LPN/LVN Fluid, Electrolyte & Acid-Base Balance Practice Exam
(2026/2027) UPDATE |SBON
1. A nurse is caring for a client with heart failure who has developed fluid
volume excess. Which assessment finding should the nurse prioritize?
A. Auscultation of crackles in the lungs
B. Auscultation of crackles in the lungs
C. Pitting edema in the lower extremities
D. Increased urine output
B. Weight gain of 1 lb in a week
Answer: A
Rationale: Crackles indicate pulmonary edema, which is a life-threatening complication of
fluid volume excess and requires immediate intervention.
2. Which IV solution is considered isotonic and is commonly used for fluid
resuscitation?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 10% Dextrose in Water
D. 0.9% Sodium Chloride
Answer: D
Rationale: 0.9% Sodium Chloride (Normal Saline) is an isotonic solution, meaning its
osmolarity is similar to blood plasma.
,3. An LPN is reviewing laboratory results. A client’s potassium level is 3.2 mEq/L.
Which medication is most likely responsible for this result?
A. Furosemide
B. Lisinopril
C. Spironolactone
D. Metformin
Answer: A
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, leading to
hypokalemia.
4. A client presents with a positive Chvostek’s sign. The nurse recognizes this as
a clinical manifestation of which imbalance?
A. Hypernatremia
B. Hypermagnesemia
C. Hypokalemia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of hypocalcemia and neuromuscular irritability.
5. A nurse is caring for a client with a serum sodium level of 152 mEq/L. Which
nursing intervention is most appropriate?
A. Administer 0.45% Sodium Chloride IV as ordered
B. Restrict fluid intake to 1000 mL/day
C. Encourage increased intake of salty snacks
D. Administer a sodium polystyrene sulfonate enema
Answer: A
Rationale: A sodium level of 152 mEq/L indicates hypernatremia. Treatment involves fluid
replacement with hypotonic solutions like 0.45% NaCl.
, 6. Which of the following blood gas results indicates Respiratory Acidosis?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 50, HCO3 24
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2
(>45).
7. A client has a potassium level of 6.2 mEq/L. What is the priority nursing
action?
A. Document the finding and re-check in the morning
B. Start an IV of 0.9% Normal Saline
C. Encourage the client to eat a banana
D. Place the client on a cardiac monitor
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) can cause lethal cardiac dysrhythmias; monitoring the
heart rhythm is the highest priority.
8. The nurse understands that which organ is primarily responsible for
regulating fluid and electrolyte balance?
A. Liver
B. Heart
C. Pancreas
D. Kidneys
Answer: D
Rationale: The kidneys are the primary organs for maintaining fluid and electrolyte
balance through filtration and reabsorption.
(2026/2027) UPDATE |SBON
1. A nurse is caring for a client with heart failure who has developed fluid
volume excess. Which assessment finding should the nurse prioritize?
A. Auscultation of crackles in the lungs
B. Auscultation of crackles in the lungs
C. Pitting edema in the lower extremities
D. Increased urine output
B. Weight gain of 1 lb in a week
Answer: A
Rationale: Crackles indicate pulmonary edema, which is a life-threatening complication of
fluid volume excess and requires immediate intervention.
2. Which IV solution is considered isotonic and is commonly used for fluid
resuscitation?
A. 0.45% Sodium Chloride
B. 3% Sodium Chloride
C. 10% Dextrose in Water
D. 0.9% Sodium Chloride
Answer: D
Rationale: 0.9% Sodium Chloride (Normal Saline) is an isotonic solution, meaning its
osmolarity is similar to blood plasma.
,3. An LPN is reviewing laboratory results. A client’s potassium level is 3.2 mEq/L.
Which medication is most likely responsible for this result?
A. Furosemide
B. Lisinopril
C. Spironolactone
D. Metformin
Answer: A
Rationale: Furosemide is a loop diuretic that causes the excretion of potassium, leading to
hypokalemia.
4. A client presents with a positive Chvostek’s sign. The nurse recognizes this as
a clinical manifestation of which imbalance?
A. Hypernatremia
B. Hypermagnesemia
C. Hypokalemia
D. Hypocalcemia
Answer: D
Rationale: Chvostek’s sign (facial twitching when the facial nerve is tapped) is a classic
sign of hypocalcemia and neuromuscular irritability.
5. A nurse is caring for a client with a serum sodium level of 152 mEq/L. Which
nursing intervention is most appropriate?
A. Administer 0.45% Sodium Chloride IV as ordered
B. Restrict fluid intake to 1000 mL/day
C. Encourage increased intake of salty snacks
D. Administer a sodium polystyrene sulfonate enema
Answer: A
Rationale: A sodium level of 152 mEq/L indicates hypernatremia. Treatment involves fluid
replacement with hypotonic solutions like 0.45% NaCl.
, 6. Which of the following blood gas results indicates Respiratory Acidosis?
A. pH 7.50, PaCO2 30, HCO3 22
B. pH 7.30, PaCO2 50, HCO3 24
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.48, PaCO2 40, HCO3 30
Answer: B
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and a high PaCO2
(>45).
7. A client has a potassium level of 6.2 mEq/L. What is the priority nursing
action?
A. Document the finding and re-check in the morning
B. Start an IV of 0.9% Normal Saline
C. Encourage the client to eat a banana
D. Place the client on a cardiac monitor
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) can cause lethal cardiac dysrhythmias; monitoring the
heart rhythm is the highest priority.
8. The nurse understands that which organ is primarily responsible for
regulating fluid and electrolyte balance?
A. Liver
B. Heart
C. Pancreas
D. Kidneys
Answer: D
Rationale: The kidneys are the primary organs for maintaining fluid and electrolyte
balance through filtration and reabsorption.
