Deck 24: Drugs for Fluid Balance, Electrolyte, and Acidbase Disorders

Question 1

The patient receives dextran 40 (Gentran 40).The patient experiences tachycardia,dyspnea,and a cough.What is the best evaluation by the nurse?
1)The drug caused an interaction with another drug the patient receives.
2)The patient experienced impending kidney failure.
3)The patient is allergic to the drug.
4)The drug was infused too rapidly.

Answer 1

4

Question 2

The physician orders a hypertonic crystalloid solution for the patient in critical care who has cerebral edema.The nurse hangs a bag of a hypotonic solution.What will the priority assessment by the nurse include?
1)Headache,irritability,and decreasing level of consciousness
2)Nausea,projectile vomiting,and pinpoint pupils
3)Confusion,hallucinations,and agitation
4)Hypertension,headache,and nausea

Answer 2

1

Question 3

Potential causes for respiratory alkalosis include
1)hypotension.
2)hypertension.
3)hypoventilation.
4)hyperventilation.

Answer 3

4

Question 4

Hyponatremia is marked by a serum sodium level less than
1)137 mEq/mL.
2)140 mEq/mL.
3)135 mEq/mL.
4)145 mEq/mL.

Question 5

The nurse cares for a patient in the critical care setting who was severely burned.The wife of the patient 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 patient? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"So we have an open line for resuscitation in case his heart stops."
2)"So he can receive his antibiotics."
3)"So we can keep his blood pressure stable."
4)"So we can be sure he keeps enough blood volume."
5)"So we can rapidly administer his pain medications."

Question 6

The physician orders potassium chloride (KCL)for the patient who has a nasogastric (NG)tube.What will the nurse plan to do prior to the administration of this drug?
1)Dilute the drug prior to administration through the nasogastric (NG)tube.
2)Flush the nasogastric (NG)tube with Coca-Cola before and after administration.
3)Flush the nasogastric (NG)tube with normal saline before and after administration.
4)There is no particular preparation prior to administration.

Question 7

Electrolytes are essential for many body functions,and require a
1)wide level range.
2)low level range.
3)narrow level range.
4)high level range.

Question 8

The patient 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?
1)"It will prevent excessive bleeding from the stomach."
2)"It will change the pH of the blood to neutralize the aspirin."
3)"It will change the urine so the kidneys can get rid of the aspirin quickly."
4)"It will help the liver break down the aspirin more quickly."

Question 9

The patient has a potassium level of
1)"Insulin will cause his extra potassium to go into his cells and lower the blood level."
2)"Insulin lowers his blood sugar levels and this is how the extra potassium is excreted."
3)"Insulin is safer than giving laxatives such as Kayexalate."
4)"Insulin will help his kidneys excrete the extra potassium."

Question 10

Osmolality and tonicity are not changed when movement of fluids and solution are
1)hypotonic.
2)hypertonic.
3)isotonic.
4)oncotic.

Question 11

Intravenous therapy would be indicated if
1)hypertension were present.
2)fluid intake were greater than 2500 mL/day.
3)intake and output were deregulated.
4)constipation were present.

Question 12

The patient 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?
1)Increase the rate of the infusion and continue to assess the patient for symptoms of acidosis.
2)Decrease the rate of the infusion and continue to assess the patient for symptoms of alkalosis.
3)Continue the infusion;the patient is still in acidosis.
4)Stop the infusion and notify the physician;the patient is in alkalosis.

Question 13

The nurse practitioner conducts education for home-health nurses who care for geriatric patients.Many of the patients 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)? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"The kidneys and GI tract keep electrolytes in narrow balance,where they must be."
2)"Electrolytes carry electricity in the body and must stay in balance."
3)"The electrolytes can be replaced by eating the right foods."
4)"The most important electrolytes are sodium,potassium,and magnesium."
5)"Laxatives can lower the level of potassium,necessary for proper heart function."

Question 14

Which of the following is a sign of hypokalemia?
1)Constipation
2)Hypertension
3)Muscle weakness
4)Weight gain

Question 15

The patient receives normal serum albumin.What are the priority assessments by the nurse?
1)Blood pressure and urinary output
2)Urinary output and pupil response
3)Blood pressure and level of pain
4)Urinary output and nausea or vomiting

Question 16

The physician orders potassium chloride (KCL)intravenous (IV)for the patient.The nurse administers this drug intravenous (IV)push.What will be the most likely outcome for this patient?
1)The patient will most likely experience cardiac arrest.
2)The patient will not experience adverse effects if the push was given slowly.
3)The patient will most likely experience tissue necrosis at the injection site.
4)The patient will most likely experience renal failure.

Question 17

Buffers are chemicals that help maintain normal body Ph.The two primary buffers in the body are
1)sodium and calcium ions.
2)sodium and bicarbonate ions.
3)bicarbonate and phosphate ions.
4)potassium and phosphate ions.

Question 18

The physician has ordered ammonium chloride for the patient.What will be a primary assessment of the nurse during administration?
1)The patient's level of orientation
2)The patient's blood pressure
3)The patient's renal status
4)The patient's liver status

Question 19

The nurse provides group education to active adolescents about sodium replacement after exercising outdoors.What is the best information to include?
1)Have extra salt with your breakfast on days you exercise outdoors.
2)It is best to avoid exercising outdoors in the summer.
3)You should take one salt tablet for every 2 hours spent outside.
4)Water is the best fluid replacement after exercising.

Question 20

What is a priority outcome when a patient receives dextran 40 (Gentran 40)?
1)The patient will immediately report any ototoxicity.
2)The patient will immediately report any diarrhea.
3)The patient will immediately report any hiccoughs.
4)The patient will immediately report any itching or flushing.

Question 21

The nurse is caring for a patient with severe electrolyte imbalances that have occurred as a result of kidney failure.The nurse knows that this patient is at risk for what disorders as a result of this electrolyte imbalance? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Fluid retention
2)Muscle spasms
3)Fractures
4)High cholesterol
5)Depression

Question 22

The nurse is caring for a group of patients on a medical-surgical unit.For which patients would the nurse anticipate the need for intravenous fluid therapy to correct fluid depletion? Credit will be given only if all correct choices and no incorrect choices are selected.
1)A patient suffering from constipation
2)A patient exhibiting nausea and vomiting following a surgical procedure
3)A patient with a severe burn
4)A patient with congestive heart failure with edema to the lower extremities and rales
5)A patient with uncontrolled diabetic ketoacidosis