Chapter 3: Fundamentals of Fluid and Electrolyte Balance

Chapter 3: Fundamentals of Fluid and Electrolyte Balance

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A nurse is assessing an older adult client who is disoriented to time and place. The nurse notes that the client’s eyes are sunken, the mouth is coated, the tongue has an extra longitudinal furrow, and the client’s lips are cracked. The client’s hand vein filling takes more than 5 seconds; tenting is apparent over the sternum; and the vital signs are BP 110/60 mm Hg, pulse 62, and respiratory rate of 12. Based on these assessment findings, which fluid or electrolyte imbalance should the nurse suspect?

a.	Sodium excess
b.	Magnesium deficit
c.	Fluid volume deficit
d.	Fluid volume excess

 

 

____     2.   A nurse prepares to assess a client who has been vomiting for several days. For which signs of fluid volume deficit (FVD) should the nurse assess?

a.	Bounding pulse, decreased blood pressure, and moist crackles
b.	Dyspnea, jugular vein distention, and sternum fingerprinting
c.	Increased pulse rate, decreased blood pressure, and poor skin turgor
d.	Increased respiratory rate; warm, moist skin; and decreased body temperature

 

 

____     3.   A nurse assesses a client who has moist crackles (rales) in the lung bases, an increased respiratory rate, dyspnea, and 3+ edema of the ankles. Which is the most accurate nursing diagnosis for this client?

a.	Fluid volume deficit
b.	Fluid volume excess
c.	Impaired tissue integrity
d.	Altered tissue perfusion, renal

 

 

____     4.   A nurse analyzes a client’s laboratory report that shows a serum potassium level of 5.7 mEq/L. Which client’s laboratory report is the nurse most likely reviewing?

a.	The client with ulcerative colitis
b.	The client with Cushing’s syndrome
c.	The client who has overused laxatives
d.	The client who has sustained a traumatic burn

 

 

____     5.   A nurse notes that a client admitted with renal failure has a serum phosphorus level of 7.0 mg/dL. Which medication should a nurse expect to be prescribed for this client?

a.	Calcium gluconate
b.	Calcium chloride
c.	Calcitonin (Calcimar)
d.	Aluminum hydroxide gel (Amphojel)

 

Answer Section

 

MULTIPLE CHOICE

 

1. ANS:  C

The signs and symptoms of fluid volume deficit reflect a contracted vascular compartment due to either a significant extracellular fluid (ECF) loss or an accumulation of fluid in the interstitial space. Gastrointestinal dysfunction is the most common cause of ECF deficit and the symptoms related to it, and it is most often responsible for general loss of body fluids.

 

PTS:   1                    KEY:  Cognitive Level: Analysis

 

2. ANS:  C

FVD results when water and electrolytes are lost. An increased pulse rate, decreased blood pressure, and poor skin turgor are signs of hypovolemia or FVD.

 

PTS:   1                    KEY:  Cognitive Level: Application

 

3. ANS:  B

Fluid volume excess is the most accurate nursing diagnosis for this client. Extracellular fluid (ECF) volume excess causes an expansion of the ECF compartment. The primary cause of ECF excess is cardiovascular dysfunction. Clinically, ECF volume excess has distinct signs and symptoms; the most prominent are weight gain, edemas, and alterations in respiratory and cardiovascular function.

 

PTS:   1                    KEY:  Cognitive Level: Analysis

 

4. ANS:  D

A serum potassium level greater than 5.0 mEq/L is indicative of hyperkalemia. Clients who experience cellular shifting of potassium that occurs in the early stages of massive cell destruction, such as in trauma, burns, sepsis, or with metabolic or respiratory acidosis (with the exception of diabetic acidosis), are at risk for hyperkalemia. Clients with Cushing’s syndrome or colitis and the client who has been overusing laxatives are all at risk for hypokalemia.

 

PTS:   1                    KEY:  Cognitive Level: Analysis

 

5. ANS:  D

The normal serum phosphorus level is 2.5 to 4.5 mg/dL or 1.8 to 2.6 mEq/L. This client is experiencing hyperphosphatemia, and his or her phosphorus level should be lowered. Certain medications can be given to increase the fecal excretion of phosphorus by binding phosphorus to the food in the gastrointestinal tract. Aluminum hydroxide gel is one such medication. Calcium gluconate and calcium chloride are medications used in the treatment of tetany that occurs from acute hypocalcemia. Calcitonin decreases the plasma calcium level.

 

PTS:   1                    KEY:  Cognitive Level: Application