Chapter 19 Fluid, Electrolyte and Acid Based Disturbances

Question 1

1. In which of the following fluid compartments is the majority of the body’s water contained?
   a. Interstitial
   b. Intracellular
   c. Extracellular
   d. Intravascular

Answer 1

B

Question 2

2. Which mechanism is involved with equalizing the fluid concentration when the blood plasma has a higher osmolality than the intracellular fluid in blood cells?
   a. Osmosis
   b. Diffusion
   c. Active transport
   d. Facilitated diffusion

Answer 2

A

Question 3

3a. An older woman was admitted to the medical unit with GI bleeding and fluid volume deficit. What are the clinical manifestations of the latter problem? (Select all that apply)
a. Weight loss
b. Dry oral mucosa
c. Full bounding pulse
d. Engorged neck veins
e. Decreased central venous pressure

Answer 3

A B E

Question 4

3b. Which of the following nursing actions is required for clients with hyponatremia?
a. Fluid restriction
b. Administration of hypotonic intravenous fluids
c. Administration of a cation exchange resin
d. Increased water intake for clients on nasogastric suction

Answer 4

A

Question 5

3c. Which of the following should the nurse monitor for when a client is receiving a loop diuretic?
a. Restlessness and agitation
b. Paresthesias and irritability
c. Weak, irregular pulse and poor muscle tone
d. Increased blood pressure and muscle spasms

Answer 5

C

Question 6

3d. Which of the following clients would be at greatest risk for the potential development of hypermagnesemia?
a. An 83-year-old man with lung cancer and hypertension
b. A 65-year-old woman with hypertension taking β-adrenergic blockers
c. A 42-year-old woman with systemic lupus erythematosus and renal failure
d. A 50-year-old man with benign prostatic hyperplasia and a urinary tract infection

Answer 6

C

Question 7

3e. In a client who has just undergone a total thyroidectomy, it is especially important for the nurse to assess which of the following?
a. Weight gain
b. Depressed reflexes
c. Positive Chvostek’s sign
d. Confusion and personality changes

Answer 7

C

Question 8

3f. Care of the client experiencing hyperphosphatemia secondary to renal failure includes which of the following?
a. Calcium supplements
b. Potassium supplements
c. Magnesium supplements
d. Fluid replacement therapy

Answer 8

A

Question 9

4. How do the lungs act as an acid–base buffer?
   a. By increasing respiratory rate and depth when CO2 levels in the
   blood are high, thereby reducing acid load
   b. By increasing respiratory rate and depth when CO2 levels in the blood are low, thereby reducing base load
   c. By decreasing respiratory rate and depth when CO2 levels in the blood are high, thereby reducing acid load
   d. By decreasing respiratory rate and depth when CO2 levels in the blood are low, thereby increasing acid load

Answer 9

A

Question 10

5. A client has the following arterial blood gas results: pH, 7.52; partial pressure of carbon dioxide in the arterial blood (PaCO2), 30 mm Hg;
   HCO3− level, 24 mmol/L. These results indicate the presence of which acid–base disturbance?
   a. Metabolic acidosis
   b. Metabolic alkalosis
   c. Respiratory acidosis
   d. Respiratory alkalosis

Answer 10

D

Question 11

6. What is the typical fluid replacement for the client with a fluid volume deficit?
   a. Dextran
   b. 0.45% Saline
   c. Lactated Ringer’s solution
   d. 5% Dextrose in 0.45% saline

Answer 11

C

Question 12

7. The nurse is unable to flush a central venous access device and suspects occlusion. Which of the following would be the best nursing intervention?
   a. Apply warm moist compresses to the insertion site.
   b. Attempt to force 10 mL of normal saline into the device.
   c. Place the client on the left side with head-down position.
   d. Instruct the client to change positions, raise arm, and cough.

Answer 12

D