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Medical Surgical Nursing Critical Thinking for Person Centred Care 3rd Edition Lemone Test Bank instant download all chapter
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Chapter 9
Overview of Normal Fluid and Electrolyte Balance
SHORT ANSWER. Write the word or phrase that best completes each statement or answers the
question.
1) The nurse assesses a person’s recent weight loss as being 10 kilograms. How many litres of fluid did this
person lose? ____________
2) A postoperative person with a fluid volume deficit is prescribed progressive ambulation, yet is weak
from the inadequate fluid status. What can the nurse do to help this person?
Correct Answer: D
Diff: 2
Type: MC
A-head in 3e: 9.2 The person with Fluid Volume Deficit
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
NMBA: Standard 6: Provides safe, appropriate and responsive quality nursing practice
3) An older adult does not complain of thirst. What should the nurse do to assess whether this person is
dehydrated?
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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A) Check pupillary reactions. B) Assess the urine-specific gravity.
C) Assess deep tendon reflexes. D) Check for compensatory changes in respirations.
Correct Answer: B
Diff: 2
Type: MC
A-head in 3e: 9.2 The Person with Fluid Volume Deficit
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
4) An elderly person who is being medicated for pain had an episode of incontinence. What is this person
at risk of developing?
Correct Answer: A
Diff: 1
Type: MC
A-head in 3e: 9.2 The person with Fluid Volume Deficit
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
Correct Answer: B
Diff: 2
Type: MC
A-head in 3e: 9.3 Fluid Volume Excess
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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NMBA: Standard 1: Thinks critically and analyses nursing practice
6) An older adult is at home after being diagnosed with a fluid volume excess. Which of the following
should the community nurse instruct this person to do?
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.3 Fluid Volume Excess
Learning Outcome in 2e: Compare and contrast the causes, effects and care of the person with fluid
volume or electrolyte imbalance.
Sodium Imbalance
7) A person is admitted with an elevated serum sodium level caused by being stranded in rugged
bushland for 5 days without a fresh water source. Which of the following is this person at risk of
developing?
Correct Answer: A
Diff: 2
Type: MC
A-head in 3e: 9.4 Sodium Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus
8) A person with fluid retention related to renal problems is admitted to the hospital. The nurse realises
that this person could possibly have which of the following electrolyte imbalances?
A) Hypercapnia B) Hypocalcaemia
C) Hypernatraemia D) Hypophosphataemia
Correct Answer: C
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
3
Diff: 1
Type: MC
A-head in 3e: 9.4 Sodium Imbalance
Learning Outcome 2e: Describe the functions and regulatory mechanisms that maintain water and
electrolyte balance in the body.
Potassium imbalance
9) A person is prescribed 40 mEq of potassium as a replacement. How should this be administered?
Correct Answer: C
Diff: 2
Type: MC
A-head in 3e: 9.5 Potassium imbalance
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
NMBA: Standard 6: Provides safe, appropriate and responsive quality nursing practice
10) A person who is taking digoxin (Lanoxin) is admitted with a low serum potassium level. Which of the
following does the nurse realise might occur with this person?
A) Digoxin toxicity
B) Fluid volume deficit
C) The need for a diuretic
D) The possible need for a higher dose of digoxin (Lanoxin)
Correct Answer: A
Diff: 2
Type: MC
A-head in 3e: 9.5 Potassium Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus.
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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11) An older adult comes into the clinic complaining of watery diarrhoea for several days with abdominal
and muscle cramping. The nurse realises that this person could be experiencing: which condition?
A) Hypocalcaemia B) Hypernatraemia
C) Hypervolaemia D) Hyponatraemia
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.5 Potassium Imbalance
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
12) The nurse is admitting a person who was diagnosed with acute renal failure. Which of the following
electrolytes will be most affected with this disorder?
Correct Answer: B
Diff: 1
Type: MC
A-head in 3e: 9.5 Potassium Imbalance
Learning Outcome 2e: Describe the functions and regulatory mechanisms that maintain water and
electrolyte balance in the body.
13) An older adult with a history of sodium retention arrives at the clinic complaining of ‘missed
heartbeats’ and leg tremors. Which of the following should the nurse ask this person regarding these
symptoms?
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.5 Potassium Imbalance
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
Calcium Imbalance
14) A 35-year-old postoperative woman comes into the clinic after a parathyroidectomy. Which of the
following should the nurse teach this person?
Correct Answer: B
Diff: 1
Type: MC
A-head in 3e: 9.6 Calcium Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus.
15) A person is admitted for treatment of hypercalcaemia. What will this person’s intravenous fluid most
likely be?
Correct Answer: A
Diff: 2
Type: MC
A-head in 3e: 9.6 Calcium imbalance
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
NMBA: Standard 6: Provides safe, appropriate and responsive quality nursing practice
Magnesium Imbalance
16) A 28-year-old male is admitted with diabetic ketoacidosis. The nurse realises that this person may have
a need for which of the following electrolytes?
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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A) Phosphate B) Sodium C) Potassium D) Magnesium
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.7 Magnesium Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus.
17) An older adult with peripheral neuropathy has been self-medicating with magnesium supplements.
The nurse realises that which of the following symptoms can indicate hypermagnesaemia?
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.7 Magnesium Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus.
Phosphate imbalance
18) A person is admitted with burns over 50% of his body. The nurse realises that this person is at risk of
which of the following electrolyte imbalances?
A) Hyponatraemia B) Hypercalcaemia
C) Hypermagnesaemia D) Hypophosphataemia
Correct Answer: D
Diff: 3
Type: MC
A-head in 3e: 9.8 Phosphate imbalance
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
7
19) A person is diagnosed with an elevated serum phosphate level. The nurse realises that this person
might also have an imbalance of which of the following electrolytes?
Correct Answer: B
Diff: 3
Type: MC
A-head in 3e: 9.8 Phosphate Imbalance
Learning Outcome 2e: Explain the pathophysiology and manifestations of imbalances of sodium,
potassium, calcium, magnesium and phosphorus.
20) The nurse is reviewing a person’s blood pH level. Which body system helps regulate blood pH?
A) Musculoskeletal B) Renal
C) Neurological D) Gastrointestinal
Correct Answer: B
Diff: 1
Type: MC
A-head in 3e: 9.9 Regulation of Acid-Base Balance
Learning Outcome 2e: Describe the causes and effects of acid–base imbalances.
21) The nurse observes a person’s respirations and notes that the rate is 30 breaths per minute and the
respirations are very deep. What disorder might this person be experiencing?
Correct Answer: A
Diff: 2
Type: MC
A-head in 3e: 9.9 Regulation of Acid-Base Balance
Learning Outcome 2e: Describe the causes and effects of acid–base imbalances.
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
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Acid-Base Imbalance
22) An elderly postoperative person is demonstrating lethargy, confusion and a respiratory rate of 8
breaths per minute. Which of the following acid-base disorders might this person be experiencing?
Correct Answer: D
Diff: 1
Type: MC
A-head in 3e: 9.10 Acid-Base Imbalance
Learning Outcome 2e: Describe the causes and effects of acid–base imbalances.
23) The blood gases of a person with an acid-base disorder show a blood pH outside of normal limits.
Which of the following is correct? The person is:
Correct Answer: D
Diff: 2
Type: MC
A-head in 3e: 9.10 Acid-Base Imbalance
Learning Outcome 2e: Describe the causes and effects of acid–base imbalances.
24) A person’s blood gases show a pH above 7.53 and a bicarbonate level of 36 mEq/L. Which acid-base
disorder is the person demonstrating
Correct Answer: D
Diff: 2
Type: MC
A-head in 3e: 9.10 Acid-Base Imbalance
Learning Outcome 2e: Describe the causes and effects of acid–base imbalances
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
9
25) A person is prescribed 20 mEq of potassium chloride. Why is the person most likely receiving this
replacement? To:
6) C
Diff: 3
Type: MC
A-head in 3e: 9.10 Acid-base imbalance
Learning Outcome 2e: Compare and contrast the causes, effects and care of the person with fluid volume
or electrolyte imbalance.
Copyright © 2017 Pearson Australia (a division of Pearson Australia Group Pty Ltd) 9781488611759, LeMone, Medical-Surgical Nursing 3e
10
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Merry’s Adventures.
chapter xvii.
chapter xvi.
The grotto of Pausilippo.—A dying man.—The Lazzaroni.—Weather
at Naples.—The grotta del cane.—Inhuman sport.—Subterranean
fires.—A Funeral.—Characteristics of the Neapolitans.
chapter xi.
The meeting.—Discussion.—A government adopted.—Conclusion
for the present.
The time for the meeting of the people to take measures for the
establishment of a government for the island of Fredonia, was fixed
for the day which followed the events narrated in the last chapter.
This meeting was looked forward to with intense interest, by all
parties. The men, who knew that there could be no peace or safety
in society, without government, regarded the event as likely to decide
whether the inhabitants of the island were to be happy or miserable.
The women, who were perhaps not apt to reflect upon these
things, had also learned from their experience that a government,
establishing and enforcing laws, was indispensable to the quiet and
security of society: they saw that their own lives, their freedom, their
homes, were not secure, without the protection of law. Even the
children had found that government was necessary, and these as
well as the women, were now rejoicing at the prospect of having this
great blessing bestowed upon the little community of Fredonia.
The day for the meeting arrived, and the men of the island
assembled, agreeably to the appointment. First came the men of the
tent party, and then, those from the Outcast’s cave. The latter were
greeted by a shout of welcome, and mingling with the rest, a kind
shaking of hands took place between those, who so lately were
arrayed against each other in deadly conflict.
After a short time, Mr. Bonfils, being the oldest man of the
company, called the assembly to order, and he being chosen
chairman, went on to state the objects of the assembly, in the
following words:
“My dear friends; it has been the will of Providence to cast us
together upon this lonely, but beautiful island. It would seem that so
small a community, regulated by mutual respect and mutual good
will, might dwell together in peace and amity, without the restraints of
law, or the requisitions of government. But history has told us, that in
all lands, and in all ages, peace, order, justice, are only to be
secured by established laws, and the means of carrying them into
effect. There must be government, even in a family; there must be
some power to check error, to punish crime, to command obedience
to the rule of right. Where there is no government, there the violent,
the unjust, the selfish, have sway, and become tyrants over the rest
of the community. Our own unhappy experience teaches us this.
“Now we have met together, with a knowledge, a conviction of
these truths. We know, we feel, we see that law is necessary, and
that there must be a government to enforce it. Without this, there is
no peace, no security, no quiet fireside, no happy home, no pleasant
society. Without this, all is fear, anxiety, and anarchy.
“Let us then enter upon the duties of this occasion, with a proper
sense of the obligation that rests upon us; of the serious duty which
is imposed on every man present. We are about to decide questions
which are of vital interest, not only to each actor in this scene, but to
these wives and sisters and children, whom we see gathered at a
little distance, watching our proceedings, as if their very lives were at
stake.”
This speech was followed by a burst of applause; but soon a man
by the name of Maurice arose—one who had been a leading
supporter of Rogere—and addressed the assembly as follows:
“Mr. Chairman; it is well known that I am one of the persons who
have followed the opinions of that leader who lost his life in the battle
of the tents. I followed him from a conviction that his views were
right. The fact is, that I have seen so much selfishness in the officers
of the law, that I have learned to despise the law itself. Perhaps,
however, I have been wrong. I wish to ask two questions—the first is
this: Is not liberty a good thing? You will answer that it is. It is
admitted, all the world over, that liberty is one of the greatest
enjoyments of life. My second question then is—Why restrain liberty
by laws? Every law is a cord put around the limbs of liberty. If you
pass a law that I shall not steal, it is restraint of my freedom; it limits
my liberty; it takes away a part of that, which all agree is one of the
greatest benefits of life. And thus, as you proceed to pass one law
after another, do you not at last bind every member of society by
such a multiplied web of restraints, as to make him the slave of law?
And is not a member of a society where you have a system of laws,
like a fly in the hands of the spider, wound round and round by a
bondage that he cannot burst, and which only renders him a slave of
that power which has thus entangled him?”
When Maurice had done, Brusque arose, and spoke as follows:
“Mr. Chairman; I am happy that Mr. Maurice has thus stated a
difficulty which has arisen in my own mind: he has stated it fairly, and
it ought to be fairly answered. Liberty is certainly a good thing;
without it, man cannot enjoy the highest happiness of which he is
capable. All useless restraints of liberty are therefore wrong; all
unnecessary restraints of liberty are wrong. But the true state of the
case is this: we can enjoy no liberty, but by submitting to certain
restraints. It is true that every law is an abridgment of liberty; but it is
better to have some abridgment of it, than to lose it all.
“I wish to possess my life in safety; accordingly I submit to a law
which forbids murder: I wish to possess my property in security; and
therefore I submit to a law which forbids theft and violence: I wish to
possess my house without intrusion; I therefore submit to a law
which forbids one man to trespass upon the premises of another: I
wish to go and come, without hindrance, and without fear; I therefore
submit to a law which forbids highway robbery, and all interference
with a man’s pursuit of his lawful business.
“Now, if we reflect a little, we shall readily see that by submitting
to certain restraints, we do actually increase the amount of practical,
available, useful liberty. By submitting to laws, therefore, we get
more freedom than we lose. That this is the fact, may be easily
tested by observation. Go to any civilized country, where there is a
settled government and a complete system of laws, and you will find,
in general, that a man enjoys his house, his home, his lands, his
time, his thoughts, his property, without fear: whereas, if you go to a
savage land, where there is no government and no law, there you
will find your life, property, and liberty, exposed every moment to
destruction. Who, then, can fail to see that the very laws which
abridge liberty in some respects, actually increase the amount of
liberty enjoyed by the community.”
Maurice professed himself satisfied with this solution of his
difficulties; and the meeting proceeded to appoint a committee, to go
out and prepare some plan, to be submitted to the meeting. This
committee returned, and after a short space, brought in a resolution,
that Mr. Bonfils be for one year placed at the head of the little
community, with absolute power; and that, at the end of that period,
such plan of government as the people might decree, should be
established.
This resolution was adopted unanimously. The men threw up their
hats in joy, and the air rang with acclamations. The women and
children heard the cheerful sounds, and ran toward the men, who
met them half way. It was a scene of unmixed joy. Brusque and
Emilie met, and the tears of satisfaction fell down their cheeks.
François went to his aged mother, and even her dimmed eye was
lighted with pleasure at the joyful issue of the meeting.
We must now take leave of the island of Fredonia—at least for a
time—and whether we ever return to it, must depend upon the
wishes of our young readers. If they are anxious to see how the
people flourished under the reign of their aged old chief, and how
they proceeded in after years, perchance we may lift the curtain and
show them the scene that lies behind it. But I hope that our readers
have learnt, that not only men and women, but children, have an
interest in government, and therefore that it is a thing they should try
to understand.
The Tanrec.