LEWIS CHAPTER 17: FLUID,
ELECTROLYTE, AND ACID-BASE
IMBALANCES EXAM 2025 QUESTIONS
AND ANSWERS
During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake
and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances
primarily because:
a. older adults have an impaired thirst mechanism and need reminding to drink fluids
b. water accounts for a greater percentage of body weight in the older adult than in younger
adults
c. older adults are more likely than younger adults to lose extracellular fluid during surgical
procedures
d. small losses of fluid are more significant because body fluids account for only about 50% of
body weight in older adults - ANS d. small losses of fluid are more significant because body
fluids account for only about 50% of body weight in older adults
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,Rationale: In the older adult, body water content averages 45% to 55% of body weight.
During administration of a hypertonic IV solution, the mechanism involved in equalizing the
fluid concentration between ECF and the cells is:
a. osmosis
b. diffusion
c. active transport
d. facilitated diffusion - ANS a. osmosis
Rationale: Osmosis is the movement of water between two compartments separated by a
semipermeable membrane. Water moves through the membrane from an area of low solute
concentration to an area of high solute concentration.
An older woman was admitted to the medical unit with dehydration. Clinical indications of this
problem are (select all that apply):
a. weight loss
b. dry oral mucosa
c. full bounding pulse
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, d. engorged neck veins
e. decreased central venous pressure - ANS a, b, & e
Rationale: Body weight loss, especially sudden change, is an excellent indicator of overall fluid
volume loss. Other clinical manifestations of dehydration include dry mucous membranes and a
decreased central venous pressure, which reflect fluid volume loss.
The nursing care for a patient with hyponatremia includes:
a. fluid restriction
b. administration of hypotonic IV fluids
c. administration of a cation-exchance resin
d. increased water intake for patients on nasogastric suction - ANS a. fluid restriction
Rationale: In hyponatremia that is caused by water excess, fluid restriction often is all that is
needed to treat the problem.
The nurse should be alert for which manifestations n a patient receiving a loop diuretic?
a. Restlessness and agitation
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ELECTROLYTE, AND ACID-BASE
IMBALANCES EXAM 2025 QUESTIONS
AND ANSWERS
During the postoperative care of a 76-year-old patient, the nurse monitors the patient's intake
and output carefully, knowing that the patient is at risk for fluid and electrolyte imbalances
primarily because:
a. older adults have an impaired thirst mechanism and need reminding to drink fluids
b. water accounts for a greater percentage of body weight in the older adult than in younger
adults
c. older adults are more likely than younger adults to lose extracellular fluid during surgical
procedures
d. small losses of fluid are more significant because body fluids account for only about 50% of
body weight in older adults - ANS d. small losses of fluid are more significant because body
fluids account for only about 50% of body weight in older adults
1 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
,Rationale: In the older adult, body water content averages 45% to 55% of body weight.
During administration of a hypertonic IV solution, the mechanism involved in equalizing the
fluid concentration between ECF and the cells is:
a. osmosis
b. diffusion
c. active transport
d. facilitated diffusion - ANS a. osmosis
Rationale: Osmosis is the movement of water between two compartments separated by a
semipermeable membrane. Water moves through the membrane from an area of low solute
concentration to an area of high solute concentration.
An older woman was admitted to the medical unit with dehydration. Clinical indications of this
problem are (select all that apply):
a. weight loss
b. dry oral mucosa
c. full bounding pulse
2 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
, d. engorged neck veins
e. decreased central venous pressure - ANS a, b, & e
Rationale: Body weight loss, especially sudden change, is an excellent indicator of overall fluid
volume loss. Other clinical manifestations of dehydration include dry mucous membranes and a
decreased central venous pressure, which reflect fluid volume loss.
The nursing care for a patient with hyponatremia includes:
a. fluid restriction
b. administration of hypotonic IV fluids
c. administration of a cation-exchance resin
d. increased water intake for patients on nasogastric suction - ANS a. fluid restriction
Rationale: In hyponatremia that is caused by water excess, fluid restriction often is all that is
needed to treat the problem.
The nurse should be alert for which manifestations n a patient receiving a loop diuretic?
a. Restlessness and agitation
3 Copyright ©2025 FYNDLAY ALL RIGHTS RESERVED.
