Question 1

A 35-year-old female patient is recovering from a parathyroidectomy. What should the nurse include when teaching health promotion activities to this patient?

Accepted Answer

After a parathyroidectomy, the patient may experience low calcium levels. Milk and milk-based products are excellent sources of calcium and should be included in the patient's diet to help maintain normal calcium levels. Red wine and red meat are not specifically recommended for this patient, and excessive sun exposure should be avoided but not completely avoided as sunlight is essential for vitamin D production.

Question 2

A 28-year-old male patient is admitted with diabetic ketoacidosis. Which electrolyte should the nurse expect to be replaced in this patient?

Accepted Answer

The answer of A 28-year-old male patient is admitted with...

Question 3

A patient is diagnosed with hyperphosphatemia. The nurse realizes that this patient might also have an imbalance of what electrolyte?

Accepted Answer

Hyperphosphatemia can cause a decrease in serum calcium levels as excess phosphate ions can bind with calcium, leading to hypocalcemia. Therefore, the nurse should suspect a calcium imbalance in this patient.

Question 4

A postoperative patient is diagnosed with fluid volume overload. What should the nurse expect to assess in this patient?

Accepted Answer

Distended neck veins are a sign of fluid volume overload as the excess fluid accumulates in the vasculature, leading to increased venous pressure. Poor skin turgor and concentrated hematocrit levels are signs of dehydration or fluid volume deficit, while decreased urine output can be a sign of both fluid overload and deficit. However, in a postoperative patient, fluid volume overload is more common due to the administration of IV fluids during and after surgery.

Question 5

A patient is admitted for treatment of hypercalcemia. Which type of intravenous fluid should the nurse expect to be prescribed for this patient?

Accepted Answer

Normal saline (0.9% sodium chloride) is the preferred intravenous fluid for the treatment of hypercalcemia as it helps to promote renal excretion of excess calcium by increasing urine output. Dextrose solutions are not recommended as they may worsen hypercalcemia by stimulating insulin secretion, which promotes calcium absorption.

Question 6

A patient is prescribed 40 mEq potassium as a replacement. How should the nurse plan to administer this medication?

Accepted Answer

Potassium should be mixed in the prescribed intravenous fluid and given slowly to avoid hyperkalemia and cardiac arrhythmias. Direct administration into the venous access line or via intramuscular injection can cause tissue irritation and damage. Rectal suppositories are not typically used for potassium replacement.

Question 7

An older patient comes into the clinic complaining of watery diarrhea for several days with abdominal and muscle cramping. The nurse realizes that this patient is demonstrating which imbalance?

Accepted Answer

The symptoms of watery diarrhea and muscle cramping suggest a loss of sodium in the body, which is consistent with hyponatremia. Fluid volume excess would present with edema and weight gain, which are not mentioned as symptoms. Hypernatremia and hyperkalemia would present with different symptoms such as muscle weakness, confusion, and arrhythmias.

Question 8

A patient's respiration rate is 30 per minute and very deep. What disorder should the nurse suspect is occurring in this patient?

Accepted Answer

Respirations that are deep and rapid (over 20 per minute) can indicate an increase in carbon dioxide in the blood (hypercapnia) which can be caused by a number of respiratory disorders such as pneumonia, asthma, and chronic obstructive pulmonary disease (COPD). Hypernatremia (A) is an electrolyte imbalance and would not typically cause a change in respiratory rate. Hypertension (C) is high blood pressure and does not directly affect respiratory rate. Pain (D) may affect respiratory rate but would not typically cause deep and rapid respirations.

Question 9

A patient with fluid retention related to renal problems is admitted to the hospital. The nurse realizes that this patient could possibly have which electrolyte imbalance?

Accepted Answer

Renal problems can lead to fluid retention and decreased urine output, which can result in an increase in sodium levels in the body, leading to hypernatremia. A and D are not typically electrolyte imbalances associated with renal problems, and C is not an electrolyte but rather a waste product that is eliminated through respiratory function.

Question 10

A postoperative patient with a fluid volume deficit is prescribed progressive ambulation, yet is weak from an inadequate fluid status. What should the nurse do to help this patient?

Accepted Answer

Assisting the patient to move into different positions in stages would be the best option as it allows for progressive ambulation while accommodating the patient's weakness from fluid volume deficit. This can help prevent falls and promote safe mobility. Maintaining a standing position for several minutes or recommending bed rest may not be appropriate for this patient's condition. Contacting physical therapy for a walker may not be necessary at this time.

Question 11

A patient is admitted with burns over 50% of his body. The nurse realizes that this patient is at risk for which electrolyte imbalances?

Accepted Answer

Burn patients are at risk for hypophosphatemia due to increased demand for phosphorus in the healing process and loss of phosphorus through wound exudate. Hypercalcemia, hypernatremia, and hypermagnesemia are not typically associated with burns.

Question 12

A patient is admitted with hypernatremia caused by being stranded on a boat in the Atlantic Ocean for five days without a fresh water source. What is this patient at risk for developing?

Accepted Answer

Hypernatremia can lead to neuronal and cerebral dehydration, which in turn can cause cerebral bleeding, seizures, and neurological deficits. Treatment should aim to gradually lower serum sodium levels to prevent cerebral edema and other complications.

Question 13

An older patient with a history of sodium retention arrives to at the clinic with the complaints of "heart skipping beats" and leg tremors. What should the nurse ask this patient regarding these symptoms?

Accepted Answer

Salt substitutes often contain potassium, which can lead to hyperkalemia, a condition that can cause symptoms such as heart palpitations and muscle tremors. Given the patient's history of sodium retention, the use of a salt substitute could exacerbate these symptoms by further unbalancing electrolytes.

Question 14

A patient who is taking digoxin (Lanoxin) is admitted with possible hypokalemia. What should the nurse realize might occur with this patient?

Accepted Answer

Hypokalemia increases the risk of digoxin toxicity, as low potassium levels enhance the binding of digoxin to cardiac tissue. Therefore, the nurse should closely monitor the patient for signs of digoxin toxicity.

Question 15

The nurse is reviewing a patient's blood pH level. What systems in the body does the nurse recognize as contributing to the regulation of blood pH?

Accepted Answer

The renal system regulates blood pH by reabsorbing or excreting hydrogen ions and bicarbonate ions. Buffers in the body help to maintain a stable pH by absorbing excess hydrogen ions or releasing them when needed. The respiratory system also contributes to pH regulation by controlling the amount of carbon dioxide in the body. The cardiac and integument systems are not directly involved in blood pH regulation.

Question 16

An older patient with peripheral neuropathy has been taking magnesium supplements. The nurse realizes that which symptoms indicate hypermagnesemia?

Accepted Answer

Hypermagnesemia can cause vasodilation leading to hypotension, warmth, and sweating.

Question 17

An older patient is at home after being diagnosed with fluid volume overload. What should the home care nurse instruct this patient to do?

Accepted Answer

Wearing support hose can help reduce the effects of fluid volume overload by promoting venous return and reducing edema, which is particularly beneficial for older patients who may have compromised circulation.

Question 18

The blood gases of a patient with an acid‒base disorder show a blood pH outside of normal limits. The nurse realizes that this patient is

Accepted Answer

A blood pH outside of normal limits indicates an acid‒base disorder. If the patient's body has attempted to compensate for the disorder, the blood pH may be partially compensated. The patient may require further treatment to fully correct the imbalance. The information provided does not suggest that the patient is undergoing anaerobic metabolism or in need of intravenous fluids, so options B and D can be eliminated.

Question 19

A patient's blood gases show a pH of 7.53 and bicarbonate level of 36 mEq/L. The nurse realizes that the patient is demonstrating which acid‒base disorder?

Accepted Answer

The patient's blood gases indicate a high pH level (7.53), suggesting alkalosis, and an elevated bicarbonate level (36 mEq/L), which points to a metabolic cause. Therefore, the condition is metabolic alkalosis.

Question 20

The nurse is admitting a patient who was diagnosed with acute renal failure. Which electrolyte should the nurse expect to be most affected with this disorder?

Accepted Answer

Acute renal failure can cause hyperkalemia (elevated potassium levels) due to impaired excretion of potassium by the kidneys.

Quiz 10: Nursing Care of Patients With Altered Fluid, Electrolyte, and Acidbase Balance