Fluids 1

41 Questions

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Fluids 1

Exam


Questions and Answers
  • 1. 
    1.  You are caring for a patient with a diagnosis of syndrome of inappropriate antidiuretic hormone secretion. Your patient has specific gravities ordered every 4 hours. What does this test detect?
    • A. 

      A) Nutritional deficit

    • B. 

      B) Hyperkalemia

    • C. 

      C) Hypercalcemia

    • D. 

      D) Fluid volume status

  • 2. 
    • A. 

      A) Diminished deep tendon reflexes

    • B. 

      B) Tachycardia

    • C. 

      C) Cool, clammy skin

    • D. 

      D) Increased serum magnesium

  • 3. 
    • A. 

      A) Hypertension

    • B. 

      B) Bradycardia

    • C. 

      C) Hypervolemia

    • D. 

      D) Hypovolemia

  • 4. 
    • A. 

      A) Respiratory acidosis

    • B. 

      B) Respiratory alkalosis

    • C. 

      C) Increased PaCO2

    • D. 

      D) CNS disturbances

  • 5. 
    • A. 

      A) Respiratory acidosis with no compensation

    • B. 

      B) Metabolic alkalosis with a compensatory alkalosis

    • C. 

      C) Metabolic acidosis with no compensation

    • D. 

      D) Metabolic acidosis with a compensatory respiratory alkalosis

  • 6. 
    6.  You are making initial shift assessments on your patients. While assessing one patient's peripheral IV site, you note edema around the insertion site. How will you document this complication related to IV therapy?
    • A. 

      A) Air emboli

    • B. 

      B) Phlebitis

    • C. 

      C) Infiltration

    • D. 

      D) Fluid overload

  • 7. 
    7.  You are doing an admission assessment on an elderly patient newly admitted for end-stage liver disease. You must assess the patient's skin turgor. What should you remember when evaluating skin turgor?
    • A. 

      A) Overhydration causes the skin to tent.

    • B. 

      B) Dehydration causes the skin to appear edematous and spongy.

    • C. 

      C) Inelastic skin turgor is a normal part of aging.

    • D. 

      D) Normal skin turgor is moist and boggy.

  • 8. 
    • A. 

      A) Choose a proximal site

    • B. 

      B) Choose a distal site

    • C. 

      C) Have the patient hold his arm over his head

    • D. 

      D) Leave the tourniquet on for at least 5 minutes

  • 9. 
    • A. 

      A) Hydrostatic pressure

    • B. 

      B) Osmosis and osmolality

    • C. 

      C) Diffusion

    • D. 

      D) Active transport

  • 10. 
    10.  You are the nurse caring for a 65-year-old female patient who is in renal failure. During your shift assessment, the patient complains of tingling in her lips and fingers whenever anyone takes her blood pressure. She tells you that she gets a spasm in her wrist and hand and that it is very painful. What would you suspect?
    • A. 

      A) Hypophosphatemia

    • B. 

      B) Hypocalcemia

    • C. 

      C) Hypermagnesemia

    • D. 

      D) Hyperkalemia

  • 11. 
    11.  The nursing instructor is discussing renal failure with her senior nursing class. The instructor states, “A patient in renal failure partially loses the ability to regulate changes in pH.” What is the cause of this partial inability?
    • A. 

      A) The kidneys regulate and reabsorb carbonic acid to change and maintain pH.

    • B. 

      B) The kidneys buffer acids through electrolyte changes.

    • C. 

      C) The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH.

    • D. 

      D) The kidneys combine carbonic acid and bicarbonate to maintain a stable pH.

  • 12. 
    12.  You are caring for a 65-year-old male patient admitted to your unit 72 hours ago with pyloric stenosis. A nasogastric tube was placed upon admission has been on low intermittent suction ever since. You notice that the patient's potassium is very low. What would you be concerned that the patient may be at risk for?
    • A. 

      A) Hypercalcemia

    • B. 

      B) Metabolic acidosis

    • C. 

      C) Metabolic alkalosis

    • D. 

      D) Respiratory acidosis

  • 13. 
    13.  Nursing students are learning the skill of starting a peripheral IV in the skills lab setting. After gathering all the supplies, the nurse would begin to prepare the site. How should the nurse always start?
    • A. 

      A) Leave one hand ungloved to assess the site

    • B. 

      B) Prepare the skin with an iodine solution

    • C. 

      C) Ask the patient if he is allergic to latex or iodine

    • D. 

      D) Remove excessive hair at the selected site

  • 14. 
    • A. 

      A) Respiratory acidosis

    • B. 

      B) Metabolic alkalosis

    • C. 

      C) Respiratory alkalosis

    • D. 

      D) Metabolic acidosis

  • 15. 
    15.  While admitting a new patient to your medical-surgical unit, you note that the patient is oliguric. You notify the  the acute-care nurse practitioner who orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. What do you know this intervention will do?
    • A. 

      A) Help distinguish hyponatremia from hypernatremia

    • B. 

      B) Help evaluate pituitary gland function

    • C. 

      C) Help distinguish reduced renal blood flow from decreased renal function

    • D. 

      D) Help provide an effective treatment for hypertension-induced oliguria

  • 16. 
    16.  The home health nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The nurse notes that the woman seems confused and has poor skin turgor. When asked about her fluid intake, the patient states, “I stop drinking water early in the day because it is just too difficult to get up during the night to go to the bathroom.” What would be the nurse's best response?
    • A. 

      A) “I will need to have your medications adjusted so you will need to be readmitted to the hospital for a complete workup.”

    • B. 

      B) “Limiting your fluids can create imbalances in your body that can result in confusion. Maybe we need to adjust the timing of you fluids.”

    • C. 

      C) “It is normal to be a little confused following surgery, and it's safe not to urinate a night.”

    • D. 

      D) “Confusion following surgery is common in the elderly due to a loss of sleep. “

  • 17. 
    17.  A 73-year-old man comes into the emergency department (ED) by ambulance after slipping on a small carpet in his home. The patient fell on his hip with a resultant fracture. He is alert and oriented; PERLA is intact. His heart rate is elevated, he is anxious and thirsty, a Foley catheter is placed, and 40 mL of urine is present. What is the nurse's most likely explanation for the urine output?
    • A. 

      A) The man urinated prior to his arrival to the ED and will probably not need to have the Foley catheter kept in place.

    • B. 

      B) The man has a brain injury, lacks ADH, and needs vasopressin.

    • C. 

      C) The man is in heart failure and is releasing atrial natriuretic peptide that results in decreased urine output.

    • D. 

      D) He is having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output.

  • 18. 
    18.  The student nurses are in the skills lab learning the technique for the insertion of an IV catheter. How should these students be taught to treat excess hair at the intended site?
    • A. 

      A) Leave the hair intact

    • B. 

      B) Shave the area

    • C. 

      C) Clip the hair in the area

    • D. 

      D) Remove the hair with a depilatory

  • 19. 
    19.  You are the nurse evaluating a new patient's laboratory results. Based upon the laboratory findings, what will cause the release of antidiuretic hormone (ADH)?
    • A. 

      A) Increased serum sodium

    • B. 

      B) Decreased serum sodium

    • C. 

      C) Decrease in serum osmolality

    • D. 

      D) Decrease in thirst

  • 20. 
    20.  A new nurse is admitting a patient with a history of emphysema. The new nurse's preceptor is going over the patient's past lab reports with the new nurse. The nurse takes note that the patient's PaCO2 has been between 56 and 64mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurse's best response?
    • A. 

      A) The patient's calcium will rise dramatically due to pituitary stimulation.

    • B. 

      B) The oxygen will increase the patient's intracranial pressure and create confusion.

    • C. 

      C) The oxygen may cause the patient to hyperventilate and become acidotic.

    • D. 

      D) Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.

  • 21. 
    21.  When oxygen and carbon dioxide are exchanged between the pulmonary capillaries and the alveoli, which process is used?
    • A. 

      A) Diffusion

    • B. 

      B) Osmosis

    • C. 

      C) Active transport

    • D. 

      D) Filtration

  • 22. 
    22.  In the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur?
    • A. 

      A) The active transport of hydrogen ions across the capillary walls

    • B. 

      B) The pressure of the blood in the renal capillaries

    • C. 

      C) The number of dissolved particles contained in a unit of blood

    • D. 

      D) The hydrostatic pressure resulting from the pumping action of the heart

  • 23. 
    23.  The baroreceptors, located in the left atrium, and the carotid and aortic arches respond to changes in the circulating blood volume and regulate sympathetic and parasympathetic neural activity as well as endocrine activities. Sympathetic stimulation constricts renal arterioles, causing what?
    • A. 

      A) Decrease in the release of aldosterone

    • B. 

      B) Increase of filtration in the Loop of Henle

    • C. 

      C) Decrease in the reabsorption of sodium

    • D. 

      D) Decrease in glomerular filtration

  • 24. 
    24.  You are the nurse caring for a 77-year-old male who fell off his roof. You note that the patient's labs indicate minimally elevated serum creatinine levels. What can this indicate in older adults?
    • A. 

      A) Substantially reduced renal function

    • B. 

      B) Reduced respiratory function

    • C. 

      C) Increased cardiac function

    • D. 

      D) Alterations in ratio of body fluids to muscle mass

  • 25. 
    You are the nurse caring for a patient who is to receive IV daunorubicin. You start the infusion and check the insertion site as per protocol. This time when you look at the IV site, you note that the IV has infiltrated. You stop the infusion. What is your main concern with this infiltration?
    • A. 

      A) Extravasation of the medication

    • B. 

      B) Discomfort to the patient

    • C. 

      C) Blanching at the site

    • D. 

      D) Reaction to the medication

  • 26. 
    • A. 

      A) Increased bowel motility

    • B. 

      B) Dilute urine

    • C. 

      C) Increased muscle strength

    • D. 

      D) Excessive thirst

  • 27. 
    28.  You are caring for a patient on the oncology floor with a diagnosis of metastatic brain cancer. During your assessment, you note the patient complains of abdominal pain. Skin turgor indicates dehydration is present. What would you further assess for in this patient?
    • A. 

      A) Hypernatremia

    • B. 

      B) Hypomagnesemia

    • C. 

      C) Hypophosphatemia

    • D. 

      D) Hypercalcemia

  • 28. 
    29.  As the ICU nurse caring for a patient with multiple traumas from an ATV accident, you draw arterial blood gasses (ABGs) every 4 hours. What are you assessing in this patient with the ABGs?
    • A. 

      A) The bicarbonate-carbonic acid buffer system

    • B. 

      B) The patient's oxygen status

    • C. 

      C) The patient's intracellular buffer systems

    • D. 

      D) Metabolic acidosis status

  • 29. 
    30.  The nursing instructor is discussing metabolic acidosis with her senior nursing students. What would she tell her students about the role of the kidneys in metabolic acidosis?
    • A. 

      A) The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance.

    • B. 

      B) The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance.

    • C. 

      C) The kidneys react rapidly to compensate for imbalances in the body.

    • D. 

      D) The kidneys regulate the bicarbonate level in the ICF.

  • 30. 
    31.  The nurse in the medical ICU is caring for a patient who is in respiratory acidosis due to inadequate ventilation. What diagnosis could the patient have that could cause inadequate ventilation?
    • A. 

      A) Insomnia

    • B. 

      B) Multiple myloma

    • C. 

      C) Guillain-Barré syndrome

    • D. 

      D) Overdose of amphetamines

  • 31. 
    • A. 

      A) Respiratory acidosis

    • B. 

      B) Metabolic alkalosis

    • C. 

      C) Respiratory alkalosis

    • D. 

      D) Mixed acid-base disorder

  • 32. 
    33.  Isotonic IV fluids are fluids with a total osmolality close to that of the ECF. Most IV fluids contain either dextrose or electrolytes in water. When would you infuse electrolyte-free water intravenously?
    • A. 

      A) Never, it rapidly enters red blood cells, causing them to rupture.

    • B. 

      B) When the patient is severely dehydrated

    • C. 

      C) When the patient is in an excess of an electrolyte, i.e. hypercalcemia

    • D. 

      D) When the patient is in a deficit of an electrolyte, i.e. hypocalcemia

  • 33. 
    34.  Dehydration in the elderly is a problem that is all too common. What causes dehydration in the elderly? (Mark all that apply.)
    • A. 

      A) Decreased kidney mass

    • B. 

      B) Increased conservation of sodium

    • C. 

      C) Increased total body water

    • D. 

      D) Decreased renal blood flow

    • E. 

      E) Decreased excretion of potassium

  • 34. 
    35.  You are called to your patient's room by a family member who voices concern about the patient's status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance would you suspect?
    • A. 

      A) Hypercalcemia

    • B. 

      B) Hyponatremia

    • C. 

      C) Hyperchloremia

    • D. 

      D) Hypophosphatemia

  • 35. 
    36.  Metabolic acidosis can be divided clinically into two forms: normal anion gap acidosis and high anion gap acidosis. What causes normal anion gap acidosis?
    • A. 

      A) Constipation

    • B. 

      B) Small bowel fistulas

    • C. 

      C) Late renal insufficiency

    • D. 

      D) Excessive administration of chloride

  • 36. 
    37.  The nurse is caring for a patient in metabolic alkalosis. The patient has a nasogastric tube to low intermittent suction for a diagnosis of bowel obstruction. What drug would the nurse expect to find on the medication orders?
    • A. 

      A) Cimetidine

    • B. 

      B) Maalox

    • C. 

      C) KCl

    • D. 

      D) Fursosemide

  • 37. 
    38.  You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a poor historian. The patient appears malnourished and TPN has been started. Why would you know to start the TPN slowly?
    • A. 

      A) Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly.

    • B. 

      B) Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively.

    • C. 

      C) Malnourished patients who receive fluids too rapidly are at risk for hypernatremia.

    • D. 

      D) Patients receiving TPN are at risk for hypochloremia if fluids are introduced too rapidly.

  • 38. 
    39.  You are doing discharge teaching with a patient who is going home with a diagnosis of hypophosphatemia. The patient has a diet ordered that is high in phosphate. What foods would you teach this patient to include in his diet? (Mark all that apply.)
    • A. 

      A) Milk

    • B. 

      B) Beef

    • C. 

      C) Poultry

    • D. 

      D) Green vegetables

    • E. 

      E) Liver

  • 39. 
    40.  You are caring for a patient with a secondary diagnosis of hypermagnesemia. What would you assess this patient for?
    • A. 

      A) Hypertension

    • B. 

      B) Kussmaul respirations

    • C. 

      C) Increased DTRs

    • D. 

      D) Shallow respirations

  • 40. 
    41.  A patient's lab results show a slight decrease in potassium. The physician has declined to treat with drug therapy but has suggested increasing potassium through diet. Which of the following would be a good source of potassium?
    • A. 

      A) Apples

    • B. 

      B) Asparagus

    • C. 

      C) Carrots

    • D. 

      D) Bananas

  • 41. 
    42.  The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance does a positive Chvostek's sign indicate?
    • A. 

      A) Hypermagnesemia

    • B. 

      B) Hypercalcemia

    • C. 

      C) Hypocalcemia

    • D. 

      D) Hyperkalemia