Prolonged vomiting tends to cause metabolic alkalosis, while prolonged diarrhea tends to cause metabolic acidosis.
Correct Answer
True
True. Fluid lost from the stomach carries hydrogen ions, so acid is lost and alkalosis follows. Fluid lost from the intestine below the stomach carries bicarbonate, so base is lost and acidosis follows.
Category: Acid-Base Imbalances
Question 2
Hypokalemia can contribute to metabolic alkalosis because hydrogen ions move into cells as potassium leaves them.
Correct Answer
True
True. To keep electrical neutrality, hydrogen ions shift into cells when potassium moves out, which raises blood pH. Correcting the low potassium is part of treating this alkalosis.
Category: Acid-Base Imbalances
Question 3
In respiratory acidosis, the pH falls as the arterial carbon dioxide level rises.
Correct Answer
True
True. Retained carbon dioxide combines with water to form carbonic acid, lowering the pH. In a respiratory disorder, carbon dioxide and pH move in opposite directions.
Category: Acid-Base Imbalances
Question 4
Metabolic alkalosis is marked by a rise in pH together with a fall in bicarbonate.
Correct Answer
False
False. In metabolic alkalosis, both pH and bicarbonate rise. In metabolic disorders, bicarbonate moves in the same direction as pH.
Category: Acid-Base Imbalances
Question 5
Respiratory compensation for a metabolic imbalance begins faster than renal compensation for a respiratory imbalance.
Correct Answer
True
True. A change in breathing rate alters carbon dioxide almost at once, while the kidneys adjust bicarbonate and hydrogen ion handling slowly. For this reason chronic respiratory disorders show more complete renal compensation than acute ones.
Category: Acid-Base Imbalances
Question 6
A patient with hyponatremia caused by drinking large amounts of plain water is encouraged to drink more water.
Correct Answer
False
False. Hyponatremia from excess water intake is treated by limiting water and stopping any hypotonic IV fluids, because more water dilutes sodium further. Patients who can eat may be offered salty foods or broth, while severe cases may need hypertonic saline.
Category: Sodium and Potassium
Question 7
Opioids and sedatives cause respiratory alkalosis by stimulating breathing.
Correct Answer
False
False. Opioids, sedatives, alcohol and anesthesia depress breathing, so carbon dioxide builds up and respiratory acidosis develops. Treatment includes reversing oversedation and supporting ventilation.
Category: Acid-Base Imbalances
Question 8
Lactic acidosis develops when tissues receive more oxygen than they need.
Correct Answer
False
False. Lactic acidosis results from impaired tissue oxygenation, when cells shift to anaerobic metabolism and produce lactic acid. It is a common cause of metabolic acidosis in hospitalized patients.
Category: Acid-Base Imbalances
Question 9
A patient with chronic hypercapnia from COPD can tolerate higher carbon dioxide levels before mental status changes than a person with normal lungs.
Correct Answer
True
True. With long-standing carbon dioxide retention, the kidneys compensate and the body adapts, so consciousness is not depressed until levels are much higher. A rapid rise in carbon dioxide, as in acute respiratory acidosis, causes mental status changes sooner.
Category: Acid-Base Imbalances
Question 10
Hypochloremia is commonly associated with metabolic acidosis.
Correct Answer
False
False. Chloride moves inversely with bicarbonate, so a low chloride is associated with metabolic alkalosis. A high chloride is associated with metabolic acidosis.
Category: Acid-Base Imbalances
Question 11
Hyponatremia and hypochloremia often occur together and can produce similar findings.
Correct Answer
True
True. Chloride levels track sodium levels, so when sodium is low, chloride is often low as well. When a sodium imbalance is found, the nurse also checks chloride.
Category: Sodium and Potassium
Question 12
During correction of hypernatremia, the nurse reports a new headache or confusion because it can signal cerebral edema.
Correct Answer
True
True. If sodium falls too quickly, water shifts into brain cells that had adapted to the high osmolarity, causing swelling that can become life-threatening. Correction is therefore gradual, with frequent neurologic checks and sodium levels.
Category: Sodium and Potassium
Question 13
Hypercalcemia typically causes hyperactive reflexes and tetany.
Correct Answer
False
False. High calcium depresses neuromuscular activity and causes muscle weakness, along with constipation, nausea and increased thirst and urination. Hyperactive reflexes and tetany are signs of low calcium.
Category: Calcium, Magnesium, Phosphorus
Question 14
Hypomagnesemia often occurs together with low calcium and low potassium levels, so the nurse watches for signs of each imbalance.
Correct Answer
True
True. Electrolytes influence one another, and a low magnesium level commonly accompanies low calcium and low potassium. Regular monitoring of all electrolytes and continuous telemetry help detect related changes.
Category: Calcium, Magnesium, Phosphorus
Question 15
Hypermagnesemia typically causes tachycardia.
Correct Answer
False
False. High magnesium depresses nerve and muscle function, causing bradycardia, decreased reflexes and muscle weakness, and in severe cases heart block or asystole. Patients are taught to stop magnesium-containing laxatives and antacids.
Category: Calcium, Magnesium, Phosphorus
Question 16
Hypotonic IV fluids are the preferred choice for hypovolemia with hyponatremia.
Correct Answer
False
False. Hypotonic fluids would dilute sodium further. Hypovolemia with hyponatremia is usually treated with isotonic saline, which restores both volume and sodium; hypertonic saline is reserved for severe, symptomatic hyponatremia.
Category: IV Fluid Therapy
Question 17
A patient with hypovolemia may have few symptoms at first because compensatory mechanisms keep blood pressure stable.
Correct Answer
True
True. The heart rate rises and blood vessels constrict to maintain perfusion, which can mask early fluid loss. The nurse watches trends such as falling urine output, thirst and new confusion.
Category: Fluid Volume Imbalances
Question 18
Hypertonic IV solutions are given slowly with close monitoring because they pull water into the vascular space and can cause fluid overload.
Correct Answer
True
True. Hypertonic fluids draw water out of the cells into the bloodstream, which can overload the circulation and lead to pulmonary edema. The nurse also checks serum sodium often, because raising sodium too quickly can cause osmotic demyelination.
Category: IV Fluid Therapy
Question 19
For a patient with fluid volume excess and severe leg edema, the nurse positions the legs below the level of the heart.
Correct Answer
False
False. Edematous extremities are elevated above the level of the heart to help fluid return to the circulation, and compression stockings may be used for severe edema. Keeping the legs dependent lets more fluid pool in the tissues.
Category: Fluid Volume Imbalances
Question 20
Older adults are less likely than younger adults to develop serious fluid, electrolyte and acid-base imbalances.
Correct Answer
False
False. Heart, kidney and lung function often decline with age, so older adults are at higher risk, and an imbalance that is mild in a healthy adult can become life-threatening. Reduced cardiac output also lowers kidney perfusion and filtration.
Category: Regulation of Balance