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CHAPTER 16: FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024 $13.99
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CHAPTER 16: FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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CHAPTER 16: FLUID, ELECTROLYTE, AND ACID-BASE IMBALANCES LEWIS: MEDICAL-SURGICAL NURSING, 10TH EDITION QUESTIONS AND ANSWERS WITH SOLUTIONS 2024

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  • August 31, 2024
  • 10
  • 2024/2025
  • Exam (elaborations)
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  • chapter 16 fluid electrolyte and acid base imba

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  • Lewis Medical Surgical Nursing 12TH
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CHAPTER 16: FLUID, ELECTROLYTE,
AND ACID-BASE IMBALANCES LEWIS:
MEDICAL-SURGICAL NURSING, 10TH
EDITION QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
A patient who has a small cell carcinoma of the lung develops syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should notify the health care provider about which assessment finding?

a. Serum hematocrit of 42%

b. Serum sodium level of 120 mg/dL

c. Reported weight gain of 2.2 lb (1 kg)

d. Urinary output of 280 mL during past 8 hours - ANSWER ANS: B

Hyponatremia is the most important finding to report. SIADH causes water retention and a decrease in
serum sodium level. Hyponatremia can cause confusion and other central nervous system effects. A
critically low value likely needs to be treated. At least 30 mL/hr of urine output indicates adequate
kidney function. The hematocrit level is normal. Weight gain is expected with SIADH because of water
retention.



A patient who is taking a potassium-wasting diuretic for treatment of hypertension complains of
generalized weakness. Which action is appropriate for the nurse to take?

a. Assess for facial muscle spasms.

b. Ask the patient about loose stools.

c. Recommend the patient avoid drinking orange juice with meals.

d. Suggest that the health care provider order a basic metabolic panel. - ANSWER ANS: D

Generalized weakness is a manifestation of hypokalemia. After the health care provider orders the
metabolic panel, the nurse should check the potassium level. Facial muscle spasms might occur with
hypocalcemia. Orange juice is high in potassium and would be advisable to drink if the patient is
hypokalemic. Loose stools are associated with hyperkalemia.



Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient. Which statement by
the patient indicates that the teaching about this medication has been effective?

a. "I will try to drink at least 8 glasses of water every day."

, b. "I will use a salt substitute to decrease my sodium intake."

c. "I will increase my intake of potassium-containing foods."

d. "I will drink apple juice instead of orange juice for breakfast." - ANSWER ANS: D

Because spironolactone is a potassium-sparing diuretic, patients should be taught to choose low-
potassium foods (e.g., apple juice) rather than foods that have higher levels of potassium (e.g., citrus
fruits). Because the patient is using spironolactone as a diuretic, the nurse would not encourage the
patient to increase fluid intake. Teach patients to avoid salt substitutes, which are high in potassium.



A patient with new-onset confusion and hyponatremia is being admitted. When making room
assignments, the charge nurse should take which action?

a. Assign the patient to a semi-private room.

b. Assign the patient to a room near the nurse's station.

c. Place the patient in a room nearest to the water fountain.

d. Place the patient on telemetry to monitor for peaked T waves.. - ANSWER ANS: B

The patient should be placed near the nurse's station if confused for the staff to closely monitor the
patient. To help improve serum sodium levels, water intake is restricted. Therefore a confused patient
should not be placed near a water fountain. Peaked T waves are a sign of hyperkalemia, not
hyponatremia. A confused patient could be distracting and disruptive for another patient in a
semiprivate room.



A postoperative patient who had surgery for a perforated gastric ulcer has been receiving nasogastric
suction for 3 days. The patient now has a serum sodium level of 127 mEq/L (127 mmol/L). Which
prescribed therapy should the nurse question?

a. Infuse 5% dextrose in water at 125 mL/hr.

b. Administer 3% saline at 50 mL/hr for a total of 200 mL.

c. Administer IV morphine sulfate 4 mg every 2 hours PRN.

d. Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea. - ANSWER ANS: A

Because the patient's gastric suction has been depleting electrolytes, the IV solution should include
electrolyte replacement. Solutions such as lactated Ringer's solution would usually be ordered for this
patient. The other orders are appropriate for a postoperative patient with gastric suction.



A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for
continued mechanical ventilation. How should the nurse interpret the following arterial blood gas
results: pH 7.48, PaO2 85 mm Hg, PaCO2 32 mm Hg, and HCO3 25 mEq/L?

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