Deck 8: Fluid and Electrolyte Management

Question 1

The nurse is caring for a patient with congestive heart failure who is admitted to the medical-surgical unit with acute hypokalemia. Which prescribed medication may have contributed to the patient's current hypokalemic state?
1)Cortisol
2)Oxycodone
3)Flexeril
4)Nonsteroidal anti-inflammatory drugs (NSAIDs)

Answer 1

1

Question 2

The nurse is caring for a patient admitted with hypertension and chronic renal failure who receives hemodialysis three times per week. The nurse is assessing the patient's diet and notes the use of salt substitutes. When teaching the patient to avoid salt substitute, which rationale supports this teaching point?
1)They can potentiate hyperkalemia.
2)They may cause the client to retain fluid.
3)They may interfere with the hemodialysis.
4)They may interact with the client's antihypertensive medications.

Answer 2

1

Question 3

A nurse is reviewing the serum chemistry results on a patient who has a nasogastric tube to low intermittent suction secondary to a gunshot to the abdomen 2 days ago. Which electrolyte value does the nurse correlate to the NG suctioning?
1)Serum chloride of 90 mEq/L
2)Serum sodium of 148 mEq/L
3)Serum potassium of 5.2 mEq/L
4)Serum calcium of 11.3 mg/dL

Answer 3

1

Question 4

The nurse is providing care to a patient who seeks emergency treatment for headache and nausea. The patient works in a mill without air conditioning. The patient states, "I drink water several times each day, but I seem to sweat more than I am able to replace." Which suggestions does the nurse provide to this patient?
1)Drink juices and carbonated sodas.
2)Eat something salty when drinking water.
3)Eat something sweet when drinking water.
4)Double the amount of water being ingested.

Question 5

In reviewing laboratory results for a patient presenting to the Emergency Department with changes in level of consciousness, the nurse correlates which value as placing the patient at greatest risk for seizures?
1)Serum calcium of 12 mg/dL
2)Serum potassium of 3.0 mEq/L
3)Serum sodium of 135 mEq/L
4)Serum magnesium of 2.6 mEq/L

Question 6

The nurse provides care to a patient whose serum potassium level is 3.2 mEq/L. Which healthcare provider order does the nurse question based on this data?
1)Serum chemistries (basic metabolic panel) every morning
2)Continuous cardiac monitoring 3.10 mEq KCl (potassium chloride) in 100 mL normal saline slow IVP (intravenous pyelogram)
4)25 mg spironolactone (Aldactone) by mouth daily

Question 7

Which assessment data collected by the nurse indicate that an older adult patient is at risk for dehydration?
1)Poor skin turgor
2)Body mass index of 20.5
3)Blood pressure of 140/98 mm Hg
4)Oral intake of 48 ounces per day

Question 8

The nurse is caring for a patient with congestive heart failure who is admitted to the medical-surgical unit with acute hypokalemia. Which prescribed medication may have contributed to the patient's current hypokalemic state?
1)Cortisol
2)Oxycodone
3)Flexeril
4)Nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 9

The nurse is caring for a patient with a potassium level of 5.9 mEq/L. The healthcare provider prescribes both glucose and insulin for the patient. The patient's spouse asks, "Why is insulin needed? " Which response by the nurse is the most appropriate?
1)"The insulin will help his kidneys excrete the extra potassium."
2)"The insulin is safer than other medications that can lower potassium levels."
3)"The insulin lowers his blood sugar levels, and this is how the extra potassium is excreted."
4)"The insulin will cause his extra potassium to move into his cells, which will lower potassium in the blood."

Question 10

The nurse is caring for a patient who is receiving intravenous fluids postoperatively after cardiac surgery. The nurse correlates the patient's risk for fluid volume excess to which cause?
1)Decreased mobility as a result of surgery and pain
2)Administration of intravenous fluids
3)Decreased levels of aldosterone
4)Increased levels of antidiuretic hormone

Question 11

The nurse is providing care to a patient who is prescribed furosemide for treatment of congestive heart failure (CHF). The patient's serum potassium level is 3.4 mEq/L. Which food should the nurse encourage the patient to eat based on this data?
1)Peas
2)Iced tea
3)Bananas
4)Baked fish

Question 12

In reviewing laboratory results for a female patient suspected of having a fluid imbalance, the nurse correlates which laboratory value with a diagnosis of dehydration?
1)Hemoglobin of 10.5 g/dL
2)Hematocrit 49%
3)Serum potassium 3.8 mEq/L
4)Serum osmolality 230 mOsm/kg

Question 13

The nurse provides care to a patient who is prescribed 0.45% normal saline (NS) by intravenous (IV) infusion. Which data cause the nurse to question the healthcare provider regarding this IV fluid order?
1)Urine output 40 mL/hour
2)Blood pressure 100/60 mm Hg
3)Respiratory rate 12 breaths/min
4)Serum sodium level of 145 mEq/L

Question 14

A patient presents in the emergency department (ED) with fever, nausea, and vomiting over the past 2 days. The nurse monitors for which laboratory result in this patient?
1)Urine specific gravity of 1.040
2)Serum potassium of 4.8 mEq/L
3)Serum sodium of 135 mEq/L
4)Urine positive for glucose and ketones

Question 15

In reviewing a patient's laboratory results before administering digoxin, which laboratory result places the patient at greatest risk for digoxin toxicity?
1)Serum sodium 156 mEq/L
2)Serum potassium 3.0 mEq/L
3)Serum phosphorus of 1.5 mg/dL
4)Serum creatinine of 1.6 mg/dL

Question 16

The nurse is analyzing the intake and output record for a patient being treated for dehydration. The patient weighs 176 lbs and had a 24-hour intake of 2,000 mL and urine output of 1,200 mL. Based on this data, which conclusion by the nurse is the most appropriate?
1)Treatment has not been effective.
2)Treatment needs to include a diuretic.
3)Treatment is effective and should continue.
4)Treatment has been effective and should end.

Question 17

The nurse is planning care for the patient with acute renal failure and incorporates the nursing diagnosis of Excess Fluid Volume. Which assessment data support this nursing diagnosis?
1)Wheezing in the lungs
2)Generalized weakness
3)Urine output of 20 mL/hour
4)Pitting edema in the lower extremities

Question 18

A patient is prescribed 20 mEq of potassium chloride because of excessive vomiting. The nurse includes which information in explaining the rationale for this medication?
1)It controls and regulates water balance in the body.
2)It is used in the body to synthesize ingested protein.
3)It is vital in regulating muscle contraction and relaxation.
4)It is needed to maintain skeletal, cardiac, and neuromuscular activity.

Question 19

The nurse is providing care to an older adult patient who is receiving intravenous (IV) fluids at 150 mL/hour. It is important that the nurse assess for which clinical manifestations that could indicate fluid volume excess in this patient?
1)Flattened neck veins
2)Elevated blood pressure
3)Bradycardia
4)Skin tenting

Question 20

The nurse plans care for a hospitalized patient. Which data necessitate the inclusion of interventions to address a fluid volume deficit?
1)Urine output of 30 mL/hour
2)Heart rate of 110 bpm
3)Weight gain of 10 pounds in 3 days
4)Plus-3 edema in bilateral lower extremities

Question 21

The nurse educates a patient who is prescribed furosemide (Lasix) for congestive heart failure on foods rich in potassium. Which patient menu choices indicate to the nurse a correct understanding of the information presented? Select all that apply.
1)Pasta
2)Spinach
3)Applesauce
4)A sweet potato
5)Low-fat milk

Question 22

The nurse provides care for a patient who is experiencing hypomagnesemia. Which food choice is best for this patient?
1)A medium-sized banana
2)One medium-sized baked potato
3)Three ounces of cooked halibut
4)A half-cup of cooked black-eyed peas

Question 23

The nurse correlates which clinical manifestations to the patient at risk for hypovolemic shock? Select all that apply.
1)Blood pressure of 110/70
2)Heart rate of 146
3)Urine output of 0 to 10 mL/hour
4)Cool, clammy skin
5)Increased bowel sounds

Question 24

The nurse is providing care to a patient whose serum calcium levels have increased since a surgical procedure performed 3 days ago. Which intervention does the nurse implement to decrease the risk for the development of hypercalcemia?
1)Monitor vital signs every 8 hours.
2)Encourage ambulation three times a day.
3)Irrigate the Foley catheter one time a day.
4)Recommend turning, coughing, and deep breathing every 2 hours.

Question 25

The nurse recognizes which intervention as the priority in the care of the patient with a serum phosphorus level of 2.0 mg/dL?
1)Decrease fluid intake.
2)Strain all urine for kidney stones.
3)Encourage consumption of milk and yogurt.
4)Discourage consumption of a high-calorie diet.

Question 26

The nurse monitors for which clinical manifestations in the patient admitted with hypermagnesemia?
1)Elevated blood pressure
2)Bradycardia
3)Increased deep tendon reflexes
4)Hyperventilation

Question 27

The nurse is providing care to a patient who is exhibiting clinical manifestations of a fluid and electrolyte deficit. Which of the following orders does the nurse implement to address this disorder? Select all that apply.
1)Administer diuretics
2)Administer antibiotics
3)Place the patient in high-Fowler's position
4)Monitor patient's I&O
5)Initiate intravenous therapy

Question 28

The nurse is monitoring laboratory results on assigned patients. The patient with which laboratory has the highest risk of laryngospasm?
1)Serum calcium 7.5 mg/dL
2)Serum magnesium 3.0 mg/dL
3)Serum potassium 5.6 mEq/L
4)Serum phosphorus 1 mg/dL

Question 29

A patient's serum sodium level is 150 mg/dL. Based on this information, which interventions should the nurse plan for this patient? Select all that apply.
1)Elevate the head of the bed.
2)Instruct on a low-sodium diet.
3)Monitor heart rate and rhythm.
4)Administer diuretics as prescribed.
5)Administer potassium supplement as prescribed.

Question 30

The nurse recognizes which clinical manifestations as age-related changes that may impact fluid and electrolyte in the older adult? Select all that apply.
1)Increased salivation
2)Increased urine output
3)Decreased sense of smell
4)Decreased visual acuity
5)Changes in taste sensation

Question 31

The nurse is preparing an educational session for members of a community health center that focuses on ways to maintain fluid balance during the summer months. Which interventions should the nurse recommend? Select all that apply.
1)Drink diet soda.
2)Reduce the intake of coffee and tea.
3)Drink more fluids during hot weather.
4)Drink flat cola or ginger ale if vomiting.
5)Exercise during the hours of 10 a.m. and 2 p.m.