,1. A nurse is preparing to administer 0.9% NaCl (normal saline solution)
to a client who has dehydration. Which of the following statements is true
about this type of IV fluid?
a) It is isotonic and has the same concentration of solutes as blood plasma.
b) It is hypotonic and has lesser concentration of solutes than blood
plasma.
c) It is hypertonic and has greater concentration of solutes than blood
plasma.
d) It is a colloid and contains large molecules that do not cross the
capillary membrane.
Answer: A
Rationale: 0.9% NaCl is an isotonic solution that has the same osmolarity
as blood plasma. It is used to replace fluid losses without causing fluid
shifts between compartments.
2. A nurse is caring for a client who has diabetic ketoacidosis (DKA) and
is receiving intravenous therapy with dextrose 5% in water (D5W). The
nurse knows that this type of IV fluid is:
a) Isotonic in the bag but becomes hypotonic in the body as dextrose is
metabolized.
b) Hypotonic in the bag but becomes isotonic in the body as dextrose is
metabolized.
c) Hypertonic in the bag but becomes isotonic in the body as dextrose is
metabolized.
d) Hypertonic in the bag but becomes hypotonic in the body as dextrose is
metabolized.
Answer: A
Rationale: D5W is isotonic in the bag but becomes hypotonic in the body
as dextrose is rapidly metabolized by cells, leaving only water. It is used
to provide calories and water, and to treat hypernatremia and DKA.
3. A nurse is monitoring a client who is receiving intravenous therapy
with lactated Ringer's solution. The nurse understands that this type of IV
fluid contains:
a) Sodium, potassium, calcium, chloride, and lactate.
b) Sodium, potassium, magnesium, bicarbonate, and phosphate.
c) Sodium, chloride, acetate, gluconate, and malate.
, d) Sodium, chloride, albumin, dextran, and gelatin.
Answer: A
Rationale: Lactated Ringer's solution is an isotonic solution that contains
sodium, potassium, calcium, chloride, and lactate. It is used to replace
fluid and electrolyte losses, and to treat metabolic acidosis.
4. A nurse is administering a blood transfusion to a client who has severe
anemia. The nurse knows that the type of IV fluid that should be used to
prime the tubing and as a compatible solution with blood products is:
a) 0.9% NaCl
b) D5W
c) Lactated Ringer's
d) 0.45% NaCl
Answer: A
Rationale: 0.9% NaCl is the only IV fluid that is compatible with blood
products. Other solutions may cause hemolysis or clotting of blood cells.
5. A nurse is caring for a client who has increased intracranial pressure
(ICP) due to cerebral edema. The nurse expects that the physician will
order which of the following types of IV fluids to reduce the ICP?
a) 0.45% NaCl
b) D10W
c) 3% NaCl
d) Lactated Ringer's
Answer: C
Rationale: 3% NaCl is a hypertonic solution that has greater osmolarity
than blood plasma. It is used to draw water out of the cells and into the
blood vessels, thereby reducing cerebral edema and ICP.
6. A nurse is assessing a client who is receiving intravenous therapy with
0.45% NaCl. The nurse observes signs of fluid overload such as crackles
in the lungs, edema, and weight gain. The nurse suspects that the client
has:
a) Hypernatremia
b) Hyponatremia
c) Hyperkalemia
d) Hypokalemia
Answer: B
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