N4 test Fluid and Electrolyte Balance

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition Chapter 11: Fluid and Electrolyte Balance

1. Why do women have less total body water at any age than do men of a comparable age?
A. The “thirst center” of the hypothalamus in women is not as active as in men because of the influence of estrogen.
B. Fat cells contain little or no water compared to muscle cells and women have proportionately more fat cells than men because of the influence of estrogen.
C. Women have less total body sodium than do men and because “where sodium goes, water follows,” women lose more water daily than do men.
D. Testosterone, which is present in higher concentrations in men, has some properties of aldosterone, thus men have greater renal reabsorption of water and sodium compared to women.

2. The 92-year-old client has a serum potassium level of 3.2 mEq/L (mmol/L) and serum calcium level of 8.2 mg/dL. What is your best action?
A. Notify the physician that the client is hypokalemic and hypocalcemic.
B. Notify the physician that the client is hyperkalemic and hypercalcemic.
C. Obtain another specimen to verify the results.
D. Document the findings as the only action.

3. What are the expected immediate responses when a hypotonic solution is added to the extracellular fluid? ECF osmolarity _______; ICF volume _______.
A. increases; expands
B. increases; contracts
C. decreases; expands
D. decreases; contracts

4. What is the expected response to the presence of atrial natriuretic peptide? Urine output _______; urine osmolarity _______.
A. increases; increases
B. increases; decreases
C. decreases; increases
D. decreases; decreases

5. Which finding should you investigate further when assessing a client for hydration status?
A. Pulse pressure of 12 mm Hg
B. Urine specific gravity of 1.020
C. Neck veins full in the supine position
D. A 6 mm Hg drop in systolic blood pressure on standing

6. Which food selections made by a client on a sodium-restricted diet indicates the need for further teaching regarding the sodium content of food?
A. A patty of ground beef and a glass of whole milk
B. One cup of white rice with 2 tablespoons of soy sauce
C. A sandwich with 2 slices of white bread and 4 ounces of chicken
D. Two slices of roast pork (uncured) and a whole-wheat roll