fluid and electroyltes (before midterm)

Question 1

Which blood product is indicated to increase clotting factor levels in patients with a demonstrated deficiency?
a. Cryoprecipitate
b. Fresh frozen plasma
c. Packed red blood cells
d. Plasma protein fractions

Answer 1

ANS: B
Fresh frozen plasma is indicated to increase clotting factor levels in patients with a demonstrated deficiency.

Question 2

otassium supplements are contraindicated in patients with a history of which condition?
a. Burns
b. Diarrhea
c. Kidney disease
d. Cardiac tachydysrhythmias

Answer 2

NS: C
Potassium supplements are contraindicated in the presence of severe kidney disease. Patients with hypokalemia due to burns or diarrhea and patients with cardiac tachydysrhythmias may be treated with potassium supplements. Potassium supplements are contraindicated in patients with severe kidney disease.

Question 3

During a blood transfusion, a patient begins to report chills and back pain. Which action is appropriate for the nurse to take?
a. Observe for other symptoms.
b. Slow the infusion rate and monitor vital signs.
c. Discontinue the infusion immediately and notify the physician.
d. Tell the patient that the symptoms are a normal reaction to the blood product.

Answer 3

ANS: C
Because of the possibility of a transfusion reaction, the infusion should be discontinued immediately and the physician notified.

Question 4

Which is a true statement about the administration of potassium?
a. The intravenous rate should not exceed 30 mmol/hr.
b. Oral forms should be given on an empty stomach to maximize absorption.
c. The concentration of potassium in intravenous solutions should not exceed 60
mmol/L.
d. When given intravenously, potassium must always be given in diluted form.

Answer 4

ANS: D
Intravenous potassium must always be given in a diluted form and administered slowly. Intravenous (IV) bolus or undiluted forms may cause cardiac arrest. IV rates are not to exceed 20 mmol/hr. The generally accepted maximum concentration for peripheral infusion is 20 to 40 mmoL/L. Oral forms should be mixed with juice or water or taken according to instructions.

Question 5

A patient is being treated for mild hyponatremia after spending a long day doing gardening work in the heat of the day. What is the most appropriate method with which to treat her condition?
a. Oral supplementation of fluids
b. IV bolus of lactated Ringer’s solution
c. Normal saline infusion, administered slowly
d. Oral administration of sodium chloride tablets

Answer 5

ANS: D
Mild hyponatremia is usually treated with the oral administration of sodium chloride tablets. Pronounced sodium depletion is treated with intravenous normal saline or lactated Ringer’s solution. Oral supplementation with fluids such as water would lower the sodium level and worsen the hyponatremia.

Question 6

Which is a symptom of early hypokalemia?
a. Seizures
b. Paralytic ileus
c. Stomach cramps
d. Muscle weakness

Answer 6

ANS: D
Muscle weakness is an early symptom of hypokalemia. Late symptoms of hypokalemia include cardiac irregularities, neuropathies, and paralytic ileus. Seizures and stomach cramps are not symptoms of hypokalemia.

Question 7

During the infusion of albumin, the nurse should monitor the patient for the development of which event?
a. Hypernatremia
b. Fluid volume deficit
0c. Fluid volume excess d. Transfusion reaction

Answer 7

ANS: C
During the infusion of albumin, the nurse should monitor for the development of fluid volume excess.

Question 8

A patient requires transfusion with fresh frozen plasma (FFP). What condition is noted on the patient’s medical record?
a. Hypovolemic shock
b. Anemia
c. Coagulation disorder
d. Previous transfusion reaction

Answer 8

ANS: C
FFP is used as an adjunct to massive blood transfusion in the treatment of patients with underlying coagulation disorders.

Question 9

The nurse is planning to transfuse a patient with a unit of packed red blood cells (PRBCs). Which is the only solution with which PRBCs can be administered?
a. 5% dextrose in water
b. 0.9% sodium chloride
c. 5% dextrose in 0.9% sodium chloride
d. 5% dextrose in lactated Ringer’s solution

Answer 9

ANS: B
Blood products should be given only with 0.9% sodium chloride. A solution of 5% dextrose in water will cause hemolysis of the blood product.

Question 10

The nurse is planning to transfuse a patient with a unit of PRBCs. Which patient is most likely to be treated with this transfusion?
a. A patient with a coagulation disorder
b. A patient with severe anemia
c. A patient who has lost a massive amount of blood after emergency surgery
d. A patient who has a clotting factor deficiency

Answer 10

ANS: B
PRBCs are given to increase oxygen-carrying capacity in patients with anemia, in patients with substantial hemoglobin deficits, and in patients who have lost up to 25% of their total blood volume. A patient with a coagulation disorder and a patient with a clotting factor deficiency would receive fresh frozen plasma. A patient who has lost a massive amount of blood after emergency surgery would receive whole blood.