Fundamentals Of Nursing Exam 4: Questions & Answers
The patient receives an infusion of albumin to pull water from the tissues into the bloodstream. Which
process is demonstrated by this treatment?
a. Diffusion
b. Osmosis
c. Filtration
d. Clarification - ANSWER:b. Osmosis
Ch 18: Osmosis is movement of water across a semipermeable membrane from a compartment of lower
particle concentration to one that has a higher particle concentration. Diffusion is passive movement of
electrolytes or other particles from an area of higher concentration to an area of lower concentration.
Filtration is the net effect of several forces that tend to move fluid across a membrane. Clarification is
explanation of a concept in greater detail or removal of impurities.
Which patient should receive an IV solution of D5W?
a. A trauma patient with massive hemorrhage
b. A patient being resuscitated after cardiac arrest
c. A patient with CHF and acute pulmonary edema
d. A patient with a serum sodium level of 162 mEq/L - ANSWER:d. A patient with a serum sodium level of
162 mEq/L
Ch 18: D5W solution is used to lower elevated serum sodium levels. Normal saline solution should be
administered to hypovolemic patients and during resuscitation after cardiac arrest. D5W solution will
worsen fluid overload with CHF and acute pulmonary edema.
Lactated Ringer's solution is administered to the patient during surgery. What is the purpose of this
infusion?
a. Cause cells to shrink and reduce swelling.
b. Expand the body's intravascular fluid volume.
c. Move fluid from intravascular space into cells.
d. Pull fluid from cells into the intravascular space. - ANSWER:b. Expand the body's intravascular fluid
volume.
,Ch 18: Fluids that have the same osmolality as normal blood are called isotonic. Isotonic solutions such
as Lactated Ringer's expand the body's extracellular fluid volume without causing water to shift in or out
of cells. Infusion of hypertonic intravenous solutions (more concentrated than normal blood), such as 3%
sodium chloride, pulls fluid from cells by osmosis, causing them to shrink. Physiologically hypotonic
solutions (less concentrated than normal blood after they are infused) move water from the extracellular
compartment into the cells by osmosis, causing them to swell.
What causes the patient to feel thirsty and drink more water?
a. Colloid osmotic pressure
b. Osmoreceptor stimulation
c. Increased oncotic pressure
d. Decreased hydrostatic pressure - ANSWER:b. Osmoreceptor stimulation
Ch 18: Thirst, a conscious desire for water, regulates fluid intake when plasma osmolality increases
(osmoreceptor-mediated thirst) or the blood volume decreases (baroreceptor-mediated thirst and
angiotensin II-mediated thirst). The thirst-control mechanism is in the hypothalamus of the brain.
Osmoreceptors there continually monitor plasma osmolality; when osmolality increases, the
hypothalamus stimulates thirst. Colloid osmotic pressure (oncotic pressure) is an inward-pulling force
caused by the presence of protein molecules. Hydrostatic pressure is the force of a fluid pressing
outward against the walls of its container. Thus capillary hydrostatic pressure is an outward-pushing
force.
The nurse is caring for a patient with metabolic acidosis due to severe hyperglycemia. Which assessment
finding indicates to the nurse that the patient's body is attempting to compensate for the acidosis?
a. The patient's breathing is very deep and rapid.
b. The patient's temperature has been rising steadily.
c. The patient's skin is flushed and warm to the touch.
d. The patient is urinating large amounts of light colored urine. - ANSWER:a. The patient's breathing is
very deep and rapid.
Ch 18: The patient's deep breathing is an attempt by the body to blow off additional carbon dioxide
which converts to carbonic acid. Reduction of carbonic acid in the body will raise the pH and compensate
for the acidosis. Elevated temperature, flushed skin, and increased urine output will not compensate for
the acidosis.
The nurse is caring for a patient who is very malnourished and laboratory results show that the patient's
albumin level is extremely low. Which finding would the nurse expect to observe during the patient's
physical assessment?
,a. The patient has generalized edema.
b. The patient is confused and irritable.
c. The patient has an irregular heartbeat.
d. The patient's eyes are red, irritated, and itchy. - ANSWER:a. The patient has generalized edema.
Ch 18: Albumin is responsible for keeping water within the bloodstream using oncotic pressure. Low
albumin levels allow water to seep from the bloodstream into the tissues causing generalized edema.
Confusion, irregular pulse, and irritated eyes are not expected with low albumin levels.
The nurse is caring for a patient with a serum potassium level of 7.1 mEq/L. Which is the highest priority
nursing diagnosis for this patient?
a. Risk for spiritual distress related to chronic illness despair
b. Powerlessness related to illness-related physical limitations
c. Impaired social interaction related to limited physical activity
d. Risk for decreased cardiac output related to altered heart rhythm - ANSWER:d. Risk for decreased
cardiac output related to altered heart rhythm
Ch 18: The patient's potassium level is dangerously high, which can cause ventricular fibrillation. For this
reason the highest priority diagnosis for the patient is risk for decreased cardiac output related to altered
heart rhythm. Risk for spiritual distress, powerlessness, and impaired social interaction are not the
priority.
The nurse is caring for a patient who has been vomiting. The patient's sodium level is 124 mEq/L. Which
laboratory result will the nurse also expect to see in the patient's chart?
a. Chloride 81 mEq/L
b. Calcium 11.1 mg/dL
c. Phosphate 5.1 mg/dL
d. Magnesium 2.3 mEq/L - ANSWER:a. Chloride 81 mEq/L
Ch 18: Chloride levels are closely associated with sodium levels. When the serum sodium level is low, the
chloride level will drop as well. The normal sodium level is 135 to 145 mEq/L so the patient's 124 mEq/L
level indicates hyponatremia. The nurse will expect to find the patient's chloride level to be 81, below
the 95 to 105 normal range. Hypercalcemia, normal magnesium level, and hyperphosphatemia are not
expected with hyponatremia due to vomiting.
, The nurse is caring for a patient with a poorly controlled hypoparathyroid condition. Which is the highest
priority nursing diagnosis for this patient?
a. Risk for injury/fracture related to bone fragility
b. Disturbed energy field related to chronic illness
c. Deficient knowledge related to importance of exercise
d. Disturbed body image related to hormonal changes - ANSWER:a. Risk for injury/fracture related to
bone fragility
Ch 18: Hypoparathyroid disease can lead to low serum calcium levels and osteoporosis, putting the
patient at risk for developing a pathological fracture. Risk for fracture is the highest priority diagnosis for
this patient. Disturbed energy field, deficient knowledge, and disturbed body image are not as important
as the risk for fracture.
The patient reports muscle weakness after taking prescribed furosemide daily. Which laboratory finding
will the nurse expect to see in the patient's chart?
a. Chloride 84 mEq/L
b. Sodium 124 mEq/L
c. Calcium 12.6 mg/dL
d. Potassium 2.8 mEq/L - ANSWER:d. Potassium 2.8 mEq/L
Ch 18: Loop diuretics cause hypokalemia. The nurse will expect to find the patient's potassium level to be
2.8 mEq/L as a result. The patient would not have hyponatremia (sodium 124 mEq/L), hypercalcemia
(calcium 12.6 mg/dL), or hypochloremia (chloride 84 mEq/L) as a result of taking loop diuretics.
The nurse is caring for a dyspneic patient with a long history of smoking. The blood gas report shows a
pH of 7.33, PaCO2 of 47, PaO2 of 78, and HCO3- of 26. What is the patient's acid-base status?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis - ANSWER:b. Respiratory acidosis
Ch 18: Normal arterial blood pH value is 7.35 to 7.45 (acidic is less than 7.35, and alkalotic is greater than
7.45). Respiratory acidosis is an increased PaCO2 and an increased hydrogen ion concentration (pH
below 7.35) that reflect the excess carbonic acid (H2CO3) in the blood. Hypoventilation produces
respiratory acidosis, which causes the cerebrospinal fluid and brain cells to become acidic, thus
The patient receives an infusion of albumin to pull water from the tissues into the bloodstream. Which
process is demonstrated by this treatment?
a. Diffusion
b. Osmosis
c. Filtration
d. Clarification - ANSWER:b. Osmosis
Ch 18: Osmosis is movement of water across a semipermeable membrane from a compartment of lower
particle concentration to one that has a higher particle concentration. Diffusion is passive movement of
electrolytes or other particles from an area of higher concentration to an area of lower concentration.
Filtration is the net effect of several forces that tend to move fluid across a membrane. Clarification is
explanation of a concept in greater detail or removal of impurities.
Which patient should receive an IV solution of D5W?
a. A trauma patient with massive hemorrhage
b. A patient being resuscitated after cardiac arrest
c. A patient with CHF and acute pulmonary edema
d. A patient with a serum sodium level of 162 mEq/L - ANSWER:d. A patient with a serum sodium level of
162 mEq/L
Ch 18: D5W solution is used to lower elevated serum sodium levels. Normal saline solution should be
administered to hypovolemic patients and during resuscitation after cardiac arrest. D5W solution will
worsen fluid overload with CHF and acute pulmonary edema.
Lactated Ringer's solution is administered to the patient during surgery. What is the purpose of this
infusion?
a. Cause cells to shrink and reduce swelling.
b. Expand the body's intravascular fluid volume.
c. Move fluid from intravascular space into cells.
d. Pull fluid from cells into the intravascular space. - ANSWER:b. Expand the body's intravascular fluid
volume.
,Ch 18: Fluids that have the same osmolality as normal blood are called isotonic. Isotonic solutions such
as Lactated Ringer's expand the body's extracellular fluid volume without causing water to shift in or out
of cells. Infusion of hypertonic intravenous solutions (more concentrated than normal blood), such as 3%
sodium chloride, pulls fluid from cells by osmosis, causing them to shrink. Physiologically hypotonic
solutions (less concentrated than normal blood after they are infused) move water from the extracellular
compartment into the cells by osmosis, causing them to swell.
What causes the patient to feel thirsty and drink more water?
a. Colloid osmotic pressure
b. Osmoreceptor stimulation
c. Increased oncotic pressure
d. Decreased hydrostatic pressure - ANSWER:b. Osmoreceptor stimulation
Ch 18: Thirst, a conscious desire for water, regulates fluid intake when plasma osmolality increases
(osmoreceptor-mediated thirst) or the blood volume decreases (baroreceptor-mediated thirst and
angiotensin II-mediated thirst). The thirst-control mechanism is in the hypothalamus of the brain.
Osmoreceptors there continually monitor plasma osmolality; when osmolality increases, the
hypothalamus stimulates thirst. Colloid osmotic pressure (oncotic pressure) is an inward-pulling force
caused by the presence of protein molecules. Hydrostatic pressure is the force of a fluid pressing
outward against the walls of its container. Thus capillary hydrostatic pressure is an outward-pushing
force.
The nurse is caring for a patient with metabolic acidosis due to severe hyperglycemia. Which assessment
finding indicates to the nurse that the patient's body is attempting to compensate for the acidosis?
a. The patient's breathing is very deep and rapid.
b. The patient's temperature has been rising steadily.
c. The patient's skin is flushed and warm to the touch.
d. The patient is urinating large amounts of light colored urine. - ANSWER:a. The patient's breathing is
very deep and rapid.
Ch 18: The patient's deep breathing is an attempt by the body to blow off additional carbon dioxide
which converts to carbonic acid. Reduction of carbonic acid in the body will raise the pH and compensate
for the acidosis. Elevated temperature, flushed skin, and increased urine output will not compensate for
the acidosis.
The nurse is caring for a patient who is very malnourished and laboratory results show that the patient's
albumin level is extremely low. Which finding would the nurse expect to observe during the patient's
physical assessment?
,a. The patient has generalized edema.
b. The patient is confused and irritable.
c. The patient has an irregular heartbeat.
d. The patient's eyes are red, irritated, and itchy. - ANSWER:a. The patient has generalized edema.
Ch 18: Albumin is responsible for keeping water within the bloodstream using oncotic pressure. Low
albumin levels allow water to seep from the bloodstream into the tissues causing generalized edema.
Confusion, irregular pulse, and irritated eyes are not expected with low albumin levels.
The nurse is caring for a patient with a serum potassium level of 7.1 mEq/L. Which is the highest priority
nursing diagnosis for this patient?
a. Risk for spiritual distress related to chronic illness despair
b. Powerlessness related to illness-related physical limitations
c. Impaired social interaction related to limited physical activity
d. Risk for decreased cardiac output related to altered heart rhythm - ANSWER:d. Risk for decreased
cardiac output related to altered heart rhythm
Ch 18: The patient's potassium level is dangerously high, which can cause ventricular fibrillation. For this
reason the highest priority diagnosis for the patient is risk for decreased cardiac output related to altered
heart rhythm. Risk for spiritual distress, powerlessness, and impaired social interaction are not the
priority.
The nurse is caring for a patient who has been vomiting. The patient's sodium level is 124 mEq/L. Which
laboratory result will the nurse also expect to see in the patient's chart?
a. Chloride 81 mEq/L
b. Calcium 11.1 mg/dL
c. Phosphate 5.1 mg/dL
d. Magnesium 2.3 mEq/L - ANSWER:a. Chloride 81 mEq/L
Ch 18: Chloride levels are closely associated with sodium levels. When the serum sodium level is low, the
chloride level will drop as well. The normal sodium level is 135 to 145 mEq/L so the patient's 124 mEq/L
level indicates hyponatremia. The nurse will expect to find the patient's chloride level to be 81, below
the 95 to 105 normal range. Hypercalcemia, normal magnesium level, and hyperphosphatemia are not
expected with hyponatremia due to vomiting.
, The nurse is caring for a patient with a poorly controlled hypoparathyroid condition. Which is the highest
priority nursing diagnosis for this patient?
a. Risk for injury/fracture related to bone fragility
b. Disturbed energy field related to chronic illness
c. Deficient knowledge related to importance of exercise
d. Disturbed body image related to hormonal changes - ANSWER:a. Risk for injury/fracture related to
bone fragility
Ch 18: Hypoparathyroid disease can lead to low serum calcium levels and osteoporosis, putting the
patient at risk for developing a pathological fracture. Risk for fracture is the highest priority diagnosis for
this patient. Disturbed energy field, deficient knowledge, and disturbed body image are not as important
as the risk for fracture.
The patient reports muscle weakness after taking prescribed furosemide daily. Which laboratory finding
will the nurse expect to see in the patient's chart?
a. Chloride 84 mEq/L
b. Sodium 124 mEq/L
c. Calcium 12.6 mg/dL
d. Potassium 2.8 mEq/L - ANSWER:d. Potassium 2.8 mEq/L
Ch 18: Loop diuretics cause hypokalemia. The nurse will expect to find the patient's potassium level to be
2.8 mEq/L as a result. The patient would not have hyponatremia (sodium 124 mEq/L), hypercalcemia
(calcium 12.6 mg/dL), or hypochloremia (chloride 84 mEq/L) as a result of taking loop diuretics.
The nurse is caring for a dyspneic patient with a long history of smoking. The blood gas report shows a
pH of 7.33, PaCO2 of 47, PaO2 of 78, and HCO3- of 26. What is the patient's acid-base status?
a. Respiratory alkalosis
b. Respiratory acidosis
c. Metabolic alkalosis
d. Metabolic acidosis - ANSWER:b. Respiratory acidosis
Ch 18: Normal arterial blood pH value is 7.35 to 7.45 (acidic is less than 7.35, and alkalotic is greater than
7.45). Respiratory acidosis is an increased PaCO2 and an increased hydrogen ion concentration (pH
below 7.35) that reflect the excess carbonic acid (H2CO3) in the blood. Hypoventilation produces
respiratory acidosis, which causes the cerebrospinal fluid and brain cells to become acidic, thus
