Deck 5: Fluids and Electrolytes, Acids and Bases
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Deck 5: Fluids and Electrolytes, Acids and Bases
1
Which statement by the staff indicates teaching was successful concerning aldosterone?
A) The secretion of aldosterone results in decreased plasma osmolality.
B) Aldosterone secretion increases serum potassium levels.
C) Aldosterone secretion results in an increased blood volume.
D) The secretion of aldosterone causes localized edema.
A) The secretion of aldosterone results in decreased plasma osmolality.
B) Aldosterone secretion increases serum potassium levels.
C) Aldosterone secretion results in an increased blood volume.
D) The secretion of aldosterone causes localized edema.
Aldosterone secretion results in an increased blood volume.
2
What type of fluid compartment is blood plasma considered to be?
A) Intracellular fluid (ICF)
B) Extracellular fluid (ECF)
C) Interstitial fluid
D) Intravascular fluid
A) Intracellular fluid (ICF)
B) Extracellular fluid (ECF)
C) Interstitial fluid
D) Intravascular fluid
Intravascular fluid
3
A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected?
A) Symptoms subside quickly
B) Increased ICF volume
C) Decreased ECF volume
D) Intracellular dehydration
A) Symptoms subside quickly
B) Increased ICF volume
C) Decreased ECF volume
D) Intracellular dehydration
Intracellular dehydration
4
A 42-year-old female presents to her primary care provider reporting muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalemic. Which of the following could be the cause of her condition?
A) Respiratory acidosis
B) Constipation
C) Hypoglycemia
D) Laxative abuse
A) Respiratory acidosis
B) Constipation
C) Hypoglycemia
D) Laxative abuse
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5
Which organ system should the nurse monitor when the patient has long-term potassium deficits?
A) Central nervous system (CNS)
B) Lungs
C) Kidneys
D) Gastrointestinal tract
A) Central nervous system (CNS)
B) Lungs
C) Kidneys
D) Gastrointestinal tract
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6
A 10-year-old male is brought to the emergency room (ER) incoherent and semiconscious. CT scan reveals that he is suffering from cerebral edema. This type of edema is referred to as:
A) localized edema.
B) generalized edema.
C) pitting edema.
D) lymphedema.
A) localized edema.
B) generalized edema.
C) pitting edema.
D) lymphedema.
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7
While planning care for older individuals, the nurse remembers that older adults are at a higher risk for developing dehydration. Why is this so?
A) Older adults have a higher total body water volume.
B) Older individuals have decreased muscle mass.
C) Older adults generally have increased thirst.
D) Older adults have an increased tendency toward developing edema.
A) Older adults have a higher total body water volume.
B) Older individuals have decreased muscle mass.
C) Older adults generally have increased thirst.
D) Older adults have an increased tendency toward developing edema.
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8
A 25-year-old male is diagnosed with a hormone-secreting tumour of the adrenal cortex. Which finding would the nurse expect to see in the laboratory results?
A) Decreased blood volume
B) Decreased blood K+ levels
C) Increased urine Na+ levels
D) Increased white blood cells
A) Decreased blood volume
B) Decreased blood K+ levels
C) Increased urine Na+ levels
D) Increased white blood cells
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9
An experiment was designed to test the effects of the Starling forces on fluid movement. Which of the following alterations would result in fluid moving into the interstitial space?
A) Increased capillary oncotic pressure
B) Increased interstitial hydrostatic pressure
C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
A) Increased capillary oncotic pressure
B) Increased interstitial hydrostatic pressure
C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure
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10
A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?
A) Weak pulse
B) Excessive thirst
C) Oliguria
D) Constipation
A) Weak pulse
B) Excessive thirst
C) Oliguria
D) Constipation
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11
A 19-year-old male presents to his primary care provider reporting restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition?
A) Primary hyperaldosteronism
B) Cellular trauma, like a crush injury
C) Insulin secretion
D) Diuretic use
A) Primary hyperaldosteronism
B) Cellular trauma, like a crush injury
C) Insulin secretion
D) Diuretic use
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12
Which of the following patients is the most at risk for developing hypernatremia?
A) A patient experiencing vomiting
B) A patient taking diuretics
C) A patient with dehydration
D) A patient with hypoaldosteronism
A) A patient experiencing vomiting
B) A patient taking diuretics
C) A patient with dehydration
D) A patient with hypoaldosteronism
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13
A 70-year-old male with chronic kidney failure presents with edema. Which of the following is the most likely cause of this condition?
A) Increased capillary oncotic pressure
B) Decreased interstitial oncotic pressure
C) Increased capillary hydrostatic pressure
D) Increased interstitial hydrostatic pressure
A) Increased capillary oncotic pressure
B) Decreased interstitial oncotic pressure
C) Increased capillary hydrostatic pressure
D) Increased interstitial hydrostatic pressure
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14
What determines water movement between the ICF and ECF compartments?
A) Osmotic forces
B) Plasma oncotic pressure
C) Antidiuretic hormone
D) Buffer systems
A) Osmotic forces
B) Plasma oncotic pressure
C) Antidiuretic hormone
D) Buffer systems
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15
When planning care for a dehydrated patient, the nurse remembers that the principle of water balance is closely related to the balance of:
A) potassium.
B) chloride.
C) bicarbonate.
D) sodium.
A) potassium.
B) chloride.
C) bicarbonate.
D) sodium.
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16
Which of the following patients should the nurse assess for decreased oncotic pressure in the capillaries?
A) A patient on a high-protein diet
B) A patient with liver failure
C) A patient with low blood pressure
D) A patient with low blood glucose
A) A patient on a high-protein diet
B) A patient with liver failure
C) A patient with low blood pressure
D) A patient with low blood glucose
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17
Which of the following conditions would cause the nurse to monitor for hyperkalemia?
A) Excess aldosterone
B) Acute acidosis
C) Insulin usage
D) Metabolic alkalosis
A) Excess aldosterone
B) Acute acidosis
C) Insulin usage
D) Metabolic alkalosis
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18
A 35-year-old male weighs 70 kg. Approximately how much of this weight is considered the total volume of body water?
A) 5 L
B) 10 L
C) 28 L
D) 42 L
A) 5 L
B) 10 L
C) 28 L
D) 42 L
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19
A patient has been searching on the Internet about natriuretic hormones. When the patient asks the nurse what these hormones do, how should the nurse respond? Natriuretic hormones affect the balance of:
A) calcium.
B) sodium.
C) magnesium.
D) potassium.
A) calcium.
B) sodium.
C) magnesium.
D) potassium.
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20
A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include?
A) The secretion of ADH is increased serum potassium.
B) ADH secretion results in increased plasma osmolality.
C) There is a decreased renal blood flow when ADH is secreted.
D) ADH secretion results in generalized edema.
A) The secretion of ADH is increased serum potassium.
B) ADH secretion results in increased plasma osmolality.
C) There is a decreased renal blood flow when ADH is secreted.
D) ADH secretion results in generalized edema.
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21
A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumour. Further testing indicates that the tumour secretes ADH. Which of the following assessment findings should the nurse expect? (Select all that apply.)
A) Confusion
B) Weakness
C) Nausea
D) Muscle twitching
E) Increased reflexes
A) Confusion
B) Weakness
C) Nausea
D) Muscle twitching
E) Increased reflexes
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22
Which patient should the nurse assess for both hyperkalemia and metabolic acidosis?
A) The patient with diabetes insipidus
B) A patient with a pulmonary disorder
C) A patient with Cushing's syndrome
D) The patient with kidney failure
A) The patient with diabetes insipidus
B) A patient with a pulmonary disorder
C) A patient with Cushing's syndrome
D) The patient with kidney failure
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23
Which of the following buffer pairs is considered the major plasma buffering system?
A) Protein/fat
B) Carbonic acid/bicarbonate
C) Sodium/potassium
D) Amylase/albumin
A) Protein/fat
B) Carbonic acid/bicarbonate
C) Sodium/potassium
D) Amylase/albumin
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24
For a patient with respiratory acidosis, chronic compensation by the body will include:
A) kidney excretion of H+.
B) kidney excretion of HCO3.
C) prolonged exhalations to blow off CO2.
D) protein buffering.
A) kidney excretion of H+.
B) kidney excretion of HCO3.
C) prolonged exhalations to blow off CO2.
D) protein buffering.
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25
Which patient is most prone to metabolic alkalosis?
A) A patient retaining metabolic acids
B) The patient with hypoaldosteronism
C) The patient with excessive loss of chloride (Cl) through vomiting
D) A patient experiencing hyperventilation
A) A patient retaining metabolic acids
B) The patient with hypoaldosteronism
C) The patient with excessive loss of chloride (Cl) through vomiting
D) A patient experiencing hyperventilation
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26
A 54-year-old male with a long history of smoking complains of excessive tiredness, shortness of breath, and overall ill feelings. Lab results reveal decreased pH, increased CO2, and normal bicarbonate ion. These findings help to confirm the diagnosis of:
A) respiratory alkalosis.
B) metabolic acidosis.
C) respiratory acidosis.
D) metabolic alkalosis.
A) respiratory alkalosis.
B) metabolic acidosis.
C) respiratory acidosis.
D) metabolic alkalosis.
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27
A nurse recalls that regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:
A) buffer systems.
B) skin.
C) lungs.
D) liver.
A) buffer systems.
B) skin.
C) lungs.
D) liver.
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28
A 55-year-old female presents to her primary care provider and reports dizziness, confusion, and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2, and slightly decreased HCO3. Which of the following is the most likely diagnosis?
A) Respiratory alkalosis with renal compensation
B) Respiratory acidosis with renal compensation
C) Metabolic alkalosis with respiratory compensation
D) Metabolic acidosis with respiratory compensation
A) Respiratory alkalosis with renal compensation
B) Respiratory acidosis with renal compensation
C) Metabolic alkalosis with respiratory compensation
D) Metabolic acidosis with respiratory compensation
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29
For a patient experiencing metabolic acidosis, the body will compensate by:
A) excreting H+ through the kidneys.
B) hyperventilating.
C) retaining CO2 in the lungs.
D) secreting aldosterone.
A) excreting H+ through the kidneys.
B) hyperventilating.
C) retaining CO2 in the lungs.
D) secreting aldosterone.
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30
Which finding would support the diagnosis of respiratory acidosis?
A) Vomiting
B) Hyperventilation
C) Pneumonia
D) An increase in noncarbonic acids
A) Vomiting
B) Hyperventilation
C) Pneumonia
D) An increase in noncarbonic acids
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