Chapter 27- Fluid, Electrolytes, and Acid-Base Nursing School Test Banks

 

1.

Which of the following statements accurately describes the role of antidiuretic hormone in the regulation of body fluids? When antidiuretic hormone is present,

A)

The renal tubules become impermeable to water

B)

The renal tubules become permeable to water

C)

Urine output is increased and diluted

D)

The frequency of voiding increases

Ans:

B

Feedback:

When antidiuretic hormone is present, the distal tubule of the nephron becomes more permeable to water.

2.

The process of filtration begins at the

A)

Glomerulus

B)

Loop of Henle

C)

Bowmans capsule

D)

Collecting ducts

Ans:

A

Feedback:

The process of filtration begins at the glomerulus.

3.

The passageways of the kidney permit the urine to flow to the bladder and

A)

Act as a valve that covers the junction between the ureters and the bladder

B)

Surround the Bowmans capsule, which is where the formation of urine begins

C)

Selectively reabsorb or secrete substance to maintain fluids and electrolytes

D)

Control external sphincter of the urethra and permit the control of urination

Ans:

C

Feedback:

The capillaries of the glomerulus are porous, and, as the blood passes through the glomerular capillaries, some constituents of the blood are filtered out.

4.

Which of the following statements is an appropriate nursing diagnosis for an 80-year-old patient with the diagnosis of congestive heart failure with symptoms of edema, orthopnea, and confusion?

A)

Extracellular volume excess related to heart failure as evidenced by edema and orthopnea

B)

Congestive heart failure related to edema

C)

Fluid volume excess related to loss of sodium and potassium

D)

Fluid volume deficit related to congestive heart failure as evidenced by shortness of breath

Ans:

A

Feedback:

Extracellular volume excess is the state in which a person experiences an excess of vascular and interstitial fluid.

5.

A young man has developed gastric esophageal reflux disease. He is treating it with antacids. Which acid-base imbalance is he at risk for developing?

A)

Respiratory alkalosis

B)

Metabolic alkalosis

C)

Respiratory acidosis

D)

Metabolic acidosis

Ans:

B

Feedback:

Endocrine disorders and ingestion of large amounts of antacids cause metabolic alkalosis.

6.

The nurse is reviewing the patients arterial blood gas results. The test reveals a pH of 7.52, a PaO2 level of 49 mmHg and an HCO3 level of 28 mEq/L. The nurse suspects the patient is most likely experiencing which of the following conditions?

A)

Metabolic alkalosis

B)

Metabolic acidosis

C)

Respiratory acidosis

D)

Respiratory alkalosis

Ans:

A

Feedback:

Metabolic alkalosis occurs when there is excessive loss of body acids or with unusual intake of alkaline substances. It can also occur in conjunction with an ECF deficit or potassium deficit (known as contraction alkalosis). Vomiting or vigorous nasogastric suction frequently causes metabolic alkalosis. Endocrine disorders and ingestion of large amounts of antacids are other causes. The loss of stomach acid or taking in of base causes H+ shifts in the blood, and pH increases.

7.

When an 80-year-old patient who takes diuretics for management of hypertension informs the nurse she takes laxatives daily to promote bowel movements, the nurse assesses the patient for possible symptoms of

A)

Hypocalcemia

B)

Hypothyroidism

C)

Hypoglycemia

D)

Hypokalemia

Ans:

D

Feedback:

The frequent use of laxatives and diuretics promotes the excretion of potassium and magnesium from the body, increasing the risk for fluid and electrolyte deficits.

8.

A 50-year-old patient with hypertension is being treated with a diuretic. The patient complains of muscle weakness and falls easily. The nurse should assess which electrolyte?

A)

Sodium

B)

Chloride

C)

Phosphorous

D)

Potassium

Ans:

D

Feedback:

Diuretics, commonly given to treat high blood pressure and heart failure, can cause an extracellular deficit or loss of electrolytes including potassium, calcium, and magnesium.

9.

Which of the following individuals will take longer to sense thirst?

A)

18-year-old

B)

30-year-old

C)

50-year-old

D)

70-year-old

Ans:

D

Feedback:

When adults older than 65 years of age were compared with younger adults, the plasma osmolarity at which the older group experienced thirst was increased, indicating an increased risk for development of a water deficit.

10.

Which of the following age groups is at risk for fluid and electrolyte imbalances resulting from fad dieting?

A)

Adolescents

B)

Young adults

C)

Middle-aged adults

D)

Older adults

Ans:

A

Feedback:

Fad diets or purging to lose weight can cause severe fluid and electrolyte imbalances.

11.

A student has joined the marching band at his high school. The band begins practicing outside in August. This student and other band members need to be instructed that

A)

This exercise will have a minimal effect on fluid and electrolytes

B)

The band members should drink large amounts of water

C)

Endurance increases as time increases on the field with heat

D)

The hot weather will assist in building them up for the marching season

Ans:

B

Feedback:

Caution children and adolescents against the potential dangers of excessive exercise without adequate fluid replacement, especially in hot weather, because muscle damage and fluid and electrolyte imbalances can occur.

12.

A mother of an infant calls the pediatric nurse and asks which fluids she should provide her baby since he is suffering from diarrhea. The nurse would inform the mother not to give

A)

Pedialyte

B)

Formula

C)

Breast milk

D)

Bottled water

Ans:

D

Feedback:

Hyponatremic seizures among infants fed with commercial bottled drinking water has been noted.

13.

Which of the following individuals with diarrhea for 3 days are more likely to suffer from fluid and electrolyte imbalance?

A)

Infant

B)

School-age child

C)

Adolescent

D)

Young adult

Ans:

A

Feedback:

The very young child and older adults are at greatest risk for fluid or electrolyte imbalances.

14.

You are educating elementary school teachers on dietary requirements for students. You instruct them that phosphorous is important for bone structure. What food is a significant source of phosphorous?

A)

Cake

B)

Steak

C)

Butter

D)

Nuts

Ans:

B

Feedback:

Good dietary sources of phosphorous include dairy products, meats, vegetables, fruits, and cereals.

15.

A patient reports she has lactose intolerance and questions the nurse about alternative sources of calcium. What options can be provided by the nurse?

A)

Eggs

B)

Chicken

C)

Apples

D)

Spinach

Ans:

D

Feedback:

Sardines, whole grains, and green leafy vegetables also provide calcium.

16.

A child is eating a peanut butter sandwich. He is ingesting an excellent source of

A)

Potassium

B)

Sulfate

C)

Calcium

D)

Magnesium

Ans:

D

Feedback:

Good dietary sources of magnesium include green leafy vegetables, legumes, citrus fruit, peanut butter, and chocolate.

17.

You are instructing a young woman on her dietary needs for calcium in the prevention of osteoporosis. What food supplies the greatest amount of calcium?

A)

Cheese

B)

Meat

C)

Cauliflower

D)

Salad

Ans:

A

Feedback:

Dairy products are excellent sources of calcium.

18.

When the nurse reviews the patients laboratory reports revealing sodium, 140 mEq/L; potassium, 4.1 mEq/L; calcium, 7.9 mg/dL; and magnesium, 1.9 mg/dL; the nurse should notify the physician of the patients

A)

Low potassium

B)

Low calcium

C)

High sodium

D)

High magnesium

Ans:

B

Feedback:

Normal total serum calcium levels range between 8.9 and 10.1 mg/dL.

19.

Potassium is needed for neural, muscle, and

A)

Optic function

B)

Auditory function

C)

Cardiac function

D)

Skeletal function

Ans:

C

Feedback:

Potassium is essential for normal cardiac, neural, and muscle function and contractility of all muscles.

20.

Major control over the extracellular concentration of potassium within the human body is exerted by insulin and

A)

Aldosterone

B)

Albumin

C)

Progesterone

D)

Testosterone

Ans:

A

Feedback:

Two hormones exert major control over the extracellular concentration of potassium: insulin and aldosterone. Aldosterone enhances renal secretion of potassium.

21.

When atrial pressure is increased, then sodium

A)

Decreases

B)

Increases

C)

Maintains the same

D)

Is unchanged

Ans:

A

Feedback:

When atrial pressure is increased, ANP released by the atrial and ventricular myocytes acts on the nephron to increase sodium excretion.

22.

A decrease in arterial blood pressure will result in the release of

A)

Protein

B)

Thrombus

C)

Renin

D)

Insulin

Ans:

C

Feedback:

Decreased arterial blood pressure, decreased renal blood flow, increased sympathetic nerve activity, and/or low-salt diet can stimulate renin release.

23.

A patient with dehydration will have an increase in

A)

Albumin

B)

Potassium

C)

Glucose

D)

Aldosterone

Ans:

D

Feedback:

The renin-angiotensin aldosterone and natriuretic peptide hormone systems regulate the volume within narrow limits by adjusting fluid intake and the urinary excretion of sodium, chloride, and water.

24.

Which patient has more extracellular fluid?

A)

Adult woman

B)

Adolescent man

C)

Female school-age child

D)

Newborn

Ans:

D

Feedback:

Newborns have more extracellular fluid than intracellular fluid.

25.

Which patient will have more adipose tissue and less fluid?

A)

A woman

B)

A man

C)

An infant

D)

A child

Ans:

A

Feedback:

Women have a lower fluid content because they have more adipose tissue than men.

26.

The primary extracellular electrolytes are

A)

Potassium, phosphate, and sulfate

B)

Magnesium, sulfate, and carbon

C)

Sodium, chloride, and bicarbonate

D)

Phosphorous, calcium, and phosphate

Ans:

C

Feedback:

The primary extracellular electrolytes are sodium, chloride, and bicarbonate.

27.

When an elderly patient receiving a blood transfusion presents with an elevated blood pressure, distended neck veins, and shortness of breath, the patient is most likely experiencing

A)

Allergic reaction

B)

Pulmonary embolism

C)

Fluid overload

D)

Anaphylaxis

Ans:

C

Feedback:

Fluid overload can occur when blood components are infused too quickly or too voluminously. Symptoms include increased venous pressure, distended neck veins, dyspnea, coughing, and abnormal breath sounds.

28.

Which of the following solutions should be administered slowly to prevent circulatory overload?

A)

0.9% NaCl

B)

0.45% NaCl

C)

Dextrose 5%

D)

5% NaCl

Ans:

D

Feedback:

When a hypertonic solution is infused, it raises serum osmolarity, pulling fluid from the cells and the interstitial tissues into the vascular space. Examples of hypertonic solutions include 3% (NaCl) and 5% saline (NaCl).

29.

Which of the following solutions is a crystalloid solution that has the same osmotic pressure as that found within the cells of the body and is used to expand the intravascular volume?

A)

Hypertonic

B)

Colloid

C)

Isotonic

D)

Hypotonic

Ans:

C

Feedback:

Isotonic fluids have an osmolarity of 250375 mOsm/L, which is the same osmotic pressure as that found within the cell.

30.

A patient has a physicians order for NPO (nothing by mouth) following abdominal surgery to repair a bowel obstruction. The patient has a nasogastric tube inserted to low intermittent suction. The patient requires intravenous therapy to

A)

Replace fluid and electrolytes

B)

Administer blood products

C)

Provide protein supplements

D)

Treat the patients infection

Ans:

A

Feedback:

The therapeutic goal may be maintenance, replacement, treatment, diagnosis, monitoring, palliation, or a combination. This patient requires intravenous fluids for replacement of those lost due to the NPO order and the loss of fluid and electrolytes due to the nasogastric suctioning.

31.

A 58-year-old woman is suffering from food poisoning after eating at a local restaurant. She has had nausea, vomiting, and diarrhea for the past 12 hours. Her blood pressure is 88/50 and she is diaphoretic. She requires

A)

An access route to administer medications intravenously

B)

Replacement of fluids for those lost from vomiting and diarrhea

C)

An access route to replace fluids in combination with blood products

D)

Intravenous fluids to be administered on an outpatient basis

Ans:

B

Feedback:

The therapeutic goal may be maintenance, replacement, treatment, diagnosis, monitoring, palliation, or a combination. This patient requires intravenous fluids for replacement of those lost from vomiting and diarrhea.

32.

A patient is taking a diuretic such as Lasix. When implementing patient teaching, what information should be included?

A)

Increased sodium levels

B)

Increased potassium levels

C)

Decreased potassium levels

D)

Decreased oxygen levels

Ans:

C

Feedback:

Many diuretics such as Lasix are potassium wasting; hence, potassium levels are measured to detect hypokalemia.

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