Fluid And Electrolyte Imbalance

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  • 1. 
    Three reasons for IV fluid use is:
    • A. 

      Maintain daily body fluid requirements

    • B. 

      Restore with the anticipation of fluid loss

    • C. 

      Replace current body fluid losses

    • D. 

      All the above

    • E. 

      Restore previous body fluid losses


  • 2. 
    A solution that is similar to the osmolality of plasma that will cause no cell damage, it is called:
    • A. 

      Hypotonic

    • B. 

      Normal Saline

    • C. 

      Isotonic

    • D. 

      Hypertonic


  • 3. 
    Can the use of isotonic IV fluids cause problems?
    • A. 

      Yes

    • B. 

      No


  • 4. 
    A solution that is lower in osmolality of plasma that will cause a cell to swell, it is called:
    • A. 

      Hyportonic

    • B. 

      Normal Saline

    • C. 

      Isotonic

    • D. 

      Hypertonic


  • 5. 
    A nurse understands hypotonic solutions when the nurse states:
    • A. 

      Cells that need to be "dried" out are best served by this solution.

    • B. 

      A pt that has had diuretic therapy (DKA) will benefit from replacing cellular fluid.

    • C. 

      This type of fluid helps with renal problems of over drying cells.

    • D. 

      This type of fluid helps release more NA through the renal system by extracting excess water from the cells.


  • 6. 
    Which type of fluid can cause ICP and 3rd spacing problems along with water intoxication?
    • A. 

      Isotonic

    • B. 

      Hypertonic

    • C. 

      Normal Saline

    • D. 

      Hypotonic


  • 7. 
    A nurse understand hypertonic solutions when the nurse states:
    • A. 

      It has a higher osmolality than plasma

    • B. 

      It draws fluid out of the cells.

    • C. 

      It pushes fluid into the cells.

    • D. 

      It has a lower osmolality than plasma


  • 8. 
    Nick has had surgery and is having post op edema.  Which solution would you expect, as the nurse, to see being used for Nick?
    • A. 

      Isotonic

    • B. 

      Hypertonic

    • C. 

      Hypotonic

    • D. 

      Normal Saline


  • 9. 
    A nurse understand the use of hypertonic solutions to be used in surgery when the nurse states:
    • A. 

      It is used to keep BP lower during surgery.

    • B. 

      It is used to when there is slight to moderate loss of blood volume.

    • C. 

      It is used when there is substantial loss of blood and BP needs to be raised.

    • D. 

      All patients are put on hypertonic IV solutions when in surgery.


  • 10. 
    Nancy is having a low output of urine.  The doctor orders an hypotonic solution.  Should you question the order?
    • A. 

      Yes

    • B. 

      No


  • 11. 
    A nurse understands the danger or hypertonic solutions and hypernatremia when the nurse states:
    • A. 

      Hypertonic solutions could rob the cells of Na.

    • B. 

      Hypertonic solutions could increase the level of Na even more.

    • C. 

      Hypertonic solutions will not affect the Na in cells.


  • 12. 
    Which condition needs extra assessment when considering hypertonic solutions?
    • A. 

      Respiratory

    • B. 

      Renal

    • C. 

      Heart

    • D. 

      Liver


  • 13. 
    How often does a nurse want to assess a pt on IV fluids?
    • A. 

      Hourly

    • B. 

      2 hours

    • C. 

      4 hours

    • D. 

      8 hours


  • 14. 
    Concentrations of electrolytes are similar in ICF and ECF.
    • A. 

      True

    • B. 

      False


  • 15. 
    Serum Na is what?
    • A. 

      Regulated by BP and kidney perfusion

    • B. 

      Regulated by hormones such as aldosterone and ADH

    • C. 

      Reflects the blood osmolality

    • D. 

      Not affected by K pumps.

    • E. 

      All the above


  • 16. 
    Hypernatremia can be caused by:
    • A. 

      Diabetes insipidous

    • B. 

      Diarrhea

    • C. 

      Excess sweating

    • D. 

      High fever

    • E. 

      Heatstroke


  • 17. 
    Mary Anne is a 86 year old woman.  She has olguria and a swollen tongue.  She does ask for water.  She is confused and has muscle weakness.  Her Na serum came back at 165.  What could the problem be?
    • A. 

      She has hyponateremia

    • B. 

      She has hypernatremia

    • C. 

      She has dementia.

    • D. 

      This is normal for a woman this age.


  • 18. 
      Hyponatremia GI losses include:
    • A. 

      Emisis

    • B. 

      NG suctioning

    • C. 

      Burns

    • D. 

      Diarrhea

    • E. 

      Diuretics


  • 19. 
    When giving an enema or tube feeding with tap water, what concern is there?
    • A. 

      Hyponatremia

    • B. 

      Hypernatremia

    • C. 

      Caridovascular overload

    • D. 

      It is preferable to use tap water.


  • 20. 
    K is important for what functions?
    • A. 

      Renal function

    • B. 

      Muscle function

    • C. 

      Insulin

    • D. 

      Fat regulation

    • E. 

      Protein regulation


  • 21. 
    Oral K is not usually a problem unless a pt has this problem?
    • A. 

      Diabetes

    • B. 

      Renal failure

    • C. 

      Respiratory infection

    • D. 

      MI


  • 22. 
    A nurse understand K and IV infusion when the nurse states:
    • A. 

      Improperly mixed bags can cause K problems.

    • B. 

      Should never be infused into a pt.

    • C. 

      To fast an infusion can cause problems.

    • D. 

      Every K IV order should be double checked with the MD.


  • 23. 
    Why is old blood and injuries like burns important to K monitoring?
    • A. 

      K is used to heal damaged cells.

    • B. 

      K is horded by cells that are damaged.

    • C. 

      K is released from damaged blood cells.

    • D. 

      K is not important to blood cells but the tissue needs it to function under stress.


  • 24. 
    Can Hypercalemia be caused by renal failure?
    • A. 

      Yes

    • B. 

      No


  • 25. 
    What are manifestations of hyperkalemia?
    • A. 

      Intestinal cramping

    • B. 

      Anxiety/Irritability

    • C. 

      Hyperactivity

    • D. 

      Muscle twitching

    • E. 

      Decreased vision


  • 26. 
    A nurse understands K and renal function when the nurse states:
    • A. 

      The use of non sparring diuretics helps promote K health.

    • B. 

      Urine promotion helps to clear K.

    • C. 

      Renal failure decreases the amount of K.

    • D. 

      K is vital to renal function.


  • 27. 
    Why is insulin good for K regulation?
    • A. 

      Keeps K from being moved out of the cells.

    • B. 

      Insulin neutralizes K.

    • C. 

      K promotes diabetes.

    • D. 

      K binds with insulin lowering the available K, keeping the cells healthy.


  • 28. 
    A patient is hyperkalemic, which foods are best for this patient?
    • A. 

      Whole grain bread.

    • B. 

      Low Na broth.

    • C. 

      Beans and chicken.

    • D. 

      Pudding


  • 29. 
    A nurse understand hypokalermia when the nurse states:
    • A. 

      Hypokalemia can lead to bracycardia/arrythmias.

    • B. 

      Hypokalemia can cause muscle twitching and paralysis.

    • C. 

      Hypokalemia can decrease BT.

    • D. 

      Hypokalemia will cause an increase in serum K.


  • 30. 
    In pt teaching about hypokalemia, what is the most important education to be done?
    • A. 

      Decreased consumption of bananas.

    • B. 

      Bowel management care.

    • C. 

      Use of rapid weight loss programs.

    • D. 

      Increased insulin in diabetics.


  • 31. 
    How much Ca is stored in the bones?
    • A. 

      1%

    • B. 

      2%

    • C. 

      95%

    • D. 

      99%


  • 32. 
    PTH is released when Ca++ is at what level?
    • A. 

      <9

    • B. 

      >9

    • C. 

      <11

    • D. 

      >11


  • 33. 
    Calcitonin is released when Ca++ levels are at:
    • A. 

      <9

    • B. 

      >9

    • C. 

      <11

    • D. 

      >11


  • 34. 
    A nurse understand Ca and hormones when the nurse states:
    • A. 

      Ca needs are not important to a person under 33.

    • B. 

      Ca is stored in the liver and pancrease.

    • C. 

      Ca needs vitamin D to be absorbed in the GI tract.

    • D. 

      Ca needs aldosterone to be absorbed in the kidneys.


  • 35. 
    What symptoms do pts with Hyperkalemia exhibit?
    • A. 

      Memory Loss

    • B. 

      Vision Loss

    • C. 

      Constipation

    • D. 

      Poluria


  • 36. 
    Which deficiencies are linked to hypocalcemia?
    • A. 

      PTH

    • B. 

      Magnesium

    • C. 

      Aldosterone

    • D. 

      Testosterone

    • E. 

      Vitamin D


  • 37. 
    Tetany, or the muscles tightening, is considered the most characteristic sign of:
    • A. 

      Hyponatremia

    • B. 

      Hypokalemia

    • C. 

      Hypocalcemia

    • D. 

      Polyuria


  • 38. 
    Chvostek sign is understood by the nurse when the nurse states:
    • A. 

      This occurs when taking a pt BP and they get a dorsaflexion in the hand.

    • B. 

      When the knee reflex is slow acting when struck by a malllet.

    • C. 

      A finger run down the trigeminal nerve that makes the mouth droop in that direction.


  • 39. 
    A nurse understands Trousseaus when the nurse states:
    • A. 

      This occurs when taking a pt BP and they get a dorsaflexion in the hand.

    • B. 

      When the knee reflex is slow acting when struck by a malllet.

    • C. 

      A finger run down the trigeminal nerve that makes the mouth droop in that direction.


  • 40. 
    Which is vital to muscles, red blood cells, metabolism of carbs, and acid-base balance?
    • A. 

      Magnesium

    • B. 

      Phosphorus

    • C. 

      Calcum

    • D. 

      K

    • E. 

      Na


  • 41. 
    If there is an increase in phosphorus, what is the relationship to Ca?
    • A. 

      Increased Ca

    • B. 

      Decreased Ca


  • 42. 
    An increase in phosphorous may cause high deposits of calcium where?
    • A. 

      Joints

    • B. 

      Arteries

    • C. 

      Skin

    • D. 

      Corneas

    • E. 

      Kidneys


  • 43. 
    How can a person cause themselves to have hyperphosphotemia?
    • A. 

      Excessive consumption of bananas

    • B. 

      Excessive diuretic use

    • C. 

      Excessive use of laxatives

    • D. 

      Excessive vitamin D


  • 44. 
    What does magnesium balance with
    • A. 

      Ca

    • B. 

      Na

    • C. 

      K

    • D. 

      Phosphorus


  • 45. 
    What is the most common cause of hypermagnesemia?
    • A. 

      Hepatic failure

    • B. 

      Renal failure

    • C. 

      Pulmonary disorders

    • D. 

      Cardiovascular disorders


  • 46. 
    What is an emergency treatment for hypermagnesemia?
    • A. 

      IV Phosphorus

    • B. 

      IV Ca

    • C. 

      IV Na

    • D. 

      IV K


  • 47. 
    Hypomagnesemia is most often caused by:
    • A. 

      Chronic alcoholism

    • B. 

      GI impairment

    • C. 

      Malnutrition

    • D. 

      Poorly controlled diabetes


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