Chapter 25 Drugs for Fluid Balance, Electrolyte, and Acid—Base Disorders

1) Which causes should the nurse associate with respiratory alkalosis?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select

all that apply.

1. Hyperventilation

2. Severe diarrhea

3. Severe vomiting

4. High altitude

5. Excess alcohol ingestion

Answer: 1, 4

2) A client receiving sodium bicarbonate intravenously (IV) for correction of metabolic acidosis is experiencing cyanosis, decreased respirations, and an irregular pulse. Which is the nurse's priority action?

1. Increase the rate of the infusion

2. Decrease the rate of the infusion

3. Continue the infusion

4. Stop the infusion and notify the healthcare provider

4. Stop the infusion and notify the healthcare provider

3) The nurse understands which is the primary purpose for intravenous fluid replacement for a client that has a burn injury?

1. Antibiotic administration

2. Maintain blood pressure

3. Electrolyte replacement

4. Administration of pain prescriptions

2. Maintain blood pressure

4) The educator is discussing intravenous solutions with a nurse. Which should the educator include when discussing crystalloid isotonic solutions?

1. Lactated Ringer's

2. 5% albumin

3. Dextran 70 in normal saline

4. Hetastarch 6% in normal saline

1. Lactated Ringer's

5) Which intravenous solution should the nurse anticipate to be prescribed for the client who

is dehydrated with a stable blood pressure?

1. D5 0.45% NS

2. 5% dextrose in NS

3. 0.45% NaCl

4. 0.9% NaCl

3. 0.45% NaCl

6) A client has a serum sodium level of 125 mEq/L. Which prescription should the nurse

anticipate?

1. Encourage the patient to drink fluids.

2. Administer normal saline intravenous (IV).

3. Administer 0.45% NaCl.

4. Provide a diet high in NaCl.

2. Administer normal saline intravenous (IV).

7) A client with a potassium level of 5.9 mEq/L is prescribed glucose and insulin. Which

statement should the nurse include in the client's education?

1. "Insulin will cause extra potassium to go into cells and lower the blood level."

2. "Insulin lowers blood sugar levels and this is how the extra potassium is excreted."

3. "Insulin is safer than giving laxatives such as Kayexalate."

4. "Insulin will help kidneys excrete the extra potassium."

1. "Insulin will cause extra potassium to go into cells and lower the blood level."

8) Which accounts for the percentage of intracellular fluid compartment of body weight?

1. 20%

2. 40%

3. 60%

4. 80%

3. 60%

9) A client receiving dextran 40 (Gentran 40) begins experiencing tachycardia, dyspnea, and a

cough. Which should the nurse understand is the causative factor of the symptoms?

1. Pulmonary edema

2. Renal failure

3. Allergic reaction

4. Fluid overload

4. Fluid overload

10) Which should the nurse understand is a potential client outcome if potassium chloride (KCl) is administered intravenous (IV) push?

1. Cardiac arrest

2. Hypernatremia

3. Respiratory distress

4. Seizures

1. Cardiac arrest

11) A client with an NG tube is prescribed potassium chloride (KCl). Which intervention should

the nurse anticipate to include in the administration of the prescription?

1. Dilute the drug prior to administration through the nasogastric tube.

2. Flush the nasogastric tube with Coca−Cola before and after administration.

3. Flush the nasogastric tube with normal saline before and after administration.

4. Crush the tablet prior to administration through the nasogastric tube.

1. Dilute the drug prior to administration through the nasogastric tube.

12) Which should the nurse understand the reason sodium bicarbonate is prescribed for a client that has overdosed on aspirin?

1. Prevention of ulceration of the gastrointestinal tract

2. Prevention of bleeding

3. Promotes renal excretion

4. Promotes detoxification in the liver

3. Promotes renal excretion

13) Which are the nurse's priority assessments of a client who has received normal serum

albumin?

1. Blood pressure and urinary output

2. Urinary output and pupil response

3. Blood pressure and level of pain

4. Urinary output and nausea or vomiting

1. Blood pressure and urinary output

14) Which adverse effect should the nurse instruct the client receiving dextran 40 (Gentran 40) to report?

1. Ototoxicity

2. Diarrhea

3. Difficulty urinating

4. Unexplained cough

4. Unexplained cough

15) The nurse is providing education for a client about the replacement of sodium after

strenuous exercise. Which information should the nurse include?

1. Increase salt in the meals prior to exercising.

2. Avoid exercising in the outdoor heat.

3. Take one salt tablet prior to strenuous exercise.

4. After exercising drink plenty of water.

4. After exercising drink plenty of water.

16) Which condition should the nurse anticipate the healthcare provider to prescribe

intravenous fluid therapy?

1. Orthostatic hypotension

2. Pulmonary edema

3. Fluid output exceeds intake

4. Fluid intake of 2500 mL/day

3. Fluid output exceeds intake

17) Which information should the nurse provide a client with hyperkalemia experiencing

constipation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Increase fluid intake.

2. Include prune juice in your daily fluids.

3. Add fruits and vegetables to the diet.

4. Increase activity such as walking.

5. Use salt substitutes to reduce the sodium level.

Answer: 1, 4

18) Which action should the nurse take when initiating a prescription of intravenous dextran 40 (Gentran 40)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Start the infusion no faster than 240 mg/min.

2. Monitor the patient's vital signs continuously during administration.

3. Monitor for signs of anaphylaxis.

4. Monitor the client for deep vein thrombosis.

5. Discard any unused portion of the infusion.

Answer: 1, 2, 3, 5

19) Which serum sodium level should the nurse recognize as hyponatremia?

1. 137 mEq/mL

2. 140 mEq/mL

3. 133 mEq/mL

4. 145 mEq/mL

3. 133 mEq/mL

ON QUIZ

20) Which condition is a symptom of hypokalemia?

1. Constipation

2. Hypertension

3. Muscle weakness

4. Weight gain

3. Muscle weakness

21) Which primary buffers help maintain a normal body pH?

1. Sodium and calcium ions

2. Sodium and bicarbonate ions

3. Bicarbonate and phosphate ions

4. Potassium and phosphate ions

3. Bicarbonate and phosphate ions

ON QUIZ

22) Which should the nurse recognize are potential causes for respiratory alkalosis?

1. Hypotension

2. Hypertension

3. Hypoventilation

4. Hyperventilation

4. Hyperventilation

23) Which conditions should the nurse anticipate the need for intravenous fluid therapy to

correct a fluid imbalance?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select

all that apply.

1. Constipation

2. Postoperative nausea and vomiting

3. Severe burn

4. Congestive heart failure

5. Diabetic ketoacidosis

Answer: 2, 3, 5

24) The educator is preparing to review the movement of body fluids with a nurse. Which

statement should the educator use when referring to tonicity?

1. The ability to cause change in water movement across a membrane.

2. The measure of the number of dissolved particles, or solutes in 1 liter of water.

3. Water moves from areas of low concentration to areas of high solute concentration.

4. A solution that contains a greater concentration of solutes than plasma.

1. The ability to cause change in water movement across a membrane.

25) Which fluids should the nurse recognize are appropriate isotonic solutions to be prescribed for the treatment of fluid loss during surgery?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. 5% dextrose in lactated Ringer's

2. 0.9% sodium chloride (NS)

3. 0.45% sodium chloride

4. Lactated Ringer's

5. 5% dextrose in water

Answer: 2, 4, 5

26) The nurse is caring for a client kidney failure experiencing severe electrolyte imbalances. For which conditions is the client most at risk?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select

all that apply.

1. Fluid retention

2. Muscle spasms

3. Fractures

4. High cholesterol

5. Depression

Answer: 1, 2, 3

27) Which prescriptions should the nurse anticipate to be included in the treatment of a client

with a pH of 7.32?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Oral bicarbonate

2. Sodium chloride

3. Sodium citrate

4. Potassium chloride

5. Ammonium chloride

Answer: 1, 3

28) Which nursing interventions should the nurse implement when administering oral

potassium chloride (KCl)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select

all that apply.

1. Instruct the client to sit straight up to swallow the pill.

2. Crush the tablet and put it in a soft food.

3. Instruct the client to chew the tablet.

4. Administer the prescription with an antacid.

5. Instruct the client to take the prescription prior to eating a meal.

Answer: 1, 4, 5

29) The nurse reviewing a client's records notes the client has received polystyrene sulfonate

(Kayexalate). Which condition should the nurse associate with the treatment?

1. Hyperphosphatemia

2. Hyperkalemia

3. Hypernatremia

4. Hypercalcemia

2. Hyperkalemia

30) Which nursing actions are appropriate for a client prescribed oral polystyrene sulfonate

(Kayexalate)?

Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select

all that apply.

1. Monitor for onset of action of this drug in an hour.

2. Administer sorbitol concurrently.

3. Repeat the dose in 4 hours if needed.

4. Mix the dose with a liquid high in glucose.

5. Administer with sodium bicarbonate.

Answer: 1, 2, 3