Chapter 33 Fluids And Electrolytes

Chapter 33  Fluids And Electrolytes

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse, providing oxygen to a client, realizes that oxygen reaches the blood through the process in which particles move across a permeable membrane and disperse in all directions. This process is considered to be:
1.
diffusion.
3.
active transport.
2.
osmosis.
4.
filtration.

ANS: 1
Diffusion is the process in which particles move across a permeable membrane and disperse in all directions through a solution or a gas. Oxygenation is an example of diffusion. Osmosis is the process where solvent molecules move across a membrane to an area where there is a higher concentration of solute that cannot pass through the membrane. Active transport occurs when a cell membrane moves molecules or ions against an electrochemical gradient from an area of lesser concentration to an area of greater concentration. Filtration is the movement of fluid through a semipermeable membrane from an area with higher hydrostatic pressure to an area with lower hydrostatic pressure.

PTS: 1 DIF: Analysis
REF: Table 33-3 Movement of Body Fluid| Figure 33-3 Process of diffusion

2. The nurse, caring for a client diagnosed with an acid-base imbalance, realizes that the system that regulates acid-base balance in the body most rapidly is the:
1.
respiratory compensatory mechanism.
3.
renal mechanism.
2.
bicarbonate-carbonic acid system.
4.
all act at the same speed.

ANS: 2
The bicarbonate-carbonic acid system is the body’s primary buffer system. This system will correct the body’s pH to normal limits the quickest. The respiratory compensatory mechanism takes several minutes to respond to changes in the carbon dioxide concentration in extracellular fluid. The renal mechanism takes several hours or days to correct an acid-base imbalance. These compensatory mechanisms do not all act at the same speed.

PTS: 1 DIF: Analysis REF: Regulators of Acid-Base Balance

3. A client had minor surgery and is ambulating frequently. The client is perspiring profusely and is now complaining of a headache and muscle weakness, and is apprehensive, lethargic, and confused. These findings are most consistent with which electrolyte disturbance?
1.
Hypokalemia
3.
Hyponatremia
2.
Hyperkalemia
4.
Hypernatremia

ANS: 3
Sweating and exercise can cause the body to lose water and sodium. Manifestations of hyponatremia include headache, muscle weakness, apprehension, lethargy, and confusion. Manifestations of hypernatremia include restlessness, muscle twitching, and agitation. Manifestations of hypokalemia include nausea, vomiting, malaise, and muscle weakness. Manifestations of hyperkalemia include diarrhea, muscle weakness, and electrocardiogram changes.

PTS: 1 DIF: Analysis
REF: Lifestyle| Table 33-4 The Clinical Management of Clients Experiencing Common Electrolyte Disturbances

4. The nurse should assess a client with a serum potassium of 7.8 mEq/L for which of the following?
1.
Polyuria
3.
Bone pain
2.
Hyperreflexia
4.
Cardiac dysrhythmias

ANS: 4
In a client with a serum potassium level of 7.8 mEq/L, the nurse should assess for cardiac changes to include bradycardia, T wave tenting, small P waves, widened QRS complex, and life-threatening dysrhythmias. Polyuria, hyperreflexia, and bone pain are not seen with elevated potassium levels.

PTS: 1 DIF: Application
REF: Table 33-4 The Clinical Manifestations of Clients Experiencing Common Electrolyte Disturbances

5. The client has received several units of citrated blood very quickly. The nurse notes that the client now has hyperreflexia. What electrolyte disturbance is the client most likely to be experiencing?
1.
Hypokalemia
3.
Hypermagnesemia
2.
Hypocalcemia
4.
Hyperphosphatemia

ANS: 2
Hypocalcemia is a decrease in the extracellular level of calcium The rapid administration of citrated blood increases the activity of calcium binders and decreases the amount of free calcium, causing hypocalcemia. Hypokalemia, hypermagnesemia, nor hyperphosphatemia are not associated with disorders after receiving citrated blood.

PTS: 1 DIF: Analysis REF: Hypocalcemia