Deck 6: Nursing Care of Patients With Fluid, Electrolyte, and Acid-Base Imbalances

Question 1

A patient with severe diarrhea develops an imbalance of potassium. The nurse expects the client to exhibit which of the following symptoms?

A)Shallow respirations, lethargy, nausea
B)Kussmaul's breathing, thirst, furrowed tongue
C)Apathy, weakness, positive Chvostek's sign
D)Pitting edema, confusion, bounding pulse

Answer 1

Shallow respirations, lethargy, nausea

Question 2

The nurse tests a patient for Trousseau's sign by inflating a blood pressure cuff around the upper arm for 2 minutes. Which patient response indicates a positive result?

A)Weakness of the arm
B)Redness of the arm below the cuff
C)Spasticity of the arm and fingers
D)Pain in the arm and hand

Answer 2

Spasticity of the arm and fingers

Question 3

An older adult patient has an intravenous infusion of 0.45% normal saline infusing at 150 mL/hr. The nurse is most concerned by which of the following assessment findings?

A)Tenderness at the IV site
B)Urine specific gravity is 1.018
C)Capillary refill is < 3 seconds
D)Newly noted crackles in the lungs

Answer 3

Newly noted crackles in the lungs

Question 4

What is a serious respiratory complication of fluid volume excess?

A)Pulmonary infarct
B)Pulmonary fibrosis
C)Pulmonary embolism
D)Pulmonary edema

Question 5

While assessing an older adult patient with fluid excess, the nurse notes the following: T = 98.6°F, P = 92, R = 18, BP = 166/88 mm Hg, bilateral crackles, oxygen saturation = 95%. Which of the following actions should the nurse take first?

A)Place the patient in a high Fowler's position.
B)Provide a urinal and encourage the patient to void.
C)Provide oxygen at 2 L per nasal cannula.
D)Lay the patient flat in bed to listen to bowel sounds.

Question 6

Which definition best describes an electrolyte?

A)A substance secreted by a gland which carries messages to target tissues
B)A chemical that can conduct electricity when dissolved in water
C)A substance that uses electrical current to attach to receptor sites
D)Any substance that enhances a chemical reaction

Question 7

A patient with hypertension is placed on a low-sodium diet. The nurse recognizes that further teaching is necessary if the patient chooses which of the following menus?

A)Grilled chicken, boiled potatoes, frozen green beans, and gelatin dessert
B)Pork chop, steamed brown rice, and fruit cocktail
C)Tomato soup, grilled cheese sandwich, salad, and chocolate chip cookie
D)Broiled salmon, mashed sweet potato, broccoli, and pumpkin pie

Question 8

Which of the following foods should be encouraged in a postmenopausal woman who is 5 feet, 1 inch tall and weighs 100 lb?

A)Red meat
B)Dairy products
C)Whole grains
D)Fresh fruits

Question 9

A nurse is providing care for an 82-year-old patient who has a colostomy and was admitted 3 days ago with weakness, nausea, vomiting, and loose stools. To determine the effectiveness of care, which of the following actions should the nurse take first?

A)Check a pulse oximetry reading
B)Determine the creatinine clearance
C)Weigh the patient
D)Measure urine specific gravity

Question 10

Which term describes a solution that has a lower osmolarity than blood?

A)Isotonic
B)Hypertonic
C)Hypotonic
D)Hydrophobic

Question 11

A 22-year-old patient is admitted with a diagnosis of inflammatory bowel disease. The patient has been having 16 or more stools per day. Which of the following symptoms would the nurse expect to find during the admission assessment?

A)Furrows of the tongue and sticky mucous membranes
B)Decreased hemoglobin and hematocrit
C)Bounding pulse and increased blood pressure
D)Dyspnea and crackles in the lungs

Question 12

Which type of fluid loss is an example of insensible loss?

A)Perspiration
B)Urination
C)Vomiting
D)Diarrhea

Question 13

A patient with a history of renal failure is admitted to the hospital because of decreasing urine output and a potassium level of 5.9 mEq/L. Which of the following foods should the nurse teach the patient to avoid?

A)Gelatin
B)Potatoes
C)White bread
D)Zucchini

Question 14

An older adult has approximately six loose stools a day and is admitted to the hospital with a diagnosis of gastroenteritis. In addition to being disoriented and weak, the patient has the following laboratory test results: Hct 56% (normal 40% to 51%)
BUN 32 mg/dL (normal 6 mg/dL to 20 mg/dL)
Which nursing diagnosis would be most appropriate for this patient?

A)Excess fluid volume
B)Deficient fluid volume
C)Impaired skin integrity
D)Risk for injury

Question 15

A patient develops an irregular heart rate, abdominal cramping, and diarrhea after a thyroidectomy. Which emergency medication should the nurse anticipate being prescribed?

A)Furosemide (Lasix)
B)Calcium gluconate
C)Potassium chloride
D)Diazepam (Valium)

Question 16

Which definition best describes the process of diffusion?

A)Movement of a solute from an area of higher concentration to an area of lesser concentration
B)Movement of water from an area of lesser concentration to an area of higher concentration
C)The expenditure of energy to transport a solute
D)The movement of solute and water caused by hydrostatic pressure differences

Question 17

Which electrolyte should the nurse monitor carefully when administering furosemide (Lasix)?

A)Calcium
B)Potassium
C)Phosphate
D)Magnesium

Question 18

Which complication is associated with an abnormal potassium level?

A)Tetany with laryngospasm
B)Fluid overload
C)Internal bleeding
D)Cardiac arrest

Question 19

A patient is admitted to a surgical unit with acute abdominal pain. The laboratory calls to report a serum potassium level of 2 mEq/L. What should the nurse do first?

A)Administer a Kayexalate enema.
B)Document the result on the chart.
C)Notify the physician during morning rounds.
D)Call the physician STAT.

Question 20

The nurse should recognize that an 82-year-old patient is at risk for dehydration because of a reduction in which of the following functions?

A)Filtration
B)Sensation of thirst
C)Kidney function
D)Cardiac contractility

Question 21

The nurse is providing care to a patient being treating for fluid volume excess. Which of the following assessment findings indicates that treatment has been effective?

A)Respiratory rate 24/min
B)Blood pressure 132/80 mm Hg
C)Weight loss of 5 lb in 24 hours
D)Output 1,500 mL in 24 hours

Question 22

Respiratory disorders associated with hypoventilation and retention of carbon dioxide lead to which acid-base imbalance?

A)Respiratory acidosis
B)Respiratory alkalosis
C)Metabolic acidosis
D)Metabolic alkalosis

Question 23

What condition predisposes a patient to develop respiratory acidosis?

A)Diabetes
B)Anxiety
C)Kidney failure
D)Chronic lung disease
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Question 24

The patient with a serum pH of less than 6.35 is in which acid-base imbalance?

A)Acidosis
B)Alkalosis

Question 25

A patient is having a severe anxiety attack. Arterial blood gas results show respiratory alkalosis. Which of the following nursing actions should the nurse take first?

A)Place the patient in high Fowler's position.
B)Have the patient rebreathe air from a paper bag.
C)Administer nasal oxygen at 6 L/min.
D)Give the patient a glass of orange juice.

Question 26

A patient with uncontrolled diabetes mellitus develops metabolic acidosis. Which of the following assessment findings indicates that the patient's compensatory mechanisms are working?

A)Watery diarrhea
B)Vomiting
C)Excessive thirst
D)Deep rapid breathing

Question 27

A patient has been placed on Furosemide (Lasix). Which of the following foods should the nurse recommend?

A)Potatoes and fruits
B)Breads and cereals
C)Pasta and cream soups
D)Eggs and broths

Question 28

Which of the following foods would the nurse include when teaching a patient how to increase dietary calcium? (Select all that apply.?

A)Carrots
B)Cauliflower
C)Spinach
D)Oatmeal
E)Peaches
F)Milk