Test Bank For Medical Surgical Nursing 7th Edition Adrianne Dill Linton

Test Bank for Medical-Surgical Nursing, 7th Edition, Adrianne Dill Linton,
Test Bank for Medical-Surgical Nursing, 7th Edition,

Adrianne Dill Linton,
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adrianne-dill-linton/
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Chapter 06: Fluid, Electrolyte, and Acid–Base Imbalance
Linton: Medical-Surgical Nursing, 7th Edition
MULTIPLE CHOICE
1. A nurse assesses that a patient’s urine has become much more concentrated. What is the
most likely cause for the change?
a. Adrenaline
b. Aldosterone
c. Antidiuretic hormone (ADH)
d. Insulin
ANS: B
Aldosterone acts on the kidney tubules, affecting water retention and its attendant urine
concentration.
DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 6

TOP: Urine Concentration KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
2. When the water absorption in the renal tubules becomes greater than normal, what
assessment finding should a nurse anticipate?
a. More concentrated urine
b. Less concentrated urine
c. More alkaline urine
d. Less alkaline urine
ANS: A
When more water is kept back in the body, the water left to form urine is less; therefore,
the urine is more concentrated.
DIF: Cognitive Level: Analysis REF: p. 85 OBJ: 6

TOP: Water Reabsorption by Kidney KEY: Nursing Process Step: Assessment
3. What process occurs when oxygen is directed out of the arteries and into the capillaries?
a. Active transport
b. Diffusion
c. Filtration
d. Osmosis
ANS: B
Diffusion is the movement from areas of higher concentration to areas of lower
concentration.
DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 2

TOP: Fluid Movements between Portions of the Circulatory System
KEY: Nursing Process Step: Implementation
4. A patient’s intravenous (IV) injection has been infusing at a very high rate. What
assessment indicates fluid volume overload in this patient?
a. Hypotension
b. Tachycardia
c. Pulmonary edema
d. Kidney failure
ANS: C
An IV infusing at a high rate is used to increase intravascular fluid volume, but there is an
equalization level, after which the patient goes into fluid overload; this results in
pulmonary edema.
DIF: Cognitive Level: Application REF: p. 87 OBJ: 4

TOP: Fluid Overload KEY: Nursing Process Step: Assessment
5. A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle
of baby aspirin approximately 8 hours earlier. In addition to providing reassurance to the
patient, which nursing action is the most appropriate?
a. Providing IV treatments as ordered but without sodium bicarbonate
b. Frequently assessing the mental and neurologic status
c. Taking daily weights and vital signs
d. Inducing vomiting
ANS: B
The baby aspirin was ingested too long ago to have vomiting or stomach aspiration be of
any use. The child requires frequent assessment of neurologic function because the child
may need mechanical ventilation.
DIF: Cognitive Level: Application REF: pp. 98-99 OBJ: 8

TOP: Metabolic Acidosis KEY: Nursing Process Step: Implementation
6. What is primarily responsible for carrying fluids with nutrients and wastes on a random
basis throughout the body?
a. Filtrates
b. Extracellular fluid
c. Intracellular fluid
d. Osmolytes
ANS: B
The blood and lymph are the main media for transporting nutrients and wastes in the body.

TOP: Fluid Transportation KEY: Nursing Process Step: Implementation
7. A nurse clarifies that electrolytes, such as sodium and potassium (K+), break down into
smaller particles when dissolved. What are these smaller particles?
a. Cells
b. Elements
c. Ions
d. Molecules
ANS: C
Electrolytes dissolved in water are called ions.

TOP: Ions KEY: Nursing Process Step: Implementation
8. A nurse assists a patient with dyspnea to sit in a high Fowler position. What process
allows gravity to help move oxygen from the pulmonary capillaries into the blood when
the patient is in this position?
a. Active transport
b. Diffusion
c. Filtration
d. Osmosis
ANS: B
The Fowler position increases blood flow through the lungs and therefore facilitates better
oxygen diffusion.

TOP: Movement of Oxygen in the Body KEY: Nursing Process Step: Implementation
9. A nurse evaluates the laboratory reports on electrolyte values carefully to assess the
balance between positive and negative ions. What is responsible for the regulation of this
process?
a. Adaptation
b. Diffusion
c. Homeostasis
d. Osmosis
ANS: B
Diffusion allows the ions to support homeostatic balance.

TOP: Electrolyte Values KEY: Nursing Process Step: Implementation
10. What is being administered when a nurse hangs an IV bag with Na+, K+, and Cl–?
a. Nutrients
b. Electrolytes
c. Enzymes
d. Vitamins
ANS: B
Sodium, K+, and chlorides are electrolytes.

TOP: Electrolyte Administration KEY: Nursing Process Step: Implementation
11. Each compartment of the body has a water-fluid distribution movement of its own. What
is the process allowing these fluids to move and distribute themselves among
compartments?
a. Active transport
b. Diffusion
c. Filtration
d. Osmosis
ANS: D
The intracellular and extracellular compartments contain water and dissolved substances.
The water filters back and forth as needed to maintain homeostasis via osmolarity.

TOP: Water Distribution and Movement KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
12. A licensed practical/vocational nurse (LPN/LVN) is preparing to add a new IV of 5%

dextrose in water (D5W) with potassium (K+) to an existing line. The LPN/LVN notices
that only 25 mL of urine has been collected over the past hour. What is the most
appropriate nursing intervention?
a. Avoid hanging the IV with K+ and inform the registered nurse (RN) of the urine
output.
b. Run the IV rapidly for 30 minutes to stimulate urine production.
c. Call the physician who ordered the K+.
d. Hang the IV as ordered and chart the output.
ANS: A
The low urine output will allow K+ to build up to a hazardous level. K+ administration is
dependent on adequate urine output. LVN/LPNs are required to report problematic
findings to an RN.

TOP: K+ Administration KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological Therapies
13. Both the intracellular and extracellular fluids are made up of many different electrolytes.
What is the most abundant intracellular positively charged electrolyte?
a. Calcium
b. Chloride
c. Potassium
d. Sodium
ANS: C
K+ is the most abundant electrolyte in the cell.

TOP: Electrolytes KEY: Nursing Process Step: N/A MSC: NCLEX: N/A
14. For what compensatory condition should the nurse carefully assess when the patient with
metabolic acidosis is hyperventilating?
a. Metabolic alkalosis
b. Respiratory acidosis
c. Respiratory alkalosis
d. Thyroid imbalances
ANS: C
When in metabolic acidosis, the body attempts to compensate by increasing respirations
and creating respiratory alkalosis.

TOP: Acidosis and Compensatory Alkalosis
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease
15. The K+ laboratory report shows a level of 5.2 mEq/L. What is the most important
assessment for the nurse to make?
a. Excessive thirst
b. Irregular heartbeat
c. Swelling of ankles
d. Frightening hallucinations
ANS: B
Arrhythmias can be triggered by hyperkalemia.

TOP: Hyperkalemia KEY: Nursing Process Step: Assessment
16. A patient has renal damage because of diabetes. What is the highest risk for this patient?
a. Hypercalcemia
b. Hypocalcemia
c. Hyperkalemia
d. Hypokalemia
ANS: C
When the renal system cannot rid the body of enough K+, this electrolyte builds up and a
condition called hyperkalemia develops.

TOP: Kidney Damage Limiting Excretion of Potassium
KEY: Nursing Process Step: Assessment
17. What is usually associated with hyperchloremia?

a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis
ANS: A
Chlorides bind with positively charged ions such as K+ in the patient with metabolic
acidosis.

TOP: Hyperchloremia KEY: Nursing Process Step: Assessment
18. Older adults are at risk for dehydration because of reduced thirst and aging kidneys. What
should the nurse assess as an early indicator of dehydration?
a. Reduced skin turgor
b. Constipation
c. Concentrated urine
d. Disorientation
ANS: B
Because older adults have poor skin turgor and urine concentration is difficult to assess,
constipation is the earliest indicator of a fluid deficit.

TOP: Fluid Loss in Older Adults KEY: Nursing Process Step: Assessment
19. A nurse has two newly admitted patients with dehydration. One patient is dehydrated from
heat exhaustion, and the other is dehydrated from an overdose of Lasix. What finding
should be present in both patients?
a. Increased skin turgor
b. Decreased pulse and respirations
c. Copious saliva and nasal secretions
d. Increased laboratory values of hemoglobin and hematocrit
ANS: D
Water has been lost; therefore, the red blood cells will concentrate and show artificially
high values of hemoglobin and hematocrit.

TOP: Dehydration Assessment KEY: Nursing Process Step: Assessment
20. A nurse understands that fluid balance is mainly monitored in the body by which two
systems?
a. Circulatory and renal
b. Respiratory and circulatory
c. Renal and gastrointestinal
d. Hepatic and lymphatic
ANS: A
The monitoring of basic fluid balance in the body is performed by the renal and circulatory
systems.

TOP: Fluid Balance KEY: Nursing Process Step: Assessment
21. What primarily maintains extracellular fluid osmolarity?

a. Chloride
b. Magnesium
c. Potassium
d. Sodium
ANS: D
Sodium, as the primary extracellular electrolyte, controls the osmolarity (either too much
or too little) of the extracellular fluid.

TOP: Extracellular Fluid Osmolarity KEY: Nursing Process Step: Assessment
22. How does the healthy kidney adjust the volume and composition of filtrate that prevents
excessive fluid loss?
a. Active transport
b. Filtration in the lymphatic system
c. Secretion of adrenalin
d. Tubular reabsorption
ANS: D
The kidney reabsorbs water and other electrolytes in response to chemical receptors.

TOP: Renal Physiology KEY: Nursing Process Step: Implementation
23. What process involves blood being brought by the incoming capillaries into the kidney,
which contains nitrogenous substances to be excreted as waste?
a. Active transport
b. Diffusion
c. Filtration
d. Osmosis
ANS: C
Capillary blood from the renal arteries filters into the kidney for processing as the first
step.

TOP: Kidney Filtration KEY: Nursing Process Step: Implementation
24. What should treatment focus on when a patient is hypovolemic?

a. Extracellular fluid deficit and limiting drinking water
b. Hypertonic intracellular deficit and limiting water intake
c. Extracellular fluid deficit and encouraging fluid intake
d. Circulatory system hormone deficit and limiting water intake
ANS: C
A fluid volume deficit occurs when the fluid volume in the body is inadequate; the nurse
may encourage drinking fluids as a nursing action.

TOP: Fluid Deficit KEY: Nursing Process Step: Implementation
25. A patient is frequently thirsty. To what should the nurse attribute this symptom?
a. Too much sodium and too much water in the body
b. Too little sodium and too much water in the body
c. Too much sodium and too little water in the body
d. Too little sodium and too little water in the body
ANS: C
Normal thirst is the body’s way of calling for an increase in fluid volume, which could
mean that the body is retaining too much sodium and too little water.

TOP: Thirst Assessment KEY: Nursing Process Step: Assessment
MULTIPLE RESPONSE
1. What should a nurse instruct a patient with a K+ level of 6.2 to avoid? (Select all that
apply.)
a. Lima beans
b. Bananas
c. Carrots
d. Tomatoes
e. Celery
ANS: B, C, D, E
Banana, carrots, tomatoes, and celery are all high in K+ and should be avoided. Lima beans
are low in K+.

TOP: Foods High in K+ KEY: Nursing Process Step: Implementation
COMPLETION
1. A nurse assesses that a patient with congestive heart failure who is being treated with a
diuretic has lost 4.4 lb in 1 day. This weight loss is equivalent to the loss of ____ L of
fluid.
ANS:
2
1 L of fluid is equal to 2.2 lb. A weight loss of 4.4 lb is equal to 2 L.
DIF: Cognitive Level: Analysis REF: pp. 87-88 OBJ: 4

TOP: Fluid Loss KEY: Nursing Process Step: Evaluation
2. A nurse assesses deep-rapid respirations in a patient with metabolic acidosis to be an

indicator of the homeostatic system at work to reduce the __________ level. (Do not
abbreviate your answer.)
Test Bank for Medical-Surgical Nursing, 7th Edition, Adrianne Dill Linton,
ANS:
carbon dioxide
The lungs are primarily responsible for the regulation of CO2 by changing the rate and
depth of respirations.

TOP: Metabolic Acidosis KEY: Nursing Process Step: Assessment
3. A nurse should anticipate in a patient with respiratory acidosis that the blood pH reading
would be lower than ______.
ANS:
7.3
The lowest normal value for blood pH is 7.35. Any value lower than 7.3 indicates acidosis.

TOP: Respiratory Acidosis KEY: Nursing Process Step: Assessment
4. A nurse cautions a group of high school athletes about fluid loss in hot, dry weather,
because the normal loss from respiration, which is 300 to _____ mL/day, is doubled.
ANS:
400
The normal fluid loss through evaporation is 300 to 400 mL a day. The fluid loss increases
in hot, dry weather.

TOP: Insensible Fluid Loss KEY: Nursing Process Step: Implementation
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Test Bank for Medical-Surgical Nursing, 7th Edition, Adrianne Dill Linton,

Test Bank for Medical-Surgical Nursing, 7th Edition,

To download the complete and accurate content document, go to:

Visit TestBankBell.com to get complete for all chapters

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 6

DIF: Cognitive Level: Analysis REF: p. 85 OBJ: 6

DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 2

DIF: Cognitive Level: Application REF: p. 87 OBJ: 4

DIF: Cognitive Level: Application REF: pp. 98-99 OBJ: 8

DIF: Cognitive Level: Knowledge REF: p. 82 OBJ: 3

DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 2

DIF: Cognitive Level: Comprehension REF: p. 84 OBJ: 3

DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 3

DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 2

DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 3

12. A licensed practical/vocational nurse (LPN/LVN) is preparing to add a new IV of 5%

DIF: Cognitive Level: Analysis REF: p. 96 OBJ: 8

DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 5

DIF: Cognitive Level: Application REF: p. 96 OBJ: 11

DIF: Cognitive Level: Comprehension REF: p. 96 OBJ: 8

DIF: Cognitive Level: Analysis REF: p. 96 OBJ: 6

17. What is usually associated with hyperchloremia?

DIF: Cognitive Level: Comprehension REF: p. 96 OBJ: 6

DIF: Cognitive Level: Application REF: p. 86 OBJ: 9

DIF: Cognitive Level: Analysis REF: p. 92 OBJ: 4

DIF: Cognitive Level: Knowledge REF: p. 85 OBJ: 3

21. What primarily maintains extracellular fluid osmolarity?

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 5

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 3

DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 3

24. What should treatment focus on when a patient is hypovolemic?

DIF: Cognitive Level: Application REF: p. 91 OBJ: 8

DIF: Cognitive Level: Comprehension REF: p. 85 OBJ: 6

DIF: Cognitive Level: Application REF: p. 95 OBJ: 8

1 L of fluid is equal to 2.2 lb. A weight loss of 4.4 lb is equal to 2 L.

DIF: Cognitive Level: Analysis REF: pp. 87-88 OBJ: 4

2. A nurse assesses deep-rapid respirations in a patient with metabolic acidosis to be an

DIF: Cognitive Level: Comprehension REF: p. 97 OBJ: 10

DIF: Cognitive Level: Application REF: p. 98 OBJ: 10

DIF: Cognitive Level: Application REF: p. 86 OBJ: 3

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