Chapter 14: Fluids and Electrolytes
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse assesses that a patient’s urine has become much more concentrated. What is the most
likely cause for the change?
a.
Adrenaline
b.
Aldosterone
c.
Antidiuretic hormone (ADH)
d.
Insulin
2. When the water absorption in the renal tubules becomes greater than normal, what assessment
finding should a nurse anticipate?
a.
More concentrated urine
b.
Less concentrated urine
c.
More alkaline urine
d.
Less alkaline urine
3. What process occurs when oxygen is directed out of the arteries and into the capillaries?
a.
Active transport
b.
Diffusion
c.
Filtration
d.
Osmosis
4. A patient’s intravenous (IV) injection has been infusing at a very high rate. What assessment
indicates fluid volume overload in this patient?
a.
Hypotension
b.
Tachycardia
c.
Pulmonary edema
d.
Kidney failure
5. A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of
baby aspirin approximately 8 hours earlier. In addition to providing reassurance to the patient,
which nursing action is the most appropriate?
a.
Providing IV treatments as ordered but without sodium bicarbonate
b.
Frequently assessing the mental and neurologic status
c.
Taking daily weights and vital signs
d.
Inducing vomiting
6. What is primarily responsible for carrying fluids with nutrients and wastes on a random basis
throughout the body?
a.
Filtrates
b.
Extracellular fluid
c.
Intracellular fluid
d.
Osmolytes
7. A nurse clarifies that electrolytes, such as sodium and potassium (K+), break down into
smaller particles when dissolved. What are these smaller particles?
a.
Cells
b.
Elements
c.
Ions
d.
Molecules
8. A nurse assists a patient with dyspnea to sit in a high Fowler position. What process allows
gravity to help move oxygen from the pulmonary capillaries into the blood when the patient is
in this position?
a.
Active transport
b.
Diffusion
c.
Filtration
d.
Osmosis
9. A nurse evaluates the laboratory reports on electrolyte values carefully to assess the balance
between positive and negative ions. What is responsible for the regulation of this process?
a.
Adaptation
b.
Diffusion
c.
Homeostasis
d.
Osmosis
10. What is being administered when a nurse hangs an IV bag with Na+, K+, and Cl−?
a.
Nutrients
b.
Electrolytes
c.
Enzymes
d.
Vitamins
11. Each compartment of the body has a water-fluid distribution movement of its own. What is
the process allowing these fluids to move and distribute themselves among compartments?
a.
Active transport
b.
Diffusion
c.
Filtration
d.
Osmosis
12. A licensed practical/vocational nurse (LPN/LVN) is preparing to add a new IV of 5%
dextrose in water (D5W) with potassium (K+) to an existing line. The LPN/LVN notices that
only 25 mL of urine has been collected over the past hour. What is the most appropriate
nursing intervention?
a.
Avoid hanging the IV with K+ and inform the registered nurse (RN) of the urine
output.
b.
Run the IV rapidly for 30 minutes to stimulate urine production.
c.
Call the physician who ordered the K+.
d.
Hang the IV as ordered and chart the output.
13. Both the intracellular and extracellular fluids are made up of many different electrolytes. What
is the most abundant intracellular positively charged electrolyte?
a.
Calcium
b.
Chloride
c.
Potassium
d.
Sodium
14. For what compensatory condition should the nurse carefully assess when the patient with
metabolic acidosis is hyperventilating?
a.
Metabolic alkalosis
b.
Respiratory acidosis
c.
Respiratory alkalosis
d.
Thyroid imbalances
15. The K+ laboratory report shows a level of 5.2 mEq/L. What is the most important assessment
for the nurse to make?
a.
Excessive thirst
b.
Irregular heartbeat
c.
Swelling of ankles
d.
Frightening hallucinations
16. A patient has renal damage because of diabetes. What is the highest risk for this patient?
a.
Hypercalcemia
b.
Hypocalcemia
c.
Hyperkalemia
d.
Hypokalemia
17. What is usually associated with hyperchloremia?
a.
Metabolic acidosis
b.
Metabolic alkalosis
c.
Respiratory acidosis
d.
Respiratory alkalosis
18. Older adults are at risk for dehydration because of reduced thirst and aging kidneys. What
should the nurse assess as an early indicator of dehydration?
a.
Reduced skin turgor
b.
Constipation
c.
Concentrated urine
d.
Disorientation
19. A nurse has two newly admitted patients with dehydration. One patient is dehydrated from
heat exhaustion, and the other is dehydrated from an overdose of Lasix. What finding should
be present in both patients?
a.
Increased skin turgor
b.
Decreased pulse and respirations
c.
Copious saliva and nasal secretions
d.
Increased laboratory values of hemoglobin and hematocrit
20. A nurse understands that fluid balance is mainly monitored in the body by which two
systems?
a.
Circulatory and renal
b.
Respiratory and circulatory
c.
Renal and gastrointestinal
d.
Hepatic and lymphatic
21. What primarily maintains extracellular fluid osmolarity?
a.
Chloride
b.
Magnesium
c.
Potassium
d.
Sodium
22. How does the healthy kidney adjust the volume and composition of filtrate that prevents
excessive fluid loss?
a.
Active transport
b.
Filtration in the lymphatic system
c.
Secretion of adrenalin
d.
Tubular reabsorption
23. What process involves blood being brought by the incoming capillaries into the kidney, which
contains nitrogenous substances to be excreted as waste?
a.
Active transport
b.
Diffusion
c.
Filtration
d.
Osmosis
24. What should treatment focus on when a patient is hypovolemic?
a.
Extracellular fluid deficit and limiting drinking water
b.
Hypertonic intracellular deficit and limiting water intake
c.
Extracellular fluid deficit and encouraging fluid intake
d.
Circulatory system hormone deficit and limiting water intake
25. A patient is frequently thirsty. To what should the nurse attribute this symptom?
a.
Too much sodium and too much water in the body
b.
Too little sodium and too much water in the body
c.
Too much sodium and too little water in the body
d.
Too little sodium and too little water in the body
MULTIPLE RESPONSE
26. What should a nurse instruct a patient with a K+ level of 6.2 to avoid? (Select all that apply.)
a.
Lima beans
b.
Bananas
c.
Carrots
d.
Tomatoes
e.
Celery
COMPLETION
27. A nurse assesses that a patient with congestive heart failure who is being treated with a
diuretic has lost 4.4 lb in 1 day. This weight loss is equivalent to the loss of _____ of fluid.
28. A nurse assesses deep-rapid respirations in a patient with metabolic acidosis to be an indicator
of the homeostatic system at work to reduce the _____ level.
29. A nurse should anticipate in a patient with respiratory acidosis that the blood pH reading
would be lower than _____.
30. A nurse cautions a group of high school athletes about fluid loss in hot, dry weather, because
the normal loss from respiration, which is _____ to _____ mL/day, is doubled.