Chapter 41: Agents Affecting the Volume and Ion Content of Body

Chapter 41: Agents Affecting the Volume and Ion Content of Body

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1. A 187-pound patient presents to the emergency department after a motor vehicle accident. The patient is confused, has a superficial cut on the head, a bruised abdomen, and a compound fracture of the right femur. The patient’s vital signs are: P–122/minute, R–32/minute, BP–100/51, and T–99.0° F. Based on these findings, the nurse should prepare to administer which of the following intravenous solutions?

ANS:   A

Administration of an isotonic solution would be the correct action because of the expected loss in blood volume after the patient’s accident and subsequent injuries.

D₅W would be indicated for hypoglycemia.

3% NaCl would be indicated for hyponatremia.

D₅NS would also be indicated if the patient had hypernatremia.

DIF:    Cognitive Level: Application             REF:    p. 455

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A dehydrated patient is rapidly and aggressively treated with a 0.9% sodium chloride IV solution. Which assessment finding would prompt the nurse to discontinue the infusion and call the prescriber?

ANS:   A

Aggressive treatment with IV fluids may result in fluid overload, which is manifested by difficulty breathing as a result of fluid in the lungs and heart. The IV infusion should be discontinued, and the prescriber should be notified.

A urinary output of 35 mL/hour is within normal limits.

Diarrhea is not an indication of fluid overload but may occur as a result of changes in osmolality.

A rapid heart rate indicates dehydration, not fluid overload.

DIF:    Cognitive Level: Analysis                  REF:    pp. 455-456

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

3. A nurse is reviewing laboratory results and discovers a magnesium level of 3.5 mg/dL. The patient complains of muscle weakness and paralysis. The patient has been receiving magnesium sulfate intravenously. The nurse should immediately prepare to administer which of the following medications?

ANS:   C

The neuromuscular blocking actions of magnesium sulfate can be counteracted with the administration of calcium gluconate. When parenteral magnesium is being administered, an injectable form of calcium, calcium gluconate, should be immediately available.

Potassium phosphate, magnesium chloride, and bicarbonate would not help counter the effects of magnesium toxicity.

DIF:    Cognitive Level: Analysis                  REF:    p. 459

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Reduction of Risk Potential

4. A nurse is stuck in the elevator with an anxious patient who fears that no one will know they are stuck, even though the nurse has pushed the emergency button. The patient becomes hysterical, with respirations of 48/minute. The nurse attempts to reassure the patient, but the patient is inconsolable. The nurse should anticipate the patient will manifest symptoms of which of the following acid-base alterations?

ANS:   B

A patient having a panic attack will hyperventilate, blowing off carbon dioxide, and develop respiratory alkalosis.

Respiratory acidosis most often results from hypoventilation.

Metabolic acidosis often results from diarrhea.

Metabolic alkalosis most often results from vomiting.

NOTE: Respiratory alkalosis can be compensated for by metabolic acidosis; respiratory acidosis by metabolic alkalosis; metabolic acidosis by respiratory alkalosis; and metabolic alkalosis by respiratory acidosis.

DIF:    Cognitive Level: Application             REF:    p. 456

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies