med surg final Brunner: Medical-Surgical Nursing, 10th Edition

Chapter 14: Fluids and Electrolytes: Balance and Distribution

1. Which of the following body functions is accomplished through osmosis?
A) Urine production
B) Menstruation
C) Weight gain
D) Respiration

Ans: A
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 1
Feedback: Osmosis occurs when two different solutions are separated by a membrane impermeable to
the dissolved substances; fluid shifts through the membrane from the region of the low solute
concentration to the region of high solute concentration until the solutions are of equal concentration.

2. Which of the following would be considered transcellular fluid?
A) Digestive secretions
B) Synovial fluid
C) Nucleolus
D) A and C

Ans: D
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Comprehension
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 1
Feedback: Transcellular fluid includes synovial fluid and digestive secretions.

3. A nurse is caring for a patient who requires measurement of specific gravity every 4 hours. What
might this test detect?
A) Nutritional deficit
B) Hyperkalemia
C) Hypercalcemia
D) Fluid volume deficit

Ans: D
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 2
Feedback: A specific gravity will detect if the patient has a fluid volume deficit. This will not detect

,hyperkalemia, hypercalcemeia, or nutritional deficits.
4. Which of the following electrolytes is the most abundant in the extracellular fluid?
A) Potassium
B) Sodium
C) Magnesium
D) Calcium

Ans: B
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Knowledge
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 2
Feedback: Sodium is the most abundant electrolyte in the extra cellular fluid.

5. For which of the following might the nurse assess in a patient diagnosed with hypermagnesemia?
A) Diminished deep tendon reflexes
B) Tachycardia
C) Cool clammy skin
D) Increased serum magnesium

Ans: A
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Analysis
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 2
Feedback: To gauge a patient's magnesium status, the nurse should check deep tendon reflexes. If the
reflex is absent, this may indicate high serum magnesium.

6. A patient is receiving furosemide (Lasix) 40 mg/d. What should be monitored when a patient is
receiving a loop diuretic?
A) Sodium deficit
B) Hematocrit
C) Decrease potassium
D) Magnesium deficit

Ans: A
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Analysis
Concepts and Processes: Nursing Process
Difficulty: Difficult
Objective: 2
Feedback: The diuretics act on the ascending loop of Henle to prevent re-absorption of water and
sodium. Because of this, sodium levels should be monitored when a patient is receiving diuretics.

,7. Which of the following would cause the release of an antidiuretic hormone (ADH)?
A) Increased serum sodium
B) Decreased serum sodium
C) Decrease in serum osmolality
D) Decrease in thirst

Ans: A
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 3
Feedback: Increased serum sodium causes increased thirst and the release of ADH by the posterior
pituitary gland. When serum osmolality decreases and thirst and ADH secretions are suppressed, the
kidney excretes more water to restore normal osmolality.

8. Third spacing occurs when fluid moves out of the intravascular space but not into the
intracellular space. Which of the following can occur?
A) Hypertension
B) Bradycardia
C) Hypervolemia
D) Hypovolemia

Ans: D
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 4
Feedback: Third-spacing fluid shift, which occurs when fluid moves out of the intravascular space but not
into the intracellular space, can cause hypovolemia.

9. Which of the following procedures may contribute to extracellular losses?
A) Removal of an ingrown toenail
B) Tooth extraction
C) Abdominal surgery
D) Cataract surgery

Ans: C
Chapter: 14
Client Needs: IV-1
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate

, Objective: 4
Feedback: Fluid loss from the extracellular compartment can be caused by abdominal surgery.




10. The renin and angiotensin systems help to maintain the balance of sodium and water in the
body. What other functions do these systems have?
A) Regulating hemoglobin levels
B) Maintaining a healthy blood volume
C) Releasing platelets when tissues are injured
D) Lowering blood volumes

Ans: B
Chapter: 14
Client Needs: IV-4
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 4
Feedback: The rennin and angiotensin systems help to maintain the balance of sodium and water in the
body and maintain healthy blood volumes.

11. A patient's lab results show a slight decrease in potassium. The physician has declined to treat with
medication but has suggested increasing the potassium through diet. Which of the following would be a
good source of potassium?
A) Apples
B) Potatoes
C) Carrots
D) Bananas

Ans: D
Chapter: 14
Client Needs: IV-1
Cognitive Categories: Application
Concepts and Processes: Nursing Process
Difficulty: Moderate
Objective: 4
Feedback: Bananas are high in potassium. Apples, carrots, and potatoes are not high in potassium.

12. A nurse is caring for a patient with pulmonary edema. A priority in the nurse's assessment should
include which of the following?
A) Oral mucosa
B) Chest sounds
C) Pupil reaction
D) Skin temperature

Ans: B
Chapter: 14