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Quiz on Fluid and Electrolyte imbalance, created by asissons on 21/03/2015.

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Fluid and Electrolyte imbalance

Question 1 of 82

1

which are forces that favour filtration?

Select one or more of the following:

  • capillary hydrostatic pressure

  • capillary oncotic pressure

  • interstitial hydostatic pressure

  • interstitial oncotic pressure

Explanation

Question 2 of 82

1

Which are forces that oppose filtration?

Select one or more of the following:

  • capillary oncotic pressure

  • capillary hydrostatic pressure

  • interstitial oncotic pressure

  • interstitial hydrostatic pressure

Explanation

Question 3 of 82

1

Which are causes for edema

Select one or more of the following:

  • increased capillary hydrostatic pressure

  • decreased plasma oncotic pressure

  • increased capillary membrane permeability

  • lympathic obstruction

  • too much candy

Explanation

Question 4 of 82

1

Infants are most susceptible to significant losses in total body water because of an infant’s

Select one of the following:

  • High body surface–to–body size ratio

  • Slow metabolic rate

  • Kidneys are not mature enough to counter fluid losses

  • Inability to communicate adequately when he or she is thirsty

Explanation

Question 5 of 82

1

Obesity creates a greater risk for dehydration in people because:

Select one of the following:

  • Adipose cells contain little water because fat is water repelling.

  • The metabolic rate of obese adults is slower than the rate of lean adults.

  • The rate of urine output of obese adults is higher than the rate of output of lean
    adults

  • The thirst receptors of the hypothalamus do not function effectively

Explanation

Question 6 of 82

1

A patient’s blood gases reveal the following findings: pH, 7.3; bicarbonate (HCO3) 27 mEq/L;
carbon dioxide (CO2), 58 mm Hg. What is the interpretation of these gases?

Select one of the following:

  • Respiratory alkalosis

  • Metabolic acidosis

  • Respiratory acidosis

  • Metabolic alkalosis

Explanation

Question 7 of 82

1

Water movement between the intracellular fluid (ICF) compartment and the extracellular fluid
(ECF) compartment is primarily a function of:

Select one of the following:

  • Osmotic forces

  • Plasma oncotic pressure

  • Antidiuretic hormone

  • Hydrostatic forces

Explanation

Question 8 of 82

1

In addition to osmosis, what force is involved in the movement of water between the plasma
and interstitial fluid spaces?

Select one of the following:

  • Oncotic pressure

  • Buffering

  • Hydrostatic pressure

Explanation

Question 9 of 82

1

Venous obstruction is a cause of edema because of an increase in which pressure?

Select one of the following:

  • Capillary hydrostatic

  • Interstitial hydrostatic

  • Capillary oncotic

  • Interstitial oncotic

Explanation

Question 10 of 82

1

As edema accumulates it gets trapped in...

Select one of the following:

  • a second space

  • a third space

Explanation

Question 11 of 82

1

Sodium accounts for 90% of the ...... cations (positively charged ions)

Select one of the following:

  • ICF

  • ECF

Explanation

Question 12 of 82

1

potassium is a major cation of ......

Select one of the following:

  • ICF

  • ECF

Explanation

Question 13 of 82

1

what is the minimal daily requirement of sodium?

Select one of the following:

  • 200 mg

  • 600 mg

  • 500 mg

Explanation

Question 14 of 82

1

what are the two major functions of Angiotensin 2?

Select one or more of the following:

  • vasoconstriction (which elevates blood pressure)

  • stimulates the secretion of aldosterone

  • it prevents sodium from leaving the cell

Explanation

Question 15 of 82

1

ANP and BNP increase sodium and water excretion by the kidneys this

Select one or more of the following:

  • increases blood volume and blood pressure

  • decreases blood volume and blood pressure

Explanation

Question 16 of 82

1

ADH ________ the permeability of renal tubular cells to water which ______ water reabsorption and promotes the restoration of plasma volume and blood pressure.

Select one or more of the following:

  • increases, increases

  • decreases, increases

Explanation

Question 17 of 82

1

The term isotonic refers to a solution that has the _______ concentration of solutes as plasma

Select one or more of the following:

  • more

  • less

  • the same

Explanation

Question 18 of 82

1

Isotonic fluid loss results in in....

Select one or more of the following:

  • hypervolemia

  • hypovolemia

Explanation

Question 19 of 82

1

Excess isotonic fluids results in...

Select one or more of the following:

  • hypovolemia

  • hypervolemia

Explanation

Question 20 of 82

1

Hypertonic fluid alterations occur when osmolality of the ECF is ______above normal. The most common causes are an increased concentration of ECF.....

Select one or more of the following:

  • elevated, sodium (hypernatrium)

  • elevated potassium (hyperkalemia)

Explanation

Question 21 of 82

1

Hypernatremia occurs when serum sodium levels exceed_______. And can be caused by a ______ of water or _____in sodium

Select one or more of the following:

  • 147 mEq/L, Loss of water or gain in sodium

  • 127 mEq/L, loss of water or gain in sodium,

Explanation

Question 22 of 82

1

intracellular fluid contains a greater proportion of total body water than does extracellular fluid

Select one of the following:

  • True
  • False

Explanation

Question 23 of 82

1

All the homeostatic mechanisms that monitor and adjust the composition of body fluids respond to changes in the ECF, not in the ICF

Select one of the following:

  • True
  • False

Explanation

Question 24 of 82

1

no receptors directly monitor fluid or electrolyte balance

Select one of the following:

  • True
  • False

Explanation

Question 25 of 82

1

diffusion is the movement of molecules from an area of high concentration to an area of low concentration.

Select one of the following:

  • True
  • False

Explanation

Question 26 of 82

1

Osmosis is the movement of water between two compartments by a membrane permeable to water but not to solute. Moves form LOW solute to HIGH solute concentration and requires no energy

Select one of the following:

  • True
  • False

Explanation

Question 27 of 82

1

What is osmotic pressure?

Select one of the following:

  • The amount of pressure required to move water

  • the amount of pressure required to stop osmotic flow of water

Explanation

Question 28 of 82

1

Hydrostatic pressure is

Select one of the following:

  • the major force that pushes water out of the vascular system at the capillary level

  • the force of water being moved

Explanation

Question 29 of 82

1

Oncotic pressure

Select one of the following:

  • osmotic pressure is pressure exerted by colloids in solution

  • the pressure of cancer

Explanation

Question 30 of 82

1

Causes of edema

Select one or more of the following:

  • plasma to interstitial fluid shift

  • increased capillary hydrostatic pressure

  • decreased plasma oncotic pressure

  • increased capillary permeability

  • lymph obstruction

  • sodium retention

Explanation

Question 31 of 82

1

What is the pathophysiology of third spacing?

Select one or more of the following:

  • A massive inflammatory response leads to the release of histamine and bradykinin which increases capillary permeability and with hydrostatic pressure fluid leaks into the interstitium

  • Any process that results in decreased protein intake, production, storage, or increased protein loss decreases the colloid osmotic pressure which prevents fluid from being pulled back into the vessels and leads to fluid accumulating in the interstitium.

Explanation

Question 32 of 82

1

Signs and symptoms of thirdspacing

Select one or more of the following:

  • decreased urine output despite adequate intake

  • increased HR

  • Decreased BP

  • Increased weight

  • Edema, acites

  • Increased ADH

Explanation

Question 33 of 82

1

Why are infants more predisposed to serious, rapid fluid volume deficits?

Select one or more of the following:

  • limited ability to concentrate urine

  • greater ratio of surface area to volume

  • higher metabolic rate

Explanation

Question 34 of 82

1

S/S of Hypervolemia:

Select one or more of the following:

  • cyanosis

  • rapid breathing

  • weight gain

  • edema including cerbral edema

  • rapid bouding pulse

Explanation

Question 35 of 82

1

What is the reference range for Sodium in Adults?

Select one or more of the following:

  • 125-135 mEq/L

  • 135-145 mEq/L

Explanation

Question 36 of 82

1

hypernatremia is caused by :

Select one or more of the following:

  • water loss or sodium gain

  • water gain or sodium loss

Explanation

Question 37 of 82

1

How to treat Hypernatremia

Select one or more of the following:

  • diurectics

  • iv 5% dextrose in water or hypotonic saline

Explanation

Question 38 of 82

1

HYPOnatremia results form

Select one or more of the following:

  • lost of sodium containing fluids or water excess

  • critical value is <120 mEq/L

Explanation

Question 39 of 82

1

Potassium is

Select one or more of the following:

  • a major ICF cation

  • necessary for transmission and conduction of nerve and muscle impluses

  • cellular growth

  • maintenance of cardiac rhythms

  • Acid-base balance

Explanation

Question 40 of 82

1

what facilitates potassium into the cells:

Select one or more of the following:

  • sodium

  • insulin

  • aldosterone

  • epinephrine

  • alkalosis

Explanation

Question 41 of 82

1

Calcium balance is controlled by

Select one or more of the following:

  • parathyroid hormone

  • calcitonin

  • vitamin D

  • Iron

Explanation

Question 42 of 82

1

A person with chronic heart failure has edema in the lower legs and sacral area. The nurse practitioner suspects this is due to a(n):

Select one or more of the following:

  • increase in capillary hydrostatic pressure;

  • Decrease in lymph obstruction pressure

  • Decrease in capillary hydrostatic pressure

Explanation

Question 43 of 82

1

Secretion of ADH and the perception of thirst are stimulated by

Select one or more of the following:

  • an increase in plasma osmolality

  • a decrease in plasma osmolaity

Explanation

Question 44 of 82

1

The nurse monitors the fluid and electrolyte status of the older adult with the knowledge that impairment of the thirst mechanism may lead to

Select one or more of the following:

  • hypernatremia

  • Hyponatremia

Explanation

Question 45 of 82

1

Intravenous potassium chloride is ordered for treatment of a patient with hypokalemia. In administering the potassium solution, the nurse is aware that

Select one or more of the following:

  • to prevent cardiac arrhythmias and arrest, the maximum amount of KCl to be administered in 1 hour is 10 mEq

  • to prevent cardiac arrhythmias and arrest, the maximum amount of KCl to be administered in 1 hour is 20 mEq

Explanation

Question 46 of 82

1

A patient who has required prolonged mechanical ventilation has the following arterial blood gas results: pH 7.48, PO2 85 mm Hg, PCO2 32 mm Hg, and HCO3 25 mEq/L. The nurse interprets these results as

Select one or more of the following:

  • respiratory alkalosis

  • respiratory acidosis

  • normal

Explanation

Question 47 of 82

1

The electrolyte imbalance hypercalcemia exhibits which clinical manifestations?

Select one or more of the following:

  • Diarrhea

  • Calcium based kidney stones

  • ECG showing narrow T waves

  • Lethargy

  • Bradycardia

Explanation

Question 48 of 82

1

The electrolyte imbalance hypokalemia exhibits which clinical manifestations?

Select one or more of the following:

  • Paralytic ileus

  • Sinus bradycardia

  • Atrioventricular block

  • Dry mucous membranes

  • Tetany

Explanation

Question 49 of 82

1

A third of the body’s fluid is contained in the extracellular interstitial fluid spaces that include

Select one or more of the following:

  • Urine

  • Intraocular fluids

  • Lymph

  • Blood plasma

  • Sweat

Explanation

Question 50 of 82

1

An imbalance of potassium can produce which dysfunctions?

Select one or more of the following:

  • Weakness skeletal muscles

  • Cardiac dysrhythmias

  • Smooth muscle atony

  • Visual impairment

  • Hearing loss

Explanation

Question 51 of 82

1

Which statements regarding total body water (TBW) are true?

Select one or more of the following:

  • During childhood, TBW slowly decreases in relationship to body weight.

  • Gender has no influence on TBW until old age.

  • Men tend to have greater TBW as a result of their muscle mass.

  • Estrogen plays a role in female TBW.

  • Older adults experience a decrease in TBW as a result of decreased muscle mass.

Explanation

Question 52 of 82

1

Sodium Regulates osmolality in the extracellular fluid (ECF) space.

Select one of the following:

  • True
  • False

Explanation

Question 53 of 82

1

Chloride Is inversely related to HCO3 concentration.

Select one of the following:

  • True
  • False

Explanation

Question 54 of 82

1

Potassium Is a major determinant of resting membrane potential.

Select one of the following:

  • True
  • False

Explanation

Question 55 of 82

1

Phosphate An intracellular metabolic form is adenosine triphosphate (ATP).

Select one of the following:

  • True
  • False

Explanation

Question 56 of 82

1

Potassium Changes in hydrogen ion concentration affect this electrolyte

Select one of the following:

  • True
  • False

Explanation

Question 57 of 82

1

At the arterial end of capillaries, fluid moves from the intravascular space into the interstitial space because the

Select one of the following:

  • Interstitial hydrostatic pressure is higher than the capillary hydrostatic pressure.

  • Capillary hydrostatic pressure is higher than the capillary oncotic pressure.

  • Interstitial oncotic pressure is higher than the interstitial hydrostatic pressure.

  • Capillary oncotic pressure is lower than the interstitial hydrostatic pressure.

Explanation

Question 58 of 82

1

Low plasma albumin causes edema as a result of a reduction in which pressure?

Select one of the following:

  • Capillary hydrostatic

  • Interstitial hydrostatic

  • Plasma oncotic

  • Interstitial oncotic

Explanation

Question 59 of 82

1

Secretion of antidiuretic hormone (ADH) and the perception of thirst are stimulated by a(n

Select one of the following:

  • Decrease in serum sodium

  • Increase in plasma osmolality

  • Increase in glomerular filtration rate

  • Decrease in osmoreceptor stimulation

Explanation

Question 60 of 82

1

Thirst activates osmoreceptors by an increase in which blood plasma?

Select one of the following:

  • Antidiuretic hormone

  • Aldosterone

  • Hydrostatic pressure

  • Osmotic pressure

Explanation

Question 61 of 82

1

It is true that natriuretic peptides:

Select one of the following:

  • Decrease blood pressure and increase sodium and water excretion

  • Increase blood pressure and decrease sodium and water excretion

  • Increase heart rate and decrease potassium excretion.

Explanation

Question 62 of 82

1

Which enzyme is secreted by the juxtaglomerular cells of the kidney when circulating blood volume is reduced?

Select one of the following:

  • Angiotensin I

  • Angiotensin II

  • Aldosterone

  • Renin

Explanation

Question 63 of 82

1

What mechanism can cause hypernatremia?

Select one of the following:

  • Syndrome of inappropriate antidiuretic hormone

  • Hypersecretion of aldosterone

  • Brief bouts of vomiting or diarrhea

  • Excessive diuretic therapy

Explanation

Question 64 of 82

1

What causes the clinical manifestations of confusion, convulsions, cerebral hemorrhage, and coma in hypernatremia?

Select one of the following:

  • High sodium in the blood vessels pulls water out of the brain cells into the blood vessels, causing brain cells to shrink.

  • High sodium in the blood vessels draws chloride into the brain cells followed by water, causing the brain cells to swell.

Explanation

Question 65 of 82

1

Vomiting-induced metabolic alkalosis, resulting in the loss of chloride, causes:

Select one of the following:

  • Retained sodium to bind with the chloride

  • Hydrogen to move into the cell and exchange with potassium to maintain cation balance

  • Retention of bicarbonate to maintain the anion balance

  • Hypoventilation to compensate for the metabolic alkalosis

Explanation

Question 66 of 82

1

The pathophysiologic process of edema is related to which mechanism?

Select one of the following:

  • Sodium depletion

  • Decreased capillary hydrostatic pressure

  • Lymphatic obstruction

Explanation

Question 67 of 82

1

Insulin is used to treat hyperkalemia because it:

Select one of the following:

  • Stimulates sodium to be removed from the cell in exchange for potassium.

  • Binds to potassium to remove it through the kidneys

  • Transports potassium from the blood to the cell along with glucose.

  • Breaks down the chemical components of potassium, causing it to be no longer effective.

Explanation

Question 68 of 82

1

A major determinant of the resting membrane potential necessary for the transmission of nerve impulses is the ratio between

Select one of the following:

  • Intracellular and extracellular Na+

    Intracellular Na+ and extra

  • Intracellular and extracellular K+

    Intracellular K+ and extracel

Explanation

Question 69 of 82

1

During acidosis, the body compensates for the increase in serum hydrogen ions by shifting hydrogen ions into the cell in exchange for which electrolyte?

Select one of the following:

  • Oxygen

  • Sodium

  • Potassium

  • Magnesium

Explanation

Question 70 of 82

1

Causes of hyperkalemia include:

Select one of the following:

  • Hyperparathyroidism and malnutrition

  • Vomiting and diarrhea

  • Renal failure and Addison disease

Explanation

Question 71 of 82

1

The calcium and phosphate balance is influenced by which three substances?

Select one of the following:

  • Parathyroid hormone, vasopressin, and vitamin D

  • Parathyroid hormone, calcitonin, and vitamin D

Explanation

Question 72 of 82

1

It is true that Kussmaul respirations indicate:

Select one of the following:

  • Anxiety is a cause of respiratory acidosis.

  • A compensatory measure is needed to correct metabolic acidosi

  • Diabetic ketoacidosis is the cause of the metabolic acidosis

Explanation

Question 73 of 82

1

Chvostek and Trousseau signs indicate which electrolyte imbalance?

Select one of the following:

  • Hypokalemia

  • Hyperkalemia

  • HYPOCalcemia

  • Hypercalcemia

Explanation

Question 74 of 82

1

An excessive use of magnesium-containing antacids and aluminum-containing antacids can result in:

Select one of the following:

  • Hypophosphatemia

  • Hypomagnesemia

Explanation

Question 75 of 82

1

The most common cause of hypermagnesemia is:

Select one of the following:

  • Renal failure

  • Pancreatitis

Explanation

Question 76 of 82

1

Two thirds of the body’s water is found in its:

Select one of the following:

  • Intracellular fluid compartments

  • Interstitial fluid spaces

Explanation

Question 77 of 82

1

Increased capillary hydrostatic pressure results in edema because of:

Select one of the following:

  • Sodium and water retention

  • Losses or diminished production of plasma albumin

Explanation

Question 78 of 82

1

The existence of hyperkalemia is likely to result in which changes to a person’s electrocardiogram (ECG)?

Select one of the following:

  • Flattened U waves

  • Peaked T waves

  • Depressed ST segments

Explanation

Question 79 of 82

1

Causes of hypocalcemia include:

Select one or more of the following:

  • Repeated blood administration

  • Pancreatitis

Explanation

Question 80 of 82

1

The electrolyte imbalance called hyponatremia exhibits which clinical manifestations?

Select one or more of the following:

  • Headache

  • Seizures

  • Paranoia

  • Confusion

  • Lethargy

Explanation

Question 81 of 82

1

The electrolyte imbalance hypercalcemia exhibits which clinical manifestations?

Select one or more of the following:

  • Diarrhea

  • Calcium based kidney stones

  • ECG showing narrow T waves

  • Lethargy

  • Bradycardia

Explanation

Question 82 of 82

1

What is the effect of low plasma albumin?

Select one of the following:

  • Clotting factors decrease, thus increasing the chance of prolonged bleeding

  • Osmotic pressure decreases, thus water moves from the capillaries to the
    interstitium

Explanation