FLUIDS AND ELECTROLYTES/ ACID BASE BALANCERamon Carlo T.

Almiranez, RN, RM USRN

1. The nurse is caring for a client with heart failure. Onassessment, the nurse notes that the client is
dyspneic,and crackles are audible on auscultation. What additionalmanifestations would the nurse
expect to note in this client ifexcess fluid volume is present?1. Weight loss and dry skin2. Flat neck and
hand veins and decreased urinary output3. An increase in blood pressure and increased respirations4.
Weakness and decreased central venous pressure (CVP)2. The nurse is preparing to care for a client with
a

potassium deficit. The nurse reviews the client’s

record and determines that the client is at risk fordeveloping the potassium deficit because of
whichsituation?1. Sustained tissue damage2. Requires nasogastric suction

3. Has a history of Addison’s disease

4. Uric acid level of 9.4 mg/dL (559 μmol/L)

3. The nurse reviews a client’s electrolyte laboratory

report and notes that the potassium level is 2.5 mEq/L (2.5mmol/L). Which patterns should the nurse
watch for on theelectrocardiogram (ECG) as a result of the laboratory value?Select all that apply.1. U
waves2. Absent P waves3. Inverted T waves4. Depressed ST segment5. Widened QRS complex4.
Potassium chloride intravenously is prescribed for aclient with hypokalemia. Which actions should
thenurse take to plan for preparation and administrationof the potassium? Select all that apply.1.
Obtain an intravenous (IV) infusion pump.2. Monitor urine output during administration.3. Prepare the
medication for bolus administration.4. Monitor the IV site for signs of infiltration or phlebitis.5. Ensure
that the medication is diluted in the appropriate volumeof fluid.6. Ensure that the bag is labeled so that
it reads the volume ofpotassium in the solution.5. The nurse provides instructions to a client with a
lowpotassium level about the foods that are high in potassium andtells the client to consume which
foods? Select all that apply.1. Peas2. Raisins3. Potatoes4. Cantaloupe5. Cauliflower6. Strawberries6. The
nurse is reviewing laboratory results and notes that a

client’s serum sodium level is 150 mEq/L (150 mmol/L). The

nurse reports the serum sodium level to the health care provider(HCP) and the HCP prescribes dietary
instructions based on thesodium level. Which acceptable food items does the nurseinstruct the client to
consume? Select all that apply.1. Peas2. Nuts3. Cheese4. Cauliflower5. Processed oat cereals7. The
nurse is assessing a client with a suspected diagnosisof hypocalcemia. Which clinical manifestation
would the nurseexpect to note in the client?1. Twitching2. Hypoactive bowel sounds
3. Negative Trousseau’s sign

4. Hypoactive deep tendon reflexes8. The nurse is caring for a client with hypocalcemia.Which patterns
would the nurse watch for on theelectrocardiogram as a result of the laboratory value? Select allthat
apply.1. U waves2. Widened T wave3. Prominent U wave4. Prolonged QT interval5. Prolonged ST
segment9. The nurse reviews the electrolyte results of an assigned clientand notes that the potassium
level is 5.7 mEq/L (5.7 mmol/L).Which patterns would the nurse watch for on the cardiac monitoras a
result of the laboratory value? Select all that apply.1. ST depression2. Prominent U wave3. Tall peaked T
waves4. Prolonged ST segment5. Widened QRS complexes10. Which client is at risk for the development
of asodium level at 130 mEq/L (130 mmol/L)?1. The client who is taking diuretics2. The client with
hyperaldosteronism

3. The client with Cushing’s syndrome

4. The client who is taking corticosteroids11. The nurse is caring for a client with heart failure who
isreceiving high doses of a diuretic. On assessment, the nursenotes that the client has flat neck veins,
generalized muscleweakness, and diminished deep tendon reflexes. The nursesuspects hyponatremia.
What additional signs would the nurseexpect to note in a client with hyponatremia?1. Muscle twitches2.
Decreased urinary output3. Hyperactive bowel sounds4. Increased specific gravity of the urine

12. The nurse reviews a client’s laboratory report and notes thatthe client’s serum phosphorus
(phosphate) level is 1.8 mg/dL

(0.45 mmol/L). Which condition most likely caused this serumphosphorus level?1. Malnutrition2. Renal
insufficiency3. Hypoparathyroidism4. Tumor lysis syndrome

13. The nurse is reading a health care provider’s (HCP’s)progress notes in the client’s record and reads
that the HCP hasdocumented “insensi

ble fluid loss of approximately 800 mL

daily.” The nurse makes a notation that insensible fluid loss

occurs through which type of excretion?1. Urinary output2. Wound drainage3. Integumentary output4.
The gastrointestinal tract14. The nurse is assigned to care for a group of clients. On

review of the clients’ medical records, the nurse determines that

which client is most likely at risk for a fluid volume deficit?1. A client with an ileostomy2. A client with
heart failure3. A client on long-term corticosteroid therapy4. A client receiving frequent wound
irrigations16. The nurse caring for a client who has been receivingintravenous (IV) diuretics suspects that
the client is experiencinga fluid volume deficit. Which assessment finding would the nursenote in a
client with this condition?1. Weight loss and poor skin turgor2. Lung congestion and increased heart
rate3. Decreased hematocrit and increased urine output4. Increased respirations and increased blood
pressure17. On review of the
clients’ medical records, the nurse

determines that which client is at risk for fluid volume excess?1. The client taking diuretics and has
tenting of the skin2. The client with an ileostomy from a recent abdominal surgery3. The client who
requires intermittent gastrointestinal suctioning4. The client with kidney disease and a 12-year history
ofdiabetes mellitus18. Which client is at risk for the development of a potassiumlevel of 5.5 mEq/L (5.5
mmol/L)?1. The client with colitis2. The client with

Cushing’s syndrome

3. The client who has been overusing laxatives4. The client who has sustained a traumatic burn19. An
elderly patient comes into the clinic with the complaint ofwatery diarrhea for several days with
abdominal & musclecramping. The nurse realizes that this patient is demonstratingwhich of the
following?1. hypernatremia2. hyponatremia3. fluid volume excess4. Hyperkalemia

20. The nurse is admitting a patient who was diagnosed withacute renal failure. Which of the following
electrolytes will bemost affected with this disorder?1. calcium2. magnesium3. phosphorous4.
Potassium21. A patient who is taking digoxin (Lanoxin) is admitted withpossible hypokalemia. Which of
the following does the nurserealize might occur with this patient?1. Digoxin toxicity may occur.2. A
higher dose of digoxin (Lanoxin) may be needed.3. A diuretic may be needed.4. Fluid volume deficit may
occur.22. A patient is prescribed 40 mEq potassium as a replacement.The nurse realizes that this
replacement should be administered1. directly into the venous access line.2. mixed in the prescribed
intravenous fluid.3. via a rectal suppository.4. via intramuscular injection.23. A 35-year-old female
patient comes into the clinicpostoperative parathyroidectomy. Which of the following shouldthe nurse
instruct this patient?1. Drink one glass of red wine per day.2. Avoid the sun.3. Milk & milk-based
products will ensure an adequate calciumintake.4. Red meat is the protein source of choice.24. A patient
is admitted for treatment of hypercalcemia. Thenurse realizes that this patient's intravenous fluids will
most likelybe which of the following?1. dextrose 5% & water2 dextrose 5% & ? normal saline3. dextrose
5% & ? normal saline4. normal saline25. A patient is diagnosed with hyperphosphatemia. The
nurserealizes that this patient might also have an imbalance of whichof the following electrolytes?a.
calcium c. potassiumb. sodium d. Chloride26. The nurse observes a patient's respirations & notes that
therate is 30 per minute & the respirations are very deep. Themetabolic disorder this patient might be
demonstrating is whichof the following?1. hypernatremia2. increasing carbon dioxide in the blood3.
hypertension4. Pain27. A pt's blood gases show a pH greater of 7.53 & bicarbonatelevel of 36 mEq/L.
The nurse realizes that the acid-base disorderthis pt is demonstrating is which of the following?1.
respiratory acidosis 3. respiratory alkalosis2. metabolic acidosis 4. metabolic alkalosis28. The pt is
receiving intravenous potassium (KCL). Whichnursing actions are required? Select all that apply.1.
Administer the dose IV push over 3 minutes.2. Monitor the injection site for redness.3. Add the ordered
dose to the IV hanging.4. Use an infusion controller for the IV.5. Monitor fluid intake & output.29. Which
pts are at risk for the development of hypercalcemia?Select all that apply.1. the pt with a malignancy2.
the pt taking lithium3. the pt who uses sunscreen to excess4. the pt with hyperparathyroidism5. the pt
who overuses antacids30. The pt who has a serum magnesium level of 1.4 mg/dL isbeing treated with
dietary modification. Which foods should thenurse suggest for this pt? Select all that apply.1. bananas2.
seafood3. white rice4. lean red meat5. Chocolate31. The pt, newly diagnosed with diabetes mellitus, is
admitted tothe emergency department with nausea, vomiting, & abdominalpain. ABG results reveal a
pH of 7.2 & a bicarbonate level of 20mEq/L. Which other assessment findings would the nurseanticipate
in this pt? Select all that apply.1. tachycardia2. weakness3. dysrhythmias4. Kussmaul's respirations5.
cold, clammy skin32

. A client’s nursing diagnosis is Deficien

t Fluid Volume relatedto excessive fluid loss. Which action related to the fluidmanagement should be
delegated to a nursing assistant?1. Administer IV fluids as prescribed by the physician.2. Provide straws
and offer fluids between meals.3. Develop plan for added fluid intake over 24 hours4. Teach family
members to assist client with fluid intake33. The client also has the nursing diagnosis Decreased
CardiacOutput related to decrease plasma volume. Which finding onassessment supports this nursing
diagnosis?1. Flattened neck veins when client is in supine position2. Full and bounding pedal and post-
tibial pulses3. Pitting edema located in feet, ankles, and calves4. Shallow respirations with crackles on
auscultation34. The nursing care plan for the client with dehydration includesinterventions for oral
health. Which interventions are within thescope of practice for the LPN/LVN being supervised by
thenurse? (Choose all that apply.)1. Remind client to avoid commercial mouthwashes.2. Encourage
mouth rinsing with warm saline.3. Assess lips, tongue, and mucous membranes4. Provide mouth care
every 2 hours while client is awake5. Seek dietary consult to increase fluids on meal trays.35. The
physician has written the following orders for the client

with Excess Fluid volume. The client’s morning assessment

includes bounding peripheral pulses, weight gain of 2 pounds,pitting ankle edema, and moist crackles
bilaterally. Which ordertakes priority at this time?1. Weight client every morning.2. Maintain accurate
intake and output.3. Restrict fluid to 1500 mL per day4. Administer furosemide (Lasix) 40 mg IV push36.
You have been pulled to the telemetry unit for the day. Themonitor informs you that the client has
developed prominent Uwaves. Which laboratory value should you check immediately?1. Sodium2.
Potassium3. Magnesium4. Calcium37

. The client’s potassium level is 6.7 mEq/L.

Which interventionshould you delegate to the student nurse under yoursupervision?1. Administer
Kayexalate 15 g orally2. Administer spironolactone 25 mg orally3. Assess WCG strip for tall T waves4.
Administer potassium 10 mEq orally38. A client is admitted to the unit with a diagnosis of syndromeof
inappropriate antidiuretic hormone secretion (SIADH). Forwhich electrolyte abnormality will you be sure
to monitor?1. Hypokalemia2. Hyperkalemia3. Hyponatremia4. Hypernatremia39. The charge nurse
assigned in the care for a client with acuterenal failure and hypernatremia to you, a newly graduated
RN.Which actions can you delegate to the nursing assistant?1. Provide oral care every 3-4 hours2.
Monitor for indications of dehydration
AD

Download to read ad-free.

3. Administer 0.45% saline by IV line4. Assess daily weights for trends40

. The experienced LPN/LVN reports that a client’s blood

pressure and heart rate have decreased and that when the faceis assessed, one side twitches. What
action should you take atthis time?1

. Reassess the client’s blood pressure and heart rate

. Review the client’s morning calcium level

3. Request a neurologic consult today4

. Check the client’s papillary reaction to light

41.You are preparing to discharge a client whose calcium levelwas low but is now just slightly within the
normal range (9-10.5mg/dL). Which statement by the client indicates the need foradditional teaching?1

. “I will call my doctor if I experience mu

scle twitching orseizu

res.”

. “I will make sure to take my vitamin

D with my calcium each

day.”

. “I will take my calcium pill every morning before breakfast.”

. “I will avoid dairy products, broccoli, and spinach when I eat.”

.You are reviewing a client’s morni

ng laboratory results. Whichof these results is of most concern?1. Serum potassium 5.2 mEq/L2. Serum
sodium 134 mEq/L3. Serum calcium 10.6 mg/dL4. Serum magnesium 0.8 mEq/L43. You are the charge
nurse. Which client is most appropriate toassign to the step-down unit nurse pulled to the intensive
careunit for the day?1. A 68-year-old client on ventilator with acute respiratory failureand respiratory
acidosis2. A 72-year-old client with COPD and normal arterial bloodgases (ABGs) who is ventilator-
dependent3. A 56-year-old new admission client with diabetic ketoacidosis(DKA) on an insulin drip4. A
38-year-old client on a ventilator with narcotic overdose andrespiratory alkalosis44.Which action should
you delegate to the nursing assistant forthe client with diabetic ketoacidosis? (Choose all that apply.)1.
Check fingerstick glucose every hour.2. Record intake and output every hour.3. Check vital signs every
15 minutes.4. Assess for indicators of fluid imbalance.45.A client with lung cancer has received
oxycodone 10 mgorally for pain. When the student nurse assesses the client,which finding should you
instruct the student to reportimmediately?1. Respiratory rate of 8 to 10 per minute2. Pain level
decreased from 6/10 to 2/103. Client requests room door be closed.4. Heart rate 90-100 per
minute46.The nursing assistant reports to you that a client seems veryanxious and that vital signs
included a respiratory rate of 38 perminute. Which acid-base imbalance should you suspect?1.
Respiratory acidosis2. Respiratory alkalosis3. Metabolic acidosis4. Metabolic alkalosis47. A client is
admitted to the unit for chemotherapy. To preventan acid-base problem, which of the following would
you instructthe nursing assistant to report?a. Repeated episodes of nausea and vomitingb. Complaints
of pain associated with exertionc. Failure to eat all food on breakfast trayd. Client hair loss during
morning bath48. pH 7.51, pCO2 40, HCO3- 31:1. Normal2. Uncompensated metabolic alkalosis3.
compensated respiratory acidosis4. Uncompensated respiratory alkalosis49. pH 7.40, pCO2 40, HCO3-
24:a. Normalb. Uncompensated metabolic acidosisc. Compensated respiratory acidosisd. Compensated
metabolic acidosis50. pH 7.12, pCO2 60, HCO3- 29:a. Uncompensated metabolic acidosisb.
Uncompensated respiratory acidosisc. Compensated respiratory acidosisd. Compensated metabolic
acidosis51. pH 7.48, pCO2 30, HCO3- 23:a. Uncompensated metabolic alkalosisb. Uncompensated
respiratory alkalosisc. Compensated respiratory alkalosisd. Compensated metabolic alkalosis73. pH 7.62,
pCO2 47, HCO3- 30:a. Uncompensated metabolic alkalosisb. Uncompensated respiratory alkalosisc.
compensated respiratory alkalosisd. compensated metabolic alkalos

is

Share this document

Share or Embed Document

Sharing Options
Share on Facebook, opens a new windowShare on Twitter, opens a new windowShare on LinkedIn,
opens a new windowShare with Email, opens mail clientCopy link

You might also like

Quiz Sankei

Quiz Sankei

Document

3 pages

Quiz Sankei

monmon

43% (14)

Test Bank For Medical Surgical Nursing Concept & Practices 2nd Edition, DeWit

Test Bank For Medical Surgical Nursing Concept & Practices 2nd Edition, DeWit

Document

24 pages

Test Bank For Medical Surgical Nursing Concept & Practices 2nd Edition, DeWit

ILL101

67% (3)

Ipi Nursing Part 1,2,3

Ipi Nursing Part 1,2,3

Document

53 pages

Ipi Nursing Part 1,2,3

Noleen Mckay

No ratings yet

Magazines

Podcasts
Sheet music

MS Nursing Questions and Answers

MS Nursing Questions and Answers

Document

8 pages

MS Nursing Questions and Answers

pihikan

80% (5)

NCLEX - Fluids and Electrolytes

NCLEX - Fluids and Electrolytes

Document

4 pages

NCLEX - Fluids and Electrolytes

issaiahnicolle

No ratings yet

Fluid and Electrolyte Exam

Fluid and Electrolyte Exam

Document

1 page

Fluid and Electrolyte Exam

teabagman

0% (1)

Fluids & Electrolytes Exam

Fluids & Electrolytes Exam

Document
13 pages

Fluids & Electrolytes Exam

Jan Macarambon

73% (11)

Study This Question Med Surg Final

Study This Question Med Surg Final

Document

14 pages

Study This Question Med Surg Final

Ana Gonzalez

83% (6)

Iggy Med Surg Test Bank Chapter 004

Iggy Med Surg Test Bank Chapter 004

Document

7 pages

Iggy Med Surg Test Bank Chapter 004

Tracy Bartell

100% (1)

Chapter 036

Chapter 036

Document

9 pages

Chapter 036

Neverends2011

60% (5)
2018 NCLEX-PN Test Prep. Questions and Answers with Explanations: Study Guide to Pass the License
Exam Effortlessly - Exam Review for Practical Nurses

2018 NCLEX-PN Test Prep. Questions and Answers with Explanations: Study Guide to Pass the License
Exam Effortlessly - Exam Review for Practical Nurses

From Everand

2018 NCLEX-PN Test Prep. Questions and Answers with Explanations: Study Guide to Pass the License
Exam Effortlessly - Exam Review for Practical Nurses

U.S. Exam Prep. Professionals, Ltd.

Rating: 4.5 out of 5 stars

4.5/5 (2)

Peripheral Vascular Diseases NCLEX

Peripheral Vascular Diseases NCLEX

Document

6 pages

Peripheral Vascular Diseases NCLEX

Potchiee Pfizer

No ratings yet

Show more

Download

AD