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WorksheetsCH. 17 & 76 Fluids & Electrolyte Balance & Disorders IN BASIC
Total questions: 50
Worksheet time: 25mins
FLUID AND ELECTROLYTE BALANCE - CHAPTER 17
Which diagram shows the correct sequence for homeostasis?
Receptor (sensing component) → control center (brain) → appropriate response (effectors—muscles, organs, hormones) → change (positive or negative feedback) = homeostasis.
Receptor (sensing component) → appropriate response (effectors—muscles, organs, hormones) → control center (brain) → change (positive or negative feedback) = homeostasis.
Appropriate response (effectors—muscles, organs, hormones) → control center (brain) → change (positive or negative feedback) → receptor (sensing component) = homeostasis.
Appropriate response (effectors—muscles, organs, hormones) → change (positive or negative feedback) → control center (brain) → receptor (sensing component) = homeostasis.
What information should be included in discussion concerning intracellular fluid? Select all that apply.
It is the fluid found inside the cell
It constitutes about one half to two thirds of the total body fluid in an adult
The major ions in intracellular fluid are potassium, magnesium, and phosphate.
It appears mostly as interstitial fluid and intravascular fluid
The volume of intracellular fluid is the most important regulated aspect of body fluid balance.
The body monitors extracellular fluid volume closely and sends messages to the brain, kidneys, and pituitary gland to maintain control. What information accurately describes the associated regulatory process?
The thirst center in the thalamus stimulates or inhibits the desire for a person to drink.
Antidiuretic hormone is released from storage in the anterior pituitary gland as part of the positive feedback mechanism in response to conditions within the cardiovascular system.
When antidiuretic hormone is released, urine production is increased and water reabsorption is decreased.
The renin–angiotensin–aldosterone system controls fluid volume with aldosterone causing increased reabsorption of sodium and water by the kidneys in an attempt to increase blood volume.
A client asks the nurse how the fluid in the ankles keeps coming back. What principal causes of edema should the nurse review with the client? Select all that apply.
Obstruction of arterial blood
Increased capillary permeability
Inflammatory reactions
External pressure
Obstruction of lymphatic return
What are the functions of water related to fluid and electrolyte imbalances? Select all that apply.
It requires only a small temperature change to alter its form
It is a participant in all chemical reactions occurring in the body
It is a poor solvent
It functions as a suspension agent
It is the source of hydrostatic pressure
What major ion found in intracellular fluid is responsible for the normal functioning of neurons and muscle cells?
Sodium
Potassium
Calcium
Magnesium
What food sources should the nurse encourage the client to eat to help raise the potassium level?
Table salt, meat, dairy foods
Dry fruits, nuts, and many vegetables
Milk and other dairy products, broccoli, green leafy vegetables
Green leafy vegetables, legumes, chocolate
What factors affect the passage of molecules to pass through a permeable membrane? Select all that apply.
Osmotic pressure
Hydrostatic pressure
Size of the molecule
Composition of the body fluid
Compatibility of the electrical charges of the molecule, the membrane and the body fluid
How should the nurse describe the process of osmosis?
Movement of molecules from an area of higher concentration to an area of lower concentration
Most important mechanism by which nutrients and waste pass across the cell membrane
Water moves from a hypotonic solution to a hypertonic solution
Pressure exerted to start the flow of water across a membrane
Which statement describes the process of filtration?
Movement of molecules from an area of higher concentration to an area of lower concentration
Most important mechanism by which nutrients and waste pass across the cell membrane
Water moves from a hypotonic solution to a hypertonic solution
Transport of water and dissolved materials through a membrane from an area of higher pressure to lower pressure
Which item is alkaline in nature?
Lemon juice
Baking soda
Black coffee
Tomato juice
Which sign or symptom is most representative of an early significant loss of extracellular fluid volume?
High urine output
Irregular heartbeat
Hypotension
Unresponsiveness
The nurse should be aware of which effects of aging on fluid and electrolyte? Select all that apply.
Intracellular fluid levels increase
Thirst sensation declines
Weight gain occurs
Laxative abuse occurs
Metabolism increases
What nursing interventions should be implemented for older adults who are at high risk of fluid and electrolyte imbalance? Select all that apply.
Encourage the client to increase intake of food and fluids
Encourage the client to exercise
Monitor the client's potassium intake
Monitor the client's blood pressure
Monitor the client's sodium level
Which assist in the regulation of the body's pH? Select all that apply.
Lungs
Kidneys
Cellular activities
Buffer systems
Liver
Which arterial blood gas results indicate respiratory acidosis?
Decreased pH; decreased bicarbonate
Decreased pH; increased carbon dioxide
Increased pH; increased bicarbonate
Increased pH; decreased carbon dioxide
Which arterial blood gas results indicate metabolic alkalosis?
Decreased pH; decreased bicarbonate
Decreased pH; increased carbon dioxide
Increased pH; increased bicarbonate
Increased pH; decreased carbon dioxide
A client has experienced a significant loss of extracellular fluid (ECF) volume. What condition is this client at risk for developing?
Hypovolemic shock
Hypertension
Heart failure
Pulmonary embolus
Which enzyme is released by the kidneys when there is a decrease in blood volume?
Erythropoietin
Renin
Glucagon
Protease
What physiological process commonly occurs during dehydration?
Increase in sodium and electrolyte disturbance
Increased capillary permeability
Loss of proteins in the plasma of the blood
Obstruction of venous blood or lymphatic return
The client has an order for IV fluids. Normal saline, an isotonic solution, is ordered. What is the best description the nurse can provide to a student nurse about isotonic solutions?
Its osmotic pressure is similar to that of blood
Causes blood cells to swell
Causes blood cells to shrink
Its concentration of solutes is greater than that of blood.
An 82-year-old client is admitted for dehydration. The daughter asks the nurse why this may have happened. What explanation should the nurse provide for the risk of dehydration for this client?
Increased frequency of urination
Increased body temperature
Decreased thirst sensations
Loss of water through increased sweating
FLUIDS ANND ELECTROLYTE DISORDERS - CHAPTER 76
The nurse is preparing a client for testing to determine acidosis or alkalosis. Which laboratory test would be ordered?
Complete blood count (CBC)
Clotting factors
Arterial blood gas (ABG)
Liver function tests (LFT)
Which assessments should the nurse conduct to identify possible indicators of fluid and electrolyte imbalances? Select all that apply.
Skin for poor skin turgor
Vital signs for decreased heart rate
C.) Gastrointestinal for presence of anorexia OR F.) Vital signs for hyperthermia
Respiratory for breathing pattern
Urinary for comparison between intake and output
The nurse is caring for a client diagnosed with fluid volume excess that has resulted in edematous legs. Which intervention should the nurse implement to help resolve the edema?
Keep the legs in the same position to avoid irritating the skin.
Elevate the legs to a position higher than the heart's level.
Limit walking to prevent the formation of ulcers.
Perform skin care on the legs at least every 4 hours.
What is a common cause of fluid volume excess?
Too-slow administration of IV fluids containing sodium
Increased urine output as occurs with kidney disorders
Excess ingestion of sodium from table salt or medications containing sodium
Inability of the body to conserve and reuse water by concentrating urine
Which client should this nurse monitor closely for an increased risk for developing edema?
A 30-year-old client with a prolonged fever
A 16-year-old client diagnosed with anorexia nervosa
A 20-year-old client who is vomiting excessively
A 78-year-old client diagnosed with liver cirrhosis
What is the preferred route of electrolyte administration when the oral route is contraindicated?
Intramuscular
Intravenous
Subcutaneous
Intradermal
What causes fluid retention in the body?
Elevated protein levels
Increased venous pressure
Elevated osmotic pressure
Increased excretion of sodium
Which discharge instruction should the nurse provide a client diagnosed with chronic renal failure?
Monitor for differences between fluid intake and output.
Allow feet to dangle at least 3 hours per day.
Check the weight on a weekly basis.
Keep walking to a minimum.
A 25-year-old client is admitted to a healthcare facility with complaints of fever, vomiting, and watery diarrhea for 2 days. On examination, the client has dry skin, delayed skin turgor, and hypotension. What is the most likely nursing diagnosis?
Impaired urinary elimination
Acute gastroenteritis
Infective diarrhea
Deficient fluid volume
An assessment indicates that the client's skin rebound from slight pressure in slightly less than 2 seconds. How should the nurse document this finding?
No edema present
+1 pitting edema
+2 pitting edema
Nonpitting edema present
A nurse assessing a client documents +4 pitting edema in several different locations. What condition is commonly associated with +4 pitting edema?
Sacral edema
Dependent edema
Anasarca
Pulmonary edema
The nurse caring for a postoperative client documents the following data: flushed dry skin, dry mucous membranes, hypotension, and lethargy. The client states that he is thirsty and requests water. Which medical condition is supported by this data?
Hypernatremia
Hyperkalemia
Hypercalcemia
Hypermagnesemia
Which major electrolyte in the extracellular fluid (ECF) influences the distribution of water and maintains acid–base balance and nerve function?
Potassium
Sodium
Calcium
Phosphorus
A client diagnosed with diabetes insipidus is prescribed a restricted diet. What dietary restriction should the nurse incorporate in the diet plan for this client?
Potassium
Calcium
Chloride
Sodium
Which serum sodium level confirms a diagnosis of hyponatremia?
150 mEq/L
145 mEq/L
135 mEq/L
130 mEq/L
For which electrolyte disturbance should the nurse monitor when caring for a client diagnosed with Hodgkin disease?
Hyponatremia
Hypercalcemia
Hypochloremia
Hyperphosphatemia
A nurse is documenting the electrolyte report of a client on diuretic therapy for heart failure. The report is as follows: sodium, 142 mEq/L; potassium, 2.5 mEq/L; calcium, 5 mEq/L; and chloride, 98 mEq/L. Which electrolyte disturbance should the nurse report to the physician?
Hyponatremia
Hypochloremia
Hypokalemia
Hypocalcemia
Which characteristics of aging predispose the older adult client to the risk of fluid and electrolyte imbalances? Select all that apply.
A.) Increased renal functioning OR D.) Self-medication with analgesics
Depressed thirst mechanism
Atypical or subtle confusion
Decreased elasticity of skin
Incontinence
Which condition is most commonly associated with hypocalcemia?
Cancer
Parathyroid hormone deficit
Primary hyperparathyroidism
Immobilization
The nurse is caring for an alcoholic client. Which electrolyte imbalance typically occurs as the result of diuretic therapy?
Hyperphosphatemia
Hyperkalemia
Hypernatremia
Hypomagnesemia
A 16-year-old presents at the emergency room with altered mental status, bradycardia, and cardiac dysrhythmia caused by uncontrolled diabetes mellitus. What acid–base imbalance is most likely occurring in this client?
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
Respiratory alkalosis
Which client condition poses the highest risk for the development of respiratory acidosis?
Renal disease
Hyperventilating
Excessive gastric suctioning
Chronic emphysema
Which description accurately identifies metabolic alkalosis?
HCO3– >+26 mEq/L
CO2 <35
HCO3– <+22 mEq/L
CO2 >45
A diabetic client is admitted to a healthcare facility for diarrhea, nausea, vomiting, and altered mental status. The arterial blood gas (ABG) report of the client shows decreased pH and decreased HCO3–. What immediate action should the nurse take?
Give a bicarbonate infusion.
Give Ringer solution.
Notify the physician.
Apply a rebreathing mask.
A nurse is caring for a client admitted to the healthcare facility with narcotic overdose. The client has shallow respirations, tremors, headache, weakness, altered sensorium, and fruity-smelling breath. According to the arterial blood gas evaluation, the client's pH is decreased and PCO2 is increased. Which acid–base imbalance has occurred?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
Which nursing intervention should the nurse implement for a client diagnosed with respiratory acidosis?
Notify the healthcare provider of skin changes.
Lower the head of the client's bed.
Administer prescribed antibiotics.
Administer ordered oxygen.
Which nursing intervention is recommended for the management of respiratory alkalosis?
Administering oxygen
Breathing into a paper bag
Administering bicarbonate
IV infusion of lactated Ringer solution
Which acid–base imbalance, if not corrected, could lead to the need for mechanical ventilation?
Respiratory acidosis
Respiratory alkalosis
Metabolic acidosis
Metabolic alkalosis
