Test Bank For deWit's Medical-Surgical Nursing 4th Edition By
Holly Stromberg 9780323608442 Chapter 1-49 Complete
Guide .
The ________ is a major factor in the regulation of fluid and electrolyte balance in the body.
a) Bladder
b) Stomach
c) Kidney
d) Heart - ANSWER: c) Kidney
Excretion of the body's fluid is achieved mainly through the kidney, with some loss in stool.
The most accurate measure for fluid gain or loss is:
a) Accurate intake and output (I&O).
b) Weight change.
c) Edema.
d) Urine specific gravity. - ANSWER: b) Weight change.
The most accurate measure of fluid gain or loss for any age group is weight change. A weight gain or
loss of 2.2 lb (1 kg) in 24 hours indicates a gain or loss of 1 L of fluid.
Which is an isotonic IV solution?
a) D5 0.9%
b) D5 0.45%
c) 0.9% NS (normal saline)
d) 0.45% NS (normal saline) - ANSWER: c) 0.9% NS (normal saline)
When living cells are surrounded by a solution that has the same concentration of particles, the water
concentration of the ICF and the ECF will be equal. Such a solution is called isotonic (of equal solute
concentration). An example of an isotonic solution is 0.9% normal saline.
Diabetic ketoacidosis can lead to:
a) Metabolic acidosis.
b) Respiratory acidosis.
c) Metabolic alkalosis.
d) Respiratory alkalosis. - ANSWER: a) Metabolic acidosis.
An excessive loss of bicarbonate ions or an increased production or retention of hydrogen ions leads
to metabolic acidosis. The main causes of metabolic acidosis include:
• Excessive loss of bicarbonate ions from diarrhea
• Renal failure
• Diabetic ketoacidosis (DKA)
• Hyperkalemia
• Sepsis
A patient has a serum potassium level of 5.2 mEq/L. Which complaint would you expect the patient to
have?
a) Muscle weakness
b) Increased thirst
, c) Abdominal cramps
d) Fatigue and nausea - ANSWER: d) Fatigue and nausea
The most common reason for increased potassium levels is decreased excretion by the kidneys due to
either renal insufficiency or drug effects. The mechanical disruption of cell membranes causes a shift
of potassium from the ICF to the ECF. This shift happens when extensive tissue damage occurs from
burns or crush injuries, resulting in increased serum potassium. Hyperkalemia can cause life-
threatening cardiac dysrhythmia.
What food should be suggested to be included in the diet of a patient who is taking a potassium-
wasting diuretic?
a) Banana
b) Red meat
c) Grapefruit
d) Apple - ANSWER: a) Banana
Common Foods High in Potassium: Apricots, Avocado, Baked potato with skin (small), Banana,
Cantaloupe, Mango, Orange juice, Orange, Pinto beans, Prune juice, Prunes, Raisins, seedless,
Spinach, Tomatoes, Winter squash
When completing a physical assessment of a patient, the LPN notes that the intravenous (IV) site is
red, swollen, and painful to touch. What should the nurse do first?
a) Remove the IV.
b) Notify the physician.
c) Slow down the rate of the IV.
d) Irrigate the IV catheter. - ANSWER: a) Remove the IV.
When attaching an IV piggyback to a primary IV, the IV piggyback bag should be hung ________ the
primary bag.
a) lower than
b) higher than
c) at the same level as
d) on a different pole from - ANSWER: b) higher than
The normal range for sodium is:
a) 110 to 115 mEq/L
b) 115 to 125 mEq/L
c) 125 to 135 mEq/L
d) 135 to 145 mEq/L - ANSWER: d) 135 to 145 mEq/L
Total parenteral nutrition (TPN) should not be infused through a:
a) Central line.
b) Peripherally inserted central catheter (PICC) line.
c) Peripheral line.
d) Groshong catheter. - ANSWER: c) Peripheral line.
TPN is essentially a form of IV feeding. TPN is total nutrition, and patients can be maintained on IV
nutrition for as long as necessary. The amounts and kinds of nutrients needed for total nutrition
cannot be administered using peripheral veins, so the nutrient mix is given using a larger central vein
through a central line. If long-term use is required, a long-term central catheter, such as a peripherally
inserted central catheter (PICC) or an implanted port, will be placed.
Holly Stromberg 9780323608442 Chapter 1-49 Complete
Guide .
The ________ is a major factor in the regulation of fluid and electrolyte balance in the body.
a) Bladder
b) Stomach
c) Kidney
d) Heart - ANSWER: c) Kidney
Excretion of the body's fluid is achieved mainly through the kidney, with some loss in stool.
The most accurate measure for fluid gain or loss is:
a) Accurate intake and output (I&O).
b) Weight change.
c) Edema.
d) Urine specific gravity. - ANSWER: b) Weight change.
The most accurate measure of fluid gain or loss for any age group is weight change. A weight gain or
loss of 2.2 lb (1 kg) in 24 hours indicates a gain or loss of 1 L of fluid.
Which is an isotonic IV solution?
a) D5 0.9%
b) D5 0.45%
c) 0.9% NS (normal saline)
d) 0.45% NS (normal saline) - ANSWER: c) 0.9% NS (normal saline)
When living cells are surrounded by a solution that has the same concentration of particles, the water
concentration of the ICF and the ECF will be equal. Such a solution is called isotonic (of equal solute
concentration). An example of an isotonic solution is 0.9% normal saline.
Diabetic ketoacidosis can lead to:
a) Metabolic acidosis.
b) Respiratory acidosis.
c) Metabolic alkalosis.
d) Respiratory alkalosis. - ANSWER: a) Metabolic acidosis.
An excessive loss of bicarbonate ions or an increased production or retention of hydrogen ions leads
to metabolic acidosis. The main causes of metabolic acidosis include:
• Excessive loss of bicarbonate ions from diarrhea
• Renal failure
• Diabetic ketoacidosis (DKA)
• Hyperkalemia
• Sepsis
A patient has a serum potassium level of 5.2 mEq/L. Which complaint would you expect the patient to
have?
a) Muscle weakness
b) Increased thirst
, c) Abdominal cramps
d) Fatigue and nausea - ANSWER: d) Fatigue and nausea
The most common reason for increased potassium levels is decreased excretion by the kidneys due to
either renal insufficiency or drug effects. The mechanical disruption of cell membranes causes a shift
of potassium from the ICF to the ECF. This shift happens when extensive tissue damage occurs from
burns or crush injuries, resulting in increased serum potassium. Hyperkalemia can cause life-
threatening cardiac dysrhythmia.
What food should be suggested to be included in the diet of a patient who is taking a potassium-
wasting diuretic?
a) Banana
b) Red meat
c) Grapefruit
d) Apple - ANSWER: a) Banana
Common Foods High in Potassium: Apricots, Avocado, Baked potato with skin (small), Banana,
Cantaloupe, Mango, Orange juice, Orange, Pinto beans, Prune juice, Prunes, Raisins, seedless,
Spinach, Tomatoes, Winter squash
When completing a physical assessment of a patient, the LPN notes that the intravenous (IV) site is
red, swollen, and painful to touch. What should the nurse do first?
a) Remove the IV.
b) Notify the physician.
c) Slow down the rate of the IV.
d) Irrigate the IV catheter. - ANSWER: a) Remove the IV.
When attaching an IV piggyback to a primary IV, the IV piggyback bag should be hung ________ the
primary bag.
a) lower than
b) higher than
c) at the same level as
d) on a different pole from - ANSWER: b) higher than
The normal range for sodium is:
a) 110 to 115 mEq/L
b) 115 to 125 mEq/L
c) 125 to 135 mEq/L
d) 135 to 145 mEq/L - ANSWER: d) 135 to 145 mEq/L
Total parenteral nutrition (TPN) should not be infused through a:
a) Central line.
b) Peripherally inserted central catheter (PICC) line.
c) Peripheral line.
d) Groshong catheter. - ANSWER: c) Peripheral line.
TPN is essentially a form of IV feeding. TPN is total nutrition, and patients can be maintained on IV
nutrition for as long as necessary. The amounts and kinds of nutrients needed for total nutrition
cannot be administered using peripheral veins, so the nutrient mix is given using a larger central vein
through a central line. If long-term use is required, a long-term central catheter, such as a peripherally
inserted central catheter (PICC) or an implanted port, will be placed.
