Chapter 8: Disorders of Fluid, Electrolyte, and Acid-Base Balance

7 Quizzes taken

Answer Key
Question 1: The nurse is administering the medications to a patient on the
(see full question) cardiac unit. Giving which of the following medications
causes the nurse to be alert for hypokalemia?

You selected: Angiotensin II receptor blockers

Incorrect

Correct response: Loop diuretic

Explanation: Potassium is typically lost with the use of thiazide or loop

diuretics. The other groups of medications may cause an
increase in potassium levels.
 

Reference: Porth, C. M. Essentials of Pathophysiology: Concepts of

Altered Health States, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2015, Ch. 8:
Disorders of Fluid, Electrolyte and Acid-Base Balance, p.
178.

Question 2: A client is brought to the emergency department with

(see full question) complaints of shortness of breath. Assessment reveals a full,
bounding pulse, severe edema and audible crackles in lower
lung fields bilaterally. The nurse notifies the physician to
obtain orders for which of these problems?

You selected: Hypocalcemia.

Incorrect

Correct response: Fluid volume excess.

Explanation: Peripheral and pulmonary edema as well as a bounding pulse

and dyspnea are indicators of fluid volume overload.
 

Reference: Porth, C. M. Essentials of Pathophysiology: Concepts of

 Altered Health States, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2015, Ch. 8:
Disorders of Fluid, Electrolyte and Acid-Base Balance, p.
173-174.

Question 3: A client with ethylene glycol toxicity is restless, and stating

(see full question) he has flank pain. What intervention should the nurse perform
to minimize complications? 

You selected: Increase IV fluids

Correct

Explanation: Symptoms of ethylene glycol toxicity appear in stages. Within

the first 12 hours, the client may appear drunk or comatose. In
the second stage the client may develop tachycardia or
pulmonary edema. During the third stage, the client may
develop flank pain and renal failure as the tubules become
plugged with oxalate crystals. Expanding extracellular fluid
volume and hemodialysis are used to flush the toxins from the
system. Aspirin is not a drug of choice because it is
metabolized in the kidney. A change in calcium will not
reduce the risk for renal failure. (less)
 

Reference: Porth, C. M. Essentials of Pathophysiology: Concepts of

Altered Health States, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2015, Ch. 8:
Disorders of Fluid, Electrolyte and Acid-Base Balance, p.
197.

Question 4: Which arterial blood gas (ABG) values tell the nurse a client
(see full question) is in respiratory alkalosis? Select all that apply.

You selected: • pCO2 of 27mm Hg

• pH 7.52

Correct

Explanation: ABGs measure pH, carbon dioxide (pCO2), bicarbonate ion

 (HCO3-), oxygen pO2, base excess, and the anion gap. A pH
that is below 7.35 is considered acidic while above 7.45 is
considered alkaline. The pCO2 is considered the primary
indicator of respiratory function. Elevation above 45mm Hg
indicates acidosis while a decrease below 35mm Hg indicates
alkalosis. Bicarbonate (HCO3-) is the primary indicator of
metabolic function and is considered alkaline if greater than26
mEq/l, and acidic if below 22 mEq/L. Base excess measures
the level of all the buffer systems in the blood. If the level is
more than 0.2 mEq/L above the normal pH of 7.4 it is
considered an excess and indicates metabolic alkalosis. Anion
gap indicates the difference between plasma concentration of
the major measured cation (sodium) and the sum of the
measured anions (chloride and bicarbonate). This level rises
in conditions of acidosis. Anion gap and base excess or deficit
are used primarily to indicate metabolic acid-base disorders.
(less)
 

Reference: Porth, C. M. Essentials of Pathophysiology: Concepts of

Altered Health States, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2015, Ch. 8:
Disorders of Fluid, Electrolyte and Acid-Base Balance, p.
195.

Question 5:
(see full question) Vitamin D, officially classified as a vitamin, functions as a
hormone in the body. What other hormone is necessary in the
body for vitamin D to work?

You selected: Thyroid hormone

Incorrect

Correct response: Parathyroid hormone

Explanation: The small, but vital, amount of ECF calcium, phosphate, and
magnesium is directly or indirectly regulated by vitamin D
and parathyroid hormone. The other answers are not correct.
(less)
 

Reference: Porth, C. M. Essentials of Pathophysiology: Concepts of

Altered Health States, 4th ed., Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2015, Chapter 8:
Disorders of Fluid, Electrolyte, and Acid-Base Balance, p.
181-182.