Fluids and Electrolytes

MULTIPLE CHOICE

1. The nurse assesses that the patient’s urine has become much more concentrated, which
results from the effect of:
1. adrenaline.
2. aldosterone.
3. antidiuretic hormone (ADH).
4. insulin.
ANS: 2
Aldosterone acts on the kidney tubules, affecting water retention and its attendant urine
concentration.

2. When the water absorption in the renal tubules becomes greater than normal, the nurse
anticipates that the urine will become:
1. more concentrated
2. less concentrated
3. more alkaline
4. less alkaline
ANS: 1
When more water is kept back in the body, the water left to form urine is less; therefore, the
urine is more concentrated.

3. The nurse explains that when oxygen is directed out of the arteries and into the capillaries,
this process is:
1. active transport.
2. diffusion.
3. filtration.
4. osmosis.
ANS: 2
Diffusion is the movement from areas of higher concentration to areas of lower
concentration.

4. The patient’s IV has been infusing at a very high rate and now the patient appears to be in
fluid volume overload, as indicated by:
1. hypotension.
2. tachycardia.
3. pulmonary edema.
4. kidney failure.
ANS: 3
 An IV infusing at a high rate is used to increase intravascular fluid volume, but there is an
equalization level, after which the patient goes into fluid overload; this results in pulmonary
edema.

5. A small child is hospitalized with severe metabolic acidosis after ingesting a whole bottle of
baby aspirin about 8 hours ago. The nursing care for this patient is geared toward reassuring
the patient and:
1. IVs as ordered, but without sodium bicarbonate.
2. frequent assessment of mental and neurological status.
3. daily weights and vital signs.
4. inducement of vomiting.
ANS: 2
The baby aspirin was ingested too long ago to have vomiting or stomach aspiration be of
any use. The child requires frequent assessment of neurological function because he or she
may need mechanical ventilation.

6. The nurse explains that fluids carrying nutrients and wastes on a random basis throughout
the body are carried primarily by:
1. filtrates.
2. extracellular fluid.
3. intracellular fluid.
4. osmolytes.
ANS: 2
The blood and lymph are the main media for transport of nutrients and wastes in the body.

7. The nurse clarifies that electrolytes, such as sodium and potassium, when dissolved, break
down into smaller particles, which are called:
1. cells.
2. elements.
3. ions.
4. molecules.
ANS: 3
Electrolytes dissolved in water are ions.

8. The nurse assists a dyspneic patient to sit in a high Fowler’s position. This aids gravity in
helping the movement of oxygen from the pulmonary capillaries into the blood by the
process of:
1. active transport.
2. diffusion.
3. filtration.
4. osmosis.
ANS: 2
 Fowler’s position increases blood flow through the lungs and therefore facilitates better
oxygen diffusion.

9. The nurse evaluates the laboratory reports on electrolyte values carefully to assess the
balance between positive and negative ions, which is regulated by the process of:
1. adaptation.
2. diffusion.
3. homeostasis.
4. osmosis.
ANS: 2
Diffusion allows the ions to support homeostatic balance.

10. When the nurse hangs an IV bag with Na+, K+, and Cl, he is aware that ____ are being
administered.
1. nutrients
2. electrolytes
3. enzymes
4. vitamins
ANS: 2
Sodium, potassium, and chlorides are electrolytes.

11. Each compartment of the body has a water-fluid distribution movement of its own. These
fluids move and distribute themselves between these compartments via a process known as:
1. active transport.
2. diffusion.
3. filtration.
4. osmosis.
ANS: 4
The intracellular and extracellular compartments contain water and dissolved substances.
The water filters back and forth as needed to maintain homeostasis via osmolarity.

12. The LPN is preparing to add a new IV of D5W with potassium to an existing line. The LPN
notices that there is only 25 mL of urine collected over the last hour. The LPN’s best
intervention is to:
1. not hang the IV with potassium; inform the RN of urine output.
2. run the IV rapidly for 30 minutes to stimulate urine production.
3. call the MD who ordered the potassium.
4. hang the IV as ordered and chart output.
ANS: 1
The low urine output will allow K+ to build up to hazardous levels. K+ administration is
dependent on adequate urine output. LPNs are required to report untoward findings to the
RN.
13. Both the intracellular and extracellular fluids are made up of many different electrolytes, but
the most abundant intracellular positively charged electrolyte is:
1. calcium.
2. chloride.
3. potassium.
4. sodium.
ANS: 3
K+ is the most abundant electrolyte in the cell.

14. The patient with metabolic acidosis should be closely monitored for the compensatory
condition of:
1. metabolic alkalosis.
2. respiratory acidosis.
3. respiratory alkalosis.
4. thyroid imbalances.
ANS: 3
When in metabolic acidosis, the body attempts to compensate by increasing respirations and
creating respiratory alkalosis.

15. The K+ laboratory report shows a level of 5.2 mEq/L. The nurse will assess the patient
closely for:
1. excessive thirst.
2. irregular heartbeat.
3. swelling of ankles.
4. frightening hallucinations.
ANS: 2
Arrhythmias can be triggered by hyperkalemia.

16. A patient has renal damage because of diabetes, which puts the patient at risk for:
1. hypercalcemia.
2. hypocalcemia.
3. hyperkalemia.
4. hypokalemia.
ANS: 3
When the renal system cannot rid the body of enough potassium, this electrolyte builds up
and a condition called hyperkalemia develops.

17. Hyperchloremia, as noted on a laboratory report, is usually associated with:

18. Older adults are at risk for dehydration because of reduced thirst and aging kidneys. The
nurse monitors for the early indicator of dehydration, which is:
1. reduced skin turgor.
2. constipation.
3. concentrated urine.
4. disorientation.
ANS: 2
Because older adults have poor skin turgor and urine concentration is difficult to assess,
constipation is the earliest indicator of fluid deficit.

19. The nurse has two newly admitted patients with dehydration. One patient is dehydrated from
heat exhaustion and the other from an overdose of Lasix. The finding that will present in
both patients is:
1. increased skin turgor.
2. decreased pulse and respirations.
3. copious saliva and nasal secretions.
4. increased laboratory values of hemoglobin and hematocrit.
ANS: 4
Water has been lost; therefore, the red blood cells will concentrate and show artificially high
hemoglobin and hematocrit values.

20. The nurse clarifies that fluid balance is mainly monitored in the body by two systems, which
are the:
1. circulatory and renal.
2. respiratory and circulatory.
3. renal and gastrointestinal.
4. hepatic and lymphatic.
ANS: 1
The monitoring of basic fluid balance in the body is done by the renal and circulatory
systems.

21. The nurse is aware that extracellular fluid osmolarity is primarily maintained by:
1. chloride.
2. magnesium.
3. potassium.
4. sodium.
ANS: 4
 Sodium as the primary extracellular electrolyte controls the osmolarity of the extracellular
fluid, either too much or too little.

22. The nurse instructs that the healthy kidney adjusts the volume and composition of the filtrate
that prevents excessive fluid loss by:
1. active transport.
2. filtration in the lymphatic system.
3. secretion of adrenalin.
4. tubular reabsorption.
ANS: 4
The kidney reabsorbs water and other electrolytes in response to chemical receptors.

23. The nurse instructs a family that the blood being brought by the incoming capillaries into
the kidney, which contains nitrogenous substances to be excreted as waste, involves a
process of:
1. active transport.
2. diffusion.
3. filtration.
4. osmosis.
ANS: 3
Capillary blood from the renal arteries filters into the kidney for processing as the first step.

24. Because the patient is hypovolemic, the nurse anticipates that treatment will be focused on:
1. extracellular fluid deficit, limit drinking water.
2. hypertonic intracellular deficit, limit water intake.
3. extracellular fluid deficit, encourage fluid intake.
4. circulatory system hormone deficit, limit water intake.
ANS: 3
A fluid volume deficit occurs when there is inadequate fluid volume in the body; the nurse
may encourage drinking fluids as a nursing action.

25. The patient is frequently thirsty. The nurse assesses this symptom as:
1. too much sodium and too much water in the body.
2. too little sodium and too much water in the body.
3. too much sodium and too little water in the body.
4. too little sodium and too little water in the body.
ANS: 3
Normal thirst is the body’s way of calling for an increase in fluid volume, which could mean
that there is too much sodium and too little water.