Question 1

A patient who is experiencing severe diarrhea is losing excessive bicarbonate ions. This patient is at risk for developing:

Accepted Answer

A)  respiratory alkalosis. 
B)  respiratory acidosis. 
C)  metabolic alkalosis. 
D)  metabolic acidosis. 
A)  respiratory alkalosis. 
B)  respiratory acidosis. 
C)  metabolic alkalosis. 
D)  metabolic acidosis.

Question 2

The nurse caring for a frail 92-year-old dehydrated patient should add to the plan of care:

Accepted Answer

A)  potential for over-hydration related to excessive thirst. 
B)  potential for diarrhea related to dehydration. 
C)  potential for pulmonary congestion related to excessive fluid intake. 
D)  potential for fall related to confusion. 
A)  potential for over-hydration related to excessive thirst. 
B)  potential for diarrhea related to dehydration. 
C)  potential for pulmonary congestion related to excessive fluid intake. 
D)  potential for fall related to confusion.

Question 3

The nurse assesses that the patient has developed abdominal pain, urinary retention, and confusion. The nurse concludes these signs are the results of an inadequate supply of:

Accepted Answer

A)  calcium (Ca2+). 
B)  sodium (NA+). 
C)  phosphates (PO43). 
D)  potassium (K+). 
A)  calcium (Ca2+). 
B)  sodium (NA+). 
C)  phosphates (PO43). 
D)  potassium (K+).

Question 4

A patient with healthy kidneys experiences metabolic alkalosis resulting from episodes of vomiting. The nurse takes into consideration that the kidneys can clear the alkaline substances and fully stabilize the patient's pH in approximately:

Accepted Answer

A)  3 to 5 minutes. 
B)  12 to 24 hours. 
C)  3 days. 
D)  1 week. 
A)  3 to 5 minutes. 
B)  12 to 24 hours. 
C)  3 days. 
D)  1 week.

Question 5

Based on the information provided, which of these measurements should be recorded on the output sheet? (Select all that apply.)

Accepted Answer

A)  250 mL nasogastric secretions 
B)  200 mL diarrhea stool 
C)  900 mL IV therapy 
D)  650 mL urine from Foley catheter 
E)  50 mL chest tube drainage
F) 240 mL milk 
A)  250 mL nasogastric secretions 
B)  200 mL diarrhea stool 
C)  900 mL IV therapy 
D)  650 mL urine from Foley catheter 
E)  50 mL chest tube drainage
F) 240 mL milk

Question 6

The patient who was admitted after vomiting for 3 days would show an abnormally low blood pressure because of a fluid shift from:

Accepted Answer

A)  intracellular to the extracellular. 
B)  interstitial to intravascular. 
C)  intravascular to the interstitial. 
D)  interstitial to the intracellular. 
A)  intracellular to the extracellular. 
B)  interstitial to intravascular. 
C)  intravascular to the interstitial. 
D)  interstitial to the intracellular.

Question 7

A patient drank a cup of coffee, a half glass of orange juice, and half a carton of milk with breakfast. Using common equivalents of food containers as a guide, the nurse notes on the intake column of the intake and output sheet that the patient consumed:

Accepted Answer

A)  360 mL. 
B)  400 mL. 
C)  420 mL. 
D)  600 mL. 
A)  360 mL. 
B)  400 mL. 
C)  420 mL. 
D)  600 mL.

Question 8

The nurse is aware that a more dynamic process that moves molecules into cells regardless of their electrical charge or concentration in the cell is:

Accepted Answer

A)  filtration. 
B)  osmosis. 
C)  active transport. 
D)  hydrostatic pressures. 
A)  filtration. 
B)  osmosis. 
C)  active transport. 
D)  hydrostatic pressures.

Question 9

For the accurate measurement to detect fluid retention, the nurse instructs the nursing assistants to measure the weight with the same scale:

Accepted Answer

A)  each morning before breakfast after the patient has voided. 
B)  each day at noon before lunch, dressed in light clothing. 
C)  in between meals, dressed in light clothing after voiding. 
D)  just before bedtime, while the patient is in a hospital gown or pajamas. 
A)  each morning before breakfast after the patient has voided. 
B)  each day at noon before lunch, dressed in light clothing. 
C)  in between meals, dressed in light clothing after voiding. 
D)  just before bedtime, while the patient is in a hospital gown or pajamas.

Question 10

The nurse is caring for a patient for whom a dose of IV potassium has been ordered. Prior to hanging the potassium, the nurse should:

Accepted Answer

A)  check urine output to be above 60 mL/hr. 
B)  check the dose with another licensed person. 
C)  confirm the IV fluid running is compatible with potassium. 
D)  start potassium with another venipuncture. 
A)  check urine output to be above 60 mL/hr. 
B)  check the dose with another licensed person. 
C)  confirm the IV fluid running is compatible with potassium. 
D)  start potassium with another venipuncture.

Question 11

The nurse is determining if I&O are within normal limits. Which of the following is an indication of a fluid imbalance?

Accepted Answer

A)  Twenty-four hour I&O totals show 2 L negative output. Compare daily weight to see if there is a weight gain of 2 kg. 
B)  Shift I&O totals show a 2 L positive output. Compare the daily weights to see if there is a weight gain of 2 kg. 
C)  Shift I&O totals show a 4 L negative output. Compare daily weights to see if there is a zero weight loss. 
D)  Twenty-four hour I&O totals are equal. Compare daily weight to see if there is a negative weight loss. 
A)  Twenty-four hour I&O totals show 2 L negative output. Compare daily weight to see if there is a weight gain of 2 kg. 
B)  Shift I&O totals show a 2 L positive output. Compare the daily weights to see if there is a weight gain of 2 kg. 
C)  Shift I&O totals show a 4 L negative output. Compare daily weights to see if there is a zero weight loss. 
D)  Twenty-four hour I&O totals are equal. Compare daily weight to see if there is a negative weight loss.

Question 12

The nurse clarifies that the electrolytes include: (Select all that apply.)

Accepted Answer

A)  sodium. 
B)  fatty acids. 
C)  potassium. 
D)  magnesium. 
E)  amino acids.
F) glucose. 
A)  sodium. 
B)  fatty acids. 
C)  potassium. 
D)  magnesium. 
E)  amino acids.
F) glucose.

Exam 25: Fluid, Electrolyte, and Acid-Base Balance

A patient who is experiencing severe diarrhea is losing excessive bicarbonate ions. This patient is at risk for developing:

The nurse caring for a frail 92-year-old dehydrated patient should add to the plan of care:

The nurse assesses that the patient has developed abdominal pain, urinary retention, and confusion. The nurse concludes these signs are the results of an inadequate supply of:

A patient with healthy kidneys experiences metabolic alkalosis resulting from episodes of vomiting. The nurse takes into consideration that the kidneys can clear the alkaline substances and fully stabilize the patient's pH in approximately:

Based on the information provided, which of these measurements should be recorded on the output sheet? (Select all that apply.)

The patient who was admitted after vomiting for 3 days would show an abnormally low blood pressure because of a fluid shift from:

A patient drank a cup of coffee, a half glass of orange juice, and half a carton of milk with breakfast. Using common equivalents of food containers as a guide, the nurse notes on the intake column of the intake and output sheet that the patient consumed:

The nurse is aware that a more dynamic process that moves molecules into cells regardless of their electrical charge or concentration in the cell is:

For the accurate measurement to detect fluid retention, the nurse instructs the nursing assistants to measure the weight with the same scale:

The nurse is caring for a patient for whom a dose of IV potassium has been ordered. Prior to hanging the potassium, the nurse should:

The nurse is determining if I&O are within normal limits. Which of the following is an indication of a fluid imbalance?

The nurse clarifies that the electrolytes include: (Select all that apply.)

Nursing and the Health Care System

Concepts of Health, Illness, Stress, and Health Promotion

Legal and Ethical Aspects of Nursing

The Nursing Process and Critical Thinking

Assessment, Nursing Diagnosis, and Planning

Implementation and Evaluation

Documentation of Nursing Care

Communication and the Nurse Patient Relationship

Patient Education and Health Promotion

Delegation, Leadership, and Management

Growth and Development: Infancy Through Adolescence

Adulthood and the Family

Promoting Healthy Adaptation to Aging

Cultural and Spiritual Aspects of Patient Care

Loss, Grief, and End-of-Life Care

Infection Prevention and Control: Protective Mechanisms and Asepsis

Infection Prevention and Control in the Hospital and Home

Safe Lifting, Moving, and Positioning of Patients

Assisting with Hygiene Personal Care Skin Care and the Prevention of Pressure Ulcers

Patient Environment and Safety

Measuring Vital Signs

Assessing Health Status

Admitting Transferring and Discharging Patients

Diagnostic Tests and Specimen Collection

Concepts of Basic Nutrition and Cultural Considerations

Nutritional Therapy and Assisted Feeding

Assisting with Respiration and Oxygen Delivery

Promoting Urinary Elimination

Promoting Bowel Elimination

Pain Comfort and Sleep

Complementary and Alternative Therapies

Pharmacology and Preparation for Drug Administration

Administering Oral, Topical, and Inhalant Medications

Administering Intradermal, Subcutaneous, and Intramuscular Injections

Administering Intravenous Solutions and Medications

Care of the Surgical Patient

Providing Wound Care and Treating Pressure Ulcers

Promoting Musculoskeletal Function

Common Physical Care Problems of the Older Adult

Common Psychosocial Care Problems of Older Adults

Filters