Deck 25: Determinants and Assessment of Fluid and Electrolyte Balance

Question 1

Which patient would the nurse expect to have the least amount of body fluid?

A)A 75-year-old woman with a body mass index (BMI)in the obese range
B)A 23-year-old female with history of type 1 diabetes
C)A 72-year-old male who had a myocardial infarction at age 50
D)A 16-year-old male who plays football on his high school team

Answer 1

A 75-year-old woman with a body mass index (BMI)in the obese range

Question 2

A patient with hypoxia is at risk for disruption of the sodium potassium pump.Which would the nurse expect if this occurs?

A)Decreased serum potassium
B)Cell death
C)Increase in the cells' ability to use active transport
D)Decreased extracellular fluid

Answer 2

Cell death

Question 3

Laboratory testing reveals a patient's serum osmolality to be 240 mOsm/kg.The nurse would assess for which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Excessive infusion of D5W
B)Dehydration
C)Hyperglycemia
D)Syndrome of inappropriate ADH (SIADH)
E)Acute kidney injury

Answer 3

Excessive infusion of D5W
Syndrome of inappropriate ADH (SIADH)

Question 4

A patient's temperature has been elevated for the past 24 hours.The nurse should monitor which electrolyte?

A)Phosphorous
B)Sodium
C)Potassium
D)Magnesium

Question 5

The nurse is planning the care of a patient in the intensive care unit.With regard to maintaining adequate fluid volume for this patient,the nurse realizes that interventions should be planned to reduce the risk of which condition?

A)Retention of potassium
B)Retention of sodium
C)Loss of calcium
D)Loss of magnesium

Question 6

A patient's laboratory report indicates critically low serum calcium levels.The nurse would conduct further assessment for which conditions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Disruption of the parathyroid glands
B)Decreased supply of vitamin D
C)Low levels of calcitonin
D)Insufficient levels of calcitriol
E)Insufficient levels of calcidiol

Question 7

A urine electrolyte test is ordered to evaluate aldosterone disorder in a patient just admitted to the intensive care unit.How would the nurse collect this specimen?

A)Collect the first specimen voided in the morning.
B)Prepare a 24-hour urine collection system.
C)Collect the specimen from the indwelling urinary catheter inserted in the emergency department.
D)Use a temporary straight catheter to collect the specimen.

Question 8

A patient's potassium and calcium levels are below the normal range.The nurse should check for a decreased level of which other electrolyte?

A)Phosphorous
B)Sodium
C)Magnesium
D)Chloride

Question 9

After reviewing a patient's laboratory values,the nurse determines the patient is experiencing fluid volume deficit.Which laboratory value would the nurse cite as supporting this determination?

A)Serum sodium 140 mEq/L
B)Urine specific gravity of 1.003
C)Urine osmolality 330 mOsm/kg
D)Serum potassium 4.3 mEq/L

Question 10

A patient admitted to the intensive care unit has been taking high levels of magnesium supplements.The nurse would add which information to this patient's plan of care?

A)Test for presence of Chvostek's sign.
B)Monitor for sudden decrease in respiratory rate.
C)Monitor for cardiac dysrhythmias.
D)Monitor for hyperthermia.

Question 11

The nurse is reviewing laboratory results for a patient just admitted to the intensive care unit.The nurse would anticipate interventions to be necessary for which values? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Calcium 8 mg/dL
B)Potassium 3 mEq/L
C)Sodium 142 mEq/L
D)Phosphate 1.8 mEq/L
E)Magnesium 2.1 mEq/L

Question 12

Which laboratory value would require that the nurse closely monitor a patient's cardiac rhythm?

A)Chloride 94 mEq/L
B)Calcium 2.2 mmol/L
C)Potassium 3.3 mEq/L
D)Phosphate 3 mg/dL

Question 13

A patient is admitted with bleeding from the gastrointestinal tract.The nurse plans interventions to support the balance of which fluid volume compartment?

A)Transcellular
B)Intravascular
C)Interstitial
D)Intracellular

Question 14

While assessing a high-acuity patient,the nurse learns the patient has a history of arthritis.Which question would provide the most information regarding potential impact on the patient's fluid and electrolyte balance?

A)"How well are you able to take care of your daily needs?"
B)"How well do you sleep?"
C)"How often do you take nonsteroidal anti-inflammatory medications?"
D)"Does your arthritis affect mostly your hands or your feet and legs?"

Question 15

Which findings would the nurse evaluate as indication that a pregnant female is hypovolemic? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Flat neck veins
B)Bilateral adventitious lung sounds
C)Flat hand veins when dependent
D)Sunken eyes
E)Tenting of the skin

Question 16

The nurse notes that a patient's serum albumin level is elevated.Which other lab result should the nurse review?

A)Potassium
B)Calcium
C)Sodium
D)Chloride

Question 17

When assessing the patient's edema of the lower extremities,the nurse notes that it takes 3 minutes before the 8-mm indentation created by applying pressure above the ankles disappears.This information should be documented as being which type of pitting edema?

A)+2
B)+1
C)+4
D)+3

Question 18

The nurse is assessing for the presence of Trousseau sign.Which findings would the nurse evaluate as indicating this sign is present? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The fingers hyperflex.
B)The thumb flexes toward the palm.
C)The fingers hyperextend.
D)The thumb hyperextends.
E)The hand makes a fist.

Question 19

A patient's BUN/creatinine ratio is 13:1.How would the nurse interpret this finding?

A)The patient is hypervolemic.
B)Renal tubule dysfunction may be present.
C)The patient is normovolemic.
D)The patient's glomerular filtration rate is decreased.

Question 20

A patient in the intensive care unit has low blood pressure.If the patient's baroreceptors are functioning appropriately,what will the nurse assess in this patient?

A)Reduced urine output
B)Weak hand grasps
C)Decreased level of consciousness
D)Peripheral edema