Q: A nurse is caring for a patient with metabolic acidosis. Which of the following arterial blood gas (ABG) values would most likely be observed?

pH \u003c 7.35, $$HCO_3$$^- \u003c 22~\text{mEq/L}, $$PaCO_2$$~\text{normal}

Q: Which of the following is the correct formula for calculating the IV drip rate in drops per minute?

$$\text{Drip rate} = \frac{\text{Volume to be infused (mL)} \times \text{Drop factor (gtts/mL)}}{\text{Time (min)}}$$

Question 1

Which of the following statements best describes the principle of osmosis in the context of fluid and electrolyte balance?

Accepted Answer

Osmosis is the movement of water from an area of lesser solute concentration and more water to an area of greater solute concentration and less water until equilibrium is established.

Question 2

A patient presents with a serum sodium level of 150 mEq/L and signs of neurologic impairment. Which of the following best explains the cellular changes occurring in this patient?

Accepted Answer

Water moves out of the cells into the extracellular fluid, causing the cells to shrink.

Question 3

Which equation correctly represents the relationship between pH and hydrogen ion concentration in body fluids?

Accepted Answer

pH = -\log_{10}[H^+]

Question 4

A nurse is caring for a patient with metabolic acidosis. Which of the following arterial blood gas (ABG) values would most likely be observed?

Accepted Answer

pH \u003c 7.35, $$HCO_3$$^- \u003c 22~	ext{mEq/L}, $$PaCO_2$$~	ext{normal}

Question 5

Which of the following is a major function of potassium ($$K^+) in $$the body?

Accepted Answer

Regulator of cellular enzyme activity and transmission of electrical impulses in nerve, heart, skeletal, intestinal, and lung tissue

Question 6

A patient with severe burns is at risk for third-space fluid shift. Which of the following best describes this phenomenon?

Accepted Answer

Fluid moves into the transcellular compartment, such as pleural or peritoneal spaces, and is unavailable for use.

Question 7

Which of the following is the correct formula for calculating the IV drip rate in drops per minute?

Accepted Answer

$$	ext{Drip rate} = \frac{	ext{Volume to be infused (mL)} 	imes 	ext{Drop factor (gtts/mL)}}{	ext{Time (min)}}$$

Question 8

A patient is receiving a hypotonic IV solution. Which of the following is most likely to occur at the cellular level?

Accepted Answer

Water moves into the cells, causing them to swell and possibly burst.

Question 9

Which of the following best describes the role of the kidneys in acid–base balance?

Accepted Answer

The kidneys regulate acid–base balance by excreting or retaining hydrogen ions and forming or excreting bicarbonate ions.

Question 10

A patient with congestive heart failure develops pitting edema in the ankles. Which mechanism is most responsible for this fluid accumulation?

Accepted Answer

Increased capillary hydrostatic pressure forces fluid out of the capillaries into the interstitial space.

Question 11

A patient’s arterial blood gas results are: pH = 7.29, $$PaCO_2 = 17 mm Hg$$, $$HCO_3^- = 19 $$mEq/L. Which acid–base disturbance is present?

Accepted Answer

Metabolic acidosis with partial respiratory compensation

Question 12

Which of the following interventions is most appropriate for a patient with fluid volume excess (FVE) due to heart failure?

Accepted Answer

Administer diuretics as prescribed and monitor daily weights.

Question 13

Which electrolyte imbalance is most likely to cause muscle weakness, leg cramps, and cardiac dysrhythmias?

Accepted Answer

Hypokalemia

Question 14

A patient is prescribed a potassium-containing IV solution. Which precaution should the nurse take to prevent a potentially fatal complication?

Accepted Answer

Monitor the infusion rate to ensure it does not exceed 10 mEq/hr.

Question 15

Which of the following is the most accurate indicator of fluid gain or loss in a hospitalized patient?

Accepted Answer

Daily body weight measured at the same time each day

Question 16

A patient with chronic renal failure is at risk for which electrolyte imbalance due to impaired excretion?

Accepted Answer

Hyperkalemia

Question 17

Which of the following best describes the carbonic acid–sodium bicarbonate buffer system in maintaining acid–base balance?

Accepted Answer

It maintains a ratio of 20 parts bicarbonate to 1 part carbonic acid in extracellular fluid.

Question 18

A patient receiving a blood transfusion develops hives, itching, and anaphylaxis. What is the nurse’s immediate action?

Accepted Answer

Stop the transfusion immediately and keep the vein open with normal saline.

Question 19

Which of the following is a major risk factor for fluid volume deficit in older adults?

Accepted Answer

Decreased thirst mechanism and increased percentage of body fat

Question 20

A patient with metabolic alkalosis is most likely to exhibit which of the following clinical manifestations?

Accepted Answer

Depressed respirations and tingling of fingers and toes

Fluid, Electrolyte, and Acid–Base Balance: Principles and Clinical Applications

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