Chapter 41: Fluid, Electrolyte, and Acid?Base Balance - Nurselytic

Questions 20

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Fundamentals of Nursing: The Art and Science of Person-Centered Care Tenth, North American Edition

Chapter 41 : Fluid, Electrolyte, and Acid?Base Balance Questions

Question 1 of 5

A nurse is caring for a patient who has developed hypernatremia. For which intravenous solution would the nurse anticipate a prescription?

Correct Answer: C

Rationale: 0.45% NaCl is a hypotonic solution used to treat hypernatremia by lowering sodium levels. 5% dextrose in 0.9% NaCl (
A) and normal saline (
B) are isotonic and do not correct hypernatremia. 5% dextrose in lactated Ringer's (
D) is used for hypovolemia or electrolyte replacement, not hypernatremia.

Question 2 of 5

A nurse is assessing infants in the NICU for fluid balance status. Which nursing action would the nurse depend on as the most reliable indicator of a patient's fluid balance status?

Correct Answer: D

Rationale: Daily weight is the most reliable indicator of fluid balance, especially in infants, as it reflects changes in fluid status accurately. Intake and output (
A) can be subjective. Skin turgor (
B) is less reliable due to infants' skin elasticity. Complete blood count (
C) does not directly reflect fluid balance.

Question 3 of 5

How will the nurse interpret the patient's arterial blood gas values: pH, 7.30; PaCO2, 36 mm Hg; HCO3-, 14 mEq/L?

Correct Answer: C

Rationale: Low pH (7.30) indicates acidosis. Normal PaCO2 (36 mm Hg) rules out respiratory causes, and low HCO3- (14 mEq/L) indicates metabolic acidosis. Respiratory acidosis (
A) involves high PaCO2. Respiratory alkalosis (
B) involves low PaCO2 and high pH. Metabolic alkalosis (
D) involves high HCO3- and high pH.

Question 4 of 5

A patient with dehydration has been encouraged to increase fluid intake. Which measure would be most effective for the nurse to implement?

Correct Answer: B

Rationale: Keeping preferred fluids readily available promotes intake by making it convenient and appealing. Explaining mechanisms (
A) is too complex for immediate action. Long-term benefits (
C) are less motivating than immediate access. Evening fluid intake (
D) may disrupt sleep due to increased urination.

Question 5 of 5

A nurse is flushing a patient's peripheral venous access device. The nurse finds that the access size is leaking fluid during flushing. What action will the nurse take next?

Correct Answer: A

Rationale: Leaking fluid indicates infiltration, requiring removal of the IV and restarting at a new site. Notifying the provider (
B) is unnecessary unless complications arise. Outlining the area (
C) is a follow-up action after removal. Aspirating and flushing again (
D) risks further tissue damage.

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