XFINAL 143 Module 1 - Fluid and Electrolytes (PRACTICE
QUESTIONS) WITH COMPLETE SOLUTIONS
A client has questioned the nurse's administration of intravenous
(IV) normal saline,
asking, Wouldn't sterile water be a more appropriate choice than
saltwater? Under what
circumstances would the nurse administer electrolyte-free water
intravenously?
A. Never, because it rapidly enters red blood cells, causing them
to rupture.
B. When the client is severely dehydrated, resulting in
neurologic signs and
symptoms
C. When the client is in excess of calcium and/or magnesium
ions
D. When a client's fluid volume deficit is due to acute or chronic
kidney disease
ANS: A. IV solutions contain dextrose or electrolytes mixed in
various proportions with water. Pure, electrolyte-free water can
never be given by IV because it rapidly enters red blood cells
and causes them to rupture.
The nurse is caring for a client with a secondary diagnosis of
hypermagnesemia. What
assessment finding would be most consistent with this
diagnosis?
A. Hypertension
,B. Kussmaul respirations
C. Increased DTRs
D. Shallow respirations
ANS: D. If hypermagnesemia is suspected, the nurse monitors
the vital signs, noting hypotension and shallow respirations. The
nurse also observes for decreased DTRs and changes in the level
of consciousness. Kussmaul breathing is a deep and labored
breathing pattern associated with severe metabolic acidosis,
particularly diabetic ketoacidosis (DKA), but also kidney
disease. This type of client is associated with decreased DTRs,
not increased DTRs.
The nurse is assessing the client for the presence of a Chvostek
sign. Which
electrolyte imbalance would a positive Chvostek sign indicate?
A. Hypermagnesemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
ANS: C. The nurse can induce Chvostek sign by tapping the
client's facial nerve adjacent to the ear. A brief contraction of the
upper lip, nose, or side of the face indicates Chvostek sign. Both
hypomagnesemia and hypocalcemia may be indicated by a
positive Chvostek sign.
A patient is admitted with bleeding from the gastrointestinal
tract. The nurse plans interventions to support the balance of
which fluid volume compartment?
1. Transcellular
, 2. Intravascular
3. Interstitial
4. Intracellular
Answer: 2 Explanation: 1. Transcellular fluid is cerebrospinal
fluid, peritoneal fluid, and synovial fluid. 2. Intravascular fluid
is one extracellular compartment that consists of plasma. In the
case of bleeding, the fluid compartment that will be affected first
will be the intravascular fluid. 3. Interstitial fluid is found
between the cells. 4. Intracellular fluid is that fluid found within
the cells.
Which laboratory value would require that the nurse closely
monitor a patient's cardiac rhythm?
1. Chloride 94 mEq/L
2. Calcium 2.2 mmol/L
3. Potassium 3.3 mEq/L
4. Phosphate 3 mg/dL
Answer: 3 Explanation: 1. This chloride level is slightly lower
than normal but would not cause cardiac rhythm disturbances. 2.
This normal calcium level would not be implicated in cardiac
rhythm disturbances. 3. Both high and low potassium levels can
adversely affect cardiac rhythm. 4. This normal phosphate level
would not adversely affect cardiac rhythm.
A patient's potassium and calcium levels are below the normal
range. The nurse should check for a decreased level of which
other electrolyte?
1. Phosphorous
2. Sodium
QUESTIONS) WITH COMPLETE SOLUTIONS
A client has questioned the nurse's administration of intravenous
(IV) normal saline,
asking, Wouldn't sterile water be a more appropriate choice than
saltwater? Under what
circumstances would the nurse administer electrolyte-free water
intravenously?
A. Never, because it rapidly enters red blood cells, causing them
to rupture.
B. When the client is severely dehydrated, resulting in
neurologic signs and
symptoms
C. When the client is in excess of calcium and/or magnesium
ions
D. When a client's fluid volume deficit is due to acute or chronic
kidney disease
ANS: A. IV solutions contain dextrose or electrolytes mixed in
various proportions with water. Pure, electrolyte-free water can
never be given by IV because it rapidly enters red blood cells
and causes them to rupture.
The nurse is caring for a client with a secondary diagnosis of
hypermagnesemia. What
assessment finding would be most consistent with this
diagnosis?
A. Hypertension
,B. Kussmaul respirations
C. Increased DTRs
D. Shallow respirations
ANS: D. If hypermagnesemia is suspected, the nurse monitors
the vital signs, noting hypotension and shallow respirations. The
nurse also observes for decreased DTRs and changes in the level
of consciousness. Kussmaul breathing is a deep and labored
breathing pattern associated with severe metabolic acidosis,
particularly diabetic ketoacidosis (DKA), but also kidney
disease. This type of client is associated with decreased DTRs,
not increased DTRs.
The nurse is assessing the client for the presence of a Chvostek
sign. Which
electrolyte imbalance would a positive Chvostek sign indicate?
A. Hypermagnesemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
ANS: C. The nurse can induce Chvostek sign by tapping the
client's facial nerve adjacent to the ear. A brief contraction of the
upper lip, nose, or side of the face indicates Chvostek sign. Both
hypomagnesemia and hypocalcemia may be indicated by a
positive Chvostek sign.
A patient is admitted with bleeding from the gastrointestinal
tract. The nurse plans interventions to support the balance of
which fluid volume compartment?
1. Transcellular
, 2. Intravascular
3. Interstitial
4. Intracellular
Answer: 2 Explanation: 1. Transcellular fluid is cerebrospinal
fluid, peritoneal fluid, and synovial fluid. 2. Intravascular fluid
is one extracellular compartment that consists of plasma. In the
case of bleeding, the fluid compartment that will be affected first
will be the intravascular fluid. 3. Interstitial fluid is found
between the cells. 4. Intracellular fluid is that fluid found within
the cells.
Which laboratory value would require that the nurse closely
monitor a patient's cardiac rhythm?
1. Chloride 94 mEq/L
2. Calcium 2.2 mmol/L
3. Potassium 3.3 mEq/L
4. Phosphate 3 mg/dL
Answer: 3 Explanation: 1. This chloride level is slightly lower
than normal but would not cause cardiac rhythm disturbances. 2.
This normal calcium level would not be implicated in cardiac
rhythm disturbances. 3. Both high and low potassium levels can
adversely affect cardiac rhythm. 4. This normal phosphate level
would not adversely affect cardiac rhythm.
A patient's potassium and calcium levels are below the normal
range. The nurse should check for a decreased level of which
other electrolyte?
1. Phosphorous
2. Sodium
