WorksheetsLP 1 Fluid & Electrolyte Imbalances
Total questions: 25
Worksheet time: 50mins
Which of the following findings would the nurse not expect to assess in a client with FVE?
Crackles in lower lobes of lungs
Bulging neck veins
Tachycardia and hypotension
Weight gain
The nurse has given a client the nursing diagnosis of fluid volume excess r/t compromised regulatory mechanisms secondary to heart failure AEB weight gain and peripheral edema. Which of the following actions by the nurse is most appropriate in relation to this nursing diagnosis?
Monitor the client's I&O every 24 hours
Keep the client's legs in the dependent position
Place the patient on a low magnesium diet
Auscultate breath sounds q 4 hours
A client is suffering from fluid overload due to a history of severe liver disease. Which of the following interventions would be the highest priority for the client?
Weigh the client daily
Elevate the lower extremities to reduce edema
Monitor for heart arrhythmias and the presence of crackles on auscultation
Check skin regularly for sings of skin breakdown
A nurse is working with a client who has an electrolyte imbalance due to inflammatory bowel disease. Which of the following information should the nurse provide to the patient about his food and fluid intake?
In order to avoid constipation, the client should take a stool softener
The client is at increased risk of hemorrhoids, which can be avoided by eating more fiber
The patient may be more likely to feel weak and dizzy if he develops dehydration
In order to stay hydrated, the patient should drink 16 oz. of fluid for every pound of body weight daily
An 86-year-old client is admitted to the hospital after experiencing a fall. It is discovered the client is severely dehydrated. Which of the following manifestations of dehydration would more likely develop in this client? Select all that apply
Tachypnea
Confusion
Seizures
Diarrhea
Insomnia
A 56-year-old client has been hospitalized for acute renal failure. During her shift, the nurse notes that the patient’s urine output has dropped to 5 ml/hr, despite a continuous IV infusion at 150 ml/hr. If left uncorrected, which complication would the nurse most likely expect to see?
Metabolic alkalosis
Decreased BUN and creatinine levels
Diarrhea and poor skin turgor
Pulmonary edema
A client with a serum sodium level of 118 mEq/L is admitted to the intensive care unit after a seizure. The nurse would anticipate an order from the health care provider for which of the following?
Fluid restriction of 2000 mL/day
3% Normal Saline
Furosemide 20 mg IV STAT
0.9% Normal Saline at 100 mL/hr
A client recovering from surgery has an indwelling urinary catheter. The nurse would contact this client’s health care provider with which of the following 24-hour urine output volumes?
1200 mL
650 mL
780 mL
1000 mL
A client is admitted with exacerbation of heart failure. What would you expect to find during your admission assessment?
Flat neck and hand veins
Increased blood pressure and crackles throughout the lungs
Furrowed dry tongue
Bradycardia and pitting edema in lower extremities
The health care provider 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 lbs., +2 pitting edema in the lower extremities, and crackles bilaterally. Which order should the nurse carry out first?
Maintain accurate I&O
Weigh client every morning
Administer furosemide 40 mg IV push
Restrict fluid to 1500 ml/day
The nurse is assessing a client with primary hyperaldosteronism. The nurse will monitor the client for:
Increased serum sodium
Increased urine output
Dry mucous membranes
Decreased serum osmolality
The nurse is administering 3% saline solution IV to a patient with severe hyponatremia. It is most important for the nurse to observe for what?
Decreased heart rate and blood pressure
Prolonged QT interval and facial flushing
Shortness of breath and increased respiratory rate
Increased urine output and decreased urine specific gravity
The nurse is assigned a client admitted with newly diagnosed diabetes insipidus. The nurse would expect the client to experience which electrolyte disorder?
Hypernatremia
Hypokalemia
Hypercalcemia
Hypervolemia
The nurse is teaching a client with Addison's disease. Which of the following statements made by the client would require follow up?
"My spouse uses salt substitutes when preparing my meals"
"I will start taking my furosemide right away tomorrow morning"
"I've always used acetaminophen for my aches and pains"
"My insulin dose was just increased last week to 20 units every morning"
The nurse is assessing a client with heart failure who is on the following medications: metoprolol, furosemide, amlodipine, and digoxin. Which of the following assessment findings requires immediate follow up?
Nausea and vomiting
Chvostek and trousseau sign
Hyperreflexes
Ataxia
A client 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
The nurse instructs an older adult patient to increase intake of dietary potassium when the patient is prescribed which classification of drugs?
Alpha antagonists
Beta blockers
Corticosteroids
Loop diuretics
A client prescribed spironolactone is demonstrating ECG changes and complaining of muscle weakness. The nurse realizes this client is exhibiting signs of which of the following?
Hyperkalemia
Hypokalemia
Hypercalcemia
Hypocalcemia
The nurse is planning care for a client admitted with a potassium level of 5.9 mEq/L. Which of the following will the nurse include in the client’s plan of care?
Sodium polystyrene sulfonate
Regular Insulin
Captopril
Furosemide
Spironolactone
The nurse is assessing a client admitted with multiple myeloma. Which of the following assessments would require immediate follow up?
Bone pain
Phosphorus 3.1 mg/dL
Heart rate 102 bpm
Blood in urine
A client has a low serum calcium level. During a bath, the nurse cleans the client’s face with a cloth, and the lips, nose, and side of the face contract. The nurse documents the presence of
Bell's palsy
Chvostek's sign
Facial droop
Trousseu's sign
You are taking a client’s blood pressure manually. As you pump up the cuff above the systolic pressure for a few minutes, you notice that the client develops a carpal spasm. Which of the following is true?
This is Trousseau's sign and is present in hypocalcemia
This is Trousseau's sign and is present in hypercalcemia
This is known as Chvostek's sign and is present in hypocalcemia
This is a normal response to inflating the blood pressure cuff
A nurse is assisting in the care of a client with pheochromocytoma who has been experiencing clinical manifestations of hypermagnesemia. When evaluating the client, the nurse should determine that the client’s status is returning to normal if which is no longer exhibited?
Tetany
Tremors
Areflexia
Muscular excitability
Which laboratory value requires a priority response by the nurse to notify the primary health care provider?
Sodium 133 mEq/L
Potassium 5.0 mEq/L
Calcium 9.0 mg/dL
Magnesium 4.2 mEq/L
The nurse anticipates that the client with hyperphosphatemia secondary to renal failure will require
Calcium supplements
Potassium supplements
Magnesium supplements
Fluid replacement therapy
