Deck 33: Pharmacotherapy of Fluid Imbalance, Electrolyte, and Acid-Base Disorders

Question 1

The nurse is caring for a group of clients on a medical-surgical unit.For which clients would the nurse anticipate the need for intravenous fluid therapy to correct fluid depletion?
Select all that apply.

A)A client suffering from constipation
B)A client exhibiting nausea and vomiting following a surgical procedure
C)A client with a severe burn
D)A client with congestive heart failure with edema to the lower extremities and rales
E)A client with uncontrolled diabetic ketoacidosis

Answer 1

A client exhibiting nausea and vomiting following a surgical procedure
A client with a severe burn
A client with uncontrolled diabetic ketoacidosis

Question 2

A client has vomited several times and continues to be nauseated.To correct mild hypovolemia,the nurse plans to complete which intervention?

A)Ask the client to drink 8 ounces of water every hour.
B)Administer an isotonic crystalloid.
C)Administer a hypotonic crystalloid.
D)Ask the client to drink 8 ounces of an electrolyte solution every 30 minutes for 4 hours.

Answer 2

Administer an isotonic crystalloid.

Question 3

A client is prescribed a transfusion of fresh frozen plasma (FFP).The nurse plans care based on the knowledge that the transfusion will complete which process?

A)Replace multifactor deficiency states
B)Rehydrate cells
C)Dehydrate cells
D)Cause fluid to shift out of the intravascular space

Answer 3

Replace multifactor deficiency states

Question 4

A nurse is evaluating a client's serum osmolality.Which solute is not factored into this value?

A)Sodium
B)Urea
C)Glucose
D)Water

Question 5

A nurse is providing care to several post surgical client.Which prescription would the nurse question?

A)Infuse potassium chloride 40 mEq,IV push over 1 minute,once.
B)Infuse potassium chloride 40 mEq in 250 mL NaCl,over 4 hours,once.
C)Administer potassium chloride 20 mEq,by mouth,once.
D)Administer potassium chloride,20 mEq diluted in 90 mL juice,by mouth once.

Question 6

When infusing 3% NaCl solutions,which clinical manifestation will the nurse continuously check for?

A)Signs of pulmonary edema
B)Hyponatremia
C)Signs of thirst
D)Signs of depression

Question 7

When planning care,the nurse anticipates that which client will most likely require intravenous fluid replacement?

A)A client with a minor burn to the left arm
B)A client diagnosed with congestive heart failure
C)A client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)
D)A client diagnosed with shock

Question 8

A client has a severe fluid and electrolyte imbalance.The nurse is aware that in order for the body to move large molecules and molecules with electrical charges,which two processes are required?

A)Active transport and tonicity
B)Osmosis and active transport
C)Diffusion and active transport
D)Osmosis and diffusion

Question 9

A client being treated long-term with oral sodium bicarbonate should be monitored for which acid-base imbalance?

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

Question 10

A client is prescribed a hypertonic intravenous solution.Administration of this solution will most likely cause which manifestation to occur?

A)A shift of fluid from the vascular space to the interstitial space.
B)No fluid shift
C)The plasma to have more solutes than the interstitial fluid.
D)The plasma to have fewer solutes than the interstitial fluid

Question 11

When a nurse administers a hypotonic intravenous solution to a client,how will the water move?

A)By osmosis from the plasma compartment to the interstitial compartment.
B)By diffusion from the plasma compartment to the interstitial compartment.
C)By diffusion from the interstitial compartment to the plasma compartment.
D)By osmosis from the interstitial compartment to the plasma compartment.

Question 12

The nurse is aware that body fluids are exchanged between which compartments?

A)Intravascular and interstitial
B)Intravascular and extracellular
C)Interstitial and extracellular
D)Intracellular and extracellular

Question 13

A client has a serum sodium level of 157 mEq/L.Which area of assessment is the priority?

A)Muscle pain
B)Daily weight
C)Thirst level
D)Level of consciousness

Question 14

A client diagnosed with diabetes insipidus is suffering from severe hypernatremia.The nurse anticipates the use of which type of intravenous solution?

A)A hypertonic crystalloid
B)A hypotonic crystalloid
C)An isotonic crystalloid
D)Albumin

Question 15

When treating fluid imbalances,which is the ultimate goal of care?

A)To diagnose and correct the underlying cause of the disorder
B)To maintain normal vital signs
C)To keep clients normothermic
D)To administer intravenous fluids

Question 16

The nurse is caring for a client with severe electrolyte imbalances that have occurred as a result of kidney failure.The nurse knows that this client is at risk for which disorders as a result of this electrolyte imbalance?
Select all that apply.

A)Fluid retention
B)Muscle spasms
C)Fractures
D)High cholesterol
E)Depression

Question 17

A client with long-standing hepatic cirrhosis might receive which intravenous solution to correct hypoproteinemia?

A)Dextrose 5%
B)Packed red cells
C)Whole blood
D)Albumin

Question 18

The nurse is reviewing a client's lab values,which indicate normal serum osmolality.Which intravenous solutions will not cause a fluid shift in this client?

A)Colloids
B)Isotonic solutions
C)Hypertonic solutions
D)Hypotonic solutions

Question 19

A client is prescribed 100 mL of 3% normal saline solution received 1,000 ml of 3% normal saline.Which is the priority assessment for this client?

A)Skin integrity
B)Blood pressure
C)Capillary refill
D)Coagulation profile

Question 20

A nursing instructor asks a student at what point it is appropriate to treat hyponatremia.Which response by the student is accurate?

A)"When serum levels fall below 130 mEq/L."
B)"When serum levels fall below 140 mEq/L."
C)"When serum levels fall below 145 mEq/L."
D)"When serum levels fall below 155 mEq/L."

Question 21

Nurses must administer sodium bicarbonate with caution to clients with hypertension to avoid which adverse effect?

A)Respiratory acidosis
B)Metabolic acidosis
C)Retention of fluid
D)Unexpected diuresis

Question 22

A client is prescribed ammonium chloride.Which statement indicates an appropriate understanding after medication teaching?

A)"I will report sleepiness right away."
B)"This medication should make him a little shaky."
C)"Confusion will be normal for a day or so."
D)"The IV infusion is going to be painful."

Question 23

The nurse is caring for a client diagnosed with hyperkalemia.Which interventions are appropriate to include in the client's plan of care?
Select all that apply.

A)A calcium supplement
B)A potassium supplement
C)Hypotonic fluids
D)Buffering agents
E)Citrus fruits in the diet

Question 24

The nurse is reviewing the client's medical record in preparation to administer 5% dextrose solution.Which findings would indicate a contraindication for this intravenous fluid?
Select all that apply.

A)Congestive heart failure
B)Hypoglycemia
C)Increased intracranial pressure
D)Hypernatremia
E)Hypercalcemia

Question 25

A client is scheduled receive a parenteral dose of magnesium sulfate.The nurse tests patellar reflexes and determines them to be absent.Which action by the nurse is the most appropriate?

A)Administer the drug as ordered,as this is a normal finding.
B)Hold the medication for 1 hour,then reassess.
C)Hold the medication and notify the health care provider.
D)Administer the drug after placing the client on a cardiac monitor.

Question 26

The nurse is preparing to administer magnesium sulfate to a pregnant client with pre-eclampsia.Which conditions must the nurse assess this client for while administering this medication?
Select all that apply.

A)Level of consciousness
B)Deep tendon reflexes
C)Urine output
D)Neuromuscular depression
E)Magnesium level

Question 27

A nurse is scheduled to administer a potassium supplement to a client.Which action should the nurse take prior to administering the drug?

A)Check the client's potassium level from the morning labs.
B)Tell the client that the infusion will burn.
C)Place the client in a low Fowler's position.
D)Ask the client why the medication is ordered.

Question 28

The nurse would be most concerned about administering which blood product to a client?

A)Fresh frozen plasma
B)Albumin
C)Whole blood
D)Packed red cells

Question 29

The nurse is preparing to administer a 5% dextrose in water (D₅W)infusion to a client.Which explanation as to why the infusion is ordered is the most accurate?

A)"This is a colloid,and will increase the client's blood pressure."
B)"This medication is isotonic in its container,but when infused,the solution becomes hypotonic."
C)"This medication is hypotonic and will cause fluid to shift from the intravascular space into the interstitial and intracellular spaces."
D)"This medication is hypertonic and will cause fluid to shift from the extravascular space into the vascular space."

Question 30

A nurse is providing medication teaching to a client who is prescribed potassium tablets.Which information should be included?

A)Allow potassium tablets to dissolve completely in the mouth.
B)Licorice helps alleviate the bad taste of the potassium tablets.
C)Avoid salt substitutes.
D)Add lots of potassium-rich foods to your diet.

Question 31

Which is not an indication for the use of potassium chloride?

A)Preventing hypokalemia
B)Treatment of hypokalemia
C)Treatment of peptic ulcer disease
D)Treatment of mild alkalosis

Question 32

A client is receiving an infusion of magnesium sulfate.The health care provider should be notified immediately if which response is observed?

A)A pulse rate of 99 beats per minute
B)A blood pressure of 90/60
C)Pain at the IV site
D)A respiratory rate of 9 breaths per minute

Question 33

The nurse would administering sodium bicarbonate to which client?

A)A client taking methotrexate
B)A client in chronic renal failure
C)A client on continuous nasogastric suctioning
D)A client diagnosed with metabolic acidosis