Question 1

A nursing instructor teaches that which of the following body processes is an example of diffusion?

Accepted Answer

Diffusion is the movement of particles from an area of higher concentration to an area of lower concentration. In the case of oxygen, it diffuses from the alveoli in the lungs into the bloodstream where the concentration is lower.

Question 2

When reviewing laboratory values of multiple patients with fluid and electrolyte imbalance, a nurse recognizes that which of the following values represents a therapeutic response to treatment?

Accepted Answer

A sodium level of 136 mEq represents a therapeutic response to treatment for fluid and electrolyte imbalance. The normal range for serum sodium is 135-145 mEq/L, and a level of 136 mEq/L indicates that the imbalance has been corrected without causing hypernatremia. The other options are either below or above the normal range, indicating either hyponatremia or hypernatremia, which are not therapeutic responses.

Question 3

A nursing instructor teaches that the movement of fluid from extracellular to intracellular compartments is most dependent on which of the following?

Accepted Answer

B

Question 4

During change of shift report, a nurse is informed that a patient has new orders for sodium polystyrene (Kayexalate). After providing the treatment later in the shift, which of the following statements would most likely document the patient's care?

Accepted Answer

Kayexalate (sodium polystyrene sulfonate) is used to treat hyperkalemia (high levels of potassium in the blood) by promoting the exchange of sodium for potassium in the intestines, leading to increased potassium excretion through the stools. The documentation in choice A is appropriate because it mentions the administration of Kayexalate and observes the expected outcome of increased bowel movements (two stools), which indicates the medication's effectiveness in removing potassium from the body.

Question 5

A nurse is providing care for a patient recently admitted with hypercalcemia related to breast cancer. The nurse would be most concerned if the patient reported taking which of the following medications?

Accepted Answer

Digitalis (digoxin) toxicity is increased in the presence of hypercalcemia, making it the medication of most concern for a patient with hypercalcemia related to breast cancer. Hypercalcemia can potentiate the effects of digoxin, increasing the risk of digoxin toxicity, which can be life-threatening.

Question 6

A nurse is providing care for a patient admitted with nausea, vomiting, and diarrhea who has orders to remain NPO. Family members ask, "Why can't she have anything to drink?" Which of the following responses by the nurse is best?

Accepted Answer

The patient has orders to remain NPO, which means nothing by mouth. The best option is to explain to the family members that it is best to let the patient's bowels rest, and offer alternative measures to help the patient feel comfortable, such as mouth swabs. Option A is incorrect because the patient's orders are clear, and the nurse should not alter them without consulting the healthcare provider. Option B is incorrect because the patient is ordered to remain NPO, and ice chips count as food/fluid. Option C is incorrect because the nurse should be aware of the patient's orders and should not suggest additional tests without clarification from the healthcare provider.

Question 7

Which of the following individuals will be at the lowest risk for an electrolyte imbalance?

Accepted Answer

A 42-year-old with an estimated blood loss of 1/2 pint due to traumatic injury is likely to be at the lowest risk for an electrolyte imbalance compared to the other scenarios. This is because the amount of blood loss is relatively small and can be compensated for by the body more easily than the extensive fluid losses or shifts associated with severe burns, prolonged vomiting and diarrhea, or heat stroke.

Question 8

While caring for a patient taking furosemide (Lasix), a nurse recognizes that teaching is successful if the patient chooses which of the following foods?

Accepted Answer

Furosemide (Lasix) is a loop diuretic that can cause potassium loss, so eating potassium-rich foods like oranges can help maintain potassium levels.

Question 9

A nurse working in the sports medicine complex is counseling a female college athlete about dietary concerns. Which of the following recommendations should be included in the teaching?

Accepted Answer

The recommendation for a female college athlete should be higher than the average person, which is why option C is the best choice. A liter of fluid each day (option A) is not enough for an athlete, and four to five glasses of water (option B) does not provide a specific amount. Option D is also incorrect because fluid needs do not decrease after reaching a certain age.

Question 10

While reviewing laboratory results, a nurse notes that one of the patients has a low blood urea nitrogen (BUN) level. Which of the following is the most likely cause of that result?

Accepted Answer

Fluid volume excess can dilute blood urea nitrogen levels, leading to a lower BUN result.

Question 11

A patient with hypercalcemia is at increased risk for which of the following additional electrolyte imbalances?

Accepted Answer

Hypercalcemia can lead to hypophosphatemia as elevated calcium levels can cause increased deposition of calcium and phosphate in bones, decreasing serum levels of phosphate. The other electrolyte imbalances listed are not typically associated with hypercalcemia.

Question 12

While caring for a newly admitted patient with fluid and electrolyte imbalances, a nurse would be most concerned by which of the following?

Accepted Answer

Lung fields with crackles noted bilaterally indicate fluid in the lungs, which can lead to respiratory distress and compromise the patient's breathing. This is a more urgent concern than the other options presented. A urinary output of 300 mL in 8 hours and a blood pressure of 128/60 mm Hg are both normal or within acceptable ranges. Nausea is a common symptom and can be addressed with medication if necessary.

Question 13

Which of the following individuals should follow the American Heart Association recommendation to limit salt intake to 1500 mg/d?

Accepted Answer

The American Heart Association recommends limiting salt intake to 1500 mg/d for individuals with hypertension, which is a condition where high blood pressure puts extra strain on the heart and blood vessels. Therefore, the 41-year-old with hypertension is the only individual from the given options who should follow the recommendation to limit salt intake.

Question 14

Which of the following statements indicates to a nurse that a patient taking an osmotic diuretic needs further teaching?

Accepted Answer

Osmotic diuretics work by pulling water into the renal tubule without sodium retention, leading to increased urine output and decreased water in the body, not retaining salt and water as indicated in option C.

Question 15

While caring for a patient with dehydration, a nurse is most likely to include which of the following in the patient's plan of care?

Accepted Answer

Dehydration can cause an alteration in body temperature due to the lack of fluid to regulate body temperature. Chronic pain, ineffective airway clearance, and readiness for enhanced coping are not directly related to dehydration.

Question 16

While preparing for a rotation in the intensive care unit, a student nurse is told in report that a patient is "third spacing." Which of the following symptoms does the student expect to see?

Accepted Answer

"Third spacing" refers to the accumulation of fluid in the interstitial spaces, causing swelling in the extremities. This can occur in critically ill patients due to a variety of factors such as sepsis, trauma, or heart failure. Elevated body temperature, large amounts of dilute urine, and high blood pressure are not typically associated with third spacing.

Question 17

After receiving a report from the emergency department of a new admission with hyponatremia, a nurse anticipates that which of the following intravenous (IV) fluids may be included in the treatment plan?

Accepted Answer

Hyponatremia is a condition where there is a low level of sodium in the blood. Normal saline (NS) is often used to treat hyponatremia because it is a sodium-rich solution that can help increase sodium levels in the body. Dextrose 5% in water (D5W) and 0.45% normal saline do not contain enough sodium to effectively treat hyponatremia. Sodium bicarbonate is not typically used to treat hyponatremia.

Question 18

A nurse caring for a patient taking the diuretic furosemide (Lasix) would be most concerned by which of the following findings?

Accepted Answer

Furosemide (Lasix) is a loop diuretic that can lead to electrolyte imbalances, particularly hypokalemia, which can cause muscle spasms or cramps.

Question 19

A nurse is caring for multiple patients on a medical floor. Which of the following patients should the nurse see first?

Accepted Answer

The 94-year-old with congestive heart failure and receiving IV D51/2NS with 20 mEq potassium chloride (KCl) at 120 mL/hr is the priority because potassium chloride can cause life-threatening cardiac arrhythmias if infused too quickly or in too high of a dose. The nurse needs to monitor the patient's cardiac status and electrolyte levels closely.

Question 20

For a patient with alkalosis, a nurse would expect which of the following assessments?

Accepted Answer

The answer of For a patient with alkalosis, a nurse...

Quiz 29: Fluids, Electrolytes, and Acid-Base Balance