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NSG3023 FINAL EXAM STUDY GUIDE Winter
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NSG3023 FINAL EXAM STUDY GUIDE/ Winter2018CHAPTER 18
1) Know the difference between, diffusion, osmosis, filtration and active transport (TB
Q#1)
Osmosis: movement of water across a semipermeable membrane from a
compartment of lower particle concentration to one that has a higher particle
concentration.
Diffusion: a passive movement of electrolytes or other particles from an area of
higher concentration to one of lower concentration.
Filtration: The net effect of several forces that tend to move fluid across a
membrane.
Active Transport: The energy-requiring movement of electrolytes or other
substances across cell membranes against a concentration gradient (from an area
of low concentration to one of higher concentration).
A nurse is caring for a patient who is suffering from kidney failure and is receiving peritoneal
dialysis. The nurse explains that peritoneal dialysis works by instilling a solution into the
abdomen that contains dextrose that will pull extra fluid into the abdominal cavity. What is the
name of this process?
a. Diffusion
b. Osmosis
c. Filtration
d. Active transport
2) Be able to describe and give rationale with examples of isotonic, hypertonic and
hypotonic fluids (TB Q#2, #3)
a. Isotonic: Fluids that have the same osmolality as normal blood. 0.9% sodium
chloride is an example of an isotonic solution. It expands the body’s extracellular
fluid volume without causing water to shift in or out of cells.
b. Hypertonic: more concentrated than normal blood, pulls fluid by osmosis causing
them to shrink. 3% sodium chloride is an example.
c. Hypotonic: Less concentrated than normal blood after they are infused. They
move water from extracellular compartment into the cells by osmosis causing
them to swell.
, A patient has been admitted to the postsurgical nursing unit after surgery. The health care
provider has ordered the patient to have an IV of 0.9% sodium chloride. The nurse who is
caring for the patient recognizes this as what type of solution?
a. Hypotonic
b. Isotonic
c. Hypertonic
d. Hypnotic
3) Be able to describe the mechanism behind thirst (TB Q#4)
a. Thirst is a conscious desire of water. It regulates fluid intake when plasma
osmolality increases (osmoreceptor-mediated thirst) or the blood volume
decreases. The thirst-control mechanism is in the hypothalamus of the brain.
Osmoreceptors there continually monitor plasma osmolarity; when osmolality
increases, the hypothalamus stimulates thirst.
Two nursing students were having pizza one evening as they were studying. One student
remarked that whenever she ate pizza, she was incredibly thirsty. The second student
explained that this thirst was caused by:
a. colloid osmotic pressure.
b. osmoreceptors.
c. oncotic pressure.
d. hydrostatic pressure.
4) Describe insensible water loss and the effects on particular organs (TB Q#5)
a. Fluid output occurs through 4 organs: the skin, GI tract, lungs and kidneys
(Insensible water loss is not visible). It is continuous and occurs through the skin
and lungs. Insensible water output increases with fever.
A 7-year-old patient was admitted to the hospital with a high fever. The nurse caring for the
child knows that the child has increased insensible water loss resulting from the fever and
, should receive additional water to prevent hypernatremia. Insensible water loss occurs
through which organ?
a. Kidneys
b. GI tract
c. Skin
d. Stomach
5) Be able to describe the mechanism in which fluid and electrolyte balance is maintained or
regulated partially by hormones (TB Q#7)
a. The hypothalamus controls release of ADG from the posterior pituitary gland.
Antidiuretic hormone circulates to the kidneys, where it acts on the collecting
ducts causing them to reabsorb water.
The bodys fluid and electrolyte balance is maintained partially by hormonal regulation. The
nurse conveys an understanding of this mechanism in which statement?
a. The pituitary gland secretes aldosterone.
b. The kidney secretes antidiuretic hormone.
c. The adrenal cortex secretes antidiuretic hormone.
d. The pituitary gland secretes antidiuretic hormone.
6) Educations for clients at risk for hyperthermia.ie; (hypothalamus injury)
Any injury to the hypothalamus impairs heat loss mechanisms. Educate patients at risk for
hyperthermia to do which of the following? (Select all that apply.)
a. Avoid strenuous exercise in hot, humid weather.
b. Avoid exercising in areas with poor ventilation.
, c. Drink clear fluids before and after exercising, not during.
d. Wear light, loose-fitting clothing.
e. Do not visit hot climates.
7) A head injury could result in injury of hypothalamus or pituitary which could affect
which organs
or functions? (TB Q#8)
a. It can affect/alter urine output.
A 15-year-old patient suffered a head injury as the result of a bicycle accident. The nurse is
concerned about potential fluid complications caused by the injury. What should the nurse
monitor most closely?
a. Aldosterone release
b. Urine output
c. Renin release
d. Body temperature
8) Be able to describe signs and symptoms of hyponatremia, hypokalemia, and
hypochloremia. (TB Q#9)
a. Hyponatremia: water enters cells by osmosis causing them to swell. Signs of
cerebral dysfunction occur when the brain cells swell
b. Hypokalemia: causes muscle weakness and if severe, cardiac dysrhythmias.
c. Hypochloremia: abnormally high blood chloride levels which occur with some
types of acidosis some renal conditions and other electrolyte imbalances but has
no unique signs or symptoms.
The patient is taking furosemide (Lasix) and has been complaining of muscle weakness. The
nurse should be most concerned about which imbalance?
a. Hyponatremia
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