UniversaI CoIIeges of Paraaque, Inc.

CoIIege of Nursing

FIuids & EIectroIytes

Name:_________________________________________

1. The nurse is gathering data regarding the patient's risk for
fluid volume deficit. Which of the following factors put the
patient at additional risk?

A. Liver Failure
B. Viral Gastroenteritis
C. Lymph node Dissection
D. Protein-calorie malnutrition

2. The nurse appropriately elicits a sign of hypocalcemia by:

A. tapping the face about 1inch from the earlobe
B. palpating a partially stretched tendon
C. inspecting facial symmetry
D. applying pressure in the radial pulse

3. Calcium is primarily stored in the:

A. cells and fluid compartments
B. cardiac and smooth muscle
C. protein and small organic ions
D. bones and teeth

4. Which of the following systems is able to eliminate carbon
dioxide to maintain acid-base balance?

A. renal system
B. protein buffering system
C. phosphate buffering system
D. respiratory system

5.While taking the clinical history, the female patient who was
admitted for severe gastroenteritis starts vomiting. An
appropriate nursing action would include the following except
to:

A. have the patient lie down on her back
B. encourage mouth breathing
C. turn head toward one side
D. wipe patient's face and back with a cold damp washcloth

6. An elderly man is admitted for severe disorientation,
confusion, and general weakness. His spouse reports that the
patient is not able to tolerate any food or fluids and has had
several episodes of vomiting and diarrhea. The patient is
most likely to have:

A. hypokalemia
B. metabolic acidosis
C. hyponatremia
D. repiratory alkalosis

7. A client's arterial blood gas (ABG) results are as follows:
pH 7.16, PaCO2 46mmHg, PaO2 80mmHg, HCO3 25mEq/L,
SaO2 81%. These ABG results represent which condition?

A. metabolic acidosis
B. metabolic alkalosis
C. respiratory acidosis
D. respiratory alkalosis

8. n a state of metabolic acidosis, the patient you are
assigned to manifests which of the following respiration
patterns?

A. deep and rapid
B. slow and shallow
C. cluster
D. cheyne-stokes

9. The following arterial blood gas results of Rob, your patient
has the following: pH 7.32, PaCO2 49mmHg, HCO3 25mEq/L.
What does this indicate?

A. respiratory alkalosis
B. metabolic alkalosis
C. respiratory acidosis
D. metabolic acidosis

10. A client presents to the emergency department, reporting
that he has been vomiting every 30 to 40 minutes for the past
8 hours. Frequent vomiting puts him at risk for which
condition?

A. metabolic acidosis and hyperkalemia
B. metabolic acidosis and hypokalemia
C. metabolic alkalosis and hyperkalemia
D. metabolic alkalosis and hypokalemia

11. A patient is receiving furosemide (Lasix) 40mg/dl V. What
electrolyte value should be monitored when a patient is
receiving a loop diuretic?

A. Calcium levels
B. Phosphorus levels
C. Potassium levels
D. Magnesium levels

12. The nurse is evaluating a patient's laboratory results.
Based upon the laboratory findings, what results will cause
the release of antidiuretic hormone (ADH)?

A. increased serum sodium
B. decreased serum sodium
C. decreased serum osmolality
D. decrease in thirst

13. What is the electrolyte imbalance found in diabetes
mellitus?

A. hypokalemia
B. hyperkalemia
C. hyponatremia
D. hypernatremia

14. A patient's lab results show a slight decrease in
potassium. The physician has declined to treat with drug
therapy but has suggested increasing the potassium through
diet. Which of the following would be a good source of
potassium?

A. apples
B. asparagus
C. carrots
D. bananas

15. Your patient has alcoholism, and you may suspect during
your assessment that his serum magnesium is low. What will
the nurse potentially expect to assess related to
hypomagnesemia?

A. tremor
B. pruritus
C. edema
D. decreased blood pressure

16. The nurse is assessing the patient for the presence of a
Chvostek's sign. What electrolyte imbalance does a positive
Chvostek's sign indicate?

A. hypermagnesemia
B. hypomagnesemia
C. hypocalcemia
D. hyperkalemia

17. A patient with hypokalemia and heart faliure is admitted to
the telemetry unit. The nurse is aware that hypokalemia could
cause which of the following abnormalities on an
electrocardiogram (ECG)?

A. shortened P-R interval
B. inverted T wave
C. depressed U wave
D. elevated U wave

18. Hypercalcemia is seen in:

A. hypoparathyroidism
B. hyperparathyroidism
C. dwarfism
D. calcitonin overdose

19. A nurse sees a variety of patients in the community health
clinic. Which of the following patients would be at the greatest
risk of dehydration?

A. an 18-year-old basketball player with a stress fracture of
the right foot
B. an infant with diarrhea
C. a 45-year old with stomach flu
D. an elderly patient living alone

20. A patient with diabetes insipidus is admitted to the
intensive care unit after a motor vehicle accident that resulted
in head trauma and damage to the pituitary gland. Diabetes
insipidus can occur when there is a decreased production of
which of the following?

A. ADH
B. Estrogen
C. Aldosterone
D. Renin

21. The nurse is caring for patient who is diaphoretic from a
fever. The amount of sodium excreted in the urine will:

A. decrease
B. increase
C. remain unchanged
D. fluctuate

22. The triage nurse notes upon assessment in the
emergency room that the patient with anxiety is
hyperventilating. The nurse is aware that hyperventilation is
the most common cause of which acid-base imbalance?

A. respiratory acidosis
B. respiratory alkalosis
C. increased PaCO2
D. central nervous system (CNS) disturbances

23. Your patient has the following arterial blood gas results:
pH 7.26, PaCO2 28mmHg, HCO3 11mEq/L. How would the
nurse interpret the result?

A. respiratory acidosis with no compensation
B. metabolic alkalosis with a compensatory alkalosis
C. metabolic acidosis with no compensation
D. metabolic acidosis with a compensatory respiratory
alkalosis

24. The nurse who assesses the patient's peripheral V site
and notes edema around the insertion site will document
which complication related to V therapy?

A. air emboli
B. phlebitis
C. infiltration
D. fluid overload

25. What would be the best initial nursing action prior to
inserting an V?

A. have the patient was the hands
B. prepare the V insertion site with povidone iodine
C. verify the order for V therapy
D. identify a suitable vein

26. A patient admitted with a gastrointestinal bleeding and
anemia is receiving a blood transfusion. Based upon the
patient's hypotensive blood pressure, the nurse anticipates
an order for V fluids from the physician. Which of the
following V solutions may be administered with blood
products?

A. D5 and .45% Normal Saline
B. Lactated Ringer's
C. 5% dextrose in water
D. 0.9% NaCl

27. The nurse assessing skin turgor in an elderly patient
should remember that:

A. overhydration causes the skin to tent
B. dehydration causes the skin to appear edematous and
spongy
C. inelastic skin turgor is a normal part of aging
D. normal skin turgor is moist and boggy

28. When selecting a site on the hand or arm for insertion of
an V catheter, the nurse should:

A. choose a proximal site
B. choose a distal site
C. have the patient hold his arm over his head
D. leave the tourniquet on for atleast 5minutes

29. The nurse is admitting a patient with a suspected fluid
imbalance. The most sensitive indicator of body fluid balance
is:

A. daily weight
B. serum sodium levels
C. measured intake and output
D. blood pressure

30. A patient is taking spironolactone (Aldactone) to control
her hypertension. Her serum potassium level is 6mEq/L. For
this patient, the nurse's priority would be to assess her:

A. neuromuscular function
B. bowel sounds
C. respiratory rate
D. electrocardiogram (ECG) results

31. The nurse is caring for a postthyroidectomy patient at risk
for hypocalcemia. What action should the nurse take when
assessing for hypocalcemia?

A. monitor laboratory values daily for an elevated thyroid-
stimulating hormone
B. observe for swelling of the neck, tracheal deviation and
severe pain
C. evaluate the quality of the patient's voice postoperatively,
noting any drastic changes
D. observe for muscle twitching and numbness or tingling of
the lips, fingers and toes

32. Constipation is a complication of:

A. hypercalcemia
B. hyperkalemia
C. hypocalcemia
D. hypomagnesemia

33. The following are signs of magnesium toxicity except:

A. decreased blood pressure
B. decreased urine output
C. decreased respiratory rate
D. decreased pulse rate

34. A nurse in the medical-surgical unit is giving a patient with
low blood pressure a hypertonic solution, which will increase
the number of dissolved particles in his blood, creating
pressure for fluids in the tissues to shift into the capillaries
and increase the blood volume. Which of the following terms
is associated with this process?

A. hydrostatic pressure
B. osmosis and osmolality
C. diffusion
D. active transport

35.The following are signs/symptoms of hypokalemia except:

A. periodic paralysis
B. paralytic ileus
C. constipation
D. diarrhea

36. The following are sign/symptoms of hypercalcemia
except:

A. renal stones
B. constipation
C. malignancy
D. (+) Chvostek's sign

37. Hyperkalemia is present in the following medical
conditions except:

A. renal failure
B. diabetes mellitus
C. crushing injury
D. paralysis

38. A nurse is taking care of a 65-year-old female patient in a
medical-surgical unit who is in renal failure. During the
assessment, the patient complains tingling in her lips and
fingers. When the nurse takes her blood pressure, she has a
spasm in her wrist and hand. The nurse suspects:

A. hypophosphatemia
B. hypocalcemia
C. hypermagnesemia
D. hyperkalemia

39. A 65-year-old male patient was admitted to a medical-
surgical unit 72 hours ago with pyloric stenosis. A nasogastric
tube was inserted upon admission and has been on low
intermittent suction since then. The nurse taking care of the
patient notices that his potassium level is very low and
becomes concerned that the patient may be at risk for:

A. hypercalcemia
B. metabolic acidosis
C. metabolic alkalosis
D. respiratory acidosis

40. What is the acid-base imbalance in chronic obstructive
pulmonary disease?

A. respiratory alkalosis
B. respiratory acidosis
C. metabolic acidosis
D. metabolic alkalosis

41. The nurse in the intensive care unit receives arterial blood
gases (ABG) with a patient who is complaining of being "short
of breath. The ABG has the following values: pH 7.21,
PaCO2 64mmHg, HCO3 24mmHg. The lab reflects:

A. respiratory acidosis
B. metabolic alkalosis
C. respiratory alkalosis
D. metabolic acidosis

42. What is the acid-base imbalance in hyperventilation?

A. respiratory acidosis
B. respiratory alkalosis
C. metabolic acidosis
D. metabolic alkalosis

43. Which of the following problems is a priority in the care of
a patient who has been burned and suffered smoke
inhalation?

A. pain
B. fluid balance
C. anxiety and fear
D. airway management

44. A patient is burned on the face and the left forearm in a
house fire. What percentage of burn does the patient have?

A. 10% C. 9%
B. 25% D. 18%

45. To maintain adequate nutrition and promote healing in a
burn patient, the nurse would recommend which of the
following dietary choices?

A. cheeseburger and vegetable soup
B. milkshake and vanilla pudding
C. chicken broth and jell-o
D. mashed potatoes and corn

46. The nurse receives a phone call from a frantic father who
has observed his 4-year-old child tip a pot of boiling water
onto her chest. The father has called an ambulance and the
pediatrician's office while he waits. The nurse instruct the
father to:

A. cover the burn with ice and secure with a towel
B. apply butter to the area that is burned
C. immerse the child in a cool bath
D. avoid touching the burned area and seek medical attention

47. During the emergent/resuscitative phase of burn injury,
the nurse should closely monitor which of the following blood
values?

A. sodium deficit
B. bleeding time
C. potassium deficit
D. decreased hematocrit

48. According to the Rule of Nines, a patient who is affected
by burns to the anterior and posterior trunk would
demonstrate what percentage of body burned?

A. 9% C. 27%
B. 18% D. 36%

49. A serious gastrointestinal disturbance that may frequently
occur in a patient who suffered a major burn is:

A. hermorrhoids
B. diarrhea
C. paralytic ileus
D. diverticulitis

50. A patient received burns to his entire back and left arm.
Using the Rule of Nines, the nurse can calculate that he has
sustained burns on what percentage if his body?

A. 9% C. 27%
B. 18% D. 36%


"We are what we repeatedly do.
xcellence then is not an act,
but a %."
-Aristotle