Chapter 41: Fluid, Electrolyte, and Acid-Base BalanceTest Bank MULTIPLE CHOICE 1.Approximately two thirds of the body’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—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 in regulating extracellular 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:Physiological Adaptation | Fluid and Electrolyte Imbalances2. 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-ticle concentration is known as osmosis. Hydrolysis is not a term related to fluid and electrolyte balance. Filtration is mediated by fluid pressure from an area of higher pressure to an area of lower pressure. Active transport requires metabolic activity and is not passive. D I F : R e m e m b e r R E F : 8 8 4 OBJ:Describe the processes involved in regulating extracellular 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:Physiological Adaptation | Fluid and Electrolyte Imbalances3. 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 pressurecauses edema by causing increased movement of fluid into the interstitial area. Osmotic 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. You're reading a free preview. Pages 2 to 17 are not shown in this preview. Read the full version D I F : R e m e m b e r R E F : 8 8 4 - 8 8 6 OBJ:Describe common fluid, electrolyte, and acid-base imbalances.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. 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 in regulating extracellular 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:Physiological Adaptation | Fluid and Electrolyte Imbalances5. 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 respiration. 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 OBJ:Describe common fluid, electrolyte, and acid-base imbalances.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. 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 in regulating plasma concentrations of potassium, calcium, You're Reading a Free 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 patient’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 10.5 mg/dL; 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:Interpret basic fluid, electrolyte, and acid-base laboratory values.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. The nurse would expect a patient with increased levels of serum calcium to also have _____ levels. 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 in regulating plasma concentrations of 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:Describe the processes involved in regulating acid-base balance.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 You're Reading a Free Preview Page 3 is not shown in this preview. Download a. Carbon dioxide. b. Bicarbonate. c. Oxygen. d. Phosphate. A N S : A Respiratory acidosis occurs when the lungs are not able to excrete enough carbon dioxide. Carbon dioxide and water create carbonic acid. A buildup of carbonic acid causes the ECF to be-come more acidic, decreasing the pH. Bicarbonate is normal with uncompensated respiratoryacidosis or elevated with compensated respiratory acidosis. Excessive oxygen and phosphate arenot characteristic of respiratory acidosis. D I F : R e m e m b e r R E F : 8 9 1 - 8 9 5 OBJ:Describe common fluid, electrolyte, and acid-base imbalances.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. 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 OBJ:Identify risk factors for fluid, electrolyte, and acid-base imbalances.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 patient’s respiratory rate has decreased to 12 breaths per minute. The nurse would expect the patient to have which of the following arterial 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 You're Reading a Free Preview Page 4 is not shown in this preview. Download You're Reading a Free Preview Page 5 is not shown in this preview. Download