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1. The type of fluid used to manipulate fluid shifts among compartments states is:

A. whole blood
B. TPN
C. albumin
D. Ensure

2. Mr. Miyazaki who is diagnosed of bipolar disorder has been drinking copious amounts of water and voiding frequently. The patient is experiencing muscle cramps, twitching, and is reporting dizziness. the nurse checks lab work for:

A. complete blood count results, particularly the platelets.
B. electrolytes, particularly the serum sodium
C. urine analysis, particularly for the presence of white blood cells
D. EEG results

3. When teaching a patient about foods high in magnesium, the nurse would include:

A. green vegetables
B. butter
C. cheese
D. tomatoes

4. The balance of anions and cations as it occurs across cell membranes is known as:

A. osmotic activity
B. electrical neutrality
C. electrical stability
D. sodium-potassium pump

5. Maria, an 85-year-old patient with a feeding tube, has been experiencing severe watery stool. The patient is lethargic and has poor skin turgor, a pulse of 120, and hyperactive reflexes. Nursing interventions would include:

A. measuring and recording intake and output and daily weights
B. administering salt tablets and monitoring hypertonic parenteral solutions
C. administering sedatives
D. applying wrist restraints to avoid displacement of the feeding tube

6. Disease of which of the following structures is most likely to affect electrolyte reabsorption?

A. glomerulus
B. renal tubules
C. bladder
D. renal pelvis

7. Christoff is diagnosed with hypermagnesemia. Symptoms of her condition may include:

A. hypertension
B. tachycardia
C. hyperactive deep-tendon reflex
D. cardiac arrhythmias

8. Daniel who is a marathon runner is at high risk for fluid volume deficit. Which one of the following is a related factor?

A. decreased diuresis
B. disease-related process
C. decreased breathing and perspiration
D. increased breathing and perspiration

9. Jomarick is diagnosed with FVD; which of the following nursing diagnoses might apply to his condition?

A. altered urinary elimination
B. decreased cardiac output
C. increased cardiac output
D. vomiting

10. Body fluids perform which of the following functions?

A. transport nutrients
B. transport electrical charges
C. cushion the organs
D. facilitate fat metabolism

11. Sodium levels are affected by the secretion of which of the following hormones?

A. progesterone and aldosterone
B. ADH and ACTH
C. antidiuretic hormone and FSH
D. ECF and aldosterone

12. Bicarbonate is lost during which of the following clinical conditions?

A. diarrhea
B. diuresis
C. diaphoresis
D. vomiting

13. Magnesium reabsorption is controlled by:

A. Loop of Henle
B. glomerulus
C. pituitary
D. parathyroid hormone

14. Annaliza has a nursing diagnosis of fluid volume deficit. Which one of the following medications could potentially exacerbate the problem?

A. Synthroid
B. Digoxin
C. Lasix
D. insulin

15. Alexander has hypotonic FVE; which of the following findings would the nurse expect to assess in the patient?

A. poor skin turgor and increased thirst
B. weight gain and thirst
C. interstitial edema and hypertension
D. hypotension and pitting edema

16. The interstitial space holds approximately how many liters?

A. 3 L
B. 6 L
C. 9 L
D. 12 L

17. Sodium balance is important for which of the following functions?

A. transmitting impulses in nerve and muscle fibers via the calcium-potassium pump
B. exchanging for magnesium and attracting chloride
C. combining with hydrogen and chloride for acid-base balance
D. exchanging for potassium and attracting chloride

18. In renal regulation of water balance, the functions of angiotensin II include:

A. blood clotting within the nephron
B. increasing progesterone secretion into the renal tubules
C. catalyzing calcium-rich nutrients
D. selectively constricting portions of the arteriole in the nephron

19. Which of the following nursing diagnoses might apply to a patient with hypertonic FVE?

A. ineffective airway clearance
B. potential for decreased cardiac output
C. ineffective breathing pattern
D. potential for increased cardiac output

20. The intracellular compartment holds water and:

A. proteins
B. glucose
C. sodium
D. uric acid

21. The majority gastrointestinal reabsorption of water occurs in:

A. small intestines
B. the esophagus
C. the colon
D. the stomach

22. Isotonic FVD can result from:

A. GI fluid loss through diarrhea
B. insensible water loss during prolonged fever
C. inadequate ingestion of fluids and electrolytes
D. impaired thirst regulation

23. The majority of the body’s water is contained in which of the following fluid compartments?

A. intracellular
B. interstitial
C. intravascular
D. extracellular

24. Etiologies associated with hypomagnesemia include:

A. decreased vitamin D intake
B. constipation
C. malabsorption syndrome
D. renal failure

25. The danger of fluid sequestered in the third space is that the fluid:

A. is hypertonic and can cause hypervolemia
B. is hypotonic and can cause water intoxication
C. is not available for circulation
D. contains large amounts of acids

26. The extracellular fluid space holds water, electrolytes, proteins and:

A. red blood cells
B. potassium
C. lipids
D. nucleic acids

27. Magnesium performs all of the following functions except:

A. contributing to vasoconstriction
B. assisting in cardiac muscle contraction
C. facilitating sodium transport
D. assisting in protein metabolism

28. Which of the following clinical conditions exacerbates electrolyte excretion?

A. nasogastric feedings
B. use of surgical drains
C. immobility from fractures
D. chronic water drinking

29. A diet containing the minimum daily sodium requirement for an adult would be:

A. a no-salt diet
B. a diet including 2 gm sodium
C. a diet including 4 gm sodium
D. a 1500 calorie weight-loss diet

30. Which of the following electrolytes are lost as a result of vomiting?

A. bicarbonate and calcium
B. sodium and hydrogen
C. sodium and potassium
D. hydrogen and potassium

Answers and Rationale

Here are the answers for this exam. Gauge your performance by counter checking your answers to those below. If you have any disputes or clarifications, please direct them to the comments section.

1. Answer: C. albumin

Albumin is a colloid that is used to manipulate fluid shifts among compartments. Whole blood is used to replace blood volume. TPN is used for patients who are unable to take in food or fluid. Ensure is high caloric nutritional supplement; it is not used to manipulate fluid shifts.

2. Answer: B. electrolytes, particularly the serum sodium

The patient is exhibiting behavior that could lead to a sodium and water imbalance and is exhibiting signs of hyponatremia. The nurse would check the electrolytes with attention to the sodium level.

3. Answer: A. green vegetables

Green vegetables are high in magnesium.

4. Answer: B. electrical neutrality

Electrical neutrality refers to a state in which the same number of positively charged ions and negatively charged ions are present on either side of the membrane. Osmotic activity refers to the attraction of a solute to a solvent. Sodium-potassium pump refers to the exchange of electrolytes.

5. Answer: A. measuring and recording intake and output and daily weights

The patient is exhibiting signs of hypernatremia and dehydration. The most appropriate nursing intervention is to measure and record intake and output and daily weight.

6. Answer: B. renal tubules

The renal tubules are the site of electrolyte reabsorption. The glomerulus is the site of electrolyte filtration. The bladder is where the urine is stored. The renal pelvis is where urine travels as it moves from the collecting ducts to the ureter.

7. Answer: D. cardiac arrhythmias

Cardiac arrhythmias are associated with hypermagnesemia. Hypertension, tachycardia, and hyperactive reflexes are signs of hypomagnesemia.

8. Answer: D. increased breathing and perspiration

Excessive fluid can be lost if breathing and perspiration are at an increased rate for a prolonged period.

9. Answer: B. decreased cardiac output

Decreased cardiac output is a nursing diagnosis associated with isotonic FVD. Other appropriate nursing diagnoses include altered tissue perfusion, potential for injury, and ineffective breathing pattern.

10. Answer: A. transport nutrients

Body fluids facilitate the transport of nutrients, hormones, proteins, and other molecules.

11. Answer: B. ADH and ACTH

The endocrine system secretes aldosterone and ADH to help regulate sodium levels. The pituitary secretes adrenocorticotropin hormone to help regulate sodium. A and C are reproductive hormones. ECF is not a hormone.

12. Answer: A. diarrhea

Bicarbonate is lost in diarrhea because the lower intestinal tract contains fluids rich in bicarbonate.

13. Answer: A. Loop of Henle

The Loop of Henle is responsible for magnesium reabsorption.

14. Answer: C. Lasix

Lasix will contribute to fluid loss through its action as a diuretic.

15. Answer: B. weight gain and thirst

Weight gain and thirst are symptoms of hypotonic FVE; other symptoms include excretion of dilute urine, non-pitting edema, dysrhythmias, and hyponatremia.

16. Answer: C. 9 L

The interstitial space hold 9 L.

17. Answer: D. exchanging for potassium and attracting chloride

Sodium influences the levels of potassium and chloride by exchanging for potassium and attracting chloride.

18. Answer: D. selectively constricting portions of the arteriole in the nephron

As part of the renal regulation of water balance, angiotensin II selectively constricts portions of the arteriole in the nephron.

19. Answer: B. potential for decreased cardiac output

Potential for decreased cardiac output is a nursing diagnosis associated with hypertonic FVE.

20. Answer: A. proteins

The intracellular compartment holds large amounts of water and proteins. Potassium, lipids, and nucleic acids are also components of the intracellular compartment.

21. Answer: A. small intestines

Approximately 85% to 95% of water absorption takes place in the small intestine. The colon absorbs only 500 to 100 cc.

22. Answer: C. inadequate ingestion of fluids and electrolytes

Isotonic FVD may result from inadequate intake of fluids and electrolytes that can occur secondary to an inability to ingest orally. GI fluid loss through diarrhea is an etiology of hypotonic FVD. Insensible water loss during prolonged fever is a cause of hypertonic FVD. Impaired thirst regulation is a cause of hypertonic FVD.

23. Answer: A. intracellular

The intracellular compartment holds two-thirds of total body water. The extracellular compartment is the interstitial space plus the intravascular space. The extracellular compartment accounts for one-third of total body water.

24. Answer: C. malabsorption syndrome

Malabsorption syndrome is associated with hypomagnesemia. Increased vitamin D intake and diarrhea are also associated with hypomagnesemia.

25. Answer: C. is not available for circulation

In third-spacing, fluid is sequestered and is unavailable to the general circulation.

26. Answer: A. red blood cells

The extracellular space contains red blood cells, white blood cells, and platelets in addition to water, electrolytes, and proteins. Potassium, lipids, and nucleic acids are intracellular components.

27. Answer: A. contributing to vasoconstriction

Magnesium contributes to vasodilation, not vasoconstriction.

28. Answer: B. use of surgical drains

Surgical drains will cause a fluid loss, and electrolytes are eliminated along with the fluid.

29. Answer: B. a diet including 2 gm sodium

The minimum sodium requirement for adults is 2 gm daily. Most adults consume more than this because sodium is abundant in almost all foods.

30. Answer: D. hydrogen and potassium

In upper gastrointestinal fluid loss, hydrogen and potassium are lost because these electrolytes are present in abundance in the stomach.