Test Bank For Fluid & Electrolyte NCLEX
Practice Quiz (120 Questions And
VerifiedAnswers Latest 2024)
1. 1. Question
1 Point(S)
Patient X Is Diagnosed With Constipation. As A Knowledgeable Nurse,
WhichNursing Intervention Is Appropriate For Maintaining Normal Bowel
Function?
o A. Assessing Dietary Intake
o B. Decreasing Fluid Intake
o C. Providing Limited Physical Activity
o D. Turning, Coughing, And Deep Breathing
Correct Answer: A. Assessing dietary intake
Assessing dietary intake provides a foundation for the client’s usual
practices and may help determine if the client is prone to constipation or
diarrhea. Check out usual dietary habits, eating habits, eating schedule, and
liquid intake. Irregular mealtime, type of food, and interruption of the usual
schedule can lead to constipation. Assist the patient to take at least 20 g of
dietary fiber (e.g., raw fruits, fresh vegetables, whole grains) per day.
Option B: Fluid intake should be increased to aid bowel
elimination. Encourage the patient to take in fluid 2000 to
3000 mL/day, if not contraindicated medically. Sufficient fluid
is needed to keep the fecal mass soft. But take note of some
patients or older patients having cardiovascular limitations
requiring less fluid intake.
Option C: Limited physical activity may contribute to
constipation due to decreased peristalsis. Assess the patient’s
activity level. Sedentary lifestyles such as sitting all day, lack of
exercise, prolonged bed rest, and inactivity contribute to
constipation.
, Option D: Turning, coughing and deep breathing help
promote gas exchange. Urge the patient for some physical
activity and exercise. Consider isometric abdominal and gluteal
exercises. Movement promotes peristalsis. Abdominal
exercises strengthen abdominal muscles that facilitate
defecation.
2. 2. Question
1 Point(S)
A 12-Year-Old Boy Was Admitted To The Hospital Two Days Ago Due To
Hyperthermia. His Attending Nurse, Dennis, Is Quite Unsure About His Plan
OfCare. Which Of The Following Nursing Interventions Should Be Included
In The Care Plan For The Client?
A. Room Temperature Reduction
B. Fluid Restriction Of 2,000 Ml/Day
D. Antiemetic Agent Administration
Correct Answer: A. Room temperature reduction
For the patient with hyperthermia, reducing the room temperature may
help decrease the body temperature. Tepid baths, cool compresses, and
cooling blankets may also be necessary. Adjust and monitor environmental
factors like room temperature and bed linens as indicated. Room
temperature may be accustomed to near normal body temperature and
blankets and linens may be adjusted as indicated to regulate the
temperature of the patient.
Option B: Fluids should be encouraged, not restricted to
compensate for insensible losses. Monitor fluid intake and
urine output. If the patient is unconscious, central venous
pressure or pulmonary artery pressure should be measured to
monitor fluid status. Fluid resuscitation may be required to
correct dehydration. The patient who is significantly
dehydrated is no longer able to sweat, which is necessary for
evaporative cooling.
, Option C: Tympanic or rectal temperature measurements are
generally accepted and are more accurate than axillary
measurements. Monitor the patient’s HR, BP, and especially
the tympanic or rectal temperature. HR and BP increase as
hyperthermia progresses. Tympanic or rectal temperature
gives a more accurate indication of core temperature.
Option D: Antipyretics, and not antiemetics, are indicated to
reduce fever. Give antipyretic medications as prescribed.
Antipyretic medications lower body temperature by blocking
the synthesis of prostaglandins that act in the hypothalamus.
3. 3. Question
1 Point(S)
Tom Is Ready To Be Discharged From The Medical-Surgical Unit After 5
Days Of Hospitalization. Which Client Statement Indicates To The Nurse
That TomUnderstands The Discharge Teaching About Cellular Injury?
A. "I Do Not Have To See My Doctor Unless I Have Problems."
B. "I Can Stop Taking My Antibiotics Once I Am Feeling Better."
C. "If I Have Redness, Drainage, Or Fever, I Should Call
MyHealthcare Provider."
D. "I Can Return To My Normal Activities As Soon As I Go Home."
Correct Answer: C. “If I have redness, drainage, or fever, I should call
my healthcare provider.”
The knowledge that redness, drainage, or fever — signs of infection
associated with cellular injury — require reporting indicates that the client
has understood the nurse’s discharge teaching. If a cell is unable to adapt
to increased stress, injury results. Cell injury is reversible until a certain
threshold where it progresses to cell death. Historically, cell death has been
designated into two classes: necrosis and apoptosis. Necrosis is often
coined as accidental death as it is generally seen as not controlled by the
cell. Apoptosis, on the other hand, is typically viewed as programmed cell
death, regulated and controlled.
Option A: Follow-up checkups should be encouraged. Cell
growth, division, and death are all important parts of this
, regulation, and each is highly regulated. Loss of this balance is
seen in tumor cells where mechanisms of cell death are
avoided, resulting in uncontrolled cell growth. Conversely,
conditions where extensive cell death is seen also result in loss
of homeostasis, such as in the case of neuronal loss in
Alzheimer’s disease.
Option B: The nurse should place an emphasis on antibiotic
compliance even if the client feels better. The understanding
of cell death and the players involved is a subject of constant
research. The better one understands the mechanism of cell
death, the more likely it is that knowledge can be integrated
into clinical medicine.
Option D: There are usually activity limitations after cellular
injury. Chemotherapy treatments with radiation can
manipulate these pathways more directly by causing DNA
damage that drives the cell to apoptosis. Understanding the
basics of cell death allows for a better understanding of how
tumor cells may evade death and counter-evade clinically.
4. 4. Question
1 Point(S)
Nurse Katee Is Caring For Adam, A 22-Year-Old Client, In A Long-Term
Facility.Which Nursing Intervention Would Be Appropriate When
Identifying NursingInterventions Aimed At Promoting And Preventing
Contractures? Select All That Apply.
A. Clustering Activities To Allow Uninterrupted Periods Of Rest.
B. Maintaining Correct Body Alignment At All Times.
C. Monitoring Intake And Output, Using A Urometer If Necessary.
D. Using A Footboard Or Pillows To Keep Feet In The
CorrectPosition.
E. Performing Active And Passive Range-Of-Motion Exercises.
F. Weighing The Client Daily At The Same Time And In The
SameClothes.
