Deck 44: Drugs for Fluid, Electrolyte, and Acid-Base Disorders

Question 1

The client has overdosed on aspirin. In the emergency department, the physician orders sodium bicarbonate. A family member says to the nurse, "I thought that was for stomach ulcers." What is the best response by the nurse?

A) "It will change the urine so the kidneys can get rid of the aspirin quickly."
B) "It will change the pH of the blood to neutralize the aspirin."
C) "It will help the liver break down the aspirin more quickly."
D) "It will prevent excessive bleeding from the stomach."

Answer 1

"It will change the urine so the kidneys can get rid of the aspirin quickly."

Question 2

The physician orders potassium chloride (KCL) intravenous (IV) for the client. The nurse administers this drug intravenous (IV) push. What will be the most likely outcome for this client?

A) The client will most likely experience renal failure.
B) The client will most likely experience tissue necrosis at the injection site.
C) The client will most likely experience cardiac arrest.
D) The client will not experience adverse effects if the push was given slowly.

Answer 2

The client will most likely experience cardiac arrest.

Question 3

What is a priority outcome when a client receives dextran 40 (Gentran 40)?

A) The client will immediately report any ototoxicity.
B) The client will immediately report any itching or flushing.
C) The client will immediately report any hiccoughs.
D) The client will immediately report any diarrhea.

Answer 3

The client will immediately report any itching or flushing.

Question 4

The physician orders a hypertonic crystalloid solution for the client in critical care who has cerebral edema. The nurse hangs a bag of a hypotonic solution. What will the priority assessment of the nurse include?

A) confusion, hallucinations, and agitation
B) hypertension, headache, and nausea
C) nausea, projectile vomiting, and pinpoint pupils
D) headache, irritability, and decreasing level of consciousness

Question 5

The nurse provides group education to active adolescents about sodium replacement after exercising outdoors. What is the best information to include?

A) You should take one salt tablet for every two hours spent outside.
B) Water is the best fluid replacement after exercising.
C) Have extra salt with your breakfast on days you exercise outdoors.
D) It is best to avoid exercising outdoors in the summer.

Question 6

The client receives dextran 40 (Gentran 40). The client experiences tachycardia, dyspnea, and a cough. What is the best evaluation by the nurse?

A) The drug was infused too rapidly.
B) The client is allergic to the drug.
C) The client experienced impending kidney failure.
D) The drug caused an interaction with another drug the client receives.

Question 7

The physician has ordered ammonium chloride for the client. What will be a primary assessment of the nurse during administration?

A) the client's blood pressure
B) the client's liver status
C) the client's renal status
D) the client's level of orientation

Question 8

The physician orders potassium chloride (KCL) for the client who has a nasogastric (NG) tube. What will the nurse plan to do prior to the administration of this drug?

A) Dilute the drug prior to administration through the nasogastric (NG) tube.
B) Flush the nasogastric (NG) tube with normal saline before and after administration.
C) There is no particular preparation prior to administration.
D) Flush the nasogastric (NG) tube with Coca -Cola before and after administration.

Question 9

The nurse practitioner conducts education for home -health nurses who care for geriatric clients. Many of the clients abuse laxatives, so the nurse practitioner focuses the education on problems that can be caused by chronic laxative use. The nurse practitioner evaluates that
Learning has occurred when the nurses make which statement(s)? Select all that apply.

A) "The electrolytes can be replaced by eating the right foods."
B) "The kidneys and GI tract keep electrolytes in narrow balance, where they must be."
C) "The most important electrolytes are sodium, potassium, and magnesium."
D) "Laxatives can lower the level of potassium, necessary for proper heart function."
E) "Electrolytes carry electricity in the body and must stay in balance."

Question 10

The nurse cares for a client in the critical care setting who was severely burned. The wife of the client asks the nurse, "Why does he need those intravenous infusions (IVs)?" What is (are) the best response(s) by the nurse that indicates the primary reason for intravenous infusions (IVs) with a burned client? Select all that apply.

A) "So we have an open line for resuscitation in case his heart stops."
B) "So we can rapidly administer his pain medications."
C) "So we can be sure he keeps enough blood volume."
D) "So he can receive his antibiotics."
E) "So we can keep his blood pressure stable."

Question 11

The client is receiving sodium bicarbonate intravenously (IV) for correction of acidosis secondary to diabetic coma. The nurse assesses cyanosis, slow respirations, and irregular pulse. What is the nurse's priority action?

A) Increase the rate of the infusion and continue to assess the client for symptoms of acidosis.
B) Decrease the rate of the infusion and continue to assess the client for symptoms of alkalosis.
C) Stop the infusion and notify the physician; the client is in alkalosis.
D) Continue the infusion; the client is still in acidosis.

Question 12

The client is dehydrated, but has a normal blood pressure. The new medical intern orders normal serum albumin intravenously (IV) for this client. What is the best evaluation of the nurse regarding this order?

A) The intern should have ordered 5% dextrose in normal saline.
B) It is a correct and valid order.
C) The intern should have ordered 0.9% NaCl.
D) The intern should have ordered 0.45% NaCl.

Question 13

The client has been running in a long -distance marathon on a very warm day. The client complains of dizziness and nausea, and is taken to the hospital where she becomes lethargic. The serum sodium level is 125 mEq/L. What will be the best plan of the nurse?

A) Prepare to provide a diet high in NaCl.
B) Prepare to administer 0.45% NaCl.
C) Prepare to administer normal saline intravenous (IV).
D) Prepare to encourage the client to drink fluids.

Question 14

The client has a potassium level of 5.9 mEq/L. The nurse is administering glucose and insulin. The client's wife says, "He doesn't have diabetes, why is he getting insulin"? What is the best response by the nurse?

A) "Insulin will help his kidneys excrete the extra potassium."
B) "Insulin will cause his extra potassium to go into his cells and lower the blood level."
C) "Insulin lowers his blood sugar levels and this is how the extra potassium is excreted."
D) "Insulin is safer than giving laxatives such as Kayexalate."

Question 15

The client receives normal serum albumin. What are the priority assessments by the nurse?

A) blood pressure and urinary output
B) urinary output and pupil response
C) urinary output and nausea or vomiting
D) blood pressure and level of pain