Deck 42: Agents Affecting the Volume and Ion Content of Body Fluids

Question 1

A patient collapses after running a marathon on a hot day and is brought to the emergency department to be treated for dehydration. The nurse will expect to provide which therapy?

A) Intravenous hypertonic fluids given slowly over several hours
B) Intravenous hypotonic fluids administered in stages
C) Intravenous isotonic fluids given as a rapid bolus
D) Oral electrolyte replacement fluids with potassium

Answer 1

Intravenous hypotonic fluids administered in stages

Question 2

A nurse is caring for a child whose respirations are shallow and marked by a prolonged expiratory phase. The nurse auscultates wheezes and poor air movement bilaterally. The child's respiratory rate is 26 breaths per minute, and the oxygen saturation is 89%. What does the nurse suspect?

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

Answer 2

Respiratory acidosis

Question 3

A patient is admitted to the hospital after several days of vomiting and diarrhea. After an initial bolus of isotonic (0.9%) sodium chloride solution, the prescriber orders dextrose 5% in 1/2 normal saline (D?NS) with 20 mEq potassium chloride to infuse at a maintenance rate. What should the nurse review before implementing this order?

A) Electrocardiogram
B) Arterial blood gas levels
C) Serum electrolyte levels
D) Serum glucose level
E) Urine output

Answer 3

Electrocardiogram
Serum electrolyte levels
Urine output

Question 4

A patient with congestive heart failure is admitted to the hospital. During the admission assessment, the nurse learns that the patient is taking a thiazide diuretic. The nurse notes that the admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of 95 mEq/L, and a potassium level of 3 mEq/L. The prescriber has ordered digoxin to be given immediately. What will the nurse do initially?

A) Give the digoxin and maintain close cardiac monitoring.
B) Hold the digoxin and report the laboratory values to the provider.
C) Hold the thiazide diuretic and give the digoxin.
D) Request an order for an electrocardiogram (ECG).

Question 5

A patient who was injured at home is brought to the emergency department. The nurse caring for this patient notes a respiratory rate of 32 breaths per minute and a heart rate of 90 beats/min. The injuries are minor, but the patient is inconsolable and hysterical. The nurse expects that initial management will include:

A) administering a gas mixture of 5% carbon dioxide (CO₂).
B) providing 100% oxygen via nasal cannula.
C) giving sodium bicarbonate IV.
D) providing sedatives to calm the patient.

Question 6

A patient arrives in the emergency department complaining of muscle weakness and drowsiness. The nurse notes a heart rate of 80 beats/min, a respiratory rate of 18 breaths per minute, and a blood pressure of 90/50 mm Hg. The electrocardiogram reveals an abnormal rhythm. The nurse will question the patient about which over-the-counter medication?

A) Antacids
B) Aspirin
C) Laxatives
D) Potassium supplements

Question 7

While performing an admission assessment on a patient, the nurse learns that the patient is taking furosemide [Lasix], digoxin, and spironolactone [Aldactone]. A diet history reveals the use of salt substitutes. The patient is confused and dyspneic and complains of hand and foot tingling. Which is an appropriate nursing action for this patient?

A) Contact the provider to request orders for an electrocardiogram and serum electrolyte levels.
B) Evaluate the patient's urine output and request an order for intravenous potassium.
C) Hold the next dose of furosemide and request an order for intravenous magnesium sulfate.
D) Request an order for intravenous insulin to help this patient regulate extracellular potassium.

Question 8

A patient arrives in the emergency department after becoming dehydrated. Based on the patient's history, the provider determines that isotonic dehydration has occurred. Which solution will the nurse expect to infuse to treat this patient?

A) 0.45% sodium chloride in sterile water
B) 0.9% sodium chloride in sterile water
C) 3% sodium chloride in sterile water
D) 5% dextrose solution

Question 9

A child who ingested a handful of aspirin tablets from a medicine cabinet at home is brought to the emergency department. The nurse caring for the child notes a respiratory rate of 48 breaths per minute. The nurse understands that this child's respiratory rate is the result of the body's attempt to compensate for:

A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory acidosis.
D) respiratory alkalosis.

Question 10

Which order for potassium (KCl) would the nurse question?

A) D5 1/2 NS with 20 mEq KCl to start after patient voids
B) D5 1/2 NS with 60 mEq KCl for a patient with a serum potassium of 3.2 mEq/L
C) K-Dur, 1 tablet daily for a patient with diabetic ketoacidosis
D) K-Dur, 1 tablet with a full glass of water
E) Potassium chloride, 10 mEq rapid IV push

Question 11

A patient who is a chronic alcoholic is admitted to the hospital. Admission laboratory work reveals a magnesium level of 1.2 mEq/L. The prescriber orders intravenous magnesium sulfate in a 10% solution at a rate of 10 mL/min. What will the nurse do?

A) Administer the IV dose as ordered and have calcium gluconate on hand.
B) Administer the IV dose and make preparations for mechanical ventilation.
C) Hold the IV dose until the infusion rate has been clarified with the provider.
D) Request an order for renal function tests before administering the IV dose.

Question 12

A nurse is caring for a postoperative patient who has a nasogastric tube with continuous suction. The nurse notes that the patient has shallow respirations and suspects that this patient has developed:

A) metabolic acidosis.
B) metabolic alkalosis.
C) respiratory acidosis.
D) respiratory alkalosis.