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Chapter 8 Fluid and Electrolyte Management

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Chapter 8 Fluid and Electrolyte Management

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  • November 5, 2024
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  • 2024/2025
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Chapter 8: Fluid and Electrolyte Management

Multiple Choice
Identify the choice that best completes the statement or answers the question.

____ 1. A patient presents in the emergency department (ED) with fever, nausea, and vomiting over the
past 2 days. The nurse monitors for which laboratory result in this patient?
1. Urine specific gravity of 1.040
2. Serum potassium of 4.8 mEq/L
3. Serum sodium of 135 mEq/L
4. Urine positive for glucose and ketones
____ 2. Which assessment data collected by the nurse indicate that an older adult patient is at risk for
dehydration?
1. Poor skin turgor
2. Body mass index of 20.5
3. Blood pressure of 140/98 mm Hg
4. Oral intake of 48 ounces per day
____ 3. The nurse plans care for a hospitalized patient. Which data necessitate the inclusion of
interventions to address a fluid volume deficit?
1. Urine output of 30 mL/hour
2. Heart rate of 110 bpm
3. Weight gain of 10 pounds in 3 days
4. Plus-3 edema in bilateral lower extremities
____ 4. In reviewing laboratory results for a female patient suspected of having a fluid imbalance, the
nurse correlates which laboratory value with a diagnosis of dehydration?
1. Hemoglobin of 10.5 g/dL
2. Hematocrit 49%
3. Serum potassium 3.8 mEq/L
4. Serum osmolality 230 mOsm/kg
____ 5. The nurse is analyzing the intake and output record for a patient being treated for dehydration. The
patient weighs 176 lbs and had a 24-hour intake of 2,000 mL and urine output of 1,200 mL. Based
on this data, which conclusion by the nurse is the most appropriate?
1. Treatment has not been effective.
2. Treatment needs to include a diuretic.
3. Treatment is effective and should continue.
4. Treatment has been effective and should end.
____ 6. The nurse provides care to a patient who is prescribed 0.45% normal saline (NS) by intravenous
(IV) infusion. Which data cause the nurse to question the healthcare provider regarding this IV
fluid order?
1. Urine output 40 mL/hour
2. Blood pressure 100/60 mm Hg
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3. Respiratory rate 12 breaths/min
4. Serum sodium level of 145 mEq/L
____ 7. The nurse is caring for a patient who is receiving intravenous fluids postoperatively after cardiac
surgery. The nurse correlates the patient’s risk for fluid volume excess to which cause?
1. Decreased mobility as a result of surgery and pain
2. Administration of intravenous fluids
3. Decreased levels of aldosterone
4. Increased levels of antidiuretic hormone
____ 8. The nurse is planning care for the patient with acute renal failure and incorporates the nursing
diagnosis of Excess Fluid Volume. Which assessment data support this nursing diagnosis?
1. Wheezing in the lungs
2. Generalized weakness
3. Urine output of 20 mL/hour
4. Pitting edema in the lower extremities
____ 9. The nurse is providing care to an older adult patient who is receiving intravenous (IV) fluids at 150
mL/hour. It is important that the nurse assess for which clinical manifestations that could indicate
fluid volume excess in this patient?
1. Flattened neck veins
2. Elevated blood pressure
3. Bradycardia
4. Skin tenting
____ 10. The nurse provides care to a patient whose serum potassium level is 3.2 mEq/L. Which healthcare
provider order does the nurse question based on this data?
1. Serum chemistries (basic metabolic panel) every morning
2. Continuous cardiac monitoring
3. 10 mEq KCl (potassium chloride) in 100 mL normal saline slow IVP (intravenous
pyelogram)
4. 25 mg spironolactone (Aldactone) by mouth daily
____ 11. In reviewing laboratory results for a patient presenting to the Emergency Department with changes
in level of consciousness, the nurse correlates which value as placing the patient at greatest risk for
seizures?
1. Serum calcium of 12 mg/dL
2. Serum potassium of 3.0 mEq/L
3. Serum sodium of 135 mEq/L
4. Serum magnesium of 2.6 mEq/L
____ 12. The nurse is providing care to a patient who seeks emergency treatment for headache and nausea.
The patient works in a mill without air conditioning. The patient states, “I drink water several
times each day, but I seem to sweat more than I am able to replace.” Which suggestions does the
nurse provide to this patient?
1. Drink juices and carbonated sodas.
2. Eat something salty when drinking water.
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3. Eat something sweet when drinking water.
4. Double the amount of water being ingested.
____ 13. A nurse is reviewing the serum chemistry results on a patient who has a nasogastric tube to low
intermittent suction secondary to a gunshot to the abdomen 2 days ago. Which electrolyte value
does the nurse correlate to the NG suctioning?
1. Serum chloride of 90 mEq/L
2. Serum sodium of 148 mEq/L
3. Serum potassium of 5.2 mEq/L
4. Serum calcium of 11.3 mg/dL
____ 14. The nurse is caring for a patient with congestive heart failure who is admitted to the medical-
surgical unit with acute hypokalemia. Which prescribed medication may have contributed to the
patient’s current hypokalemic state?
1. Cortisol
2. Oxycodone
3. Flexeril
4. Nonsteroidal anti-inflammatory drugs (NSAIDs)
____ 15. A patient is prescribed 20 mEq of potassium chloride because of excessive vomiting. The nurse
includes which information in explaining the rationale for this medication?
1. It controls and regulates water balance in the body.
2. It is used in the body to synthesize ingested protein.
3. It is vital in regulating muscle contraction and relaxation.
4. It is needed to maintain skeletal, cardiac, and neuromuscular activity.
____ 16. The nurse is caring for a patient with congestive heart failure who is admitted to the medical-
surgical unit with acute hypokalemia. Which prescribed medication may have contributed to the
patient’s current hypokalemic state?
1. Cortisol
2. Oxycodone
3. Flexeril
4. Nonsteroidal anti-inflammatory drugs (NSAIDs)
____ 17. In reviewing a patient’s laboratory results before administering digoxin, which laboratory result
places the patient at greatest risk for digoxin toxicity?
1. Serum sodium 156 mEq/L
2. Serum potassium 3.0 mEq/L
3. Serum phosphorus of 1.5 mg/dL
4. Serum creatinine of 1.6 mg/dL
____ 18. The nurse is providing care to a patient who is prescribed furosemide for treatment of congestive
heart failure (CHF). The patient’s serum potassium level is 3.4 mEq/L. Which food should the
nurse encourage the patient to eat based on this data?
1. Peas
2. Iced tea
3. Bananas
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