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Chapter 41: Fluid, Electrolyte, and Acid-Base BalanceTest Bank MULTIPLE CHOICE 1. Approximately two thirds of the bo the body dy’’s total water volume exists in the _____ fluid. a. Intracellular b. Interstitial c. Intravascular d. Transcellular A N S : A Intracellular fluid accounts for approximately two thirds of the fluids in the body — body — about about 42%of total body weight. Interstitial fluid, intravascular fluid, and transcellular fluid constitute extracellular fluid, which is the fluid outside a cell. D I F : R e m e m b e r R E F : 8 8 3 OBJ:Describe the processes involved involved in regulating extracellular extracellular fluid fluid volume, body fluid osmolality,a n d f l u i d d i s t r i b u t i o n . T O P : A s s e s s m e n t MSC: MSC:Phy Physio siolog logica icall Adapta Adaptati tion on | Fluid Fluid and and Elect Electrol rolyt ytee Imbala Imbalance nces2. s2. The process of passively moving water from an area of lower particle concentration to an areaof higher particle concentration is known as a. Hydrolysis. b. Osmosis. c. Filtration. d. Active transport. A N S : B The process of moving water from an area of low particle concentration to an area of higher par par-ticl icle conce ncentra tration is known own as osmos smosiis. Hydro drolys lysis is not a term erm related ted to fluid and electrolyte balance. Filtration is mediated by fluid pressure from an area of higher pressure to an area area of lo lower pressure. ure. Active transpor port requi quires meta etabolic act activity ity and is not pas passive. ve. D I F : R e m e m b e r R E F : 8 8 4 OBJ:Describe the processes involved involved in regulating extracellular extracellular fluid fluid volume, body fluid
osmolality,a n d f l u i d d i s t r i b u t i o n . T O P : A s s e s s m e n t MSC: MSC:Phy Physio siolog logica icall Adapta Adaptati tion on | Fluid Fluid and and Elect Electrol rolyt ytee Imbala Imbalance nces3. s3. The nurse knows that edema in a patient who has venous congestion from right heart failure isfacilitated by an imbalance with regard to _____ pressure. a. Hydrostatic b. Osmotic c. Oncotic d. Concentration A N S : A Venous congestion increases capillary hydrostatic pressure. Increased hydrostatic pre pressu ssurecau causes edem dema by cau causing increa reased sed movemen ementt of fluid into the inter tersti stitial ial area area.. Osmoti otic and on-cotic pressures involve the concentrations of solutes and can contribute to edema in other situa-tions. Concentration pressure is not a nursing term.
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D I F : R e m e m b e r R E F : 8 8 4 - 8 8 6 OBJ:Describ e common fluid, electrolyte, and acid-base i mb a l a n c e s . T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 4. 4. The nurse understands that administering a hypertonic solution to a patient will shift water fromthe _____ to the _____ space. a. Intracellular; extracellular b. Extracellular; intracellular c. Intravascular; intracellular d.
Intravascular; interstitial A N S : A A hypertonic solution has a concentration greater than normal body fluids, so water will shiftout of cells because of the osmotic pull of the extra particles. Movement of water into cells oc-curs when hypotonic fluids are administered. Distribution of fluid between intravascular and interstitial spaces occurs by filtration, the net sum of hydrostatic and osmotic pressures. D I F : U n d e r s t a n d R E F : 8 8 4 OBJ:Describe the processes involved involved in regulating extracellular extracellular fluid fluid volume, body fluid osmolality,a n d f l u i d d i s t r i b u t i o n . T O P : A s s e s s m e n t MSC: MSC:Phy Physio siolog logica icall Adapta Adaptati tion on | Fluid Fluid and and Elect Electrol rolyt ytee Imbala Imbalance nces5. s5. Which patient is most at risk for sensible water loss? a. A 7-year-old child with asthma b. A 24-year-old adult with constipation c. A 56-year-old patient with gastroenteritis d. An 80-year-old patient with pneumonia A N S : D Sensible water loss consists of fluids lost from the skin through visible perspiration, such aswith a resolving fever related to pneumonia. Asthma would be insensible water loss through res piration. Gastroenteritis causes diarrhea with its large volume loss. Constipation does not affectfluid loss. D I F : A p p l y R E F : 8 9 6 8 9 7 O B J : D e s c r i b e co co m m o n f l u i d , e l e c t r o l y t e , a n d a c i d - b a s e i mb a l a n c e s . T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 6. 6. The nurse knows that the most abundant cation in the blood is a. Sodium. b. Potassium. c. Chloride. d. Magnesium. A N S : A
Sodium is the most abundant cation in the blood. Potassium is the predominant intracellular cation. Chloride is an anion (negatively charged) rather then a cation (positively charged). Mag-nesium is found predominantly inside cells and in bone. D I F : R e m e m b e r R E F : 8 8 3 OBJ:Describe the processes involved involved in regulating plasma plasma concentrations concentrations of potassium, potassium, calcium, calcium,
You're Reading a Free Preview Preview Page 2 is not shown in this preview. Download m a g n e s i u m , a n d p h o s p h a t e i o n s . T O P : A s s e s s m e n t MSC:Physiological Adaptation | Fluid and Electrolyte Imbalances7. The nurse receives the the p pat atiient’ nt’s most recent blood work results. Which laboratory value is of greatest concern? a. Sodium of 145 mEq/L b. Calcium of 17.5 mg/dL c. Potassium of 3.5 mEq/L d. Chloride of 100 mEq/L A N S : B Normal calcium range is 8.5 mg/dL to to 10.5 mg/dL; therefore, therefore, a value of 17.5 mg/dL is abnor-mally high and of concern. The rest of the laboratory values are within their normal ranges:sodium 135 to 145 mEq/L; potassium 3.5 to 5.0 mEq/L; chloride 98 to 106 mEq/L. D I F : R e m e m b e r R E F : 8 8 3 OBJ: Interp re t bas b as ic fl ui d, e le ct roly ro lyte te , an d ac i d- b as e l ab o ra to ry v alu es.T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 8. 8. The nurse would expect a patient with increased levels of serum calcium to also have __ _____ level vels. a. Increased potassium b. Decreased phosphate c.
Decreased sodium d. Increased magnesium A N S : B Serum calcium and phosphate have an inverse relationship. When one is elevated, the other decreases, except in some patients with end-stage renal disease. Increased serum calcium wouldnot necessarily cause changes in levels of potassium, sodium, or magnesium. D I F : R e m e m b e r R E F : 8 8 9 OBJ:Describe the processes involved involved in regulating plasma plasma concentrations concentrations of potassium, potassium, calcium,m a g n e s i u m , a n d p h o s p h a t e i o n s . T O P : A s s e s s m e n t MSC:Physiological Adaptation | Fluid and Electrolyte Imbalances9. The nurse knows that an imbalance of which ion causes acid-base impairment? a. Hydrogen b. Calcium c. Magnesium d. Sodium A N S : A The concentration of hydrogen ions determines pH. Low pH designates an acidic environment.High pH designates an alkaline environment. Calcium, magnesium, and sodium are ions, buttheir imbalances are not direct acid-base impairments. D I F : R e m e m b e r R E F : 8 9 1 - 8 9 3 OBJ:Describ e the processes involved in regulating acid-base bal b al an ce . T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 10. The nurse would expect a patient with respiratory acidosis to have an excessive amount of
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c. Oxygen. d. Phosphate. A N S : A Respiratory acidosis occurs when the lungs are not able to excrete enough carbon dioxide. Car bon dioxide and water create carbonic acid. A buildup of carbonic acid causes the ECF EC F to be-come be -come more acidic, d decreas ecreasing ing the pH. Bicarbon Bicarbonate ate is normal normal with uncompensated uncompensated respiratoryacidosis or elevated with compensated respiratory acidosis. Excessive oxygen and ph phosphate aren areno ot char haract acteri eristi stic of respira iratory aci acidosis. is. D I F : R e m e m b e r R E F : 8 9 1 - 8 9 5 OBJ:Describ e common fluid, electrolyte, and acid-base i mb a l a n c e s . T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 11. A 2-year-old child was brought into the emergency department after ingesting several morphinetablets from a bottle in his mother’s purse. mother’s purse. The nurse knows that the child is at greatest risk for which acid-base imbalance? a. Respiratory acidosis b. Respiratory alkalosis c. Metabolic acidosis d. Metabolic alkalosis A N S : A Morphine overdose can cause respiratory depression and hypoventilation. Hypoventilation results in retention of CO 2 and respiratory acidosis. Respiratory alkalosis would result from hyper-ventilation, causing a decrease in CO 2 levels. Metabolic acid-base imbalance would be a resultof kidney dysfunction, vomiting, diarrhea, or other conditions that affect metabolic acids. D I F : A p p l y R E F : 8 9 1 8 9 5 O B J : I d e n t i fy fy r i s k fa fa c t or or s f o r f l u id id , e l ec ec t r o l y t e, e, an an d a ci ci d -b -b a s e i mb a l a n c e s . T O P : A s s e s s m e n t M S C : P h y s i o l o g i c a l A d a p t a t i o n | F l u i d a n d E l e c t r o l y t e I m b a l a n c e s 12. A patient was admitted for a bowel obstruction and has had a nasogastric tube set to low intermittent suction for the past 3 days. The p The paatien ient’s t’s respiratory rate has decreased to 12 breaths
per per minu inute. The nurse would expect the pat patient to hav have which ich of the following arteri erial blood gasvalues? a. pH 7.78, PaCO 2 40 mm Hg, HCO 3 – 30 mEq/L b. pH 7.52, PaCO 2 48 mm Hg, HCO 3 – 28 mEq/L c. pH 7.35, PaCO 2 35 mm Hg, HCO 3 – 26 mEq/L d. pH 7.25, PaCO 2 47 mm Hg, HCO 3 – 29 mEq/L A N S : B
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