Test - Fluids and Electrolytes

Practice questions from docushare.

1. When an excess of body fluid exists in the intravascular compartment, all of the following signs can be expected except:
a. Crackles
b. A bounding pulse
c. Engorged peripheral veins
d. An elevated hematocrit level

ANS: d
d. An elevated hematocrit would be expected with a deficit of body fluid in the intravascular compartment. When an excess of body fluid exists in the intravascular compartment, a decreased hematocrit would be expected.
a. Crackles (in lungs) are consistent findings with fluid volume excess.
b. An assessment finding associated with fluid volume excess is a bounding pulse.
c. Engorged peripheral veins may be seen with fluid volume excess.

REF: Text Reference: p. 1144

2. A client experiences a loss of intracellular fluid. The nurse anticipates that the IV therapy that will be used to replace this type of loss is:
a. 0.45% normal saline (NS)
b. 10% dextrose
c. 5% dextrose in lactated Ringer’s
d. Dextrose 5% in 1/2 NS

ANS: a
a. The client will need a hypotonic solution, such as 0.45% NS. A hypotonic solution has an osmolality that is less than body fluids, so the cells will draw the fluid in, which is the desired effect when the client has experienced a loss of intracellular fluid.
b. 10% dextrose is a hypertonic solution that will draw fluid into the vascular space.
c. 5% dextrose in lactated Ringer’s is a hypertonic solution. Hypertonic solutions pull fluid into the vascular space by osmosis.
d. Dextrose 5% in 1/2 NS is a hypertonic solution. Hypertonic solutions pull fluid into the vascular space by osmosis. The client needs a hypotonic solution to rehydrate the cells.

REF: Text Reference: p. 1160, Text Reference: p. 1161

3. The client has been experiencing right flank and lower back pain. Which of the following laboratory values would be most desirable for the nurse to obtain based on the client’s assessment?
a. Serum potassium
b. Serum sodium
c. Serum magnesium
d. Serum calcium

ANS: d
d. Flank pain and lower back pain may be indicative of kidney stones from excess calcium. The laboratory value for the nurse to obtain would be a serum calcium level.
a. Flank pain and lower back pain is not indicative of a problem with serum potassium being too high or too low.
b. The client is not having symptoms suggesting an altered serum sodium level.
c. The client is not displaying symptoms consistent with an altered magnesium level.

REF: Text Reference: p. 1142

4. The nurse will be starting a new intravenous infusion and needs to select the site for the insertion. In selection of a site, the nurse should:
a. Start with the most proximal site
b. Look for hard, cord-like veins
c. Use the dominant arm
d. Inspect sites on the extremity away from a dialysis graft

ANS: d
d. The nurse should avoid veins in an extremity with compromised circulation, such as a dialysis graft.
a. The nurse should use the most distal site in the nondominant arm, if possible.
b. The nurse should avoid hardened cord-like veins.
c. The nurse should use the nondominant arm, if possible.

REF: Text Reference: p. 1167


5. For a client with a nursing diagnosis of Fluid volume excess, the nurse is alert to which one of the following signs and symptoms?
a. Weak, thready pulse
b. Hypertension
c. Dry mucous membranes
d. Flushed skin

ANS. b
b. Hypertension is a symptom of fluid volume excess.
a. A weak, thready pulse is associated with fluid volume deficit. A bounding pulse is a symptom of fluid volume excess.
c. Dry mucous membranes are symptomatic of fluid volume deficit, not excess.
d. Flushed skin is a symptom of fluid volume deficit.

REF: Text Reference: p. 1150


6. A client is currently taking furosemide (Lasix) and digoxin. As a result of the medication regimen, the nurse is alert to the presence of:
a. Cardiac dysrhythmias
b. Severe diarrhea
c.Hyperactive reflexes
d. Peripheral cyanosis

ANS: a
a. Furosemide (Lasix) is a non–potassium-sparing diuretic. Without a potassium supplement, the client may become hypokalemic. Hypokalemia increases the risk for digoxin toxicity. Both hypokalemia and digoxin toxicity can cause cardiac dysrhythmias.
b. Clients with hypokalemia from diuretic use may experience intestinal distention and decreased bowel sounds. Severe diarrhea may be a cause, not a result, of hypokalemia.
c. Clients with hyperactive reflexes may have hypocalcemia. Furosemide (Lasix) and digoxin do not predispose a client to hypocalcemia.
d. Peripheral cyanosis is not a potential problem related to the client’s medication regimen.

REF: Text Reference: p. 114