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WorksheetsPNE Fluid and Electrolytes
Total questions: 75
Worksheet time: 3hrs 35mins
Hct 56% (normal 40% to 51%)
BUN 32 mg/dL (normal 6 mg/dL to 20 mg/dL)
Which nursing diagnosis should the nurse select for this patient?
Sodium138 mEq/L
Potassium3.7 mEq/L
Calcium9.2 mg/dL
Magnesium1.8 mg/dL
Chloride99 mEq/L
BUN29 mg/dL
Which of the following is an appropriate nursing diagnosis for this patient?
A patient is admitted for hypovolemia associated with multiple draining wounds. Which assessment would be the most accurate way for the nurse to evaluate fluid balance?
Skin turgor
Daily weight
Presence of edema
Hourly urine output
The home health nurse cares for an alert and oriented older adult patient with a history of dehydration. Which instructions should the nurse give to this patient related to fluid intake?
“Increase fluids if your mouth feels dry.
“More fluids are needed if you feel thirsty.”
“Drink more fluids in the late evening hours.”
“If you feel lethargic or confused, you need more to drink.”
A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of generalized weakness. It is most appropriate for the nurse to take which action?
Assess for facial muscle spasms.
Ask the patient about loose stools.
Suggest that the patient avoid orange juice with meals.
Ask the health care provider to order a basic metabolic panel.
IV potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient with severe hypokalemia. Which action should the nurse take?
Administer the KCl as a rapid IV bolus.
Infuse the KCl at a rate of 10 mEq/hour.
Only give the KCl through a central venous line.
Discontinue cardiac monitoring during the infusion.
A patient receives 3% NaCl solution for correction of hyponatremia. Which assessment ismost important for the nurse to monitor for while the patient is receiving this infusion?
Lung sounds
Urinary output
Peripheral pulses
Peripheral edema
The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which nursing action should the nurse include on the care plan?
Maintain the patient on bed rest.
Auscultate lung sounds every 4 hours.
Monitor for Trousseau’s and Chvostek’s signs.
Encourage fluid intake up to 4000 mL every day.
When caring for a patient with renal failure on a low phosphate diet, the nurse will inform unlicensed assistive personnel (UAP) to remove which food from the patient’s food tray?
Grape juice
Milk carton
Mixed green salad
Fried chicken breast
A nurse in the outpatient clinic is caring for a patient who has a magnesium level of 1.3 mg/dL. Which assessment would be most important for the nurse to make?
Daily alcohol intake
Intake of dietary protein
Multivitamin/mineral use
Use of over-the-counter (OTC) laxatives
An older patient receiving iso-osmolar continuous tube feedings develops restlessness, agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately?
Potassium 3.4 mEq/L (3.4 mmol/L)
Calcium 7.8 mg/dL (1.95 mmol/L)
Sodium 154 mEq/L (154 mmol/L)
Phosphorus 4.8 mg/dL (1.55 mmol/L)
The nurse assesses a patient who has been hospitalized for 2 days. The patient has been receiving normal saline IV at 100 mL/hr, has a nasogastric tube to low suction, and is NPO. Which assessment finding would be apriority for the nurse to report to the health care provider?
Oral temperature of 100.1° F
Serum sodium level of 138 mEq/L (138 mmol/L)
Gradually decreasing level of consciousness (LOC)
Weight gain of 2 pounds (1 kg) above the admission weight
A patient has a serum calcium level of 7.0 mEq/L. Which assessment finding is mostimportant for the nurse to report to the health care provider?
The patient is experiencing laryngeal stridor.
The patient complains of generalized fatigue.
The patient’s bowels have not moved for 4 days.
The patient has numbness and tingling of the lips.
A patient is admitted to the emergency department with severe fatigue and confusion. Laboratory studies are done. Which laboratory value will require the most immediate action by the nurse?
Arterial blood pH is 7.32.
Serum calcium is 18 mg/dL.
Serum potassium is 5.1 mEq/L.
Arterial oxygen saturation is 91%.
When assessing a pregnant patient with eclampsia who is receiving IV magnesium sulfate, which finding should the nurse report to the health care provider immediately?
The bibasilar breath sounds are decreased.
The patellar and triceps reflexes are absent.
The patient has been sleeping most of the day.
The patient reports feeling “sick to my stomach.”
A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment data will require the most rapid response by the nurse?
The patient’s radial pulse is 105 beats/minute.
There is sediment and blood in the patient’s urine.
The blood pressure increases from 120/80 to 142/94.
There are crackles audible throughout both lung fields.
A patient comes to the clinic complaining of frequent, watery stools for the last 2 days. Which action should the nurse take first?
Obtain the baseline weight.
Check the patient’s blood pressure.
Draw blood for serum electrolyte levels.
Ask about any extremity numbness or tingling.
A client has a serum sodium level of 115 mEq/L. The nurse has initiated a slow IV infusion of hypertonic saline solution per IV pump in a large vein. Which other intervention should the nurse implement as a priority?
Assess the client for dysphagia.
Have on-hand a calcium-channel blocker in case of overdose.
Initiate seizure and safety precautions.
Start a second IV in case the first one infiltrates.
A client with severe malnutrition has pedal edema and ascites. The nurse notes that the weight is unchanged for the last 2 days. The most appropriate action by the nurse is to
ask the assistive personnel to re-weigh the client.
assess vital signs, level of consciousness, and urine output.
call the physician to request IV diuretics.
have biomedical engineering check the scale.
The nurse notes that a client with renal disease has a plasma osmolality of 200 mOsm/kg and a plasma sodium level of 122 mEq/L. The nurse would further assess the client for other manifestations of
extracellular fluid volume excess.
hyperosmolar fluid volume deficit.
intracellular fluid volume excess.
iso-osmolar fluid volume deficit.
A client with dehydration is being weighed on a standing scale next to the bed. The most important action by the nurse is to
assist the client to prevent falls.
calibrate the scale per manufacturer’s directions.
document the weight and compare it with prior ones.
explain to the client what is going to happen.
The nurse who is caring for a client prescribed diuretics and fluid restriction to control edema can most easily evaluate the effectiveness of the medical protocol by
calculating plasma osmolality.
careful weight assessment.
checking the lab report on serum sodium level.
measuring the ankle circumference.
The nurse anticipates that an order for an isotonic intravenous (IV) solution will read
0.45% sodium chloride.
0.9% sodium chloride.
3% sodium chloride.
5% dextrose in water.
A client is taking an IV diuretic for fluid volume excess. Which of the following assessments should the nurse report to the physician?
Decrease in edema
Decrease in potassium level
Increase in urine output
Weight loss
A client has gastroenteritis and frequent diarrhea. The nurse should assess the client for (Select all that apply)
bradycardia.
decrease in blood pressure.
decrease in urine output.
temperature of 101.2
tenting of skin.
The nurse working with elderly clients in a nursing home assesses them for dehydration closely because the clients (Select all that apply)
are more susceptible to developing ascites and anasarca.
experience interactions among drugs they may take for chronic illnesses.
have a decreased proportion of body water as compared to fat.
may be demented and not realize they need to drink.
probably have a diminished sense of thirst.
For a client in renal failure with an abnormally elevated serum potassium level, the priority assessment by the nurse would be the client’s
electrocardiogram (ECG) strips.
level of consciousness.
serial BUN and creatinine levels.
urine output.
