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PNC 1 Final Practice Questions
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PNC 1 Final Practice QuestionsThe nurse is administering a blood transfusion to a client who is hemorrhaging. In which
fluid compartment should the nurse identify that the client is experiencing a deficit?
A. Transcellular Fluid
B. Intracellular Fluid
C. Interstitial Fluid
D. Intravascular Fluid - answerD. Intravascular fluid
Rationale: Blood loss causes a deficit in the intravascular fluid compartment, which is a
sub compartment of extracellular fluid (ECF). Transcellular and interstitial fluids, along
with lymph, make up the other compartments of ECF. Intracellular fluid is the other
major fluid compartment in the body.
The nurse reviews the care needs for a group of clients. Which condition should the
nurse realize causes a fluid volume deficit?
A. Hypertension
B. Diarrhea
C. Water intoxication
D. Kidney failure - answerB. Diarrhea
Rationale: Fluid volume deficit, or dehydration, can occur when excessive amounts of
fluids are lost through diarrhea or vomiting. Kidney failure causes water retention,
leading to fluid volume excess, not deficit. Water intoxication results from excessive fluid
intake and leads to fluid volume excess. Fluid volume excess, not deficit, can result in
hypertension.
The nurse is reviewing the fluid needs for a group of clients. Which characteristic of the
intracellular fluid compartment of the body should the nurse identify?
A. Includes cerebrospinal and peritoneal fluids
B. Serves as a medium for metabolic processes
C. Makes about one third of total body fluid in adults
D. Divides into intravascular, interstitial, and transcellular fluids - answerB.
Rationale: The intracellular fluid compartment makes up about two thirds of total body
fluid in adults and is found within cells. It is a medium for metabolic processes.
Extracellular fluid makes up the other one third of total body fluid and is divided into
intravascular, interstitial, and transcellular fluids. Cerebrospinal and peritoneal fluids are
examples of transcellular fluids.
The nurse is preparing material on fluid compartments in the body. Which fluids should
the nurse identify as the components of extracellular fluid?
A. Intravascular, interstitial, and intracellular fluids
B. Transcellular, intracellular, and extracellular fluids
C. Intravascular, interstitial, and transcellular fluids
,D. Intracellular, interstitial, and intravascular fluids - answerC.
Rationale: Body fluids found outside of the cell include intravascular, interstitial, and
transcellular fluids. Conversely, intracellular fluids are found inside the cell
The nurse prepares intravenous fluid for a client. Which mechanism should the nurse
recall that represents the movement of fluid across cell membranes from an area of less
concentration to an area of higher concentration?
A. Osmosis
B. Filtration
C. Diffusion
D. Active transport - answerA.
Rationale: Osmosis is the movement of water across cell membranes, from the less-
concentrated solution to the more-concentrated solution. Filtration is the process by
which fluid and solutes move together across a membrane from one compartment to
another. Active transport is a process by which substances move across the cell
membrane and must combine with a carrier for transportation, requiring metabolic
energy. With diffusion, the molecules move from a solution of higher concentration to a
solution of lower concentration.
The nurse is caring for a hospitalized client who is experiencing anxiety-related
hyperventilation. When calculating the client's intake and output, where would the nurse
anticipate the need for an adjustment in fluid loss?
A. Urine
B. Insensible loss
C. Sweat
D. Feces - answerB.
Rationale: With increased respirations, the client will experience a greater-than-normal
insensible loss of fluid through the lungs. Hyperventilation will not affect the amount of
fluid lost through the urine, sweat, or feces.
The nurse is completing a physical assessment with a client. On which part of the body
should the nurse focus when determining fluid and electrolyte status? (Select all that
apply.)
A. Oral Cavity
B. Endocrine system
C. Ears
D. Skin
E. Cardiovascular system - answerA, D, E
Rationale: Physical assessment for fluid and electrolyte status focuses on the skin, oral
cavity and mucous membranes, eyes, cardiovascular and respiratory systems, and
neurologic and muscular status. The ears and endocrine system are not a focus of fluid
and electrolyte status assessment.
The nurse is determining a client's fluid balance. Which method should the nurse use to
identify this client's fluid volume excess or deficit?
A. Blood pressure
,B. Skin turgor
C. Daily weight
D. Intake and output - answerC.
Rationale: Daily weight is the best indicator of fluid volume excess or deficit. Skin turgor,
blood pressure, and intake and output are assessments that would be included in the
care of a client with fluid imbalances, but daily weight is the best indicator of changes in
fluid status.
The nurse is performing an assessment on a client with fluid volume excess. Which
finding should the nurse identify that supports fluid volume excess? (Select all that
apply.)
A. Pitting edema
B. Weight gain
C. Tenting of skin
Thirst
Crackles on auscultation - answerA, B, E
Rationale: Pitting edema, weight gain, and crackles in the lungs upon auscultation are
indicative of fluid volume excess. Tenting of skin and thirst are found in fluid volume
deficit.
The nurse is assessing a client with fluid volume deficit. Which finding should the nurse
identify that supports fluid volume deficit?
A. Wheezes opon auscultation
B. Edema
C. Increased hematocrit
D. Weight gain - answerC.
Rationale: Increased hematocrit is a finding consistent with fluid volume deficit. Edema
and weight gain are consistent with fluid volume overload. Wheezes upon auscultation
of the lungs is not related to fluid imbalances.
The school nurse notes that a school-age child is experiencing mild heat exhaustion
after playing outside during recess. Which recommendation should the nurse make to
help prevent future occurrences of heat-related illness?
A. Teach children to drink water only before recess
B. Engage children to drink water when they feel thirsty
C. Move afternoon recess to cooler morning hour
D. Provide a time for children to rest after recess - answerC.
Rationale: To prevent heat-related illness, it would be best to move recess from the
hottest part of the day to a cooler part of the day. Children should be encouraged to
take frequent water breaks and drink before they begin to feel thirsty, not just when they
feel thirsty or only before recess. Children should also be encouraged to take frequent
rest breaks during recess, not just afterward.
The nurse is teaching a client ways to prevent fluid imbalances. Which fluids should the
nurse encourage the client to avoid?
A. Coffee
, B. Juice
C. Water
D. Pedialyte - answerA.
Rationale: Coffee should be avoided due to its diuretic effects. Water, Pedialyte, and
juice are acceptable drinks to avoid fluid imbalances
A client is prescribed furosemide. Which information should the nurse provide about this
medication?
A. decreased potassium in the diet
B. Check weight daily
C. Take the medication at bedtime
D. Increase sodium intake - answerB.
Rationale: Daily weight is recommended for a client taking furosemide. Increasing
sodium intake and decreasing potassium intake can lead to fluid and electrolyte
imbalances. It would be recommended to take furosemide in the morning due to the
diuresis effect of the medication.
The nurse instructs a client with fluid volume excess about dietary choices. Which meal
choice should indicate to the nurse that teaching was effective?
A. Egg whites, turkey bacon, oatmeal, and wheat toast
B. Eggs, sausage, grits, and white bread
C. Eggs, ham, mixed fruit, and wheat bread
D. Egg whites, ham, grits, and white bread - answerA.
Rationale: A meal of egg whites, turkey bacon, oatmeal, and wheat toast is the best
choice to decrease the amount of sodium, because turkey bacon has the least amount
of sodium. Choices that contain sausage, bacon, or ham are high in sodium and should
be avoided.
The nurse reviews intake and output with a graduate nurse. Which statement by the
graduate nurse should cause the nurse concern?
A. "I would not count ice cream as fluid intake because it is frozen"
B. "I should document the amount of tube irrigation as intake"
C. "I would need to record liquid feces as output"
D. "Any time the client vomits, I need to add that number to the output" - answerA.
Rationale: Accurate measurement and recording of fluid I&O provides important data
about the client's fluid balance. Ice cream would be considered intake because it is a
food that becomes liquid at room temperature. The other answers are appropriate.
Other intake includes all oral fluids, ice chips, IV fluids, IV medications, tube feedings,
and catheter or tube irrigants. Output would include urinary output, vomitus, liquid feces,
tube drainage, and wound drainage.
The nurse is teaching a marathon runner about the importance of maintaining fluid and
electrolyte balance. Which situation puts runners at a higher risk for fluid and electrolyte
imbalances?
A. The use of electrolyte replacement fluids during a race
B. The significant loss of water during a lengthy exercise session
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