Question 1

While reviewing routine laboratory results for a 14-year-old, a nurse notes the patient's calcium level is lower than normal. Which of the following is most likely the contributing cause for this deficiency?
A) Diet low in potassium
B) Inadequate vitamin D levels
C) Alcohol abuse
D) Metabolic acidosis

Accepted Answer

Low calcium levels can be caused by inadequate vitamin D levels, as vitamin D is necessary for the absorption and utilization of calcium in the body.

Question 2

To ensure survival, an individual's blood pH must stay within the very narrow range of 7.35 to 7.45. A nurse identifies this range as being
A) Slightly acidic.
B) Neutral.
C) Slightly alkaline.
D) Highly acidic.

Accepted Answer

The pH range of 7.35 to 7.45 is slightly alkaline, meaning it has a higher pH than neutral (7.0). Maintaining this range is critical for the body to function properly. If blood pH falls outside of this range, it can lead to serious health problems.

Question 3

Which of the following diagnostic tests indicates that a patient has a fluid volume deficit?
A) Elevated urine specific gravity
B) Decreased hemoglobin level
C) High hematocrit level
D) Elevated blood urea nitrogen (BUN)
E) Elevated red blood cell count

Accepted Answer

Elevated urine specific gravity (A) indicates concentrated urine due to fluid deficit. High hematocrit (C) suggests hemoconcentration from fluid loss. Elevated BUN (D) can indicate dehydration as the kidneys conserve water.

Question 4

A nurse identifies that the ratio of carbonic acid to sodium bicarbonate that must be met to maintain an acid-base balance is A) 1 part H₂CO₃ to 20 parts NaHCO₃. B) 1 part H₂CO₃ to 10 parts NaCl. C) 1 part NaHCO₃ to 15 parts H₂CO₃. D) 1 part NaOH to 10 parts NaHCO₃.

Accepted Answer

The correct ratio for maintaining acid-base balance in the body is 1 part carbonic acid (H2CO3) to 20 parts bicarbonate (NaHCO3). This ratio is crucial for the bicarbonate buffering system, which helps maintain the pH of blood and other bodily fluids.

Question 5

An instructor explains that there are three basic systems that work together in the body to regulate and maintain acid-base balance. A student shows a need for additional instruction when identifying one of these systems as the
A) Renal system.
B) Digestive system.
C) Bicarbonate buffer system.
D) Respiratory system.

Accepted Answer

The digestive system is not directly involved in the regulation of acid-base balance in the body. The three systems that do play a role are the renal system, bicarbonate buffer system, and respiratory system.

Question 6

A nurse is providing care for an individual admitted with an acute asthma attack. Arterial blood gas (ABG) results indicate pH = 7.33; CO₂ = 49; HCO₃ = 26; and oxygen saturation is 87%. After initiating treatment with intravenous (IV) fluids, bronchodilators, and oxygen therapy at 4 L via nasal cannula (NC), the patient's repeat ABG results are pH = 7.35; CO₂ = 47; HCO₃ = 26; and oxygen saturation is 89%. Which of the following actions should the nurse take next? A) Prepare to send the patient to intensive care unit (ICU). B) Document the findings in the chart. C) Inform the family that the patient's condition is worsening. D) Assess the characteristics of the patient's respirations, heart rate and rhythm, skin color, and function of oxygen delivery equipment.

Accepted Answer

The next appropriate action for the nurse would be to assess the patient's respiratory and cardiovascular status and the oxygen delivery equipment. While the patient's ABG results have slightly improved, the oxygen saturation is still below the normal range, indicating the need for continued monitoring and interventions. The patient's respiratory and cardiovascular assessments can provide important information about the effectiveness of the current treatment regimen and the need for additional interventions. It is also important to evaluate the oxygen delivery equipment to ensure that it is functioning properly and providing the prescribed amount of oxygen to the patient. Therefore, option D is the best choice. Options A and C are not appropriate as the patient's condition has not worsened, and there is no indication of the need for ICU or family notification. Option B is insufficient as it does not address the need for ongoing nursing assessments and interventions.

Question 7

A nursing instructor teaches that which of the following are found in higher concentrations outside of cells?
A) Sodium
B) Protein
C) Potassium
D) Chloride
E) Bicarbonate

Accepted Answer

Sodium, chloride, and bicarbonate are found in higher concentrations outside of cells, in the extracellular fluid. Potassium and proteins are typically found in higher concentrations inside cells.

Question 8

It is recommended that individuals within certain populations restrict their sodium intake to 1500 mg/d. A nurse identifies that these groups include all of the following except
A) African Americans.
B) Individuals with hypertension.
C) Individuals younger than 15 years.
D) Individuals who are 40 years or older.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

Accepted Answer

The populations that are recommended to restrict their sodium intake to 1500 mg/d include African Americans, individuals with hypertension, and individuals who are 40 years or older. There is no age-specific recommendation for individuals younger than 15 years.

Question 9

A nurse is receiving a new admission from the emergency room with a diagnosis of nausea/vomiting/diarrhea and dehydration. Which of the following orders would the nurse question?
A) Repeat electrolyte panel in a.m.
B) Lomotil (Diphenoxylate and Atropine) 2 tablets PO qid for 24 hours
C) Intravenous (IV) normal saline at 30 mL/hr
D) Regular diet
E) Bedrest with bathroom privileges

Accepted Answer

The answer of A nurse is receiving a new admission...

Question 10

An instructor teaches that the chemical sodium bicarbonate is one of the two chemicals used in the bicarbonate buffer system. A student identifies the chemical symbol of sodium bicarbonate as A) NaCl. B) NaHCO₃. C) H₂CO₃. D) NaOH.

Accepted Answer

The chemical symbol for sodium bicarbonate is NaHCO3. Option A (NaCl) is the chemical symbol for sodium chloride which is not the right choice. Option C (H2CO3) is the chemical symbol for carbonic acid, which is not sodium bicarbonate. Option D (NaOH) is the chemical symbol for sodium hydroxide, which is not the right choice. Therefore, the correct answer is option B (NaHCO3).

Question 11

A nurse is providing care for a patient whose arterial blood gas results are pH = 7.48; CO₂ = 44; NaHCO₃ = 29. The nurse recognizes that the patient's results indicate A) Respiratory acidosis. B) Metabolic acidosis. C) Respiratory alkalosis. D) Metabolic alkalosis.

Accepted Answer

The patient's arterial blood gas results show a pH of 7.48, which is above the normal range (7.35-7.45), indicating alkalosis. The bicarbonate (HCO3-) level is 29, which is above the normal range (22-26 mEq/L), suggesting that the alkalosis is due to a metabolic cause. Therefore, the correct diagnosis is metabolic alkalosis.

Question 12

Which of the following individuals is at increased risk for hypokalemia?
A) A 52-year-old with malnutrition
B) A 61-year-old who has had a cerebral vascular accident
C) A 65-year-old with coronary heart disease
D) A 52-year-old who is in renal failure
E) A 74-year-old with a nasogastric (NG) tube hooked to suction

Accepted Answer

Malnutrition can lead to electrolyte imbalances, including hypokalemia. An NG tube hooked to suction can cause loss of gastric contents, leading to hypokalemia.

Question 13

An alcoholic patient is experiencing withdrawal and has been given an intravenous (IV) infusion of glucose. The nurse identifies that this treatment may cause a decline in the electrolyte
A) Calcium.
B) Sodium.
C) Potassium.
D) Magnesium.

Accepted Answer

The answer of An alcoholic patient is experiencing withdrawal and...

Question 14

A nurse overhears a student discussing the treatment of fluid volume deficit. The nurse intervenes when the student says:
A) "Fluid volume deficit requires the rapid infusion of intravenous (IV) fluids."
B) "The patient's urinary output will initially be absent or less than the intake, but should gradually increase as the patient becomes more hydrated."
C) "If the source of loss is from the gastrointestinal (GI) tract, antiemetic medications may be ordered for nausea or vomiting."
D) "Once the patient is able to tolerate oral fluids, a clear liquid diet advanced as tolerated is generally ordered."

Accepted Answer

Rapid infusion of IV fluids is not always necessary and can be dangerous in certain situations, such as in patients with heart failure or renal disease. Treatment should be individualized based on the cause and severity of fluid volume deficit.

Question 15

A nurse is caring for a patient who was admitted with severe hyponatremia. Which of the following symptoms would indicate the patient has increased intracranial pressure?
A) Presence of Chvostek sign
B) Presence of Trousseau sign
C) Patient is anxious and restless
D) Blood pressure (BP) = 184/80
E) Pulse (P) = 52

Accepted Answer

The answer of A nurse is caring for a patient...

Question 16

A patient is diagnosed with mild hypochloremia. The nurse identifies that the patient's chloride level may return to normal by increasing his or her intake of
A) Dried fruits.
B) Salty snacks.
C) Whole grains.
D) Baked goods.

Accepted Answer

Salty snacks contain a high level of chloride which can help increase the patient's chloride level in case of hypochloremia. Other options like dried fruits, whole grains, and baked goods do not have a significant amount of chloride.

Question 17

A nurse teaches a patient that natural sources of dietary magnesium include which of the following?
A) Soybeans
B) Spinach
C) Barley
D) Fish
E) Tomatoes

Accepted Answer

The answer of A nurse teaches a patient that natural...

Question 18

An instructor explains that the scale used to determine acid-base balance is known as the pH scale. A student identifies that "pH" stands for
A) Phosphoric hardness.
B) Parts per hectare.
C) Parts hydrogen.
D) Potassium hydrate.

Accepted Answer

pH stands for "parts hydrogen." It is a measure of the concentration of hydrogen ions in a solution, which is used to determine the acidity or alkalinity of the solution.

Question 19

A nurse is providing care for a patient admitted with fluid volume overload. Which of the following would the nurse include in the patient's plan of care?
A) Provide diuretic therapy as ordered.
B) Assess daily weights.
C) Provide low-sodium diet.
D) Document intake/outtake every shift.
E) Encourage oral fluid of at least 2000 mL/d.

Accepted Answer

All of these interventions are appropriate for a patient with fluid volume overload. Diuretic therapy can help eliminate excess fluid, daily weights can help monitor fluid balance, a low-sodium diet can reduce fluid retention, and documenting intake and outtake can help track fluid intake and output. Encouraging oral fluids of at least 2000 mL/d is not appropriate for a patient with fluid volume overload as it may exacerbate the condition.

Question 20

An instructor explains the role of the respiratory system in maintaining proper acid-base balance in the blood. A student demonstrates understanding by saying:
A) "When body fluids become too acidic, the lungs remove excess hydrogen from the blood."
B) "When the blood is too alkaline, the lungs excrete more sodium bicarbonate into the atmosphere."
C) "The lungs work much slower than the kidneys, changing the pH balance over a period of days rather than hours."
D) "The lungs remove excess carbon dioxide to decrease the acidity of the blood."

Accepted Answer

The respiratory system helps in maintaining proper acid-base balance in the blood by removing excess carbon dioxide. Carbon dioxide is a mildly acidic compound, and when it mixes with water in the body, it creates carbonic acid. The lungs help to remove carbon dioxide from the bloodstream, which reduces the level of acid in the blood and maintains the proper pH balance.

Quiz 29: Fluids, Electrolytes, and Acid-Base Balance

While reviewing routine laboratory results for a 14-year-old, a nurse notes the patient's calcium level is lower than normal. Which of the following is most likely the contributing cause for this deficiency?

To ensure survival, an individual's blood pH must stay within the very narrow range of 7.35 to 7.45. A nurse identifies this range as being

Which of the following diagnostic tests indicates that a patient has a fluid volume deficit?

A nurse identifies that the ratio of carbonic acid to sodium bicarbonate that must be met to maintain an acid-base balance is

An instructor explains that there are three basic systems that work together in the body to regulate and maintain acid-base balance. A student shows a need for additional instruction when identifying one of these systems as the

A nursing instructor teaches that which of the following are found in higher concentrations outside of cells?

It is recommended that individuals within certain populations restrict their sodium intake to 1500 mg/d. A nurse identifies that these groups include all of the following except

A nurse is receiving a new admission from the emergency room with a diagnosis of nausea/vomiting/diarrhea and dehydration. Which of the following orders would the nurse question?

An instructor teaches that the chemical sodium bicarbonate is one of the two chemicals used in the bicarbonate buffer system. A student identifies the chemical symbol of sodium bicarbonate as

A nurse is providing care for a patient whose arterial blood gas results are pH = 7.48; CO2 = 44; NaHCO3 = 29. The nurse recognizes that the patient's results indicate

Which of the following individuals is at increased risk for hypokalemia?

An alcoholic patient is experiencing withdrawal and has been given an intravenous (IV) infusion of glucose. The nurse identifies that this treatment may cause a decline in the electrolyte

A nurse overhears a student discussing the treatment of fluid volume deficit. The nurse intervenes when the student says:

A nurse is caring for a patient who was admitted with severe hyponatremia. Which of the following symptoms would indicate the patient has increased intracranial pressure?

A patient is diagnosed with mild hypochloremia. The nurse identifies that the patient's chloride level may return to normal by increasing his or her intake of

A nurse teaches a patient that natural sources of dietary magnesium include which of the following?

An instructor explains that the scale used to determine acid-base balance is known as the pH scale. A student identifies that "pH" stands for

A nurse is providing care for a patient admitted with fluid volume overload. Which of the following would the nurse include in the patient's plan of care?

An instructor explains the role of the respiratory system in maintaining proper acid-base balance in the blood. A student demonstrates understanding by saying:

A nurse is providing care for a patient whose arterial blood gas results are pH = 7.48; CO₂ = 44; NaHCO₃ = 29. The nurse recognizes that the patient's results indicate