Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 39- Disorders of Fluid and Electrolyte Balance
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | During a period of extreme excess fluid volume, a renal dialysis patient may be administered which type of IV solution to shrink the swollen cells by pulling water out of the cell? | |
| A) | 0.9% sodium chloride | |
| B) | 5% dextrose and water | |
| C) | 3% sodium chloride | |
| D) | Lactated Ringer solution | |
| Ans: | C | |
| Feedback: | ||
| When cells are placed in a hypotonic solution, which has a lower effective osmolality than the ICF, they swell as water moves into the cell, and when they are placed in a hypertonic solution, which has a greater effective osmolality than the ICF, they shrink as water is pulled out of the cell. | ||
| 2. | A 34-year-old male client has diagnoses of liver failure, ascites, and hepatic encephalopathy secondary to alcohol abuse. The client’s family is questioning the care team as to why his abdomen is so large even though he is undernourished and emaciated. Which of the following statements most accurately underlies the explanation that a member of the care team would provide the family? | |
| A) | An inordinate amount of interstitial fluid is accumulating his abdomen. | |
| B) | The transcellular component of the intracellular fluid compartment contains far more fluid than normal. | |
| C) | Normally small transcellular fluid compartment, or third space, is becoming enlarged. | |
| D) | Gravity-dependent plasma is accumulating in his peritoneal cavity. | |
| Ans: | C | |
| Feedback: | ||
| Ascites is characterized by an accumulation of fluid in the transcellular component of the ECF, not ICF. The fluid is not categorized as belonging to the plasma component of the ECF. | ||
| 3. | Which of the following individuals would be considered to be at risk for the development of edema? Select all that apply. | |
| A) | An 81-year-old man with right-sided heart failure and hypothyroidism | |
| B) | A 60-year-old obese female with a diagnosis of poorly controlled diabetes mellitus | |
| C) | A 34-year-old industrial worker who has suffered extensive burns in a job-related accident | |
| D) | A 77-year-old woman who has an active gastrointestinal bleed and consequent anemia | |
| E) | A 22-year-old female with hypoalbuminemia secondary to malnutrition and anorexia nervosa | |
| Ans: | A, C, E | |
| Feedback: | ||
| Right-sided heart failure, burns, and low levels of plasma proteins are all associated with the development of edema. Diabetes and GI bleeds are not identified as contributors to edema. | ||
| 4. | Recognizing the prevalence and incidence of dehydration among older adults, a care aide at a long-term care facility is in the habit of encouraging residents to drink even though they may not feel thirsty at the time. Which of the following facts underlies the care aide’s advice? | |
| A) | Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high. | |
| B) | The metabolic needs for both fluid and sodium in older adults differ from those of younger individuals. | |
| C) | Regulation and maintenance of effective circulating volume by the kidneys is less effective in the elderly. | |
| D) | The renin–angiotensin–aldosterone system (RAAS) is less able to facilitate sodium clearance in older adults. | |
| Ans: | A | |
| Feedback: | ||
| The elderly are prone to hypodipsia even when osmolality and serum sodium levels are elevated, a fact that is compounded by sensory and/or neurological deficits. Hypodipsia in the elderly is not related to differing metabolic needs, ineffective kidney function, or compromise of the RAAS. | ||
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