomagnesemia. Which action should the nurse take to prevent the development of complications?

A) Observe the cardiac telemetry monitor for ventricular arrhythmias.
B) Keep calcium gluconate on hand.
C) Infuse the IV magnesium slowly.
D) Administer loop diuretics.

Question 14

The nurse would expect to assess which finding in the patient with hypermagnesemia?

A) Increased deep tendon reflexes
B) Respiratory depression
C) Hypertension
D) Tachyarrhythmias

Question 15

Which question should the nurse ask during the admission history of a patient with hypomagnesemia?

A) "Do you use magnesium-containing laxatives?"
B) "How much alcohol do you drink?"
C) "Are you taking lithium?"
D) "Do you have renal failure?"

Question 16

The nurse notes that a patient's serum phosphorus level is 6.1 mg/dL. Which disorder is most likely responsible for this phosphorous level?

A) Respiratory alkalosis
B) Hypercalcemia
C) Hyperparathyroidism
D) Chronic renal failure

Question 17

Which electrocardiogram findings would the nurse expect to observe on the rhythm strip of a patient with hypercalcemia?

A) Shortened QT interval
B) Prolonged ST segment
C) Sinus bradycardia
D) ST segment depression

Question 18

Which response by a patient with hypoparathyroidism would indicate a positive Chvostek sign?

A) A twitch of the lip on the ipsilateral side
B) A twitch of the lip on the contralateral side
C) A lack of twitching of the lip
D) Bilateral twitching of the lip

Question 19

During report, the nurse learns that a patient has a Trousseau sign. The nurse would also expect this patient to exhibit:

A) muscle weakness.
B) hypertension.
C) hypoactive bowel sounds.
D) tetany.

Question 20

When assessing a patient with hypophosphatemia, the nurse should keep in mind that the clinical manifestations of this disorder correlate with those of:

A) hypercalcemia.
B) hypocalcemia.
C) hypermagnesemia.
D) hypomagnesemia.