Fluids 1

41 Questions | By Justin82 | Updated: Mar 21, 2022 | Attempts: 595

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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.

2. You are caring for a patient admitted with a diagnosis of renal failure. When you review your patient's laboratory reports, you note that the patient's magnesium levels are high. What would be important for you to assess?
- A.
  
  A) Diminished deep tendon reflexes
- B.
  
  B) Tachycardia
- C.
  
  C) Cool, clammy skin
- D.
  
  D) Increased serum magnesium
3.

3. You are working on a burn unit. One of your patients is exhibiting signs and symptoms of third spacing, which occurs when fluid moves out of the intravascular space but not into the intracellular space. Based upon this fluid shift, what would you expect the patient to demonstrate?
- A.
  
  A) Hypertension
- B.
  
  B) Bradycardia
- C.
  
  C) Hypervolemia
- D.
  
  D) Hypovolemia
4.

4. A patient with anxiety presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid-base imbalance?
- A.
  
  A) Respiratory acidosis
- B.
  
  B) Respiratory alkalosis
- C.
  
  C) Increased PaCO2
- D.
  
  D) CNS disturbances
5.

5. You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: PH 7.26, PaCO₂ 28, HCO₃ 11 mEq/L. How would you interpret these results?
- 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.

8. The physician has ordered a peripheral IV to be inserted before the patient goes to the operating room. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter?
- 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.

9. A nurse in the medical ICU has orders to infuse a hypertonic solution into her patient with low blood pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. Which term or terms is/are associated with this process?
- 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.

14. A patient in the ICU starts complaining of being “short of breath.” An arterial blood gas (ABG) is drawn. The ABG has the following values: pH = 7.21, PaCO₂ = 64 mm Hg, HCO₃ = 24 mm Hg. What does the ABG reflect?
- 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