MANUAL OF I V THERAPEUTICS CHAPTER
3 FUNDAMENTALS OF FLUID AND
ELECTROLYTE BALANCE 2025 to 2026
COMPLETE STUDY GUIDE REVIEW NOTES
PRACTICE QUESTIONS DETAILED
RATIONALES
C -CORRECT ANSWER-A nurse is assessing an older adult client who is
disoriented to time and place. The nurse notes that the client's eyes are
sunken, the mouth is coated, the tongue has an extra longitudinal furrow,
and the client's lips are cracked. The client's hand vein filling takes more
than 5 seconds; tenting is apparent over the sternum; and the vital signs are
BP 110/60 mm Hg, pulse 62, and respiratory rate of 12. Based on these
assessment findings, which fluid or electrolyte imbalance should the nurse
suspect?
a. Sodium excess
b. Magnesium deficit
c. Fluid volume deficit
d. Fluid volume excess
C -CORRECT ANSWER-A nurse prepares to assess a client who has been
vomiting for several days. For which signs of fluid volume deficit (FVD)
should the nurse assess?
a. Bounding pulse, decreased blood pressure, and moist crackles
b. Dyspnea, jugular vein distention, and sternum fingerprinting
c. Increased pulse rate, decreased blood pressure, and poor skin turgor
,d. Increased respiratory rate; warm, moist skin; and decreased body
temperature
B -CORRECT ANSWER-A nurse assesses a client who has moist crackles
(rales) in the lung bases, an increased respiratory rate, dyspnea, and 3+
edema of the ankles. Which is the most accurate nursing diagnosis for this
client?
a. Fluid volume deficit
b. Fluid volume excess
c. Impaired tissue integrity
d. Altered tissue perfusion, renal
D -CORRECT ANSWER-A nurse analyzes a client's laboratory report
that shows a serum potassium level of 5.7 mEq/L. Which client's laboratory
report is the nurse most likely reviewing?
a. The client with ulcerative colitis
b. The client with Cushing's syndrome
c. The client who has overused laxatives
d. The client who has sustained a traumatic burn
D -CORRECT ANSWER-A nurse notes that a client admitted with renal
failure has a serum phosphorus level of 7.0 mg/dL. Which medication
should a nurse expect to be prescribed for this client?
a. Calcium gluconate
b. Calcium chloride
c. Calcitonin (Calcimar)
d. Aluminum hydroxide gel (Amphojel)
,B -CORRECT ANSWER-A nurse is caring for a client with an ileostomy.
Which acid-base imbalance will this client most likely experience?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Respiratory alkalosis
C -CORRECT ANSWER-A nurse assesses a newly admitted client and
notes fatigued muscles, reports of nausea and anorexia, irritability, and
diminished deep tendon reflexes. The nurse reviews the client's laboratory
reports that reveal a serum chloride level of 92 mEq/L, a serum potassium
level of 3.1 mEq/L, and a serum sodium level of 135 mEq/L. Which
treatment should the nurse anticipate for this electrolyte imbalance?
a. Treatment with sodium bicarbonate
b. Change of infusion to 5% dextrose in water
c. Replacement therapy with potassium chloride
d. Replacement therapy with sodium and chloride
B -CORRECT ANSWER-A pediatric nurse is thinking critically to
determine the best methods for assessing an infant's 24-hour fluid needs.
Which three methods for assessment of 24-hour fluid needs in an infant
should the nurse consider?
a. Meter square, diaper weight, and urinary output
b. Meter square, body weight, and caloric methods
c. Meter square, specific gravity of urine, and urinary output
d. Diaper weight, urinary output, and caloric needs
, C -CORRECT ANSWER-A nurse is administering I.V. potassium at a rate
of 15 mEq/hr via a peripheral vein. When infusing potassium at this rate via
this route, for which imbalance should the nurse monitor?
a. Hypernatremia
b. Hypercalcemia
c. Hyperkalemia
d. Hyperglycemia
D -CORRECT ANSWER-A nursing instructor is teaching a group of
nursing students about the intracellular and extracellular fluid
compartments of the cell. Which electrolyte is the second most plentiful
cation in the intracellular fluid compartment?
a. Calcium
b. Sodium
c. Chloride
d. Magnesium
C -CORRECT ANSWER-A nursing instructor is teaching a group of
nursing students about the intracellular and extracellular fluid
compartments of the cell. Which is the major electrolyte in the intracellular
compartment?
a. Calcium
b. Sodium
c. Potassium
d. Bicarbonate
B -CORRECT ANSWER-A client in a critical-care unit is experiencing
drastic fluctuations in serum potassium. Which sentinel event can occur if
3 FUNDAMENTALS OF FLUID AND
ELECTROLYTE BALANCE 2025 to 2026
COMPLETE STUDY GUIDE REVIEW NOTES
PRACTICE QUESTIONS DETAILED
RATIONALES
C -CORRECT ANSWER-A nurse is assessing an older adult client who is
disoriented to time and place. The nurse notes that the client's eyes are
sunken, the mouth is coated, the tongue has an extra longitudinal furrow,
and the client's lips are cracked. The client's hand vein filling takes more
than 5 seconds; tenting is apparent over the sternum; and the vital signs are
BP 110/60 mm Hg, pulse 62, and respiratory rate of 12. Based on these
assessment findings, which fluid or electrolyte imbalance should the nurse
suspect?
a. Sodium excess
b. Magnesium deficit
c. Fluid volume deficit
d. Fluid volume excess
C -CORRECT ANSWER-A nurse prepares to assess a client who has been
vomiting for several days. For which signs of fluid volume deficit (FVD)
should the nurse assess?
a. Bounding pulse, decreased blood pressure, and moist crackles
b. Dyspnea, jugular vein distention, and sternum fingerprinting
c. Increased pulse rate, decreased blood pressure, and poor skin turgor
,d. Increased respiratory rate; warm, moist skin; and decreased body
temperature
B -CORRECT ANSWER-A nurse assesses a client who has moist crackles
(rales) in the lung bases, an increased respiratory rate, dyspnea, and 3+
edema of the ankles. Which is the most accurate nursing diagnosis for this
client?
a. Fluid volume deficit
b. Fluid volume excess
c. Impaired tissue integrity
d. Altered tissue perfusion, renal
D -CORRECT ANSWER-A nurse analyzes a client's laboratory report
that shows a serum potassium level of 5.7 mEq/L. Which client's laboratory
report is the nurse most likely reviewing?
a. The client with ulcerative colitis
b. The client with Cushing's syndrome
c. The client who has overused laxatives
d. The client who has sustained a traumatic burn
D -CORRECT ANSWER-A nurse notes that a client admitted with renal
failure has a serum phosphorus level of 7.0 mg/dL. Which medication
should a nurse expect to be prescribed for this client?
a. Calcium gluconate
b. Calcium chloride
c. Calcitonin (Calcimar)
d. Aluminum hydroxide gel (Amphojel)
,B -CORRECT ANSWER-A nurse is caring for a client with an ileostomy.
Which acid-base imbalance will this client most likely experience?
a. Metabolic alkalosis
b. Metabolic acidosis
c. Respiratory acidosis
d. Respiratory alkalosis
C -CORRECT ANSWER-A nurse assesses a newly admitted client and
notes fatigued muscles, reports of nausea and anorexia, irritability, and
diminished deep tendon reflexes. The nurse reviews the client's laboratory
reports that reveal a serum chloride level of 92 mEq/L, a serum potassium
level of 3.1 mEq/L, and a serum sodium level of 135 mEq/L. Which
treatment should the nurse anticipate for this electrolyte imbalance?
a. Treatment with sodium bicarbonate
b. Change of infusion to 5% dextrose in water
c. Replacement therapy with potassium chloride
d. Replacement therapy with sodium and chloride
B -CORRECT ANSWER-A pediatric nurse is thinking critically to
determine the best methods for assessing an infant's 24-hour fluid needs.
Which three methods for assessment of 24-hour fluid needs in an infant
should the nurse consider?
a. Meter square, diaper weight, and urinary output
b. Meter square, body weight, and caloric methods
c. Meter square, specific gravity of urine, and urinary output
d. Diaper weight, urinary output, and caloric needs
, C -CORRECT ANSWER-A nurse is administering I.V. potassium at a rate
of 15 mEq/hr via a peripheral vein. When infusing potassium at this rate via
this route, for which imbalance should the nurse monitor?
a. Hypernatremia
b. Hypercalcemia
c. Hyperkalemia
d. Hyperglycemia
D -CORRECT ANSWER-A nursing instructor is teaching a group of
nursing students about the intracellular and extracellular fluid
compartments of the cell. Which electrolyte is the second most plentiful
cation in the intracellular fluid compartment?
a. Calcium
b. Sodium
c. Chloride
d. Magnesium
C -CORRECT ANSWER-A nursing instructor is teaching a group of
nursing students about the intracellular and extracellular fluid
compartments of the cell. Which is the major electrolyte in the intracellular
compartment?
a. Calcium
b. Sodium
c. Potassium
d. Bicarbonate
B -CORRECT ANSWER-A client in a critical-care unit is experiencing
drastic fluctuations in serum potassium. Which sentinel event can occur if
