Chapter 39: Fluid, Electrolytes, and Acid-Base Balance

Chapter 39: Fluid, Electrolytes, and Acid-Base Balance

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The nurse will be caring for a patient who is severely malnourished. Laboratory test results show that the patient’s albumin level is critically low. What assessment finding will the nurse expect to note when meeting with the patient?

a.	The patient has generalized 3+ pitting edema.
b.	The patient is confused and disoriented.
c.	The patient’s urine is dark and very concentrated.
d.	The patient lung sounds are very diminished.

 

 

ANS:  A

The patient’s low albumin level will lead to generalized pitting edema because there isn’t enough protein in the blood to keep water within the bloodstream. Lack of oncotic pressure from low serum albumin leads to edema.

 

DIF:    Understanding                                 REF:   p. 996 | p. 1007

TOP:   Assessment

MSC:  NCLEX Client Needs Category: Reduction of Risk Potential: Laboratory Values

NOT:  Concepts: Fluid and Electrolyte Balance

 

2. The nurse is reviewing the patient’s laboratory results. Which result must be communicated to the physician immediately?

a.	Serum chloride level 85 mEq/L
b.	Serum sodium level 134 mEq/L
c.	Serum potassium level 6.8 mEq/L
d.	Serum magnesium level 2.3 mEq/L

 

 

ANS:  C

Normal serum potassium level is 3.5 to 5.0 mEq/L. A serum potassium level of 6.8 mEq/L is very high and puts the patient at risk for cardiac arrhythmias. The potassium level should be reported to the physician immediately.

 

DIF:    Understanding                                 REF:   p. 1001           TOP:   Implementation

MSC:  NCLEX Client Needs Category: Reduction of Risk Potential: Laboratory Values

NOT:  Concepts: Fluid and Electrolyte Balance

 

3. The nurse is caring for a patient who is at risk for fluid overload as a result of a history of congestive heart failure. Which intervention will the nurse teach the patient to perform at home to monitor fluid balance?

a.	“Check to make sure that your urine is a bright yellow color.”
b.	“Weigh yourself every morning before breakfast.”
c.	“Count your heart rate every evening before you go to bed.”
d.	“Drink plain water rather than soda, coffee, or fruit juice.”

 

 

ANS:  B

Checking the weight every morning before breakfast is a sensitive indicator of the patient’s fluid volume status. Weight gain of 2 to 3 lb over 1 to 2 days generally indicates fluid retention and should be reported to the physician.

 

DIF:    Understanding                                 REF:   p. 997             TOP:   Teaching/Learning

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance: Self-Care

NOT:  Concepts: Patient Education

 

4. The nurse is caring for a patient who is admitted to the hospital with diabetic ketoacidosis. Which assessment finding indicates an attempt made by the patient’s body to correct the pH?

a.	The patient’s respirations are very deep and rapid.
b.	The patient’s urine is dark and concentrated.
c.	The patient’s skin is pale, cool, and diaphoretic.
d.	The patient is sleepy and difficult to arouse.

 

 

ANS:  A

The patient with diabetic ketoacidosis is in a state of metabolic acidosis. The body will attempt to compensate for the acidosis by blowing off extra amounts of carbon dioxide through deep, rapid respirations. Since carbon dioxide is converted to carbonic acid, removal of carbon dioxide will help shift the body’s pH to a less acidotic state.

 

DIF:    Applying        REF:   p. 1004          TOP:   Assessment

MSC:  NCLEX Client Needs Category: Physiological Adaptation: Alterations in Body Systems

NOT:  Concepts: Acid-Base Balance