Chapter 16: Fluid and Electrolyte Replacement

Chapter 16: Fluid and Electrolyte Replacement

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient’s serum osmolality is 305 mOsm/kg. Which term describes this patient’s body fluid osmolality?

a.	Iso-osmolar
b.	Hypo-osmolar
c.	Hyperosmolar
d.	Isotonic

 

 

ANS:  C

Normal osmolality is 280 to 300 mOsm/kg. This patient is therefore hyperosmolar.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 226

TOP:   NURSING PROCESS: Assessment

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

2. A patient is admitted after experiencing vomiting and diarrhea for several days. The provider orders intravenous lactated Ringer’s solution. The nurse understands that this fluid is given for which purpose?

a.	To increase interstitial and intracellular hydration
b.	To maintain plasma volume over time
c.	To pull water from the interstitial space into the extracellular fluid
d.	To replace water and electrolytes

 

 

ANS:  D

Lactated Ringer’s solution is an isotonic solution and is used to replace water and electrolytes and is often used to replace gastrointestinal losses. Hypotonic fluids increase interstitial and intracellular hydration. Colloidal solutions are used to maintain plasma volume over time. Hypertonic solutions pull water from the interstitial space into the extracellular fluid.

 

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TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

3. A patient is being treated for shock after a motor vehicle accident. The provider orders 6% dextran 75 to be given intravenously. The nurse should expect which outcome as the result of this infusion?

a.	Decreased urine output
b.	Improved blood oxygenation
c.	Increased interstitial fluid
d.	Stabilization of heart rate and blood pressure

 

 

ANS:  D

6% Dextran 75 is a high molecular-weight colloidal solution and is used to treat shock from burns or trauma. Colloids are plasma expanders, and the end result is an improvement in heart rate (decreased) and blood pressure (increased). Plasma expanders will result in an increase in urine output. Blood oxygenation is not affected, and colloids do not increase the amount of interstitial fluid.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 228

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition

 

4. The nurse is caring for a patient who weighs 75 kg. The patient has intravenous (IV) fluids infusing at a rate of 50 mL/hour and has consumed 100 mL of fluids orally in the past 24 hours. Which action will the nurse take?

a.	Contact the provider to ask about increasing the IV rate to 90 mL/hour.
b.	Discuss with the provider the need to increase the IV rate to 150 mL/hour.
c.	Encourage the patient to drink more water so the IV can be discontinued.
d.	Instruct the patient to drink 250 mL of water every 8 hours.

 

 

ANS:  A

The recommended daily fluid intake for adults is 30 to 40 mL/kg/day. This patient should have a minimum of 2250 mL/day and is currently receiving 1200 mL IV plus 100 mL orally for a total of 1300 mL. Increasing the IV rate to 90 mL/hour would give the patient 2160 mL. If the patient continues to take oral fluids, the amount of 2250 mL can be met. A rate of 150 mL per hour would give the patient 3600 mL per day, which exceeds the recommended amount. Since this patient is not taking fluids well and is not receiving adequate IV fluids, encouraging an increased fluid intake is not indicated. Even if the patient drank 250 mL of water every 8 hours, the amount would not be sufficient.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 225

TOP:   NURSING PROCESS: Evaluation

MSC:  NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition