Chapter 26 Fluids Electrolytes and Acid - Base Balance

Chapter 26 Fluids Electrolytes and Acid – Base Balance

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)Blood is ordered to be drawn immediately for a blood gas analysis. Which of the following actionsby the LPN/LVN is least correct?1)A)Obtain the blood sample from the radial or femoral artery.B)Place the sample on ice.C)Apply direct pressure to the blood draw site for 5 minutes.D)Transport the blood sample to the lab immediately.Answer:AExplanation:A)The LPN/LVN does not do arterial blood sticks, regardless of certification inphlebotomy. Transporting the blood sample immediately, applying direct pressureto the site, and placing the sample on ice are all done with arterial blood sticks.ImplementationSafe, Effective Care Environment-Coordinated CareApplicationB)The LPN/LVN does not do arterial blood sticks, regardless of certification inphlebotomy. Transporting the blood sample immediately, applying direct pressureto the site, and placing the sample on ice are all done with arterial blood sticks.ImplementationSafe, Effective Care Environment-Coordinated CareApplicationC)The LPN/LVN does not do arterial blood sticks, regardless of certification inphlebotomy. Transporting the blood sample immediately, applying direct pressureto the site, and placing the sample on ice are all done with arterial blood sticks.ImplementationSafe, Effective Care Environment-Coordinated CareApplicationD)The LPN/LVN does not do arterial blood sticks, regardless of certification inphlebotomy. Transporting the blood sample immediately, applying direct pressureto the site, and placing the sample on ice are all done with arterial blood sticks.ImplementationSafe, Effective Care Environment-Coordinated CareApplication2)A client is admitted to the emergency room with increased respiratory difficulty. The client has ahistory of chronic obstructive pulmonary disease. Arterial blood gases confirm the presence ofrespiratory acidosis. Orders are being written by the physician. Which of the following nursingactions prior to getting the physician’s orders are most correct? (Select all that apply.)2)A)Initiate recording intake and output.B)Measure the radial pulse and blood pressure.C)Obtain hourly pulse oximetry readings.D)Observe for indications of decreasing level of consciousness.E)Ask the client to describe what he has been experiencing the last few days.F)Begin oxygen by mask at 3 liters per minute.Answer:A, C, D1
Explanation:A)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysisB)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysisC)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysis2
D)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysisE)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysisF)Prior to receiving orders from the physician, the LPN/LVN and the RN can initiateindependent nursing actions based on the client’s diagnosis, status, and needs.Independent nursing actions must be within the scope of practice of the licensednurse. Initiating assessment activities such as intake and output, pulse oximetry,and observation of level of consciousness are appropriate. The nurse canindependently initiate pulse and blood pressure measurements; the nurse mustalso be correct in determining the most appropriate methods of obtaining data.This nurse should auscultate the apical pulse, not the radial pulse. The LPN/LVNshould not initiate oxygen therapy. The client needs to be quiet and not use energytalking. It is quite likely that the physician has already asked the client the samequestion if orders are now being written. If the focus is truly on the client, itshould be recognized that he does not need to be required to answer questionstwice.AssessmentSafe, Effective Care Environment-Coordinated CareAnalysis3
3)A client has been admitted to an acute care facility after experiencing burns over more than 60percent of his body, including the chest, abdomen, arms, legs, and groin. The burns are primarilythird degree, with areas of second-degree burns. Initially, blood and urine values for this client willmost likely show elevations in: (Select all that apply.)3)A)Hematocrit.B)Serum blood, urea, and nitrogen.C)Urine specific gravity.D)Serum potassium.E)Serum sodium.F)Serum glucose.Answer:A, B, CExplanation:A)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysisB)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysisC)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysisD)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysisE)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysis4
F)Extensive burns cause loss of fluid, cells, and electrolytes, which results in lowpotassium and normal or low sodium levels. Due to low circulating fluid volume,kidney function is initially slowed and the blood, urea, and nitrogen level willelevate. When fluid volume is low, hematocrit and urine specific gravity areelevated. Glucose is not initially affected.AssessmentPhysiological Integrity-Reduction of Risk PotentialAnalysis