Deck 29: Fluids, Electrolytes, and Introduction to Acid-Base Balance

Question 1

The nurse is counseling a young female client who is a long-distance runner.Which factor does the nurse recognize as the greatest risk for this client to develop dehydration?

A)Females will lose extra fluid volume due to menses.
B)Long distance runners lack the availability of fluids.
C)Sweating and hard breathing will cause fluid loss.
D)Excessive physical activity can cause vomiting and diarrhea.

Answer 1

Sweating and hard breathing will cause fluid loss.

Question 2

The nurse is caring for a client taking furosemide.The nurse recognizes that dietary teaching is successful if the client chooses which food?

A)Green beans
B)Grapes
C)Oranges
D)Zucchini

Answer 2

Oranges

Question 3

During change of shift report, a nurse is informed that a client has new orders for sodium polystyrene (Kayexalate).After providing the treatment later in the shift, which documentation will the nurse make in regard to the client's care?

A)Telemetry shows normal sinus rhythm; Kayexalate provided; client had two stools this shift.
B)Kayexalate provided; monitoring client's level of consciousness every 2 hours.
C)Kayexalate given per order for hypokalemia; client resting comfortably.
D)IV D₅ 1/2NS with 20 mEq potassium chloride (KCl)infusing without difficulty; Kayexalate provided; adequate urine output noted.

Answer 3

Telemetry shows normal sinus rhythm; Kayexalate provided; client had two stools this shift.

Question 4

The nurse is providing care for a client whose arterial blood gas results are pH = 7.48; CO₂ = 44; NaHCO₃ = 29.Which conclusion about the client's condition will the nurse draw from the testing results?

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

Question 5

The nurse is caring for a client with a low serum calcium level.Which symptom of hypocalcemia is unexpected by the nurse?

A)Muscle twitching
B)Tingling around the mouth
C)Heart rate of 52 beats/min.
D)Confusion and disorientation

Question 6

Which client does the nurse expect to need teaching about the American Heart Association recommendation to limit salt intake to 1,500 mg/d?

A)A middle-age client with hypertension
B)An adult client with appendicitis
C)A young-adult client with an ovarian cyst
D)An adolescent client with pneumonia

Question 7

The nurse needs to be aware of the functions of water in the body.Which presented function is untrue?

A)Maintains body temperature
B)Lubricates body joints and digestive tract
C)Prevents replication and growth of pathogens
D)Protects the brain and spinal cord tissue

Question 8

The nurse is transferring a client to the intensive care unit (ICU)and reports the client is experiencing "third spacing." Which manifestation will the ICU nurse expect to see?

A)Elevated body temperature
B)Large amounts of dilute urine
C)High blood pressure
D)Swelling in the extremities

Question 9

While reviewing laboratory results, the nurse notes that one of the clients has a low blood urea nitrogen (BUN)level.Which cause is the most likely related to the result?

A)Dehydration
B)Fluid volume excess
C)Hypernatremia
D)Hypokalemia

Question 10

A nurse is caring for multiple clients on a medical floor.Which client should the nurse see first?

A)An older-adult client with a history of congestive heart failure receiving IV D₅W with 20 mEq potassium chloride (KCl)at 120 mL/h
B)A middle-age client admitted with sickle cell anemia who has a client-controlled analgesia (PCA)
C)A young-adult client with Crohn disease receiving an IV of 1/2NS at 100 mL/hr
D)An adult client recovering from gastric bypass surgery who has a saline lock

Question 11

The nurse applies the principles of anatomy and physiology to client care.Which factor does the nurse understand as having the most affect on fluid movement in the body?

A)Age
B)Water intake
C)Potassium balance
D)Percentage of body fat

Question 12

The nurse is providing care for a client with a pH of 7.

A)Slow respiratory rate
B)More acidic urine
C)Low urine level of NaHCO₃
D)Deep respirations
E)Which assessment finding will the nurse identify as a normal body response to the client's condition?

Question 13

The nurse reviews a client's electrolyte levels on a laboratory report and notes the client has hyponatremia.Which symptoms will the nurse expect to find during assessment?

A)Respiratory crackles in all lobes
B)Blood pressure of 100/58 mm Hg
C)Bounding pulse at 54 beats/minute
D)Edema in lower extremities

Question 14

The nurse is receiving a client who is being admitted through the emergency department.The client is a roofer who became confused and disoriented while on a roof during the heat of the day.The nurse anticipates that which IV fluid may be included in the treatment plan?

A)Dextrose 5% in water (D₅W)
B)Normal saline (NS) 3.0.45% normal saline
C)Sodium bicarbonate

Question 15

The nurse is caring for a client taking the diuretic furosemide.The nurse will be most concerned about which assessment finding?

A)Muscle spasms
B)Hypercalcemia
C)Low urine specific gravity
D)Constricted pupils

Question 16

The nurse is providing care for a client with a history of cardiac problems.The nurse notes the client's potassium level is 3.6 mEq/L.The nurse understands that which reason supports the physician's order for a daily dose of potassium?

A)The potassium is ordered to prevent the client from becoming hypokalemic.
B)The physician is attempting to increase urinary output to decrease cardiac stress.
C)The potassium is ordered in an attempt to prevent cardiac arrhythmias.
D)The client's cardiac diet is deficient in foods with high potassium levels.

Question 17

The nurse is admitting a client into the hospital with a diagnosis of dehydration related to vomiting.Which symptom of dehydration will the nurse expect during physical assessment?

A)Chronic pain
B)Alteration in body temperature
C)Unproductive cough
D)Loss of appetite

Question 18

The nurse is reviewing laboratory values of multiple clients with fluid and electrolyte imbalance.Which laboratory value does the nurse identify as representing a therapeutic response to treatment?

A)Sodium = 132 mEq
B)Sodium = 136 mEq
C)Sodium = 147 mEq
D)Sodium = 149 mEq

Question 19

The nurse is providing care for a client recently admitted with a diagnosis of hypercalcemia.The nurse will contact the physician if the client reports taking which medication?

A)Furosemide
B)Digoxin
C)Multivitamins
D)Acetaminophen

Question 20

The nurse is caring for multiple adult clients in an acute care setting.The nurse should consider which client to be the most unlikely for an electrolyte imbalance?

A)A client with an estimated blood loss of 500 mL due to a traumatic injury
B)A client with third-degree burns to an estimated 30% of the body
C)A client experiencing uncontrollable vomiting and diarrhea for the past 3 days
D)A client hospitalized for a temperature of 102 degrees after running a marathon

Question 21

The nurse provides dietary teaching for a client diagnosed with hypomagnesemia.The nurse determines the teaching has been effective if the client discusses including which foods in the daily diet? Select all that apply.

A)Peanuts.
B)Oatmeal.
C)Flax seed.
D)Broccoli.
E)Bananas.

Question 22

The nurse is caring for a client with a diagnosis of mild hypochloremia.Which condition will the nurse associate with the client's current diagnosis?

A)Consumption of electrolyte replacement drinks
B)Hyponatremia related to a heat stroke
C)Metabolic acidosis from vomiting and diarrhea
D)Ingestion of large amounts of salty snacks

Question 23

The nurse is providing care for a client admitted with fluid volume overload.Which nursing care will the nurse implement for this client? Select all that apply.

A)Monitor the effects of diuretic therapy.
B)Obtain a daily weight on the same scale.
C)Teach about foods naturally high in sodium.
D)Assess intake and output results for imbalances.
E)Encourage oral fluid intake of at least 2,000 mL/d.

Question 24

The 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 IV fluids, bronchodilators, and oxygen therapy at 4 L via nasal cannula (NC), the client's repeat ABG results are pH = 7.35; CO₂ = 47; HCO₃ = 26; and oxygen saturation is 89%.Which action should the nurse take next?

A)Prepare to transfer the client to the intensive care unit (ICU).
B)Document the findings in the client's medical record.
C)Inform the family of the client's worsening condition.
D)Assess the function of the client's oxygen delivery system.

Question 25

The nurse is caring for a client admitted with fluid volume deficit.Which diagnostic test results does the nurse identify as supporting the client's diagnosis? Select all that apply.

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