Chapter 41- Fluid, Electrolyte, and AcidBase Balance (practice questions)
Correct Review 2023 A+
1. Approximately two thirds of the bodys total water
... [Show More] volume exists in the _____ fluid.
a.
Intracellular
b.
Interstitial
c.
Intravascular
d.
Transcellular - a.
Intracellular
ANS: A
Intracellular fluid accounts for approximately two thirds of the fluids in the bodyabout
42% of total body weight. Interstitial fluid, intravascular fluid, and transcellular fluid
constitute extracellular fluid, which is the fluid outside a cell.
2. The process of passively moving water from an area of lower particle concentration to
an area of higher particle concentration is known as
a.
Hydrolysis.
b.
Osmosis.
c.
Filtration.
d.
Active transport. - b.
Osmosis
ANS: B
The process of moving water from an area of low particle concentration to an area of
higher particle concentration is known as osmosis. Hydrolysis is not a term related to
fluid and electrolyte balance. Filtration is mediated by fluid pressure from an area of
higher pressure to an area of lower pressure. Active transport requires metabolic activity
and is not passive.
3. The nurse knows that edema in a patient who has venous congestion from right heart
failure is facilitated by an imbalance with regard to _____ pressure.
a.
Hydrostatic
b.
Osmotic
c.
Oncotic
d.
Concentration - a.
Hydrostatic
ANS: A
Venous congestion increases capillary hydrostatic pressure. Increased hydrostatic
pressure causes edema by causing increased movement of fluid into the interstitial
area. Osmotic and oncotic pressures involve the concentrations of solutes and can
contribute to edema in other situations. Concentration pressure is not a nursing term.
4. The nurse understands that administering a hypertonic solution to a patient will shift
water from the _____ to the _____ space.
a.
Intracellular; extracellular
b.
Extracellular; intracellular
c.
Intravascular; intracellular
d.
Intravascular; interstitial - a.
Intracellular; extracellular
ANS: A
A hypertonic solution has a concentration greater than normal body fluids, so water will
shift out of cells because of the osmotic pull of the extra particles. Movement of water
into cells occurs when hypotonic fluids are administered. Distribution of fluid between
intravascular and interstitial spaces occurs by filtration, the net sum of hydrostatic and
osmotic pressures.
5. Which patient is most at risk for sensible water loss?
a.
A 7-year-old child with asthma
b.
A 24-year-old adult with constipation
c.
A 56-year-old patient with gastroenteritis
d.
An 80-year-old patient with pneumonia - d.
An 80-year-old patient with pneumonia
ANS: D
Sensible water loss consists of fluids lost from the skin through visible perspiration, such
as with a resolving fever related to pneumonia. Asthma would be insensible water loss
through respiration. Gastroenteritis causes diarrhea with its large volume loss.
Constipation does not affect fluid loss.
6. The nurse knows that the most abundant cation in the blood is
a.
Sodium.
b.
Potassium.
c.
Chloride.
d.
Magnesium. - a.
Sodium
ANS: A
Sodium is the most abundant cation in the blood. Potassium is the predominant
intracellular cation. Chloride is an anion (negatively charged) rather then a cation
(positively charged). Magnesium is found predominantly inside cells and in bone.
7. The nurse receives the patients most recent blood work results. Which laboratory
value is of greatest concern?
a.
Sodium of 145 mEq/L
b.
Calcium of 17.5 mg/dL
c.
Potassium of 3.5 mEq/L
d.
Chloride of 100 mEq/L - b.
Calcium of 17.5 mg/dL
ANS: B
Normal calcium range is 8.5 mg/dL to 10.5 mg/dL; therefore, a value of 17.5 mg/dL is
abnormally high and of concern. The rest of the laboratory values are within their normal
ranges: sodium 135 to 145 mEq/L; potassium 3.5 to 5.0 mEq/L; chloride 98 to 106
mEq/L.
8. The nurse would expect a patient with increased levels of serum calcium to also have
_____ levels.
a.
Increased potassium
b.
Decreased phosphate
c.
Decreased sodium
d.
Increased magnesium - b.
Decreased phosphate
ANS: B
Serum calcium and phosphate have an inverse relationship. When one is elevated, the
other decreases, except in some patients with end-stage renal disease. Increased
serum calcium would not necessarily cause changes in levels of potassium, sodium, or
magnesium.
9. The nurse knows that an imbalance of which ion causes acid-base impairment?
a.
Hydrogen
b.
Calcium
c.
Magnesium
d.
Sodium - a.
Hydrogen
ANS: A
The concentration of hydrogen ions determines pH. Low pH designates an acidic
environment. High pH designates an alkaline environment. Calcium, magnesium, and
sodium are ions, but their imbalances are not direct acid-base impairments.
10. The nurse would expect a patient with respiratory acidosis to have an excessive
amount of
a.
Carbon dioxide.
b.
Bicarbonate.
c.
Oxygen.
d.
Phosphate. - a.
Carbon dioxide.
ANS: A
Respiratory acidosis occurs when the lungs are not able to excrete enough carbon
dioxide. Carbon dioxide and water create carbonic acid. A buildup of carbonic acid
causes the ECF to become more acidic, decreasing the pH. Bicarbonate is normal with
uncompensated respiratory acidosis or elevated with compensated respiratory acidosis.
Excessive oxygen and phosphate are not characteristic of respiratory acidosis.
11. A 2-year-old child was brought into the emergency department after ingesting
several morphine tablets from a bottle in his mothers purse. The nurse knows that the
child is at greatest risk for which acid-base imbalance?
a.
Respiratory acidosis
b.
Respiratory alkalosis
c.
Metabolic acidosis
d.
Metabolic alkalosis - a.
Respiratory acidosis
ANS: A
Morphine overdose can cause respiratory depression and hypoventilation.
Hypoventilation results in retention of CO2 and respiratory acidosis. Respiratory
alkalosis would result from hyperventilation, causing a decrease in CO2 levels.
Metabolic acid-base imbalance would be a result of kidney dysfunction, vomiting,
diarrhea, or other conditions that affect metabolic acids.
12. A patient was admitted for a bowel obstruction and has had a nasogastric tube set
to low intermittent suction for the past 3 days. The patients respiratory rate has
decreased to 12 breaths per minute. The nurse would expect the patient to have which
of the following arterial blood gas values?
a.
pH 7.78, PaCO2 40 mm Hg, HCO3 30 mEq/L
b.
pH 7.52, PaCO2 48 mm Hg, HCO3 28 mEq/L
c.
pH 7.35, PaCO2 35 mm Hg, HCO3 26 mEq/L
d.
pH 7.25, PaCO2 47 mm Hg, HCO3 29 mEq/L - b.
pH 7.52, PaCO2 48 mm Hg, HCO3 28 mEq/L
ANS: B
Compensated metabolic alkalosis should show alkalosis pH and HCO3(metabolic)
values, with a slightly acidic CO2 (compensatory respiratory acidosis). In this case, pH
7.52 is alkaline (normal = 7.35 to 7.45), PaCO2is acidic (normal 35 to 45 mm Hg), and
HCO3 is elevated (normal = 22 to 26 mEq/L). A result of pH 7.78, PaCO2 40 mm Hg,
HCO330 mEq/L is uncompensated metabolic alkalosis. pH 7.35, PaCO235 mm Hg,
HCO3 26 mEq/L is within normal limits. pH 7.25, PaCO2 47 mm Hg, HCO3 29 mEq/L is
compensated respiratory acidosis.
13. The nurse would not expect full compensation to occur for which acid-base
imbalance?
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