الجزء الثانى اسئلة اختيارى fluid and electrolyte blance

(25)تكملة اسئلة الmcq على fluid and electrolyte balance

ملاحظة: فية اسئلة مش تبعنا فى المنهج

  

(1)Which fluid order should the nurse question for a patient with a traumatic brain injury?
a. 0.45% sodium chloride
b. 0.9% sodium chloride
c. Lactated Ringer's
d. Dextrose 5% in 0.9% sodium chloride

 (2)The physician asks the nurse to monitor the fluid volume status of a congestive heart failure patient and a patient at risk for clinical dehydration. What is the most effective nursing interven-tion for monitoring both of these patients?
a. Weigh the patients every morning before breakfast.
b. Ask the patients to record their intake and output.
c. Measure the patients' blood pressure every 4 hours.
d. Assess the patients for edema in extremi-ties.

 (3)A nurse is caring for a cancer patient who presents with anorexia, blood pressure 100/60, elevated white blood cell count, and oral candidiasis. The nurse knows that the purpose of starting total parenteral nutrition (TPN) is to
a. Replace fluid, electrolytes, and nutrients in the patient.
b. Stimulate the patient's appetite to eat.
c. Provide medication to raise the patient's blood pressure.
d. Deliver antibiotics to fight off infection.

 (4)A patient presents to the emergency department with the complaint of vomiting and diarrhea for the past 48 hours. The nurse anticipates which fluid therapy initially?
a. 0.9% sodium chloride
b. Dextrose 10% in water
c. Dextrose 5% in water
d. 0.45% sodium chloride

 (5)A patient with a lower respiratory infection has pH of 7.25, PaCO2 of 55 mm Hg, and HCO3- of 20 mEq/L. The physician has been notified. Which is the priority nursing intervention for this patient?
a. Check the color of the patient's urine output.
b. Place the patient in Trendelenburg posi-tion.
c. Encourage the patient to increase respira-tions.
d. Place the patient in high Fowler's position.

 (6)The nurse knows that intravenous fluid therapy has been effective for a patient with hyper-natremia when
a. Serum sodium concentration returns to normal.
b. Systolic and diastolic blood pressure de-crease.
c. Large amounts of emesis and diarrhea de-crease.
d. Urine output increases to 150 mL/hr.

 (7)The nurse would select the dorsal venous plexus of the foot as an IV site for which patient?
a. A 2-year-old child
b. A 22-year-old adult
c. A 50-year-old patient
d. An 80-year-old patient

 (8)Which assessment finding should cause a nurse to question administering a sodium-containing isotonic intravenous fluid?
a. Blood pressure 102/58
b. Dry mucous membranes
c. Poor skin turgor
d. Pitting edema

 (9)A patient is to receive 1500 mL of 0.9% sodium chloride intravenously at a rate of 125 mL/hr. The nurse is using microdrip gravity drip tubing. What is the minute flow rate (drops per minute)?
a. 12 gtt/min
b. 24 gtt/min
c. 125 gtt/min
d. 150 gtt/min

 (10)A nurse begins infusing a 250-mL bag of IV fluid at 1845 on Monday and programs the pump to infuse at 20 mL/hr. At what time should the infusion be completed?
a. 0645 Tuesday
b. 0675 Tuesday
c. 0715 Tuesday
d. 0735 Tuesday

 (11)A nurse is caring for a diabetic patient with a bowel obstruction and has orders to ensure that the volume of intake matches the output. In the past 4 hours, the patient received dextrose 5% with 0.9% sodium chloride through a 22-gauge catheter infusing at 4 mL/hr and has eaten 200 mL of ice chips. The patient also has an NG suction tube set to low continuous suction that had 300 mL output. The patient has voided 400 mL of urine. After reporting these values to the physician, what orders does the nurse anticipate?
a. Add a potassium supplement to replace loss from output.
b. Decrease the rate of intravenous fluids to 100 mL/hr.
c. Discontinue the nasogastric suctioning.
d. Administer a diuretic to prevent fluid volume excess.

 (12)A nurse is caring for a patient who is in hypertensive crisis. When the nurse is flushing the patient's peripheral IV, the patient complains of pain. Upon assessment, the nurse notices a red streak that is warm to the touch. What is the nurse's initial action?
a. Notify the physician.
b. Administer pain medication.
c. Discontinue the IV.
d. Start a new IV line.

 (13)A patient was admitted for hypovolemia and has intravenous fluid running at 250 mL/hr. The patient complains of burning at the IV insertion site. Upon assessment, the nurse does not find redness, swelling, heat, or coolness. The nurse suspects that the
a. IV has infiltrated.
b. IV has caused phlebitis.
c. Fluid is infusing too quickly.
d. Patient is allergic to the fluid.

 (14)The nurse is caring for a patient with sepsis. The plan of care for the patient is to administer antibiotics 3 times a day for 4 weeks. What device will be used to administer these antibiotics?
a. A continuous infusion
b. A heparin locked peripheral catheter
c. A PICC line
d. An implanted port catheter

 (15)A nurse is preparing to administer a blood transfusion. Which assessment finding would the nurse report immediately?
a. Blood pressure 120/60
b. Temperature 101.3° F
c. Poor skin turgor and pallor
d. Heart rate of 100 beats per minute

 (16)A patient had an acute intravascular hemolytic reaction to a blood transfusion. After discontinu-ing the blood transfusion, what is the nurse's next action?
a. Run normal saline through the existing tubing.
b. Start normal saline at TKO rate using new tubing.
c. Discontinue the IV catheter.
d. Return the blood to the blood bank.

 (17)A nurse is assessing a patient who is receiving a blood transfusion and finds that the patient is anxiously fidgeting in bed. The patient is afebrile and dyspneic. The nurse auscultates crackles in both lung bases and sees jugular vein distention. The nurse recognizes that the patient is experi-encing which transfusion complication?
a. Anaphylactic shock
b. Septicemia
c. Fluid volume overload
d. Hemolytic reaction

 (18)The nurse selects appropriate tubing for a blood transfusion by ensuring that the tubing has
a. Two-way valves to allow the patient's blood to mix and warm the blood trans-fusing.
b. An injection port to mix additional elec-trolytes into the blood.
c. An air vent to let bubbles in the blood es-cape.
d. A filter to ensure that clots do not enter the patient.

 (19)The nurse is caring for a patient with hyperkalemia. Which body system would be most important for the nurse plan to monitor closely?
a. Gastrointestinal
b. Neurological
c. Cardiac
d. Respiratory

 (20)Which assessment finding would the nurse expect for a patient with the following laboratory values: sodium 145 mEq/L, potassium 4.5 mEq/L, calcium 4.5 mg/dL?
a. Lightheadedness when standing up
b. Weak quadriceps muscles
c. Tingling of the extremities and tetany
d. Decreased deep tendon reflexes

 (21)A patient informs the nurse that he has the type of diabetes that does not require insulin. The nurse advises the patient to make which dietary change?
a. Drink plenty of fluids throughout the day to stay hydrated.
b. Avoid food high in acid to avoid meta-bolic acidosis.
c. Reduce the quantity of carbohydrates in-gested to lower blood sugar.
d. Include a serving of dairy in each meal to elevate calcium levels.

(22)When selecting a site to insert an intravenous catheter on an adult, the nurse should (Select all that apply.)
a. Start proximally and move distally on the arm.
b. Choose a vein with minimal curvature.
c. Choose the patient's dominant arm.
d. Check for contraindications to the extrem-ity.
e. Select a vein that is rigid.
f. Avoid areas of flexion.

 (23)Which of the following assessments would indicate that a patient's IV has infiltrated? (Select all that apply.)
a. Edema of the extremity near the insertion site
b. Skin discolored or bruised in appearance
c. Pain and warmth at the insertion site
d. Skin cool to the touch
e. Reddish streak proximal to the insertion site
f. Numbness or loss of sensation
g. Palpable venous cord

 (24)When discontinuing a peripheral IV access, the nurse should (Select all that apply.)
a. Use scissors to remove the IV site dressing and tape.
b. Keep the catheter parallel to the skin while removing it.
c. Apply firm pressure with sterile gauze during removal.
d. Stop the infusion before removing the IV catheter.
e. Wear sterile gloves and a mask.
f. Apply pressure to the site for 2 to 3 minutes after removal.

 (25)Which individual would least likely suffer from a disturbance in fluid volume, electrolyte, or acid-base balance?
A. An infant suffering from gastroenteritis for three days
B. An elderly client suffering from a type I decubitus
C. Adults with impaired cardiac function
D. Clients who are confused 

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