Ch18 Fluids and Electrolytes PDF

Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 18: Fluids and Electrolytes Cooper: Foundations of Nursing, 8th Edition MULTIPLE CHOICE 1. What percentage of an adult’s body weight consists of water? a. 10% to 20% b. 30% to 40% c. 50% to 60% d. 70% t...

Stuvia.com - The Marketplace to Buy and Sell your Study Material Chapter 18: Fluids and Electrolytes Cooper: Foundations of Nursing, 8th Edition MULTIPLE CHOICE 1. What percentage of an adult’s body weight consists of water? a. 10% to 20% b. 30% to 40% c. 50% to 60% d. 70% to 80% ANS: C The percentage of water declines to 50% to 60% in adults. DIF: Cognitive Level: Knowledge REF: 483 OBJ: 1 TOP: Fluids KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 2. When administering intravenous (IV) fluids, the nurse ensures that the IV fluids are infusing as ordered to prevent dehydration in an adult. When could dehydration become lethal? a. If the patient loses 5% of body fluid b. If the patient loses 10% of body fluid c. If the patient loses 15% of body fluid d. If the patient loses 20% of body fluid ANS: D A loss of 20% of body fluid in an adult is fatal. DIF: Cognitive Level: Knowledge REF: 483 OBJ: 1 TOP: Fluids KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 3. The nurse uses a diagram to show that fluids in the interstitial and intravascular compartments are combined. What do they combine to form? a. Intercellular compartment b. Circulating compartment c. Vertical compartment d. Extracellular compartment ANS: D The fluids in the interstitial and intravascular compartments are combined to form the extracellular compartment. DIF: Cognitive Level: Knowledge REF: 483 OBJ: 1 TOP: Fluid compartments KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 4. The nurse encourages a patient who has been vomiting to drink fluids because the body fluid lost daily must match the amount of fluid taken in to maintain homeostasis. What is the recommended daily amount of fluid for an adult? WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material a. 1000 mL b. 1500 mL c. 2050 mL d. 2500 mL ANS: D Daily fluid intake and output is about 2200 to 2700 mL/day, and urinary output is about 1000 to 2000 mL/day. DIF: Cognitive Level: Knowledge REF: 489 OBJ: 1 TOP: Fluids KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 5. The nurse must keep an accurate intake and output record to assess kidney efficiency. In order for the kidneys to remove waste, what is the least amount of hourly urine output the kidneys must produce to remove waste? a. 10 mL b. 20 mL c. 30 mL d. 40 mL ANS: C The kidneys must excrete a minimum of 30 mL/h to eliminate waste products. DIF: Cognitive Level: Knowledge REF: 485 OBJ: 6 TOP: Fluids KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 6. The nurse weighs a patient at the same time of day with the same scale and same clothing. What is this a simple and accurate method of determining? a. An accurate weight b. Water balance c. Adequate nutrition d. Urinary output ANS: B A simple and accurate method of determining water balance is to weigh the patient under the same conditions each day. DIF: Cognitive Level: Comprehension REF: 485 OBJ: 8 TOP: Fluids KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 7. When a patient takes substances into the body, they first enter the extracellular compartment. What must the substances enter to carry out their function? a. Horizontal compartment b. Intracellular compartment c. Compartmental d. Vertical compartment ANS: B To carry out their function, substances must enter the cell. WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material DIF: Cognitive Level: Comprehension REF: 483-484 OBJ: 2 TOP: Fluids KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 8. What is the method by which inhaled oxygen is moved into the intravascular compartment called? a. Active transport b. Oxygenation c. Passive transport d. Mass movement ANS: C Passive transport occurs when the patient inhales oxygen into the lungs, with the oxygen passing by diffusion into the intravascular compartment. DIF: Cognitive Level: Comprehension REF: 485-486 OBJ: 4 TOP: Transport process KEY: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity 9. The nurse explains to a patient that the drug Lasix reduces edema by drawing water from the interstitial space into the intravascular space. What is this process called? a. Diffusion b. Filtration c. Osmosis d. Homeostasis ANS: C Osmosis is the movement of water from an area of lower concentration to an area of higher concentration. DIF: Cognitive Level: Knowledge REF: 486 OBJ: 2 TOP: Transport process KEY: Nursing Process Step: Intervention MSC: NCLEX: Physiological Integrity 10. What does actively transporting electrolytes from an area of higher concentration to an area of lower concentration require? a. Hydrostatic pressure b. Osmotic pressure c. Blood pressure d. Pulse pressure ANS: A Electrolytes are moved by hydrostatic pressure, which is a form of active transport. DIF: Cognitive Level: Comprehension REF: 487 OBJ: 4 TOP: Transport process KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 11. Electrolytes are not measured by weight; their chemical activity is expressed in milliequivalents. What does 1 mEq of potassium have the same combining power as? a. 1 mEq of nitrogen b. 1 mEq of oxygen WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material c. 1 mEq of hydrogen d. 1 mEq of magnesium ANS: C Electrolytes are measured in milliequivalents: 1 mEq of any electrolyte is equal to 1 mEq of hydrogen. DIF: Cognitive Level: Knowledge REF: 487 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 12. Sodium is the most abundant electrolyte in the body. The location of electrolytes is important for maintaining homeostasis. Sodium is the major electrolyte in which fluid compartment? a. Intracellular b. Intravascular c. Extracellular d. Interstitial ANS: C Sodium is the major extracellular electrolyte. DIF: Cognitive Level: Knowledge REF: 487 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 13. The lactating mother is counseled by the nurse to eat adequate amounts of meat and legumes. What level will this help to increase? a. Potassium b. Chloride c. Magnesium d. Phosphorus ANS: D Phosphorus should be increased during pregnancy and lactation. DIF: Cognitive Level: Knowledge REF: 493 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 14. A nurse assesses an edematous cardiac patient. The nurse is aware that this condition is a result of retained fluid. What is the patient considered to be? a. Hyponatremic b. Hypokalemic c. Hypernatremic d. Hypercalcemic ANS: C Hypernatremia is a greater-than-normal concentration of sodium, which leads to retained fluids and edema. DIF: Cognitive Level: Comprehension REF: 488 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material 15. What is the nurse closely assessing for in a patient with hypokalemia? a. Systemic edema b. Cardiac complications c. Muscle cramping d. Impaired kidney function ANS: B Hypokalemia can affect cardiac function. DIF: Cognitive Level: Application REF: 489 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 16. The nurse modifies the care plan for the immobilized patient after assessing a calcium level of 6.2 mEq/L. What nursing assessment should the nurse include when modifying this care plan? a. Osteoporosis b. Tooth loss c. Renal calculi d. Contractures ANS: C Hypercalcemia occurs when calcium levels exceed 5.8 mEq/L. It may occur when calcium stored in the bone enters the circulation, for example, in patients who are immobilized. Renal calculi may develop because of high levels of calcium. DIF: Cognitive Level: Application REF: 492-493 OBJ: 5 TOP: Electrolytes KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity 17. Homeostasis of the hydrogen ion concentration in body fluids depends on the ratio of carbonic acid to bicarbonate in the extracellular fluid. What is this ratio? a. 1:5 b. 1:10 c. 1:15 d. 1:20 ANS: D The ratio needed for homeostasis is 1 part carbonic acid to 20 parts bicarbonate. DIF: Cognitive Level: Knowledge REF: 494 OBJ: 3 TOP: Electrolytes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A 18. When reading the laboratory report of a patient with excessive diarrhea, the nurse notes that the pH is 7.10, and the PaCO2 and the PaO2 are normal. What should the nurse recognize as this patient’s state from this information alone? a. Respiratory acidosis b. Metabolic acidosis c. Respiratory alkalosis d. Metabolic alkalosis WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: B The profile of a patient in metabolic acidosis is that the blood pH will be below 7.35 and the oxygen readings are within normal limits. DIF: Cognitive Level: Comprehension REF: 498 OBJ: 7 TOP: Electrolytes KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 19. What should the nurse expect when assessing a patient with respiratory alkalosis? a. Slow respirations b. Muscle weakness c. Strong, even heart rate d. Flushed face ANS: B Tetany and muscle weakness, tachypnea, and cardiac arrhythmias are symptomatic of respiratory alkalosis. DIF: Cognitive Level: Application REF: 497 OBJ: 7 TOP: Electrolytes KEY: Nursing Process Step: Analysis MSC: NCLEX: Physiological Integrity 20. Three body systems work at different speeds to keep the pH in the narrow range of normal. What is the order of effectiveness for these three systems? a. Blood buffers, kidneys, and lungs b. Kidneys, lungs, and blood buffers c. Blood buffers, lungs, and kidneys d. Lungs, kidneys, and blood buffers ANS: C The three systems are blood buffers, lungs, and kidneys. The blood buffers’ speed is a fraction of a second, the lungs take minutes, and the kidneys take hours to days. DIF: Cognitive Level: Comprehension REF: 495 OBJ: 6 TOP: Acid-base balance KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 21. A patient admitted in a state of extreme anxiety has vital signs of T 98.6°F (37°C), P 81, BP 130/86, R 32. What will result if this hyperventilation continues? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis ANS: D Respiratory alkalosis is caused by hyperventilation as the lungs blow off large amounts of CO2. DIF: Cognitive Level: Application REF: 497 OBJ: 7 TOP: Acid-base balance KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material 22. A patient began vomiting and continued to do so for several hours. What is the result of this loss of stomach contents? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis ANS: B The most common cause of metabolic alkalosis is vomiting gastric contents. DIF: Cognitive Level: Application REF: 498 OBJ: 7 TOP: Acid-base balance KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 23. What should the nurse focus on when creating a nursing care plan for a patient with metabolic acidosis? a. Frequent periods of ambulation b. Increasing fluid intake c. Decreasing fluid intake d. Deep-breathing exercises ANS: D Deep breathing will cause the patient to blow off CO2 and assist in increasing the pH and reduce the acidity. DIF: Cognitive Level: Application REF: 495 | 496 OBJ: 8 TOP: Acid-base balance KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity 24. The nurse is educating a patient regarding the need to avoid foods high in potassium. What food choices led the nurse to conclude that teaching was not effective? a. Apples and green beans b. Kiwis and onions c. Apricots and asparagus d. Grapes and lima beans ANS: C Apricots and asparagus are potassium-rich. DIF: Cognitive Level: Application REF: 489 OBJ: 8 TOP: Nursing process KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity MULTIPLE RESPONSE 1. What are the three types of passive transport? (Select all that apply.) a. Diffusion b. Titration c. Osmosis d. Distillation e. Filtration WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: A, C, E The three types of passive transport are diffusion, osmosis, and filtration. DIF: Cognitive Level: Knowledge REF: 485 OBJ: 4 TOP: Passive transport KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. What are the three buffer systems of the body? (Select all that apply.) a. Bicarbonate/carbonic acid system b. Respiratory system c. Renal system d. GI system e. Integumentary system ANS: A, B, C The bicarbonate/carbonic acid system, the respiratory system, and the renal system are the buffer systems of the body. DIF: Cognitive Level: Knowledge REF: 495 OBJ: 6 TOP: Buffer systems KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance COMPLETION 1. The nurse expects an adult with normal ______________ function to void a minimum of 120 mL of urine in 4 hours. ANS: kidney The norm is to excrete at least 30 mL/h. In 4 hours, the urine output is expected to be 120 mL. DIF: Cognitive Level: Comprehension REF: 496 OBJ: 8 TOP: Kidney output KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 2. A child has been having an asthma attack for the last 8 hours. Because of the child’s inability to exhale effectively, the nurse assesses for respiratory __________. ANS: acidosis Retained CO2 will lead to respiratory acidosis. DIF: Cognitive Level: Application REF: 496-497 OBJ: 7 TOP: Respiratory acidosis KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 3. The nurse explains that a normal adult will lose approximately 350 mL of water through respiration in the course of a(n) ________. WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?  Stuvia.com - The Marketplace to Buy and Sell your Study Material ANS: day Adults lose about 350 mL of water daily through respiration. DIF: Cognitive Level: Knowledge REF: 484 OBJ: 8 TOP: Insensible loss KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance WWW.THENURSINGMASTERY.COM Downloaded by: janmcbride57 | [email protected] Want to earn $1.236 Distribution of this document is illegal extra per year?