NSG 170: Fluid and Electrolytes Actual Final Exam Test Bank| A Review of 154 Real Past Papers Exams Questions With Correct Answers and Rationale| Guaranteed 100% Pass| (Brand New!!)

SG 170 Fluid and Electrolytes Study Guide: Nursing Notes, Electrolyte Imbalances & IV Therapy This comprehensive NSG 170 study guide covers essential fluid and electrolyte balance concepts for nursing students and practicing nurses. NSG 170: Fluid and Electrolytes Actual Final Exam Test Bank| A Review of 154 Real Past Papers Exams Questions With Correct Answers and Rationale| Guaranteed 100% Pass| (Brand New!!) 1. A patient has a tumor that secretes excessive antidiuretic hormone (ADH). He is confused and lethargic. His partner wants to know how a change in blood sodium can cause these symptoms. What should the nurse teach the patient's partner? A. Decreased sodium in the blood causes the blood volume to decrease so that not enough oxygen reaches the brain. B. Decreased sodium in the blood causes brain cells to swell so that they do not work as effectively. C. Increased sodium in the blood causes the blood volume to increase so that too much oxygen reaches the brain. D. Increased sodium in the blood causes brain cells to shrivel so that they do not work as effectively. ANS: B. Decreased sodium in the blood causes brain cells to swell so that they do not work as effectively. The normal action of ADH is renal reabsorption of water, which dilutes the blood. Excessive ADH causes hyponatremia, which is manifested by a decreased level of consciousness because the osmotic shift of water into the brain cells impairs their function. Hyponatremia does not decrease the blood volume. Answers that include increased sodium in the blood are incorrect because ADH excess causes hyponatremia rather than hypernatremia. 2. The home health nurse should assess a patient who has chronic diarrhea for which fluid and electrolyte imbalances? Select All That Apply: A. Extracellular fluid volume (ECV) excess B. Extracellular fluid volume (ECV) deficit C. Hypokalemia D. Hyperkalemia E. Hypocalcemia F. Hypercalcemia Ans: B. ECV deficit. C. Hypokalemia. E. Hypocalcemia. Chronic diarrhea has a high risk of causing ECV deficit, hypokalemia, and hypocalcemia because it increases the fecal output of sodium-containing fluid, potassium, and calcium. Unless the intake of these substances increases appropriately, imbalances will occur. Excesses of ECV, potassium, and calcium are not likely, because the ECV, potassium, and calcium are being removed from the body. 3. A patient injured in an earthquake today when a wall fell on his legs received 9 units of blood an hour ago because he was hemorrhaging. Which laboratory value should the nurse check first when the report returns? A. Serum sodium. B. Serum potassium. C. Serum total calcium. D. Serum magnesium. ANS: B. Serum potassium. The patient has two major risk factors for hyperkalemia: massive sudden cell death from a crushing injury (potassium shift from cells into the extracellular fluid) and massive blood transfusion (rapid potassium intake). Although massive blood transfusion may cause calcium and magnesium ions to bind to citrate in the blood, thereby decreasing the physiologic availability of those ions, it does not decrease the total calcium or magnesium laboratory measurements. Clinically significant changes in serum sodium are the least likely in this patient. 4. Your patient has severe hypercalcemia. What are your priority nursing interventions? (Select all that apply.) A.) Fall prevention interventions B.) Teaching regarding sodium restriction C.) Encouraging increased fluid intake D.) Monitoring for constipation E.) Explaining how to take daily weights: ANS ;A. Fall prevention interventions C.) Encouraging increased fluid intake D.) Monitoring for constipation Severe hypercalcemia causes lethargy, which creates a risk for falling and constipation. Increased fluid intake is important to prevent renal calculi during hypercalcemia. 5. Which assessment do you interpret as a transfusion reaction? A.) Crackles in dependent parts of lungs B.) High fever, severe hypotension C.) Anxiety, itching, confusion D.) Chills, tachycardia, and flushing ANS: D.) Chills, tachycardia, and flushing A transfusion reaction occurs when the immune system reacts against the blood that is being transfused. Chills, tachycardia, and flushing are common manifestations. 6. Your older-adult patient is receiving intravenous (IV) 0.9% NaCl. You detect new onset of crackles in the lung bases. What is your priority action? A.) Notify a health care provider B.) Record in medical record C.) Decrease the IV flow rate D.) Discontinue the IV site ANS: C.) Decrease the IV flow rate When an IV fluid is infusing, monitor for excess infusion. Crackles in the lung bases are an indication of extracellular fluid volume excess. For patient safety the IV flow rate must be decreased immediately 7. Your patient is hyperventilating from acute pain and hypoxia. Interventions to manage his pain and oxygenation will decrease his risk of which acid-base imbalance? ANS: D.) Respiratory alkalosis Hyperventilation causes excessive excretion of carbonic acid, putting the patient at risk for developing respiratory alkalosis. Interventions to decrease the pain and hypoxia that are causing his hyperventilation will decrease his risk of respiratory alkalosis. 8. An intravenous (IV) fluid is infusing more slowly than ordered. The infusion pump is set correctly. Which factors could cause this slowing? A.) Infiltration at vascular access device (VAD) site B.) Patient lying on tubing C.) Roller clamp wide open D.) Tubing kinked in bedrails E.) Circulatory overload ANS: A, B, D Factors that could slow an IV infusion even if the infusion pump is set correctly include increased pressure at the outflow site (e.g., infiltration) and compression of the tubing lumen (e.g., patient lying on the tubing or tubing kinked in bedrails). 9. Which assessment do you use as a clinical marker of vascular volume in a patient at high risk of extracellular fluid volume (ECV) deficit? A.) Dryness of mucous membranes B.) Presence or absence of edema C.) Fullness of neck veins when supine D.) Fullness of neck veins when upright ANS: C.) Fullness of neck veins when supine ECV deficit involves decreased vascular and interstitial volume. One way to assess vascular volume is to examine the fullness of neck veins when an individual is supine. With normal ECV neck veins are full when the individual is supine. With ECV deficit they are flat. 10. What is the correct order for discontinuing intravenous (IV) access? 1. Per- form hand hygiene and apply gloves.2. Explain procedure to patient.3. Remove IV site dressing and tape.4. Use two identifiers to ensure correct patient.5. Stop the infusion and clamp the tubing.6. Carefully check the health care provider's order.7. Clean the site, withdraw the catheter, and apply pressure ANS.: 6, 4, 2, 1, 3, 5, 7 A health care provider's order is necessary before discontinuing IV access, unless there is a complication such as infiltration or phlebitis. Identifying the patient and explaining the procedure are performed before hand hygiene and glove application to maintain clean gloves. Removing the site dressing before stopping the infusion and then withdrawing the catheter keeps the vascular access device patent without forming a clot that could embolize during catheter withdrawal. 11. Which patient do you plan to teach regarding water restriction? A.) A 23-year-old with extracellular fluid volume (ECV) deficit B.) A 34-year-old with hyponatremia C.) A 47-year-old with hypercalcemia D.) A 69-year-old with metabolic acidosis ANS: B.) A 34-year-old with hyponatremia Hyponatremia involves excessive water for the amount of sodium in the blood; the body fluids are too dilute. Therefore water restriction is the most common therapy for hyponatremia. 12. IV infiltration: the leaking of IV fluid into the tissue surrounding the vein. This occurs when IV fluids continue to be delivered even though the tip of the catheter is no longer in the vessel or is blocked. 13. Osmosis: Diffusion of water through a selectively permeable membrane 14. Diffusion: Movement of molecules from an area of higher concentration to an area of lower concentration. 15. Filtration: A technique that uses a porous barrier to separate a solid from a liquid 16. Active transport requires: energy (ATP) 17. Active transport: the movement of materials through a cell membrane using energy 18. Intracellular fluid: fluid within cells 19. Extracellular fluid: fluid outside the cell 20. Isotonic dehydration: WATER LOSS = ELECTROLYTE LOSS aka Hypovolemia Results: decreased circulating blood volume and inadequate tissue perfusion Most common type of dehydration!