Question 1

What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?

Accepted Answer

A)  Too much sodium in the feedings 
B)  Excess of feedings 
C)  Inadequate water intake 
D)  Kidney failure 
A)  Too much sodium in the feedings 
B)  Excess of feedings 
C)  Inadequate water intake 
D)  Kidney failure C

Question 2

Which alterations can lead to edema?

Accepted Answer

A)  Decreased capillary hydrostatic pressure 
B)  Increased capillary colloid osmotic pressure 
C)  Decreased lymphatic flow 
D)  Decreased capillary membrane permeability 
A)  Decreased capillary hydrostatic pressure 
B)  Increased capillary colloid osmotic pressure 
C)  Decreased lymphatic flow 
D)  Decreased capillary membrane permeability C

Question 3

A known cause of hypokalemia is

Accepted Answer

A)  oliguric renal failure. 
B)  pancreatitis. 
C)  insulin overdose. 
D)  hyperparathyroidism. 
A)  oliguric renal failure. 
B)  pancreatitis. 
C)  insulin overdose. 
D)  hyperparathyroidism. C

Question 4

The inward-pulling force of particles in the vascular fluid is called _____ pressure.

Accepted Answer

A)  capillary hydrostatic 
B)  interstitial osmotic 
C)  capillary osmotic 
D)  interstitial hydrostatic 
A)  capillary hydrostatic 
B)  interstitial osmotic 
C)  capillary osmotic 
D)  interstitial hydrostatic

Question 5

The fraction of total body water (TBW)volume contained in the intracellular space in adults is

Accepted Answer

A)  three fourths. 
B)  two thirds. 
C)  one half. 
D)  one third. 
A)  three fourths. 
B)  two thirds. 
C)  one half. 
D)  one third.

Question 6

A patient has a positive Chvostek sign.The nurse interprets this as a sign of

Accepted Answer

A)  hypercalcemia. 
B)  hypermagnesemia. 
C)  decreased neuromuscular excitability. 
D)  increased neuromuscular excitability. 
A)  hypercalcemia. 
B)  hypermagnesemia. 
C)  decreased neuromuscular excitability. 
D)  increased neuromuscular excitability.

Question 7

A patient diagnosed with chronic compensated heart failure reports that,"My feet swell if I eat salt but I don't understand why" The nurse's best response is

Accepted Answer

A)  "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell." 
B)  "Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." 
C)  "Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling." 
D)  "Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling." 
A)  "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell." 
B)  "Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." 
C)  "Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling." 
D)  "Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling."

Question 8

Clinical manifestations of moderate to severe hypokalemia include

Accepted Answer

A)  muscle spasms and rapid respirations. 
B)  muscle weakness and cardiac dysrhythmias. 
C)  confusion and irritability. 
D)  vomiting and diarrhea. 
A)  muscle spasms and rapid respirations. 
B)  muscle weakness and cardiac dysrhythmias. 
C)  confusion and irritability. 
D)  vomiting and diarrhea.

Question 9

The imbalance that occurs with oliguric renal failure is

Accepted Answer

A)  metabolic alkalosis. 
B)  hyperkalemia. 
C)  hypokalemia. 
D)  hypophosphatemia. 
A)  metabolic alkalosis. 
B)  hyperkalemia. 
C)  hypokalemia. 
D)  hypophosphatemia.

Question 10

Decreased neuromuscular excitability is often the result of

Accepted Answer

A)  hypercalcemia and hypermagnesemia. 
B)  hypomagnesemia and hyperkalemia. 
C)  hypocalcemia and hypokalemia. 
D)  hypernatremia and hypomagnesemia. 
A)  hypercalcemia and hypermagnesemia. 
B)  hypomagnesemia and hyperkalemia. 
C)  hypocalcemia and hypokalemia. 
D)  hypernatremia and hypomagnesemia.

Question 11

Manifestations from sodium imbalances occur primarily as a result of

Accepted Answer

A)  cellular fluid shifts. 
B)  vascular collapse. 
C)  hyperosmolarity. 
D)  hypervolemia. 
A)  cellular fluid shifts. 
B)  vascular collapse. 
C)  hyperosmolarity. 
D)  hypervolemia.

Question 12

Clinical manifestations of hyponatremia include

Accepted Answer

A)  weak pulse, low blood pressure, and increased heart rate. 
B)  thirst, dry mucous membranes, and diarrhea. 
C)  confusion, lethargy, coma, and perhaps seizures. 
D)  cardiac dysrhythmias, paresthesias, and muscle weakness. 
A)  weak pulse, low blood pressure, and increased heart rate. 
B)  thirst, dry mucous membranes, and diarrhea. 
C)  confusion, lethargy, coma, and perhaps seizures. 
D)  cardiac dysrhythmias, paresthesias, and muscle weakness.

Question 13

What is likely to lead to hyponatremia?

Accepted Answer

A)  Insufficient ADH secretion 
B)  Excess aldosterone secretion 
C)  Administration of intravenous normal saline 
D)  Frequent nasogastric tube irrigation with water 
A)  Insufficient ADH secretion 
B)  Excess aldosterone secretion 
C)  Administration of intravenous normal saline 
D)  Frequent nasogastric tube irrigation with water

Question 14

Hypernatremia may be caused by

Accepted Answer

A)  decreased aldosterone secretion. 
B)  decreased antidiuretic hormone secretion. 
C)  compulsive water drinking. 
D)  excessive dietary potassium. 
A)  decreased aldosterone secretion. 
B)  decreased antidiuretic hormone secretion. 
C)  compulsive water drinking. 
D)  excessive dietary potassium.

Question 15

Signs and symptoms of extracellular fluid volume excess include

Accepted Answer

A)  tachycardia. 
B)  increased serum sodium concentration. 
C)  bounding pulse. 
D)  increased hematocrit. 
A)  tachycardia. 
B)  increased serum sodium concentration. 
C)  bounding pulse. 
D)  increased hematocrit.

Question 16

Effects of hypernatremia on the central nervous system typically include

Accepted Answer

A)  confusion. 
B)  excitation. 
C)  insomnia. 
D)  hallucinations. 
A)  confusion. 
B)  excitation. 
C)  insomnia. 
D)  hallucinations.

Question 17

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

Accepted Answer

A)  excess proteins. 
B)  renal damage. 
C)  deficiency of ATP. 
D)  hypocalcemia. 
A)  excess proteins. 
B)  renal damage. 
C)  deficiency of ATP. 
D)  hypocalcemia.

Question 18

Total body water in older adults is

Accepted Answer

A)  increased because of decreased adipose tissue and decreased bone mass. 
B)  increased because of decreased renal function and hormonal fluctuations. 
C)  decreased because of increased adipose tissue and decreased muscle mass. 
D)  decreased because of renal changes that cause diuresis with sodium excretion. 
A)  increased because of decreased adipose tissue and decreased bone mass. 
B)  increased because of decreased renal function and hormonal fluctuations. 
C)  decreased because of increased adipose tissue and decreased muscle mass. 
D)  decreased because of renal changes that cause diuresis with sodium excretion.

Question 19

The process responsible for distribution of fluid between the interstitial and intracellular compartments is

Accepted Answer

A)  filtration. 
B)  osmosis. 
C)  active transport. 
D)  diffusion. 
A)  filtration. 
B)  osmosis. 
C)  active transport. 
D)  diffusion.

Question 20

When a parent asks how they will know if their 2-month-old baby,who is throwing up and has frequent diarrhea,is dehydrated,the nurse's best response is

Accepted Answer

A)  "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria." 
B)  "If he doesn't wet his diaper all afternoon and his neck veins look flat when he is lying down, then he is probably dehydrated." 
C)  "If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated." 
D)  "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated." 
A)  "Clinical dehydration is the combination of extracellular fluid volume deficit and hypernatremia, so those are the diagnostic criteria." 
B)  "If he doesn't wet his diaper all afternoon and his neck veins look flat when he is lying down, then he is probably dehydrated." 
C)  "If he sleeps more than usual and acts tired when he is awake, then he is probably dehydrated." 
D)  "If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."

Exam 24: Fluid and Electrolyte Homeostasis and Imbalances

What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?

Which alterations can lead to edema?

A known cause of hypokalemia is

The inward-pulling force of particles in the vascular fluid is called _____ pressure.

The fraction of total body water (TBW)volume contained in the intracellular space in adults is

A patient has a positive Chvostek sign.The nurse interprets this as a sign of

A patient diagnosed with chronic compensated heart failure reports that,"My feet swell if I eat salt but I don't understand why" The nurse's best response is

Clinical manifestations of moderate to severe hypokalemia include

The imbalance that occurs with oliguric renal failure is

Decreased neuromuscular excitability is often the result of

Manifestations from sodium imbalances occur primarily as a result of

Clinical manifestations of hyponatremia include

What is likely to lead to hyponatremia?

Hypernatremia may be caused by

Signs and symptoms of extracellular fluid volume excess include

Effects of hypernatremia on the central nervous system typically include

Clinical manifestations of severe symptomatic hypophosphatemia are caused by

Total body water in older adults is

The process responsible for distribution of fluid between the interstitial and intracellular compartments is

When a parent asks how they will know if their 2-month-old baby,who is throwing up and has frequent diarrhea,is dehydrated,the nurse's best response is

Introduction to Pathophysiology

Homeostasis, Allostasis, and Adaptive Responses to Stressors

Cell Structure and Function

Cell Injury, Aging, and Death

Genome Structure, Regulation, and Tissue Differentiation

Genetic and Developmental Disorders

Neoplasia

Infectious Processes

Inflammation and Immunity

Alterations in Immune Function

Malignant Disorders of White Blood Cells

HIV Disease and Aids

Alterations in Oxygen Transport

Alterations in Homeostasis and Blood Coagulation

Alterations in Blood Flow

Alterations in Blood Pressure

Cardiac Function

Alterations in Cardiac Function

Heart Failure and Dysrhythmias: Common Sequelae of Cardiac Diseases

Shock

Respiratory Function and Alterations in Gas Exchange

Obstructive Pulmonary Disorders

Restrictive Pulmonary Disorders

Acid-Base Homeostasis and Imbalances

Renal Function

Intrarenal Disorders

Acute Kidney Injury and Chronic Kidney Disease

Disorders of the Lower Urinary Tract

Male Genital and Reproductive Function

Alterations in Male Genital and Reproductive Function

Female Genital and Reproductive Function

Alterations in Female Genital and Reproductive Function

Sexually Transmitted Infections

Gastrointestinal Function

Gastrointestinal Disorders

Alterations in Function of the Gallbladder and Exocrine Pancreas

Liver Diseases

Endocrine Physiology and Mechanisms of Hypothalamic-Pituitary Regulation

Disorders of Endocrine Function

Diabetes Mellitus

Alterations in Metabolism and Nutrition

Structure and Function of the Nervous System

Acute Disorders of Brain Function

Chronic Disorders of Neurologic Function

Alterations in Special Sensory Function

Pain

Neurobiology of Psychotic Illnesses

Neurobiology of Nonpsychotic Illnesses

Structure and Function of the Musculoskeletal System

Alterations in Musculoskeletal Function: Trauma, Infection, and Disease

Alterations in Musculoskeletal Function: Rheumatic Disorders

Alterations in the Integumentary System

Burn Injuries

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