Deck 4: Fluids and Electrolytes, Acids and Bases

Question 1

An experiment was designed to test the effects of the Starling forces on fluid movement.Which of the following alterations would result in fluid moving into the interstitial space?

A) Increased capillary oncotic pressure
B) Increased interstitial hydrostatic pressure
C) Decreased capillary hydrostatic pressure
D) Increased interstitial oncotic pressure

Answer 1

Increased interstitial oncotic pressure

Question 2

Which of the following patients is the most at risk for developing hypernatremia? A patient with:

A) Vomiting
B) Diuretic use
C) Dehydration
D) Hypoaldosteronism

Answer 2

Dehydration

Question 3

A 10-year-old male is brought to the emergency room (ER)because he is incoherent and semiconscious.CT scan reveals that he is suffering from cerebral edema.This type of edema is referred to as:

A) Localized edema
B) Generalized edema
C) Pitting edema
D) Lymphedema

Answer 3

Localized edema

Question 4

A patient has been searching on the Internet about natriuretic hormones.When the patient asks the nurse what do these hormones do,how should the nurse respond? Natriuretic hormones affect the balance of:

A) Calcium
B) Sodium
C) Magnesium
D) Potassium

Question 5

When taking care of a patient with hyperkalemia,which principle is priority? Hyperkalemia causes a(n)_____ in resting membrane potential with _____ excitability of cardiac muscle.

A) Increase; increased
B) Decrease; increased
C) Increase; decreased
D) Decrease; decreased

Question 6

A 52-year-old diabetic male presents to the ER with lethargy,confusion,and depressed reflexes.His wife indicates that he does not follow the prescribed diet and takes his medication sporadically.Lab results indicate hyperglycemia.Which assessment finding is most likely to occur?

A) Clammy skin
B) Decreased sodium
C) Decreased urine formation
D) Metabolic alkalosis

Question 7

A nurse is teaching the staff about antidiuretic hormone (ADH).Which information should the nurse include? Secretion of ADH is stimulated by:

A) Increased serum potassium
B) Increased plasma osmolality
C) Decreased renal blood flow
D) Generalized edema

Question 8

When planning care for a dehydrated patient,the nurse remembers the principle of water balance is closely related to _____ balance.

A) Potassium
B) Chloride
C) Bicarbonate
D) Sodium

Question 9

Hyperlipidemia and hyperglycemia are associated with:

A) Hypernatremia
B) Hypertonic hyponatremia
C) Hypokalemia
D) Acidosis

Question 10

The most common cause of pure water deficit is:

A) Renal water loss
B) Hyperventilation
C) Sodium loss
D) Insufficient water intake

Question 11

A 70-year-old male with chronic renal failure presents with edema.Which of the following is the most likely cause of this condition?

A) Increased capillary oncotic pressure
B) Decreased interstitial oncotic pressure
C) Increased capillary hydrostatic pressure
D) Increased interstitial hydrostatic pressure

Question 12

A 25-year-old male is diagnosed with a hormone-secreting tumor of the adrenal cortex.Which finding would the nurse expect to see in the lab results?

A) Decreased blood volume
B) Decreased blood K⁺ levels
C) Increased urine Na⁺ levels
D) Increased white blood cells

Question 13

Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in:

A) Decreased plasma osmolality
B) Increased serum potassium levels
C) Increased blood volume
D) Localized edema

Question 14

A 35-year-old male weighs 70 kg.Approximately how much of this weight is ICF?

A) 5 L
B) 10 L
C) 28 L
D) 42 L

Question 15

A 5-year-old male presents to the ER with delirium and sunken eyes.After diagnosing him with severe dehydration,the primary care provider orders fluid replacement.The nurse administers a hypertonic intravenous solution.Which of the following would be expected?

A) Symptoms subside quickly
B) Increased ICF volume
C) Decreased ECF volume
D) Intracellular dehydration

Question 16

Which of the following patients should the nurse assess for a decreased oncotic pressure in the capillaries? A patient with:

A) A high-protein diet
B) Liver failure
C) Low blood pressure
D) Low blood glucose

Question 17

A nurse is reviewing lab reports.The nurse recalls blood plasma is located in which of the following fluid compartments?

A) Intracellular fluid (ICF)
B) Extracellular fluid (ECF)
C) Interstitial fluid
D) Intravascular fluid

Question 18

Water movement between the ICF and ECF compartments is determined by:

A) Osmotic forces
B) Plasma oncotic pressure
C) Antidiuretic hormone
D) Buffer systems

Question 19

While planning care for elderly individuals,the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):

A) Higher total body water volume
B) Decreased muscle mass
C) Increase in thirst
D) Increased tendency towards developing edema

Question 20

Which of the following patients is most prone to hypochloremia? A patient with:

A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Increased bicarbonate intake

Question 21

For a patient with respiratory acidosis,chronic compensation by the body will include:

A) Kidney excretion of H⁺
B) Kidney excretion of HCO₃
C) Prolonged exhalations to blow off CO₂
D) Protein buffering

Question 22

A 60-year-old male with a 30-year history of smoking is diagnosed with a hormone-secreting lung tumor.Further testing indicates that the tumor secretes ADH.Which of the following assessment findings should the nurse expect? (Select all that apply.)

A) Confusion
B) Weakness
C) Nausea
D) Muscle twitching
E) Weight loss

Question 23

Which of the following conditions would cause the nurse to monitor for hyperkalemia?

A) Excess aldosterone
B) Acute acidosis
C) Insulin usage
D) Metabolic alkalosis

Question 24

The nurse would anticipate the patient with syndrome of inappropriate ADH (SIADH)to demonstrate which of the following symptoms? (Select all that apply.)

A) Weakness
B) Nausea
C) Headache
D) Weight loss
E) Muscle twitching

Question 25

A 55-year-old female presents to her primary care provider and reports dizziness,confusion,and tingling in the extremities.Blood tests reveal an elevated pH,decreased PCO₂,and slightly decreased HCO₃.Which of the following is the most likely diagnosis?

A) Respiratory alkalosis with renal compensation
B) Respiratory acidosis with renal compensation
C) Metabolic alkalosis with respiratory compensation
D) Metabolic acidosis with respiratory compensation

Question 26

A nurse recalls regulation of acid-base balance through removal or retention of volatile acids is accomplished by the:

A) Buffer systems
B) Kidneys
C) Lungs
D) Liver

Question 27

A 54-year-old male with a long history of smoking complains of excessive tiredness,shortness of breath,and overall ill feelings.Lab results reveal decreased pH,increased CO₂,and normal bicarbonate ion.These findings help to confirm the diagnosis of:

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

Question 28

A 60-year-old female is diagnosed with hyperkalemia.Which assessment finding should the nurse expect to observe?

A) Weak pulse
B) Excessive thirst
C) Oliguria
D) Constipation

Question 29

Which finding would support the diagnosis of respiratory acidosis?

A) Vomiting
B) Hyperventilation
C) Pneumonia
D) An increase in noncarbonic acids

Question 30

Which patient should the nurse assess for both hyperkalemia and metabolic acidosis? A patient diagnosed with:

A) Diabetes insipidus
B) Pulmonary disorders
C) Cushing syndrome
D) Renal failure

Question 31

A 19-year-old male presents to his primary care provider reporting restlessness,muscle cramping,and diarrhea.Lab tests reveal that he is hyperkalemic.Which of the following could have caused his condition?

A) Primary hyperaldosteronism
B) Acidosis
C) Insulin secretion
D) Diuretic use

Question 32

For a patient experiencing metabolic acidosis,the body will compensate by:

A) Excreting H⁺ through the kidneys
B) Hyperventilating
C) Retaining CO₂ in the lungs
D) Secreting aldosterone

Question 33

Physiologic pH is maintained around 7.4 because carbonic acid and bicarbonate exist in a ratio of:

A) 20:1
B) 1:20
C) 10:2
D) 2:10

Question 34

Which of the following buffer pairs is considered the major plasma buffering system?

A) Protein/fat
B) Carbonic acid/bicarbonate
C) Sodium/potassium
D) Amylase/albumin

Question 35

Which patient is most prone to metabolic alkalosis? A patient with:

A) Retention of metabolic acids
B) Hypoaldosteronism
C) Excessive loss of chloride (Cl)
D) Hyperventilation

Question 36

Which organ system should the nurse monitor when the patient has long-term potassium deficits?

A) Central nervous system (CNS)
B) Lungs
C) Kidneys
D) Gastrointestinal tract

Question 37

A 42-year-old female presents to her primary care provider reporting muscle weakness and cardiac abnormalities.Laboratory tests indicate that she is hypokalemic.Which of the following could be the cause of her condition?

A) Respiratory acidosis
B) Constipation
C) Hypoglycemia
D) Primary hyperaldosteronism

Question 38

Outcomes of laboratory tests include an elevated level of natriuretic peptides.Which organ is the priority assessment?

A) Lungs
B) Heart
C) Liver
D) Brain