Chapter 3

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Chapter 3
2012-04-21 22:26:29
IV therapy

Test #1
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  1. A nurse assesses that a client has +3 edema of the feet and ankles. The nurse realizes that this edema is occurring because of a build-up of fluid within the interstitial spaces of the lower extremities. Fluids within the interstitial spaces are also called.
    Tissue fluids
  2. A nursing instructor teaches nursing students about passive transport. The instructor states that diffusion is a passive process where molecules move across the cell membrane without the use of chemical energy. The instructor should also inform the students that diffusion involves the movement of molecules from:
    An area of high concentration to one of low concentration
  3. A client has a nasogastric tube that is attached to low suction. For which acid-base imbalance is this client most at risk?
    Metabolic alkalosis
  4. A physician orders lactated Ringer's solution (275mOsm) for a client. A nurse, understanding the principles of osmosis, know that this solution will:
    Move from the intracellular space to the vascular space
  5. A nurse analyzes a client's laboratory data and notes an increase in serum sodium, a decrease in potassium, an elevated hematocrit, and an increase in blood urea nitrogen. Based on this information, which condition should the nurse anticipate in this client? (select all)
    • Fluid volume deficit
    • decreased urinary output
  6. A dehydrated client requires intrvenous (IV) fluid replacement. A physician orders an isotonic that has an osmolarity similar to that of blood plasma. A nurse administers 0.9 NaCL (normal saline) because the osmolarity of this isotonic solution is:
    250-375 mOsm/L
  7. In reviewing a lab report, a nurse notes that a client has a potassium level of 6.0 meq/L. For which electrocardiogram (ECG) change should the client be monitored?
    Narrow, peaked T waves
  8. A client presents to an emergency department with confusion, a respiratory rate of 30 breaths per minute, blood pressure 100/70 mmHg, and a previous admission for renal failure. The client's arterial blood gases reveal a pH of 7.32, a HCO3 of 20 mEq/l, and a PaCO2 of 34 mmHg. which imbalance should a nurse suspect?
    Metabolic Acidosis
  9. A nurse in a long-term care facility is assessing the fluid colume status of clients. Which are acceptable methods of assessing fluid volume status in an elderly, aduilt client? (select all)
    • Rate and filling of veins of the hand
    • Skin turgor
  10. A pediactric nurse is preparing to administer a hypotonic intravenous (IV) solution to a child experiencing dehydration. a physician orders 0.5% normal salin (NS) intravenouslyat 100ml/hr. The nurse understands that infusion with a hypotonic IV solution will cause osmosis to occur. Osmosis is defined as the:
    Movement of water from a lower to a higher concentration across a semipermable membrane
  11. A nurse notes that a client is reporting episodes of nausea and headache. The nurse suspects hyponatremia. For which additional sign should the nurse assess to confirm this suspicion?
  12. A client is admitted with a diagnosis of hypocalcemia. which clinical manifestations are indicative of this diagnosis? (select all)
    • Hyperactive reflexes
    • Positive trousseau's sign
    • Tingling sensations
  13. Which nursing action would be most important after adding 20 mEq of potassium chloride to an IV bag of 1000 ml of 5% dextrose in water?
    Rotate the bag gently
  14. A nurse initiates a plasma infusion for a client diagnoses with a bleeding disorder. When performing the plasma infusion, the nurse understands that plasma protein help contain blood within the blood vessels by exerting which type of pressure?
    Colloid osmotic pressure
  15. A client, who has been experiencing vomiting and diarrhea for several days, is admitted to the hospital with a fluid volume deficit and numerous electrolyte imbalances. Which organs are involved in the regulation of fluid and electrolyte balance in the client's body?(select all)
    • The thyroid gland
    • the lung
    • The kidney
  16. A perioperative nurse is preparing a client for surgery. The nurse begins an intravenous (IV) infusion of Lactated Ringers solution at 150mL/hr per protocol. The nurse understands that Lactated Ringer's solution, which has an osmolarity (tonicity) of 275, is considered to be:
    An isotonic solution
  17. A nurse educator is teaching a nursing student about the active and passive transport of fluids across cell membranes. Which is a method of passive transport of fluids?
  18. A nurse educatory is conducting an in-service presentation on electrolytes. Which group of electrolytes should the educatory refer to as being "positively charges"?
    Potassium, sodium, calcium
  19. A nurse asesesses a client who has been experiencing vomiting and diarrhea for 3 days. Which assessment finding should indicate to the nurse that the client has a fluid colume deficit?
    Central venous pressure (CVP) reading of 3mm H2O
  20. A client's weight has increased by 2 pounds in 1 day. a nurse calculates that this increase in weight means that the client has retained approximately ____ of fluid.
    1 L
  21. A 3 year old child is hospitalized because of persistent vomiting. For which condition should a nurse carefully monitor the child?
    Metabolic alkalosis
  22. A nurse is administering intravenous potassium at a rate of 15 mEq/hr via a peripheral vein. When infusing potassium at this rate via this route, for which imbalance should the nurse monitor?
  23. A client is hospitalized with manifestations of hyponatremia. After treatment, which lab value should indicate to a nurse that the client's hyponatremia has been corrected?
    135-145 mEq/L
  24. A multidisciplinary healthcare team is caring for a client diagnosed with hypercalcemia. Which treatments would be appropriate when treating this imbalance? (select all)
    • Inorganic phosphates
    • Infusion of 0.45% OF 0.9% Sodium chloride
    • Calcitonin
  25. A client presents to an emergency department and is diagnosed with respiratory acidosis. A nurse caring for the client knows that respiratory acidosis may be caused by which conditions? (select all)
    • Pneumonia
    • Emphysema
    • Asthma
  26. A nurse educator teaches a nursing student about fluid and electrolyte balance in the body. Which body system is primarliy responsible for water balance?
    Renal system
  27. An adult with a critically high serum potassium level recieves sodium polystyrene sulfonate (Kayexalate). When evaluating the client's lab results after administering the medication, which lab value should indicate to a nurse that treatment of the high serum potassium level has been effective?
    5.1 mEq/L
  28. A nurse is caring for multiple clients on a medical-surgical unit who have been receiving intravenous fluids. Which client is at the greatest risk for developing fluid volume excess?
    Clinets with renal failure
  29. A nurse is caring for an elderly, hospitalized client diagnosed with ephysema. The clientarterial blood gases reveal that the blood chemistry is lightly alkaline bus is considered physiologically neutral. To be considered physiologically neutral, or normal, what is the client's serum pH?
  30. A nurse is caring for a 45 year old male client diagnosed with renal disease. The nurse weighs the client daily and carefully records the client's intake and output. When analyzing the client's data, the nurse correctly recalls that the percentage of bodily water weight for a healthy adult under age 60 is:
  31. A nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD). Which acid-base imbalance will this client most likely experience?
    Respiratory acidosis
  32. A nurse assesses a newly admitted client and notes fatigued muscles, reports of nausea and anorexia, irritability, and diminished deep tendon reflexes. The nurse reviews the client
    s laboratory reports, which reveal a serum chloride level of 92 mEq/L, a serum potassium level of 3.1 mEq/L, and a serum sodium level of 135 mEq/L. Which electrolyte imbalance should the nurse suspect?
  33. A nurse is caring for a client whohas been receiving diuretic therapy for congestive heart failure. The client has developed metabolic alkalosis (bicarbonate excess). which clinical manifestations would a nurse most likely note when assessing this client?
    Dizziness, depressed respirations, and impaired mentation
  34. A nurse is caring for a client who has been experiencing prolonged vomiting prior to being adminitted to a hospital. The client has develiped metabolic alkalosis. Which are manifestations of alkalosis (bicarbonate excess)?
    Impaired mentation, tingling of fingers and toes, depressed respirations
  35. An intensive care nurse is implementing orders for an elderly client diagnosed with hypermagnesemia. What is the most likely cause of hypermagnesemia in this client?
    Renal failure
  36. A nurse documents an insensible fluid loss of approximately 700mL/day. The nurse understands that insensible fluid loss occurs through which route? (select all)
    • Skin
    • Lungs
  37. A nursing instructor is teaching a group of nursing students about intracellular and extracellular fluid compartments of the cell. Which electrolyte is the second most plentiful cation in th intracellular fluid compartment?
  38. A client is diagnosed with third space syndrome. what should this diagnosis indicate to a nurse?
    the client could have fluid in his peritoneal cavity
  39. A physician orders that a client receives 0.9% sodium chlorid intravenously (IV) at 150 mL/hr. Which are characteristics of this IV solutions? (select all)
    • the solution does not affect the plasma's osmolarity
    • the solution contains only sodium and chloride ions
    • The solution is isotonic with the plasma
  40. A trauma nurse admits multiple clients injured in an automobile accident. The nurse understands that, in order to remain in stable condition, each client must be able to achieve homeostasis. Homeostasis is defined as the:
    Ability to restore equilibrium under stress
  41. A client's laboratory report indicates a serum potassium level of 5.5 mEq/L, which treatment would most effectively treat this imbalance?
    Infusion of 100 mL of calcium gluconate
  42. A client in a critical care unit is experiencing drastic fluctuations inserum potassium. which sentinel event can occur if the cient's werum potassium level is less than 2.5 mEq/L or greater than 7.0 mEq/L?
    Cardiac arrest
  43. a postoperative client has received an excessive amount of intravenous Lactated Ringer's solution. For which acid-base imbalance is this client most at risk?
    Metabolic alkalosis
  44. A nursing instructor is teaching a group of nursing students about the intracellular and extracellular fluid compartment of the cell. Which is the major electrolye in the intracellular compartment?
  45. The nurse administering 0.45% sodium chloride in 5% dextrose in water understands that this solution will hydrate the intravascular and intracellular spaces based on which of the following transport mechanisms?
  46. you have just completed a physical assessment of a 68 year old man. He knows who he is but is unsure where he is (previous orientation normal). His eyes are sunken, his mouth is coated with an extra longitudinal furrow, and his lips are cracked. Hand vein filling takes more than 5 seconds, and tenting of the skin appears over the serum. His vital signs are blood pressure of 128/60 mmHg, pulse of 78, and respiratory rate of 16 (previously 150/78, 76, 16) Your assessment would lead you to suspect:
    Fluid volume deficit
  47. If the external temperature is 101 F (38.4 C) which of the following age groups is at highest risk for fluid volume deficit?
  48. Which of the following could be the etiology for a nursind diagnosis of fluid volume excess? (select all)
    • Excessive infusion of 0.9% sodium chloride solution
    • SIADH
    • Congestive heart failure
  49. Which of the following laboratory values are consistent with fluid volume deficit?
    Serum osmolarity 305 mOsm/Kg
  50. Flushing, lethargy, hypoactive, deep tendon relfexes, depressed respirations
  51. Weakness, deep bone pain, pathologic fractures
  52. Fatigue, headache, apprehension, serum Na+ 115 mEq/L
  53. ECG with flat or inverted T wave, depressed ST segment
  54. ECG with peaked narrow T wave, shortened QT interval, prolonged PR intercal followed by disappearance of P wave
  55. Marked thirst, dry sticky mucous membranes, disorientation, chlorided may be elevated
  56. Positive trousseau's sign and Chvostek's sign, numbness of fingers
  57. Treatment for a patient with metabolic alkalosis includes which of the following? (select all)
    • Removal of underlying cause
    • IV fluid administration of NaCl
    • replacement of potassium deficit
  58. To correct metabolic acidosis, the parenteral fluid of choice is:
  59. A nursing diagnosis that would be appropriate for the patient with calcium deficit would be:
    Risk for protection inaffective: Risk for tetany and seizures related to neurosensory alterations from severe hypocalcemia
  60. An 80 year old frail man has had nausea, vomiting, and diarrhea for several days. When he becomes weak and confused he is admitted to the hospital. The best indicator of the client;s rehydration status, the nurse would assess the client's:
    Urinary output