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Electrolyte Imbalances Galen College of Nursing
Questions With Complete Solutions
An older adult patient with a history of renal failure is brought in to the emergency
department with sudden onset of acute confusion, worsening muscle weakness in
the extremities, abdominal cramps, and a weak, rapid, and thready pulse. What are
the immediate nursing interventions to stabilize the patient? Select all that apply.
1 Administering diuretics
2 Administering 0.9% saline
3 Administering antipsychotics
4 Administering calcium channel blockers
5 Administering 5% dextrose in 0.45% sodium chloride - ANSWER 1. Administering
diuretics
2. Administering 0.9% saline
5. Administering 5% dextrose in 0.45% sodium chloride
The patient's symptoms indicate hypernatremia. Administering diuretics that promote
sodium loss and administering fluids such as 0.9% saline and 5% dextrose in 0.45%
sodium chloride to restore the fluid balance are the immediate interventions needed
to stabilize the patient. The patient's acute confusion is caused by high sodium
levels, so antipsychotic drugs should not be administered. Sodium decreases the
heart contractibility by retarding the movement of calcium into the heart cells.
Therefore, calcium channel blockers should not be administered.
The nurse is providing care to a patient who is experiencing tachypnea. Which
intervention is most appropriate to maintain the patient's fluid balance?
1 Encourage oral fluids.
2 Increase intravenous fluids.
3 Implement fluid restrictions.
4 Administer prescribed diuretic. - ANSWER 2 Increase intravenous fluids.
Tachypnea: rapid breathing. The patient who is experiencing tachypnea will
experience an increase in insensible water loss, increasing the risk for dehydration.
The most appropriate intervention by the nurse is to increase intravenous fluids.
Encouraging oral fluids is not recommended due to the increased risk for aspiration
that occurs with tachypnea. Fluid restrictions and diuretics are not recommended, as
these will increase the patient's risk for dehydration.
Which will the nurse include when documenting a patient's fluid intake for the shift?
Select all that apply.
1 Emesis
2 Enemas
, 3 Oral fluids
4 Solid foods
5 Irrigation fluids - ANSWER 2 Enemas
3 Oral fluids
5 Irrigation fluids
Intake that is considered measurable when documenting a patient's fluid intake for
the shift include enemas, oral fluids, and irrigation fluids. Emesis is a measurable
output. Solid foods are considered intake but these cannot be measured.
The nurse is providing care to a patient who is admitted with fluid volume overload.
Which electrolyte imbalances does the nurse anticipate for this patient based on the
admitting diagnosis? Select all that apply.
1 Hyponatremia
2 Hypokalemia
3 Hypercalcemia
4 Hypochloremia
5 Hypermagnesemia - ANSWER 1 Hyponatremia
2 Hypokalemia
4 Hypochloremia
A patient admitted with fluid volume overload will often experience hyponatremia,
hypokalemia, and hypocholoremia. Hypercalcemia and hypermagnesemia are not
anticipated electrolyte imbalances associated with fluid volume overload.
A patient admitted with fluid overload from heart failure is treated with diuretic
therapy. What laboratory test demonstrates effectiveness of the diuretic therapy?
1 Serum magnesium
2 Serum osmolality
3 Natriuretic peptide
4 Serum creatinine - ANSWER 3 Natriuretic peptide
Natriuretic peptides (atrial and brain natriuretic peptides) are hormones secreted by
cells that line the atria and ventricles of the heart in response to changes in blood
volume and pressure. Serum osmolality may be monitored if the patient is over- or
underdiuresed. Serum magnesium and creatinine would not be indicated as a
measure of diuretic therapy.
How much fluid should a healthy adult consume each day to maintain adequate
urine output?
1 2 L/day
2 2.3 L/day
3 2.6 L/day
4 2.9 L/day - ANSWER 2 2.3 L/day
Electrolyte Imbalances Galen College of Nursing
Questions With Complete Solutions
An older adult patient with a history of renal failure is brought in to the emergency
department with sudden onset of acute confusion, worsening muscle weakness in
the extremities, abdominal cramps, and a weak, rapid, and thready pulse. What are
the immediate nursing interventions to stabilize the patient? Select all that apply.
1 Administering diuretics
2 Administering 0.9% saline
3 Administering antipsychotics
4 Administering calcium channel blockers
5 Administering 5% dextrose in 0.45% sodium chloride - ANSWER 1. Administering
diuretics
2. Administering 0.9% saline
5. Administering 5% dextrose in 0.45% sodium chloride
The patient's symptoms indicate hypernatremia. Administering diuretics that promote
sodium loss and administering fluids such as 0.9% saline and 5% dextrose in 0.45%
sodium chloride to restore the fluid balance are the immediate interventions needed
to stabilize the patient. The patient's acute confusion is caused by high sodium
levels, so antipsychotic drugs should not be administered. Sodium decreases the
heart contractibility by retarding the movement of calcium into the heart cells.
Therefore, calcium channel blockers should not be administered.
The nurse is providing care to a patient who is experiencing tachypnea. Which
intervention is most appropriate to maintain the patient's fluid balance?
1 Encourage oral fluids.
2 Increase intravenous fluids.
3 Implement fluid restrictions.
4 Administer prescribed diuretic. - ANSWER 2 Increase intravenous fluids.
Tachypnea: rapid breathing. The patient who is experiencing tachypnea will
experience an increase in insensible water loss, increasing the risk for dehydration.
The most appropriate intervention by the nurse is to increase intravenous fluids.
Encouraging oral fluids is not recommended due to the increased risk for aspiration
that occurs with tachypnea. Fluid restrictions and diuretics are not recommended, as
these will increase the patient's risk for dehydration.
Which will the nurse include when documenting a patient's fluid intake for the shift?
Select all that apply.
1 Emesis
2 Enemas
, 3 Oral fluids
4 Solid foods
5 Irrigation fluids - ANSWER 2 Enemas
3 Oral fluids
5 Irrigation fluids
Intake that is considered measurable when documenting a patient's fluid intake for
the shift include enemas, oral fluids, and irrigation fluids. Emesis is a measurable
output. Solid foods are considered intake but these cannot be measured.
The nurse is providing care to a patient who is admitted with fluid volume overload.
Which electrolyte imbalances does the nurse anticipate for this patient based on the
admitting diagnosis? Select all that apply.
1 Hyponatremia
2 Hypokalemia
3 Hypercalcemia
4 Hypochloremia
5 Hypermagnesemia - ANSWER 1 Hyponatremia
2 Hypokalemia
4 Hypochloremia
A patient admitted with fluid volume overload will often experience hyponatremia,
hypokalemia, and hypocholoremia. Hypercalcemia and hypermagnesemia are not
anticipated electrolyte imbalances associated with fluid volume overload.
A patient admitted with fluid overload from heart failure is treated with diuretic
therapy. What laboratory test demonstrates effectiveness of the diuretic therapy?
1 Serum magnesium
2 Serum osmolality
3 Natriuretic peptide
4 Serum creatinine - ANSWER 3 Natriuretic peptide
Natriuretic peptides (atrial and brain natriuretic peptides) are hormones secreted by
cells that line the atria and ventricles of the heart in response to changes in blood
volume and pressure. Serum osmolality may be monitored if the patient is over- or
underdiuresed. Serum magnesium and creatinine would not be indicated as a
measure of diuretic therapy.
How much fluid should a healthy adult consume each day to maintain adequate
urine output?
1 2 L/day
2 2.3 L/day
3 2.6 L/day
4 2.9 L/day - ANSWER 2 2.3 L/day
