Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
Introductory Medical Surgical Nursing 11th Edition by Barbara K. Tim
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Chapter 16, Caring for Clients With Fluid, Electrolyte
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 16. | A nursing instructor is teaching her class about burns. The instructor relates the following scenario: A nurse is caring for a severely burned client who now has elevated hematocrit and blood cell counts. What consequences should the nurse expect in this client? |
| A) | Slow heart rate |
| B) | Kidney stones and blood clots |
| C) | Imbalance in electrolytes |
| D) | Elevated central venous pressure (CVP) |
| Ans: | B |
| Feedback: | |
| Severe burn injury may cause high fluid loss leading to hypovolemia. Elevated hematocrit levels and blood cell counts indicate hemoconcentration, which means a high ratio of blood components in relation to watery plasma. This increases the potential for blood clots and urinary stones. In hypovolemia, the heart rate tends to be high because the heart tries to compensate for the drop in the circulatory volume. Serum electrolyte levels tend to remain normal because they are depleted in proportion to the water loss. CVP is usually below 4 cm H2O. |
| 2. | Which of the following conditions does the nurse need to confirm when he or she taps the facial nerve of a client who has dysphagia? |
| A) | Hypervolemia |
| B) | Hypercalcemia |
| C) | Hypomagnesemia |
| D) | Hypermagnesemia |
| Ans: | C |
| Feedback: | |
| If there is a unilateral spasm of facial muscles when the nurse taps over the facial muscle, it is known as Chvostek’s sign, which is a sign of hypocalcemia and hypomagnesemia. The additional symptom of dysphagia reinforces the possibility of hypomagnesemia rather than hypocalcemia. A positive Chvostek’s sign does not apply to hypercalcemia, hypervolemia, or hypermagnesemia. |
| 3. | A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes; decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145 mEq/L. Should the nurse start salt tablets when caring for this client? |
| A) | Yes, this will correct the sodium deficit. |
| B) | Yes, along with the hypotonic IV. |
| C) | No, start with the sodium chloride IV. |
| D) | No, sodium intake should be restricted. |
| Ans: | D |
| Feedback: | |
| The symptoms and the high level of serum sodium suggest hypernatremia, (excess of sodium). It is necessary to restrict sodium intake. Salt tablets and sodium chloride IV can only worsen this condition but may be required in hyponatremia (sodium deficit). Hypotonic solution IV may be a part of the treatment but not along with the salt tablets. |
| 4. | You are caring for a client who has been admitted with a possible clotting disorder. The client is complaining of excessive bleeding and bruising without cause. You know that you should take extra care to check for signs of bruising or bleeding in what condition? |
| A) | Dehydration |
| B) | Hypokalemia |
| C) | Hypocalcemia |
| D) | Hypomagnesemia |
| Ans: | C |
| Feedback: | |
| Hypocalcemia or low serum calcium levels can affect clotting. Therefore, in this condition, the nurse should take extra care to check for bruising or bleeding. There is no such risk in dehydration, hypokalemia, or hypomagnesemia. |
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