Deck 68: Fluids and Electrolytes

Question 1

The nurse has an order for an 5% dextrose in 0.45% sodium chloride with 20 mEq//L of potassium chloride to be administered to an older adult who is being admitted from the emergency department.The nurse would do which of the following at this time?

A) Question the potassium order
B) Question the intravenous order
C) Request an infusion pump
D) Request an order for a cardiac telemetry bed

Answer 1

Request an infusion pump

Question 2

The nurse understands that fluid shifts into the intracellular fluid because of dehydration is accomplished by which of the following transport mechanisms in the body?

A) Osmosis
B) Diffusion
C) Active transport
D) Gravity

Answer 2

Osmosis

Question 3

The nurse concludes that sodium polystyrene sulfate has been most effective when a subsequent serum potassium level is

A) 3.1 mEq/L.
B) 4.2 mEq/L.
C) 5.6 mEq/L.
D) 7.5 mEq/L.

Answer 3

4.2 mEq/L.

Question 4

The nurse notes that an order has been written for an intravenous solution of 5% dextrose in lactated Ringer's.The nurse checks the client name on the order sheet,anticipating that this solution is most beneficial for the assigned client with which of the following problems?

A) Diabetes mellitus
B) Heart failure
C) Burn injury
D) Fractured femur

Question 5

The nurse receives a telephone call that a client with water intoxication will be admitted to the nursing unit.The nurse anticipates that this client will require fluid volume replacement with which of the following intravenous solutions?

A) 5% Dextrose in water
B) 5% Dextrose in Ringer's solution
C) 0.9% Sodium chloride
D) 3% Sodium chloride

Question 6

Which of the following client groups is most at risk for dehydration because of reduced thirst?

A) Adolescents
B) Young adults
C) Middle adults
D) Older adults

Question 7

Which of the following clients has the least immediate need for intravenous therapy as a means of fluid replacement?

A) A client with abnormalities of serum sodium and potassium levels
B) A client in diabetic ketoacidosis
C) A client who is having an electrocardiogram
D) A client who is dehydrated with loss of consciousness

Question 8

The nurse would assess a client who is receiving an intravenous solution containing potassium for which of the following cardiac signs of hyperkalemia?

A) Increased digoxin sensitivity
B) Atrioventricular dissociation
C) Atrial tachycardia
D) Peaked T waves on cardiac rhythm strip

Question 9

The client with hypernatremia has intravenous fluid therapy ordered.The nurse selects which of the following solutions from the storage area as ordered on the physician's order sheet?

A) 5% Dextrose in 0.45% sodium chloride
B) 5% Dextrose in 0.9% sodium chloride
C) 5% Dextrose in 0.225% sodium chloride
D) 5% Dextrose in water

Question 10

The nurse would assess for which of the following in a client suspected of having hypokalemia?

A) Hypertension
B) Irritability
C) Tetany
D) Weakness

Question 11

When administering intravenous potassium solutions,the nurse would do which of the following as a critical action?

A) Give the solution as a bolus injection
B) Dilute the solution as instructed
C) Select an appropriately sized filter
D) Apply ice packs to the site of intravenous administration

Question 12

The nurse would evaluate that a client receiving sodium chloride in an intravenous solution was successfully treated for hyponatremia if which of the following symptoms resolves?

A) Lethargy
B) Hypertension
C) Tingling of fingers and toes
D) Abnormalities on cardiac rhythm strip

Question 13

In addition to cardiac manifestations,the nurse would monitor a client for which of the following other signs of hyperkalemia?

A) Thirst
B) Oliguria
C) Tetany
D) Diarrhea

Question 14

The nurse overhears the physician state that a client will be started on intravenous therapy with an isotonic solution.The nurse anticipates that which of the following solutions will be ordered?

A) 5% Dextrose in water
B) 5% Dextrose in 0.45% sodium chloride
C) 0.9% Sodium chloride
D) 5% Dextrose in lactated Ringer's

Question 15

A client who has an NPO order after surgery is receiving intravenous fluid replacement.The nurse assesses this client for which of the following signs of mild or early dehydration as one indicator of overall fluid status?

A) Increased thirst
B) Very dry mouth
C) Increased pulse rate
D) Scant urine output

Question 16

The nurse would monitor the postthyroidectomy client for which of the following signs of hypocalcemia?

A) Muscle paralysis
B) Abdominal pain
C) Numbness and tingling in fingers and toes
D) Hypertension

Question 17

A client on a medical-surgical nursing unit has an order for intravenous fluid therapy with potassium chloride supplementation.The nurse would question the order in this setting if the physician ordered how much potassium to be added to the intravenous solution?

A) 10 mEq/L
B) 20 mEq/L
C) 40 mEq/L
D) 60 mEq/L

Question 18

The nurse is monitoring the caloric intake of a malnourished client who is receiving intravenous fluid replacement.The nurse understands that the client is receiving how many calories of per liter from the infusion of 5% dextrose in 0.45% sodium chloride solution?

A) 60
B) 170
C) 300
D) 630

Question 19

The nurse reviewing the electrolyte results for a client receiving intravenous therapy would conclude that the sodium level is normal if which of the following values is noted?

A) 121 mEq/L
B) 134 mEq/L
C) 142 mEq/L
D) 156 mEq/L

Question 20

You are to administer calcium salts to a postthyroidectomy client who is hypocalcemic.During therapy,you would monitor for which of the following complications?

A) Diarrhea
B) Tetany
C) Hypertension
D) Weakness

Question 21

The nurse is explaining to a client how to take calcium carbonate as a supplement.The nurse states that to increase absorption of the dose,the supplement is best taken

A) before meals.
B) with meals.
C) 1 hour after meals.
D) at bedtime.

Question 22

When conducting a routine assessment of a client's intravenous site,the nurse expects to note which characteristic at the site if the intravenous line has infiltrated?

A) Warmth
B) Blanched appearance
C) Excessive blood return
D) Poor turgor to surrounding skin

Question 23

A client has acute hypercalcemia.The nurse prepares to administer a dose of which of the following as ordered on the physician's order sheet?

A) Disodium edetate
B) Magnesium sulfate
C) Sodium iodide
D) Potassium chloride

Question 24

The nurse would expect to assess which of the following if a client has thrombosis as a complication of intravenous therapy?

A) Cessation of infusion
B) Redness at the site
C) Coolness at the site
D) Edema

Question 25

The nurse would assess for which of the following as an adverse effect of sodium polystyrene sulfate (Kayexalate)?

A) Constipation
B) Diarrhea
C) Blurred vision
D) Joint aches

Question 26

A client receiving intravenous fluid therapy starts to exhibit dyspnea on exertion and a cough.Pulse rate is increased and lung crackles are auscultated.The nurse should take which of the following initial actions?

A) Prepare a dose of potassium in anticipation of this order
B) Slow the intravenous infusion to a keep vein open rate
C) Remove the intravenous catheter
D) Assist the client to lie in bed with the head flat

Question 27

The nurse would question an order for potassium supplements in a client who had which of the following?

A) Elevated blood urea nitrogen and creatinine
B) A potassium level of 3.1 mEq/L
C) History of liver disease
D) Overhydration

Question 28

The nurse would conclude that a client was successfully treated for hypomagnesemia after noting which of the following values on a laboratory report?

A) 0.8 mEq/dL
B) 1.0 mEq/dL
C) 1.9 mEq/dL
D) 2.8 mEq/dL

Question 29

The nurse who is teaching a client about calcium supplements explains that the dose is best absorbed when taken with a source of which of the following vitamins?

A) Vitamin A
B) Vitamin C
C) Vitamin D
D) Vitamin E

Question 30

The nurse determines that a client with a severe case of which of the following acid-base imbalances is a likely candidate for treatment with ammonium chloride injection?

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

Question 31

A client admitted to the nursing unit has several medications ordered.The nurse notes that the client is at risk for electrolyte imbalance because the only client medication that does not predispose to hypomagnesemia is which of the following?

A) Furosemide (Lasix)
B) Digoxin (Lanoxin)
C) Tobramycin (Nebcin)
D) Ranitidine (Zantac)

Question 32

The nurse would conclude that a client's calcium level is normal after noting which of the following values on a laboratory report?

A) 3.0 mEq/L
B) 4.0 mEq/L
C) 5.5 mEq/L
D) 6.5 mEq/L

Question 33

The client has an order to receive a liquid potassium supplement.The nurse would prepare this dose by mixing it with which of the following beverages?

A) Ginger ale or other carbonated beverage
B) Fruit juice
C) Milk
D) Tea

Question 34

The nurse has an order to administer a dose of sodium polystyrene sulfate (Kayexalate).Which of the following actions by the nurse would make the dose more palatable to the client?

A) Mix it in a warm beverage
B) Chill the solution
C) Dilute it in 500 mL water
D) Give it slowly over a 1-hour period

Question 35

An older adult client routinely takes magnesium salts as a means of preventing constipation.The nurse concludes that this client could have hypermagnesemia after noting which of the following client symptoms?

A) Lethargy
B) Increased respiratory rate
C) Hypertension
D) Increased deep tendon reflexes