Deck 3: Fluid, electrolytes, acid-base Balance, and Intravenous Therapy

Question 1

The nurse can record that the compensatory mechanism for the correction of metabolic acidosis is in effect when the nurse observes:

A)increased urinary output.
B)reduced abdominal distention.
C)Kussmaul's respirations.
D)decreased blood pressure.

Answer 1

Kussmaul's respirations.

Question 2

The count of the solution in the IV container at the beginning of the shift is 800 mL.A new 1000-mL bag was hung during the shift and has 650 mL left at the end of the shift.The nurse reports the IV fluid intake for the shift as _____ mL.

A)1000
B)1050
C)1100
D)1150

Answer 2

1150

Question 3

The nurse uses a diagram to demonstrate how in dehydration the water is drawn into the plasma from the cells by the process of:

A)distillation.
B)diffusion.
C)filtration.
D)osmosis.

Answer 3

osmosis.

Question 4

While the nurse is washing the face of a patient in renal failure,the patient demonstrates a spasm of the lips and face.The nurse examines the recent electrolyte levels to assess the level of:

A)potassium.
B)calcium.
C)sodium.
D)magnesium.

Question 5

Prior to hanging an IV containing potassium,the nurse will confirm that there is a:

A)blood pressure of at least 60 mm Hg diastolic.
B)urine output of at least 30 mL/hr.
C)filter on the IV line.
D)pulse of at least 50 beats/min.

Question 6

To help prevent respiratory acidosis in a young person with asthma,the nurse would encourage:

A)deep-breathing exercises every 2 hours.
B)drinking 8 ounces of fluid every 4 hours.
C)ambulating for 15 minutes twice a day.
D)sleeping with the head of the bed elevated 45 degrees.

Question 7

The nurse determines there is no need for further instruction related to a low-sodium diet when the patient says:

A)"I can have all the dried fruits I want."
B)"I'm looking forward to a tall glass of tomato juice."
C)"I'm going to eat my favorite avocado and orange salad."
D)"I'm going to eat a cheeseburger with extra catsup."

Question 8

When the nurse assesses a potassium level of 2.9 mEq/L in the patient with vomiting and diarrhea,the nurse will be alert for:

A)excessive urinary output.
B)abdominal distention.
C)increased reflexes.
D)hyperactive bowel sounds.

Question 9

The patient taking furosemide (Lasix)to correct excess edema shows a weight loss of 5.5 pounds in 24 hours.The nurse calculates this weight loss to be the excretion of approximately _____ liters of fluid.

A)1.0
B)1.5
C)2.0
D)2.5

Question 10

The nurse assessing a patient with vomiting and diarrhea observes that the urine is scant and concentrated.The nurse explains that the compensatory reabsorption of water is controlled by:

A)osmoreceptors in the hypothalamus.
B)antidiuretic hormone in the posterior pituitary.
C)baroreceptors in the carotid sinus.
D)insulin from the pancreas.

Question 11

Because there are no IV pumps available for the immediate infusion of an IV medication,the nurse must calculate the flow rate for 500 mL to run for 4 hours,using a set that delivers 15 gtt/mL.The flow rate should be _____ gtt/min.

A)30
B)35
C)40
D)45

Question 12

The nurse flushing a PRN lock will select the appropriate fluid and will clear the lumen by:

A)flushing forcefully to clear.
B)using slow, gentle pressure.
C)flushing hard enough to clear resistance.
D)aspirating prior to flushing.

Question 13

The nurse assessing the IV insertion site finds the vein hard,the skin red and tender,and a blood return in the IV line.The most effective intervention after removing the IV catheter is to:

A)notify the charge nurse.
B)elevate the arm above the level of the heart.
C)clean the site with alcohol and apply cool compresses.
D)apply a warm moist pack.

Question 14

The nurse is caring for a patient who has been on total parenteral nutrition (TPN)for 48 hours.The nurse demonstrates the most effective nursing care by:

A)checking the patient's blood glucose level according to facility protocol.
B)speeding up the solution if the prescribed intake falls behind.
C)informing the patient that TPN can only be administered via a central line for 1 week.
D)monitoring the peripheral IV site of TPN infusion for signs of infiltration at least every 8 hours.

Question 15

The nurse is assessing a patient with renal failure and notes fatigue,muscle cramps,confusion,and headache.The nurse will monitor the patient's _____ level.

A)potassium
B)sodium
C)calcium
D)chloride

Question 16

The patient with long-term obstructive pulmonary disease has a pH of 7,HCO₃- of 18 mEq/L,and a PaCO₂ of 40 mm Hg.From this laboratory information,the nurse assesses the patient is in:

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

Question 17

The nurse uses a picture to show how ions equalize their concentration by the passive transport process of:

A)osmosis.
B)filtration.
C)titration.
D)diffusion.

Question 18

The patient who has had diarrhea for the last 3 days has blood gases of pH of 7.1,HCO₃- of 20 mEq/L,and PCO₂ of 36 mm Hg.The nurse recognizes these values indicate:

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

Question 19

The nurse explains that the active transport process that is able to move sodium and potassium into or out of cells is:

A)filtration.
B)sodium pump.
C)diffusion.
D)osmosis.

Question 20

Because the 80-year-old patient is prone to dehydration related to the age-related change of decreased thirst and kidney function,the nurse monitors for the earliest sign of dehydration,which is:

A)reduced skin turgor.
B)constipation.
C)increased temperature.
D)thirst.

Question 21

The nurse is caring for a newly admitted patient with uncontrolled nausea and vomiting.The patient has a history of alcoholism and diabetes.Upon obtaining orders from the primary care provider,the nurse would question which orders: (Select all that apply.)

A)Administer 10 mg prochlorperazine maleate (Compazine), IM every 4 to 6 hours for nausea and vomiting.
B)Administer diphenoxylate atropine (Lomotil), 2 tabs, by mouth after first occurrence of nausea and vomiting.
C)Administer Lactated Ringer's solution, IV, at 100 mL/hr.
D)Monitor the patient's intake and output every 4 hours.
E)Obtain patient's weight every morning and record.

Question 22

The primary care provider writes an order for the patient to receive an IV of a solution that has the same osmotic pressure as intracellular fluid.The nurse would correctly question which of the following IV orders? (Select all that apply.)

A)5% dextrose in water
B)0.45% sodium chloride
C)5% dextrose in 0.9% sodium chloride
D)Lactated Ringer's solution
E)0.9% sodium chloride

Question 23

The nurse demonstrates knowledge of IV solutions by identifying that the IV solution which provides free water,as well as 340 calories/L,is ______________.

Question 24

Matching
The nurse explains that the chain of events that results in hypocalcemia for the patient in early renal failure is: (Match the events to the proper sequence.)

Step: 4

A)loss of calcium ions.
B)vitamin D not activated.
C)bone loss.
D)retention of phosphates.
E)loss of absorption of calcium from the GI tract.

Question 25

The nurse is assessing the hydration status of the patient.The nurse demonstrates knowledge of proper assessment techniques by: (Select all that apply.)

A)monitoring the patient's daily weight.
B)assessing the patient's skin turgor on the back of the hand.
C)checking the patient's blood glucose level 4 times a day.
D)assessing for skin tenting on the patient's forehead.
E)asking the patient if he is experiencing thirst.

Question 26

Matching
The nurse explains that the chain of events that results in hypocalcemia for the patient in early renal failure is: (Match the events to the proper sequence.)

Step: 1

A)loss of calcium ions.
B)vitamin D not activated.
C)bone loss.
D)retention of phosphates.
E)loss of absorption of calcium from the GI tract.

Question 27

Matching
The nurse explains that the chain of events that results in hypocalcemia for the patient in early renal failure is: (Match the events to the proper sequence.)

Step: 2

A)loss of calcium ions.
B)vitamin D not activated.
C)bone loss.
D)retention of phosphates.
E)loss of absorption of calcium from the GI tract.

Question 28

The nurse explains to the 85-year-old patient with a temperature that,with each degree of fever,the body loses _____% of water.

Question 29

The patient has a potassium level of 5.0.The nurse closely monitors the patient for: (Select all that apply.)

A)muscle weakness.
B)cardiac dysrhythmias.
C)decreased reflexes.
D)urinary retention.
E)hypotension.

Question 30

The nurse reminds the patient that the three body mechanisms that attempt to compensate to correct acid-base imbalances are the __________ system,the __________ system,and the __________.

Question 31

Matching
The nurse explains that the chain of events that results in hypocalcemia for the patient in early renal failure is: (Match the events to the proper sequence.)

Step: 3

A)loss of calcium ions.
B)vitamin D not activated.
C)bone loss.
D)retention of phosphates.
E)loss of absorption of calcium from the GI tract.

Question 32

Matching
The nurse explains that the chain of events that results in hypocalcemia for the patient in early renal failure is: (Match the events to the proper sequence.)

Step: 5

A)loss of calcium ions.
B)vitamin D not activated.
C)bone loss.
D)retention of phosphates.
E)loss of absorption of calcium from the GI tract.