NCLEX Practice Questions: Fluid & Electrolytes (Latest 2023), Exams of Nursing

Download NCLEX Practice Questions: Fluid & Electrolytes (Latest 2023) and more Exams Nursing in PDF only on Docsity! 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 What is the nurse's primary concern regarding fluid & electrolytes when caring for an elderly pt who is intermittently confused? 1. risk of dehydration 2. risk of kidney damage 3. risk of stroke 4. risk of bleeding - correct answer ✅Answer: 1 Rationale 1: As an adult ages, the thirst mechanism declines. Adding this in a pt with an altered level of consciousness, there is an increased risk of dehydration & high serum osmolality. Rationale 2: The risks for kidney damage are not specifically related to aging or fluid & electrolyte issues. Rationale 3: The risk of stroke is not specifically related to aging or fluid & electrolyte issues. Rationale 4: The risk of bleeding is not specifically related to aging or fluid & electrolyte issues. The nurse is planning care for a pt with severe burns. Which of the following is this pt at risk for developing? 1. intracellular fluid deficit 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 4. Ineffective Tissue Perfusion - correct answer ✅Answer: 1 Rationale 1: The pt with excessive thirst, increased urination & a medical diagnosis of diabetes insipidus is at risk for Imbalanced Fluid Volume due to the pt &'s excess volume loss that can increase the serum levels of sodium. Rationale 2: Excess Fluid Volume is not an issue for pts with diabetes insipidus, especially during the early stages of treatment. Rationale 3: Imbalanced Nutrition does not apply. Rationale 4: Ineffective Tissue Perfusion does not apply A pt recovering from surgery has an indwelling urinary catheter. The nurse would contact the pt's primary healthcare provider with which of the following 24-hour urine output volumes? 1. 600 mL 2. 750 mL 3. 1000 mL 4. 1200 mL - correct answer ✅Answer: 1 Rationale 1: A urine output of less than 30 mL per hour must be reported to the primary healthcare provider. This indicates inadequate renal perfusion, placing the pt at increased risk for acute renal failure & inadequate tissue perfusion. A 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 minimum of 720 mL over a 24-hour period is desired (30 mL multiplied by 24 hours equals 720 mL per 24 hours). A pt is receiving intravenous fluids postoperatively following cardiac surgery. Nursing assessments should focus on which postoperative complication? 1. fluid volume excess 2. fluid volume deficit 3. seizure activity 4. liver failure - correct answer ✅Answer: 1 Rationale 1: Antidiuretic hormone & aldosterone levels are commonly increased following the stress response before, during, & immediately after surgery. This increase leads to sodium & water retention. Adding more fluids intravenously can cause a fluid volume excess & stress upon the heart & circulatory system. Rationale 2: Adding more fluids intravenously can cause a fluid volume excess, not fluid volume deficit, & stress upon the heart & circulatory system. Rationale 3: Seizure activity would more commonly be associated with electrolyte imbalances. Rationale 4: Liver failure is not anticipated related to postoperative intravenous fluid administration. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 A pt is diagnosed with severe hyponatremia. The nurse realizes this pt will mostly likely need which of the following precautions implemented? 1. seizure 2. infection 3. neutropenic 4. high-risk fall - correct answer ✅Answer: 1 Rationale 1: Severe hyponatremia can lead to seizures. Seizure precautions such as a quiet environment, raised side rails, & having an oral airway at the bedside would be included. Rationale 2: Infection precautions not specifically indicated for a pt with hyponatremia. Rationale 3: Neutropenic precautions not specifically indicated for a pt with hyponatremia. Rationale 4: High-risk fall precautions not specifically indicated for a pt with hyponatremia. A pt is diagnosed with hypokalemia. After reviewing the pt's current medications, which of the following might have contributed to the pt's health problem? 1. corticosteroid 2. thiazide diuretic 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 4: The administration of normal saline with furosemide is used to increase calcium secretion. When caring for a pt diagnosed with hypocalcemia, which of the following should the nurse additionally assess in the pt? 1. other electrolyte disturbances 2. hypertension 3. visual disturbances 4. drug toxicity - correct answer ✅Answer: 1 Rationale 1: The pt diagnosed with hypocalcemia may also have high phosphorus or decreased magnesium levels. Rationale 2: The pt with hypocalcemia may exhibit hypotension, & not hypertension. Rationale 3: Visual disturbances do not occur with hypocalcemia. Rationale 4: Hypercalcemia is more commonly caused by drug toxicities. A pt with a history of stomach ulcers is diagnosed with hypophosphatemia. Which of the following interventions should the nurse include in this pt's plan of care? 1. Request a dietitian consult for selecting foods high in phosphorous. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2. Provide aluminum hydroxide antacids as prescribed. 3. Instruct pt to avoid poultry, peanuts, & seeds. 4. Instruct to avoid the intake of sodium phosphate. - correct answer ✅Answer: 1 Rationale 1: Treatment of hypophosphatemia includes treating the underlying cause & promoting a high phosphate diet, especially milk, if it is tolerated. Other foods high in phosphate are dried beans & peas, eggs, fish, organ meats, Brazil nuts & peanuts, poultry, seeds & whole grains. Rationale 2: Phosphate-binding antacids, such as aluminum hydroxide, should be avoided. Rationale 3: Poultry, peanuts, & seeds are part of a high phosphate diet. Rationale 4: Mild hypophosphatemia may be corrected by oral supplements, such as sodium phosphate. When analyzing an arterial blood gas report of a pt with COPD & respiratory acidosis, the nurse anticipates that compensation will develop through which of the following mechanisms? 1. The kidneys retain bicarbonate. 2. The kidneys excrete bicarbonate. 3. The lungs will retain carbon dioxide. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 4. The lungs will excrete carbon dioxide. - correct answer ✅Answer: 1 Rationale 1: The kidneys will compensate for a respiratory disorder by retaining bicarbonate. Rationale 2: Excreting bicarbonate causes acidosis to develop. Rationale 3: Retaining carbon dioxide causes respiratory acidosis. Rationale 4: Excreting carbon dioxide causes respiratory alkalosis The nurse is caring for a pt diagnosed with renal failure. Which of the following does the nurse recognize as compensation for the acid-base disturbance found in pts with renal failure? 1. The pt breathes rapidly to eliminate carbon dioxide. 2. The pt will retain bicarbonate in excess of normal. 3. The pH will decrease from the present value. 4. The pt's oxygen saturation level will improve. - correct answer ✅Answer: 1 Rationale 1: In metabolic acidosis compensation is accomplished through increased ventilation or "blowing off" C02. This raises the pH by eliminating the volatile respiratory acid & compensates for the acidosis. Rationale 2: Because compensation must be performed by the system other than the affected system, the pt cannot retain bicarbonate; the manifestation of metabolic acidosis of renal failure is a lower than normal bicarbonate value. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 A pt is prescribed 20 mEq of potassium chloride. The nurse realizes that the reason the pt is receiving this replacement is 1. to sustain respiratory function. 2. to help regulate acid-base balance. 3. to keep a vein open. 4. to encourage urine output. - correct answer ✅Answer: 2 Rationale 1: Potassium does not sustain respiratory function. Rationale 2: Electrolytes have many functions. They assist in regulating water balance, help regulate & maintain acid-base balance, contribute to enzyme reactions, & are essential for neuromuscular activity. Rationale 3: Intravenous fluids are used to keep venous access not potassium. Rationale 4: Urinary output is impacted by fluid intake not potassium. An elderly pt does not complain of thirst. What should the nurse do to assess that this pt is not dehydrated? 1. Ask the physician for an order to begin intravenous fluid replacement. 2. Ask the physician to order a chest x-ray. 3. Assess the urine for osmolality. 4. Ask the physician for an order for a brain scan. - correct answer ✅Answer: 3 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 1: It is inappropriate to seek an IV at this stage. Rationale 2: There is no indication the pt is experiencing pulmonary complications thus a cheat x-ray is not indicated. Rationale 3: The thirst mechanism declines with aging, which makes older adults more vulnerable to dehydration & hyperosmolality. The nurse should check the pt's urine for osmolality as a 1st step in determining hydration status before other detailed & invasive testing is done. Rationale 4: There is no data to support the need for a brain scan. An elderly pt who is being medicated for pain had an episode of incontinence. The nurse realizes that this pt is at risk for developing 1. dehydration. 2. over-hydration. 3. fecal incontinence. 4. a stroke. - correct answer ✅Correct answer : 1 Rationale 1: Functional changes of aging also affect fluid balance. Older adults who have self-care deficits, or who are confused, depressed, tube-fed, on bed rest, or taking medications (such as sedatives, tranquilizers, diuretics, & laxatives), are at greatest risk for fluid volume imbalance. Rationale 2: There is inadequate evidence to support the risk of over-hydration. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 3: There is inadequate evidence to support the risk of fecal incontinence. Rationale 4: There is inadequate evidence to support the risk of a stroke. The nurse assesses a pt's weight loss as being 22 lbs. How many liters of fluid did this pt lose? - correct answer ✅Correct answer : 10 Rationale: Each liter of body fluid weighs 1 kg or 2.2 lbs. This pt has lost 10 liters of fluid. A postoperative pt with a fluid volume deficit is prescribed progressive ambulation yet is weak from an inadequate fluid status. What can the nurse do to help this pt? 1. Assist the pt to maintain a standing position for several minutes. 2. This pt should be on bed rest. 3. Assist the pt to move into different positions in stages. 4. Contact physical therapy to provide a walker. - correct answer ✅Answer: 3 Rationale 1: The pt should avoid prolonged standing. Rationale 2: Bed rest can promote skin breakdown. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 A pt with fluid retention related to renal problems is admitted to the hospital. The nurse realizes that this pt could possibly have which of the following electrolyte imbalances? 1. hypokalemia 2. hypernatremia 3. carbon dioxide 4. magnesium - correct answer ✅Answer: 2 Rationale 1: The kidneys are the principal organs involved in the elimination of potassium. Renal failure is often associated with elevations potassium levels. Rationale 2: The kidney is the primary regulator of sodium in the body. Fluid retention is associated with hypernatremia. Rationale 3: Carbon dioxide abnormalities are not normally seen in this type of pt. Rationale 4: Magnesium abnormalities are not normally seen in this type of pt. An elderly pt comes into the clinic with the complaint of watery diarrhea for several days with abdominal & muscle cramping. The nurse realizes that this pt is demonstrating which of the following? 1. hypernatremia 2. hyponatremia 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 3. fluid volume excess 4. hyperkalemia - correct answer ✅Answer: 2 Rationale 1: Hypernatremia is associated with fluid retention & overload. FVE is associated with hypernatremia. Rationale 2: This elderly pt has watery diarrhea, which contributes to the loss of sodium. The abdominal & muscle cramps are manifestations of a low serum sodium level. Rationale 3: This pt is more likely to develop clinical manifestations associated with fluid volume deficit. Rationale 4: Hyperkalemia is associated with cardiac dysrhythmias. A pt is admitted with hypernatremia caused by being str&ed on a boat in the Atlantic Ocean for five days without a fresh water source. Which of the following is this pt at risk for developing? 1. pulmonary edema 2. atrial dysrhythmias 3. cerebral bleeding 4. stress fractures - correct answer ✅Answer: 3 Rationale 1: Pulmonary edema is not associated with dehydration. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 2: Atrial dysrhythmias are not a factor for this pt. Rationale 3: The brain experiences the most serious effects of cellular dehydration. As brain cells contract, the brain shrinks, which puts mechanical traction on cerebral vessels. These vessels may tear, bleed, & lead to cerebral vascular bleeding. Rationale 4: There have been no activities to support the development or occurrence of stress fractures. The nurse is admitting a pt who was diagnosed with acute renal failure. Which of the following electrolytes will be most affected with this disorder? 1. calcium 2. magnesium 3. phosphorous 4. potassium - correct answer ✅Answer: 4 Rationale 1: This pt will be less likely to develop a calcium imbalance. Rationale 2: This pt will be less likely to develop a magnesium imbalance. Rationale 3: This pt will be less likely to develop a phosphorous imbalance. Rationale 4: Because the kidneys are the principal organs involved in the elimination of potassium, renal failure 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 2: The pt's bowel habits are not of concern at this time. Rationale 3: The cardiac & musculoskeletal discomforts being reported are not consistent with physical exertion. Rationale 4: The pt has a history of sodium retention & might think that a salt substitute can be used. Advise pts who are taking a potassium supplement or potassium-sparing diuretic to avoid salt substitutes, which usually contain potassium. A 35-year-old female pt comes into the clinic postoperative parathyroidectomy. Which of the following should the nurse instruct this pt? 1. Drink one glass of red wine per day. 2. Avoid the sun. 3. Milk & milk-based products will ensure an adequate calcium intake. 4. Red meat is the protein source of choice. - correct answer ✅Answer: 3 Rationale 1: This pt should avoid alcohol. Rationale 2: This pt can benefit from sun exposure. Rationale 3: This pt is at risk for developing hypocalcemia. This risk can be avoided if instructed to ingest milk & milk-based products. Rationale 4: Protein monitoring is not indicated. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 A pt is admitted for treatment of hypercalcemia. The nurse realizes that this pt's intravenous fluids will most likely be which of the following? 1. dextrose 5% & water 2. dextrose 5% & ? normal saline 3. dextrose 5% & ? normal saline 4. normal saline - correct answer ✅Answer: 4 Rationale 1: If isotonic saline is not used, the pt is at risk for hyponatremia in addition to the hypercalcemia. Rationale 2: This solution is hypotonic. Isotonic saline is used because sodium excretion is accompanied by calcium excretion through the kidneys. Rationale 3: This solution is hypotonic. Isotonic saline is used because sodium excretion is accompanied by calcium excretion through the kidneys. Rationale 4: Isotonic saline is used because sodium excretion is accompanied by calcium excretion through the kidneys. A 28-year-old male pt is admitted with diabetic ketoacidosis. The nurse realizes that this pt will have a need for which of the following electrolytes? 1. sodium 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2. potassium 3. calcium 4. magnesium - correct answer ✅Answer: 4 Rationale 4: One risk factor for hypomagnesaemia is an endocrine disorder, including diabetic ketoacidosis. An elderly pt with peripheral neuropathy has been taking magnesium supplements. The nurse realizes that which of the following symptoms can indicate hypomagnesaemia? 1. hypotension, warmth, & sweating 2. nausea & vomiting 3. hyperreflexia 4. excessive urination - correct answer ✅Answer: 1 Rationale 1: Elevations in magnesium levels are accompanied by hypotension, warmth, & sweating. Rationale 2: Lower levels of magnesium are associated with nausea & vomiting. Rationale 3: Lower levels of magnesium are associated & hyperreflexia. Rationale 4: Urinary changes are not noted. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 3: Three systems work together in the body to maintain the pH despite continuous acid production: buffers, the respiratory system, & the renal system. Rationale 4: Three systems work together in the body to maintain the pH despite continuous acid production: buffers, the respiratory system, & the renal system. The nurse observes a pt's respirations & notes that the rate is 30 per minute & the respirations are very deep. The metabolic disorder this pt might be demonstrating is which of the following? 1. hypernatremia 2. increasing carbon dioxide in the blood 3. hypertension 4. pain - correct answer ✅Answer: 2 Rationale 1: Hypernatremia is associated with profuse sweating & diarrhea. Rationale 2: Acute increases in either carbon dioxide or hydrogen ions in the blood stimulate the respiratory center in the brain. As a result, both the rate & depth of respiration increase. The increased rate & depth of lung ventilation eliminates carbon dioxide from the body, & carbonic acid levels fall, which brings the pH to a more normal range. Rationale 3: The respiratory rate in a pt exhibiting hypertension is not altered. Rationale 4: Pain may be manifested in rapid, shallow respirations. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 The blood gases of a pt with an acid-base disorder show a blood pH outside of normal limits. The nurse realizes that this pt is 1. fully compensated. 2. demonstrating anaerobic metabolism. 3. partially compensated. 4. in need of intravenous fluids - correct answer ✅Answer: 3 Rationale 1: If the pH is restored to within normal limits, the disorder is said to be fully compensated. Rationale 2: Anaerobic metabolism results when the body's cells become hypoxic. Rationale 3: If the pH is restored to within normal limits, the disorder is said to be fully compensated. When these changes are reflected in arterial blood gas (ABG) values but the pH remains outside normal limits, the disorder is said to be partially compensated. Rationale 4: Although the pt may be in need of intravenous fluids, this is not the most correct or definitive answer. 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 A pt's blood gases show a pH greater of 7.53 & bicarbonate level of 36 mEq/L. The nurse realizes that the acid-base disorder this pt is demonstrating is which of the following? 1. respiratory acidosis 2. metabolic acidosis 3. respiratory alkalosis 4. metabolic alkalosis - correct answer ✅Answer: 4 Rationale 1& 2: Respiratory acidosis & metabolic acidosis are both consistent with pH less than 7.35. Rationale 3: Respiratory alkalosis is associated with a pH greater than 7.45 & a PaCO2 of less than 35 mmHG. It is caused by respiratory related conditions. Rationale 4: Arterial blood gases (ABGs) show a pH greater than 7.45 & bicarbonate level greater than 26 mEq/L when the pt is in metabolic alkalosis. An elderly postoperative pt is demonstrating lethargy, confusion, & a resp rate of 8 per minute. The nurse sees that the last dose of pain medication administered via a pt controlled anesthesia (PCA) pump was within 30 minutes. Which of the following acid-base disorders might this pt be experiencing? 1. respiratory acidosis 2. metabolic acidosis 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Rationale 1: Pts with malignancy are at risk for development of hypercalcemia due to destruction of bone or the production of hormone-like substances by the malignancy. Rationale 2: Lithium & overuse of antacids can result in hypercalcemia. Hypercalcemia can result from hyperparathyroidism which causes release of calcium from the bones, increased calcium absorption in the intestines & retention of calcium by the kidneys. Rationale 3: The pt who uses sunscreen to excess is more likely to have a vitamin D deficiency which would result in hypocalcemia. Rationale 4: Hypercalcemia can result from hyperparathyroidism which causes release of calcium from the bones, increased calcium absorption in the intestines & retention of calcium by the kidneys. Rationale 5: Lithium & overuse of antacids can result in hypercalcemia. The pt who has a serum magnesium level of 1.4 mg/dL is being treated with dietary modification. Which foods should the nurse suggest for this pt? Select all that apply. 1. bananas 2. seafood 3. white rice 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 4. lean red meat 5. chocolate - correct answer ✅Answer: 1,2,5 Rationale: Serum magnesium level of 1.4 mg/dL suggests mild hypomagnesaemia, so this pt should be counseled to eat foods high in magnesium. Foods high in magnesium include green leafy vegetables, seafood, milk, bananas, citrus fruits, & chocolate. White rice & lean red meat are not included. The pt has a serum phosphate level of 4.7 mg/dL. Which interdisciplinary treatments would the nurse expect for this pt? Select all that apply. 1. IV normal saline 2. calcium containing antacids 3. IV potassium phosphate 4. encouraging milk intake 5. increasing vitamin D intake - correct answer ✅Answer: 1,2 Rationale: Serum phosphate level of 4.7 mg/dL indicates hyperphosphatemia. IV normal saline promotes renal excretion of phosphate. The pt, newly diagnosed with diabetes mellitus, is admitted to the emergency department with nausea, vomiting, & abdominal pain. ABG results reveal a pH of 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 7.2 & a bicarbonate level of 20 mEq/L. Which other assessment findings would the nurse anticipate in this pt? Select all that apply. 1. tachycardia 2. weakness 3. dysrhythmias 4. Kussmaul's respirations 5. cold, clammy skin - correct answer ✅Answer: 2,3,4 Rationale: Further assessment findings of this condition are weakness, bradycardia, dysrhythmias, general malaise, decreased level of consciousness, warm flushed skin, & Kussmaul's respirations. Rationale: These ABG results, coupled with the pt's recent diagnosis of diabetes mellitus & history of vomiting would lead the nurse to suspect metabolic acidosis. Further assessment findings of this condition are weakness, bradycardia, dysrhythmias, general malaise, decreased level of consciousness, warm flushed skin, & Kussmaul's respirations. Homeostasis - correct answer ✅Proper functioning of all body systems; requires fluid and electrolyte balence 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 -Enemas -Irrigation Osmosis - correct answer ✅Movement of Fluid across the membrane LOWER TO HIGHER *water always wants to be where the party is at (high) Hypotonic - correct answer ✅Low More in the cell Hypertonic - correct answer ✅High More outside of cell Isotonic - correct answer ✅Normal Even Equal Normal Saline - correct answer ✅Isotonic 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 0.9% Sodium Chloride 1/2 Normal Saline - correct answer ✅Hypotonic 0.45% Sodium Chloride Lactated Ringers (LR) - correct answer ✅Isotonic D5LR - correct answer ✅Hypertonic Dextrose 5% with LR Filtration - correct answer ✅Movement of Fluid through cell or blood vessel membrane because of differences in water pressure -water volume pressing against confining walls Hydrostatic Pressure - correct answer ✅Water pushing pressure Ex. Filtration Force that pushes water outward from a confined space through a membrane 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Edema - correct answer ✅Develops with changes in normal hydrostatic Pressure differences Diffusion - correct answer ✅Free movement of particles (solute) across permeable membrane HIGHER TO LOWER Aldosterone - correct answer ✅Reabsorption of sodium also causes water to stay in body as well -Increased BP Antidiuretic Hormone - correct answer ✅"Against excretion" Maintain excretion DON'T PEE -Increased BP Natriuretic Peptides - correct answer ✅To release water -decreased BP 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Hypernatremia - correct answer ✅Excess NA >145 MEQ/L Cause: water deprivation S/S: thirst, irritability, seizures Sodium Dietary Education - correct answer ✅Teach: do not "add" salt Avoid high sodium food (milk products, processed foods) Be aware of hidden sodium Potassium - correct answer ✅Abundant inside the cell (98% found in the cell) -Responsible for intracellular excitation NORM: 3.5-5.0 MEQ/L Hypokalemia - correct answer ✅Low K <3.5 MEQ/L Most common electrolyte disturbance (because so little outside the cell) S/S: muscle weakness, leg cramps, cardiac 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 arrhythmias MORE cramps Potassium Imbalence - correct answer ✅Heart/muscle problems Hypokalemia Nursing Management - correct answer ✅-Never push IV potassium directly in the vein -urine output should be >0.5 ML/KG/HR -make sure pee lots Potassium is very irritating when PO or IV Hyperkalemia - correct answer ✅Excess K >5 MEQ/L Cause: increased retention, Increased intake of salt substitutes S/S: muscle weakness, cardiac arrhythmias MORE ♡ probs 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 2204 Fluid & Electrolyte NCLEX Practice Questions, Fundamentals Ch. 42 Fluid &Electrolytes Latest 2023 Kayexalate - correct answer ✅Liquid makes you poop alot Very liquidy poop Calcium - correct answer ✅NORM: 8.4-10.5 MG/DL 7/11 = down to 7 too low at 11 too high -Responsible for bone and muscle excitation Calcium Imbalence - correct answer ✅Muscle/cardiac probs Hypocalcemia - correct answer ✅Low calcium <8.4 MG/DL S/S: tetany, arrhythmias -chvostek's sign -trousseau's sign Treatment: calcium replacement WITH VD Hypercalcemia - correct answer ✅Excess calcium >10.5 MG/DL