Chapter 14: Fluids and Electrolytes

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FeverRN
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24440
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Chapter 14: Fluids and Electrolytes
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2010-06-21 20:41:37
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chapter fluids electrolytes nclex nursing med surg
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Chapter 14: Fluids and Electrolytes
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  1. The nurse assesses that the patient’s urine has become much more concentrated, which results from the effect of:

    A. adrenaline.
    B. antidiuretic hormone (ADH).
    C. insulin.
    D. aldosterone.
    D. Aldosterone acts on the kidney tubules, affecting water retention and its attendant urine concentration.
    (this multiple choice question has been scrambled)
  2. When the water absorption in the renal tubules becomes greater than normal, the nurse anticipates that the urine will become:

    A. more concentrated
    B. less concentrated
    C. more alkaline
    D. less alkaline
    A. When more water is kept back in the body, the water left to form urine is less; therefore, the urine is more concentrated.
    (this multiple choice question has been scrambled)
  3. The nurse explains that when oxygen is directed out of the arteries and into the capillaries, this process is:

    A. osmosis.
    B. filtration.
    C. active transport.
    D. diffusion.
    D. Diffusion is the movement from areas of higher concentration to areas of lower concentration.
    (this multiple choice question has been scrambled)
  4. The patient’s IV has been infusing at a very high rate and now the patient appears to be in fluid volume overload, as indicated by:

    A. hypotension.
    B. tachycardia.
    C. pulmonary edema.
    D. kidney failure.
    C. An IV infusing at a high rate is used to increase intravascular fluid volume, but there is an equalization level, after which the patient goes into fluid overload; this results in pulmonary edema.
    (this multiple choice question has been scrambled)
  5. A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of baby aspirin about 8 hours ago. The nursing care for this patient is geared toward reassuring the patient and:

    A. daily weights and vital signs.
    B. IVs as ordered, but without sodium bicarbonate.
    C. frequent assessment of mental and neurological status.
    D. inducement of vomiting.
    C. The baby aspirin was ingested too long ago to have vomiting or stomach aspiration be of any use. The child requires frequent assessment of neurological function because he or she may need mechanical ventilation.
    (this multiple choice question has been scrambled)
  6. The nurse explains that fluids carrying nutrients and wastes on a random basis throughout the body are carried primarily by:

    A. extracellular fluid.
    B. osmolytes.
    C. filtrates.
    D. intracellular fluid.
    A. The blood and lymph are the main media for transport of nutrients and wastes in the body.
    (this multiple choice question has been scrambled)
  7. The nurse clarifies that electrolytes, such as sodium and potassium, when dissolved, break down into smaller particles, which are called:

    A. ions.
    B. cells.
    C. elements.
    D. molecules.
    A. Electrolytes dissolved in water are ions.
    (this multiple choice question has been scrambled)
  8. The nurse assists a dyspneic patient to sit in a high Fowler’s position. This aids gravity in helping the movement of oxygen from the pulmonary capillaries into the blood by the process of:

    A. osmosis.
    B. filtration.
    C. active transport.
    D. diffusion.
    D. Fowler’s position increases blood flow through the lungs and therefore facilitates better oxygen diffusion.
    (this multiple choice question has been scrambled)
  9. The nurse evaluates the laboratory reports on electrolyte values carefully to assess the balance between positive and negative ions, which is regulated by the process of:

    A. diffusion.
    B. adaptation.
    C. osmosis.
    D. homeostasis.
    A. Diffusion allows the ions to support homeostatic balance.
    (this multiple choice question has been scrambled)
  10. When the nurse hangs an IV bag with Na+, K+, and Cl-, he is aware that ____ are being administered.

    A. nutrients
    B. enzymes
    C. electrolytes
    D. vitamins
    C. Sodium, potassium, and chlorides are electrolytes.
    (this multiple choice question has been scrambled)
  11. Each compartment of the body has a water-fluid distribution movement of its own. These fluids move and distribute themselves between these compartments via a process known as:

    A. osmosis.
    B. diffusion.
    C. active transport.
    D. filtration.
    A. The intracellular and extracellular compartments contain water and dissolved substances. The water filters back and forth as needed to maintain homeostasis via osmolarity.
    (this multiple choice question has been scrambled)
  12. The LPN is preparing to add a new IV of D5W with potassium to an existing line. The LPN notices that there is only 25 mL of urine collected over the last hour. The LPN’s best intervention is to:

    A. run the IV rapidly for 30 minutes to stimulate urine production.
    B. not hang the IV with potassium; inform the RN of urine output.
    C. call the MD who ordered the potassium.
    D. hang the IV as ordered and chart output.
    B. The low urine output will allow K+ to build up to hazardous levels. K+ administration is dependent on adequate urine output. LPNs are required to report untoward findings to the RN.
    (this multiple choice question has been scrambled)
  13. Both the intracellular and extracellular fluids are made up of many different electrolytes, but the most abundant intracellular positively charged electrolyte is:

    A. calcium.
    B. potassium.
    C. chloride.
    D. sodium.
    B. K+ is the most abundant electrolyte in the cell.
    (this multiple choice question has been scrambled)
  14. The patient with metabolic acidosis should be closely monitored for the compensatory condition of:

    A. thyroid imbalances.
    B. respiratory alkalosis.
    C. metabolic alkalosis.
    D. respiratory acidosis.
    B. When in metabolic acidosis, the body attempts to compensate by increasing respirations and creating respiratory alkalosis.
    (this multiple choice question has been scrambled)
  15. The K+ laboratory report shows a level of 5.2 mEq/L. The nurse will assess the patient closely for:

    A. frightening hallucinations.
    B. irregular heartbeat.
    C. swelling of ankles.
    D. excessive thirst.
    B. Arrhythmias can be triggered by hyperkalemia.
    (this multiple choice question has been scrambled)
  16. A patient has renal damage because of diabetes, which puts the patient at risk for:

    A. hypokalemia.
    B. hypocalcemia.
    C. hyperkalemia.
    D. hypercalcemia.
    C. When the renal system cannot rid the body of enough potassium, this electrolyte builds up and a condition called hyperkalemia develops.
    (this multiple choice question has been scrambled)
  17. Hyperchloremia, as noted on a laboratory report, is usually associated with:

    A. respiratory acidosis.
    B. respiratory alkalosis.
    C. metabolic acidosis.
    D. metabolic alkalosis.
    C. Chlorides bind with positively charged ions such as K+ in the patient with metabolic acidosis.
    (this multiple choice question has been scrambled)
  18. Older adults are at risk for dehydration because of reduced thirst and aging kidneys. The nurse monitors for the early indicator of dehydration, which is:

    A. concentrated urine.
    B. disorientation.
    C. constipation.
    D. reduced skin turgor.
    C. Because older adults have poor skin turgor and urine concentration is difficult to assess, constipation is the earliest indicator of fluid deficit.
    (this multiple choice question has been scrambled)
  19. The nurse has two newly admitted patients with dehydration. One patient is dehydrated from heat exhaustion and the other from an overdose of Lasix. The finding that will present in both patients is:

    A. decreased pulse and respirations.
    B. increased laboratory values of hemoglobin and hematocrit.
    C. increased skin turgor.
    D. copious saliva and nasal secretions.
    B. Water has been lost; therefore, the red blood cells will concentrate and show artificially high hemoglobin and hematocrit values.
    (this multiple choice question has been scrambled)
  20. The nurse clarifies that fluid balance is mainly monitored in the body by two systems, which are the:

    A. renal and gastrointestinal.
    B. circulatory and renal.
    C. hepatic and lymphatic.
    D. respiratory and circulatory.
    B. The monitoring of basic fluid balance in the body is done by the renal and circulatory systems.
    (this multiple choice question has been scrambled)
  21. The nurse is aware that extracellular fluid osmolarity is primarily maintained by:

    A. potassium.
    B. magnesium.
    C. sodium.
    D. chloride.
    C. Sodium as the primary extracellular electrolyte controls the osmolarity of the extracellular fluid, either too much or too little.
    (this multiple choice question has been scrambled)
  22. The nurse instructs that the healthy kidney adjusts the volume and composition of the filtrate that prevents excessive fluid loss by:

    A. active transport.
    B. tubular reabsorption.
    C. secretion of adrenalin.
    D. filtration in the lymphatic system.
    B. The kidney reabsorbs water and other electrolytes in response to chemical receptors.
    (this multiple choice question has been scrambled)
  23. The nurse instructs a family that the blood being brought by the incoming capillaries into the kidney, which contains nitrogenous substances to be excreted as waste, involves a process of:

    A. osmosis.
    B. filtration.
    C. active transport.
    D. diffusion.
    B. Capillary blood from the renal arteries filters into the kidney for processing as the first step.
    (this multiple choice question has been scrambled)
  24. Because the patient is hypovolemic, the nurse anticipates that treatment will be focused on:

    A. extracellular fluid deficit, encourage fluid intake.
    B. hypertonic intracellular deficit, limit water intake.
    C. extracellular fluid deficit, limit drinking water.
    D. circulatory system hormone deficit, limit water intake.
    A. A fluid volume deficit occurs when there is inadequate fluid volume in the body; the nurse may encourage drinking fluids as a nursing action.
    (this multiple choice question has been scrambled)
  25. The patient is frequently thirsty. The nurse assesses this symptom as:

    A. too little sodium and too much water in the body.
    B. too little sodium and too little water in the body.
    C. too much sodium and too much water in the body.
    D. too much sodium and too little water in the body.
    D. Normal thirst is the body’s way of calling for an increase in fluid volume, which could mean that there is too much sodium and too little water.
    (this multiple choice question has been scrambled)
  26. The nurse would instruct the patient with a K+ level of 6.2 to avoid (select all that apply):

    1. orange juice.
    2. bananas.
    3. carrots.
    4. tomatoes.
    5. celery.
    • 1, 2, 3, 4, 5
    • All the foods listed have a high concentration of K+ and should be avoided in a patient with a high K+ serum level.
  27. The nurse assesses that the patient with congestive heart failure who is being treated with a diuretic has lost 5 pounds in 1 day. This weight loss is equivalent to the loss of ____________________ liters of fluid.
    2.2 liters
  28. The nurse assesses deep rapid respirations in a patient with metabolic acidosis to be an indicator of the homeostatic system at work to reduce the ____________________ level.
    CO2
  29. The nurse would anticipate in a patient with respiratory acidosis that the blood pH reading would be lower than ____________________.
    7.3
  30. The nurse cautions a group of high school athletes about fluid loss in hot, dry weather, because the normal loss from respiration, which is ____________________ to ____________________ mL/day, is doubled.
    300, 400

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