Fluid And Electrolytes - Rosa's ProProfs Quiz
Exam With Complete Solutions
A client with hypoparathyroidism complains of numbness and tingling in his fingers and
around the mouth. The nurse would assess for what electrolyte imbalance?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia - answer B. Hypocalcemia
Hypoparathyroidism can cause low serum calcium levels. Numbness and tingling in
extremities and in the circumoral area around the mouth are the hallmark signs of
hypocalcemia. Normal calcium level is 9 to 11 mg/dl.
The nurse evaluates which of the following clients to be at risk for developing
hypernatremia?
A. 50-year-old with pneumonia, diaphoresis, and high fevers
B. 62-year-old with congestive heart failure taking loop diuretics
C. 39-year-old with diarrhea and vomiting
D. 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone
(SIADH) - answer A. 50-year-old with pneumonia, diaphoresis, and high fevers
Diaphoresis and a high fever can lead to free water loss through the skin, resulting in
hypernatremia. Loop diuretics are more likely to result in a hypovolemic hyponatremia.
Diarrhea and vomiting cause both sodium and water losses. Clients with syndrome of
inappropriate antidiuretic hormone (SIADH) have hyponatremia, due to increased water
reabsorption in the renal tubules.
A client is admitted with diabetic ketoacidosis who, with treatment, has a normal blood
glucose, pH, and serum osmolality. During assessment, the client complains of
weakness in the legs. Which of the following is a priority nursing intervention?
A. Request a physical therapy consult from the physician
B. Ensure the client is safe from falls and check the most recent potassium level
C. Allow uninterrupted rest periods throughout the day
D. Encourage the client to increase intake of dairy products and green leafy vegetables.
,- answer B. Ensure the client is safe from falls and check the most recent potassium
level
In the treatment of diabetic ketoacidosis, the blood sugar is lowered, the pH is
corrected, and potassium moves back into the cells, resulting in low serum potassium.
Client safety and the correction of low potassium levels are a priority. The weakness in
the legs is a clinical manifestation of the hypokalemia. Dairy products and green, leafy
vegetables are a source of calcium.
A client with a potassium level of 5.5 mEq/L is to receive sodium polystyrene sulfonate
(Kayexalate) orally. After administering the drug, the priority nursing action is to monitor
A. urine output.
B. blood pressure.
C. bowel movements.
C. ECG for tall, peaked T waves. - answer C. bowel movements.
Kayexalate causes potassium to be exchanged for sodium in the intestines and excreted
through bowel movements. If client does not have stools, the drug cannot work
properly. Blood pressure and urine output are not of primary importance. The nurse
would already expect changes in T waves with hyperkalemia. Normal serum potassium
is 3.5 to 5.5 mEq/L.
The nurse is caring for a client who has been in good health up to the present and is
admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L
yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate
nursing action?
A. Call the physician and report results
B. Question the results and redraw the specimen
C. Encourage the client to increase the intake of bananas
D. Initiate seizure precautions - answer B. Question the results and redraw the
specimen
A client who has been in good health up to the present is admitted for cellulitis of the
hands. When the serum potassium goes from 4.5 mEq/L to 7.0 mEq/L with no risk factors
for hyperkalemia, false high results should be suspected because of hemolysis of the
specimen. The physician would likely question results as well. Bananas are a food high
in potassium. Seizures are not a clinical manifestation of hyperkalemia.
A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4
mEq/L. Which of the following assessments would alert the nurse to immediately stop
the infusion?
,A. Absent patellar reflex
B. Diarrhea
C. Premature ventricular contractions
D. Increase in blood pressure - answer A. Absent patellar reflex
An intravenous magnesium infusion may be used to treat a low serum magnesium level.
Normal serum magnesium is 1.5 to 2.5 mEq/L. Clinical manifestations of
hypermagnesemia are the result of depressed neuromuscular transmission. Absent
reflexes indicate a magnesium level around 7 mEq/L. Diarrhea and PVCs are not clinical
manifestations of high magnesium levels. Hypermagnesemia causes hypotension.
A client with chronic renal failure reports a 10 pound weight loss over 3 months and has
had difficulty taking calcium supplements. The total calcium is 6.9 mg/dl. Which of the
following would be the first nursing action?
A. Assess for depressed deep tendon reflexes
B. Call the physician to report calcium level
C. Place an intravenous catheter in anticipation of administering calcium gluconate
D. Check to see if a serum albumin level is available - answer D. Check to see if a serum
albumin level is available
A client with chronic renal failure who reports a 10 pound weight loss over 3 months and
has difficulty taking calcium supplements is poorly nourished and likely to have
hypoalbuminemia. A drop in serum albumin will result in a false low total calcium level.
Placing an IV is not a priority action. Depressed reflexes are a sign of hypercalcemia.
Normal serum calcium is 9 to 11 mg/dl.
A client with heart failure is complaining of nausea. The client has received IV
furosemide (Lasix), and the urine output has been 2500 ml over the past 12 hours. The
client's home drugs include metoprolol (Lopressor), digoxin (Lanoxin), furosemide, and
multivitamins. Which of the following are the appropriate nursing actions before
administering the digoxin? Select all that apply.
, A. Administer an antiemetic prior to giving the digoxin
B. Encourage the client to increase fluid intake
C. Call the physician
D. Report the urine output
E. Report indications of nausea - answer C. Call the physician
D. Report the urine output
E. Report indications of nausea
Potassium is lost during diuresis with a loop diuretic such as furosemide (Lasix).
Hypokalemia can cause digitalis toxicity, which often results in nausea. The physician
should be notified, and digoxin should be held until potassium levels and digoxin levels
are checked. Peaked T waves and widened QRS are manifestations of hyperkalemia.
The nurse is caring for a bedridden client admitted with multiple myeloma and a serum
calcium level of 13 mg/dl. Which of the following is the most appropriate nursing action?
A. Provide passive ROM exercises and encourage fluid intake
B. Teach the client to increase intake of whole grains and nuts
C. Place a tracheostomy tray at the bedside
D. Administer calcium gluconate IM as ordered - answer A. Provide passive ROM
exercises and encourage fluid intake
A client who has a serum calcium of 13 mg/dl has hypercalcemia. Normal serum calcium
is 9 to 11 mg/dl. Fluid intake promotes renal excretion of excess calcium. ROM exercises
promote reabsorption of calcium into bone. Placing a tracheostomy at the bedside is a
nursing intervention for hypocalcemia. Although calcium gluconate may be
administered in hypocalcemia, it is never administered IM.
An older adult client admitted with heart failure and a sodium level of 113 mEq/L is
behaving aggressively toward staff and does not recognize family members. When the
family expresses concern about the client's behavior, the nurse would respond most
appropriately by stating
Exam With Complete Solutions
A client with hypoparathyroidism complains of numbness and tingling in his fingers and
around the mouth. The nurse would assess for what electrolyte imbalance?
A. Hyponatremia
B. Hypocalcemia
C. Hyperkalemia
D. Hypermagnesemia - answer B. Hypocalcemia
Hypoparathyroidism can cause low serum calcium levels. Numbness and tingling in
extremities and in the circumoral area around the mouth are the hallmark signs of
hypocalcemia. Normal calcium level is 9 to 11 mg/dl.
The nurse evaluates which of the following clients to be at risk for developing
hypernatremia?
A. 50-year-old with pneumonia, diaphoresis, and high fevers
B. 62-year-old with congestive heart failure taking loop diuretics
C. 39-year-old with diarrhea and vomiting
D. 60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone
(SIADH) - answer A. 50-year-old with pneumonia, diaphoresis, and high fevers
Diaphoresis and a high fever can lead to free water loss through the skin, resulting in
hypernatremia. Loop diuretics are more likely to result in a hypovolemic hyponatremia.
Diarrhea and vomiting cause both sodium and water losses. Clients with syndrome of
inappropriate antidiuretic hormone (SIADH) have hyponatremia, due to increased water
reabsorption in the renal tubules.
A client is admitted with diabetic ketoacidosis who, with treatment, has a normal blood
glucose, pH, and serum osmolality. During assessment, the client complains of
weakness in the legs. Which of the following is a priority nursing intervention?
A. Request a physical therapy consult from the physician
B. Ensure the client is safe from falls and check the most recent potassium level
C. Allow uninterrupted rest periods throughout the day
D. Encourage the client to increase intake of dairy products and green leafy vegetables.
,- answer B. Ensure the client is safe from falls and check the most recent potassium
level
In the treatment of diabetic ketoacidosis, the blood sugar is lowered, the pH is
corrected, and potassium moves back into the cells, resulting in low serum potassium.
Client safety and the correction of low potassium levels are a priority. The weakness in
the legs is a clinical manifestation of the hypokalemia. Dairy products and green, leafy
vegetables are a source of calcium.
A client with a potassium level of 5.5 mEq/L is to receive sodium polystyrene sulfonate
(Kayexalate) orally. After administering the drug, the priority nursing action is to monitor
A. urine output.
B. blood pressure.
C. bowel movements.
C. ECG for tall, peaked T waves. - answer C. bowel movements.
Kayexalate causes potassium to be exchanged for sodium in the intestines and excreted
through bowel movements. If client does not have stools, the drug cannot work
properly. Blood pressure and urine output are not of primary importance. The nurse
would already expect changes in T waves with hyperkalemia. Normal serum potassium
is 3.5 to 5.5 mEq/L.
The nurse is caring for a client who has been in good health up to the present and is
admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L
yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate
nursing action?
A. Call the physician and report results
B. Question the results and redraw the specimen
C. Encourage the client to increase the intake of bananas
D. Initiate seizure precautions - answer B. Question the results and redraw the
specimen
A client who has been in good health up to the present is admitted for cellulitis of the
hands. When the serum potassium goes from 4.5 mEq/L to 7.0 mEq/L with no risk factors
for hyperkalemia, false high results should be suspected because of hemolysis of the
specimen. The physician would likely question results as well. Bananas are a food high
in potassium. Seizures are not a clinical manifestation of hyperkalemia.
A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4
mEq/L. Which of the following assessments would alert the nurse to immediately stop
the infusion?
,A. Absent patellar reflex
B. Diarrhea
C. Premature ventricular contractions
D. Increase in blood pressure - answer A. Absent patellar reflex
An intravenous magnesium infusion may be used to treat a low serum magnesium level.
Normal serum magnesium is 1.5 to 2.5 mEq/L. Clinical manifestations of
hypermagnesemia are the result of depressed neuromuscular transmission. Absent
reflexes indicate a magnesium level around 7 mEq/L. Diarrhea and PVCs are not clinical
manifestations of high magnesium levels. Hypermagnesemia causes hypotension.
A client with chronic renal failure reports a 10 pound weight loss over 3 months and has
had difficulty taking calcium supplements. The total calcium is 6.9 mg/dl. Which of the
following would be the first nursing action?
A. Assess for depressed deep tendon reflexes
B. Call the physician to report calcium level
C. Place an intravenous catheter in anticipation of administering calcium gluconate
D. Check to see if a serum albumin level is available - answer D. Check to see if a serum
albumin level is available
A client with chronic renal failure who reports a 10 pound weight loss over 3 months and
has difficulty taking calcium supplements is poorly nourished and likely to have
hypoalbuminemia. A drop in serum albumin will result in a false low total calcium level.
Placing an IV is not a priority action. Depressed reflexes are a sign of hypercalcemia.
Normal serum calcium is 9 to 11 mg/dl.
A client with heart failure is complaining of nausea. The client has received IV
furosemide (Lasix), and the urine output has been 2500 ml over the past 12 hours. The
client's home drugs include metoprolol (Lopressor), digoxin (Lanoxin), furosemide, and
multivitamins. Which of the following are the appropriate nursing actions before
administering the digoxin? Select all that apply.
, A. Administer an antiemetic prior to giving the digoxin
B. Encourage the client to increase fluid intake
C. Call the physician
D. Report the urine output
E. Report indications of nausea - answer C. Call the physician
D. Report the urine output
E. Report indications of nausea
Potassium is lost during diuresis with a loop diuretic such as furosemide (Lasix).
Hypokalemia can cause digitalis toxicity, which often results in nausea. The physician
should be notified, and digoxin should be held until potassium levels and digoxin levels
are checked. Peaked T waves and widened QRS are manifestations of hyperkalemia.
The nurse is caring for a bedridden client admitted with multiple myeloma and a serum
calcium level of 13 mg/dl. Which of the following is the most appropriate nursing action?
A. Provide passive ROM exercises and encourage fluid intake
B. Teach the client to increase intake of whole grains and nuts
C. Place a tracheostomy tray at the bedside
D. Administer calcium gluconate IM as ordered - answer A. Provide passive ROM
exercises and encourage fluid intake
A client who has a serum calcium of 13 mg/dl has hypercalcemia. Normal serum calcium
is 9 to 11 mg/dl. Fluid intake promotes renal excretion of excess calcium. ROM exercises
promote reabsorption of calcium into bone. Placing a tracheostomy at the bedside is a
nursing intervention for hypocalcemia. Although calcium gluconate may be
administered in hypocalcemia, it is never administered IM.
An older adult client admitted with heart failure and a sodium level of 113 mEq/L is
behaving aggressively toward staff and does not recognize family members. When the
family expresses concern about the client's behavior, the nurse would respond most
appropriately by stating
