HURST REVIEW QUESTIONS AND ANSWERS | COMPLETE HURST NCLEX-RN
REVIEW STUDY GUIDE 2026/2027
fluid volume excess also another word for ? - correct answer ✔✔- Hypervolemia
definition of fluid volume excess - correct answer ✔✔- too much fluid in the vascular space ( any vessel
in our body ex: vein , artery)
what are 2 causes of fluid volume excess? - correct answer ✔✔- heart failure
- renal failure
heart failure ( HF) means what? - correct answer ✔✔- the heart is weak
- the cardiac output is DOWN
- kidney perfusion is DOWN
- urinary output is DOWN
- the volume stays in the vascular space
renal failure( RF) means what? - correct answer ✔✔- kidneys arent working
what are three things that contain A LOT of sodium? - correct answer ✔✔- canned process foods
- IVF with sodium
- fleet enemas
Aldosterone ( steroid, mineralocorticoid) is found where? - correct answer ✔✔- adrenal glands ( on top
of the kidneys)
what is the normal action of aldosterone ? - correct answer ✔✔When your blood volume gets low
through for example vomiting or hemorrhage, the aldosterone secretion increases and makes your body
retain sodium and water and therefore increases the blood volume
aldosterone makes us retain what? - correct answer ✔✔SODIUM AND WATER
when aldosterone secretion increases ----> retain sodium/water---> blood volume goes ________ ---->
retain in ______________________ - correct answer ✔✔- up
- vascular space
what two diseases have too much aldosterone? - correct answer ✔✔- cushings ( too much steroids)
- hyperaldosterosteronism ( aka: CONNS)
what disease has too little aldosterone? - correct answer ✔✔- Addisons disease ( not enough
aldosterone means you lose NA & water directly from the vascular space)
when taking a Anti-diuretic hormone ( ADH) do you retain or diurese? - correct answer ✔✔- retain
when taking a anti-diuretic what do you retain ? - correct answer ✔✔- water
,when you have too much ADH what happens in the body ? - correct answer ✔✔- RETAIN water
- fluid volume EXCESS
- Syndrome of inappropriate ADH ( TOO MANY LETTERS TOO MUCH WATER )
- urine is CONCENTRATED ( too much ADH and NA )
- blood is DILUTED
when you have not enough ADH what happens in the body ? - correct answer ✔✔- DIURESE water
- fluid volume DEFICIT
- DI ( diabetes insipidus) DIurese
- urine is DILUTED
- blood is CONCENTRATED
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine
is concentrated will it make the numbers go up or down? - correct answer ✔✔- UP
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine
is diluted will it make the numbers go up or down? - correct answer ✔✔- down
where is ADH found ? - correct answer ✔✔- pituitary gland
what should you think about first when you think your patient has a ADH problem? - correct answer
✔✔head injuries ( craniotomy, increase ICP )
transsphenoidhypophysisectomy - correct answer ✔✔all the way through ( across) sinus pituitary
removal
what are some drugs that are anti diuretic hormones ( ADH) - correct answer ✔✔- vasoPRESSIN
*ends in PRESSINS)
what are some S?S of fluid volume excess? - correct answer ✔✔- distended neck veins/ peripheral veins
( VESSELS ARE FULL)
- third spacing
- lungs are CRACKLED
- polyuria
- pulse INCREASED ( palpate the artery)
- Blood pressure INCREASES ( more volume = more pressure )
- weight INCREASES
what is the treatment for fluid volume excess? - correct answer ✔✔- low NA diet
- restrict fluids
- daily I& Os and weights
what are some diuretics you can give to help FVE? - correct answer ✔✔- FurosemIDE ( lasix )
( DECREASES K+)
- drugs that end in IDE !!!!!
what is an example of a potassium spraing drug ? - correct answer ✔✔- spironolactone ( retain K+)
,when thinking of fluid retention you should think what first? - correct answer ✔✔- HEART PROBLEMS
bed rest induces _________ by the release of ___________- and lowers the production of
____________- - correct answer ✔✔- diurese
- ANP
- ADH
what is another word for fluid volume deficit? - correct answer ✔✔- HYPOvolemia
when you have a big time deficit you should think what first ? - correct answer ✔✔- SHOCK
what are the three causes of Fluid volume deficit? - correct answer ✔✔- loss of fluid from annywhere
- third spacing
- diseases with polyuria
what is third spacing? - correct answer ✔✔- when fluid is in a place that does you no good
ex: burns, ascites ( measure abdominal girth daily/ worry about HYPOtension)
what is an example of a disease that deals with polyuria? - correct answer ✔✔- diabetes mellitus
when you see the word POLYURIA what should you think of first? - correct answer ✔✔- SHOCK
what are some S/S of fluid volume deficit ? - correct answer ✔✔- weight DOWN
- decreased skin turgor
- dry mucous membranes
- urine output DECREASED ( kidneys arent being profused or they are trying to hold on to fluid
( compensate))
- blood pressure is DOWN ( less volume, less pressure )
- pulse is INCREASED ( heart is trying to pump what little fluid is left ) ( weak and thready in FVD)
respirations are INCREASED ( hypoxia)
- veins are CONSTRICTED
- urine specific gravity is INCREASED and CONCENTRATED
what is the treatment for FVD ? - correct answer ✔✔- prevent further losses
- replace volume
ex: mild deficit- PO fluids
severe deficit- IV fluids
what are patients are higher risk for when they are dealing with FVD? - correct answer ✔✔- falls b/c of
changes in V/S & mental status
what happens in the body when you are given isotonic solutions? - correct answer ✔✔- goes into the
vascular space and stays there
what are some examples of isotonic solutions? - correct answer ✔✔- normal saline
- lactated ringers
- D5W
, which fluid is best for shock patients? - correct answer ✔✔- Lactated ringers
what do you use isotonic solutions for ? - correct answer ✔✔- pt's that lost fluids through nausea,
vomiting, burns, sweating, trauma
- normal saline is the basic solution when administering blood
DO NOT use isotonic solutions in clients with what? - correct answer ✔✔- hypertensions, cardiac disease
or renal disease
isotonic solutions can cause what? - correct answer ✔✔- FVE, hypertensions, or hypernatremia ( high
concentration of sodium in the blood)
hypotonic solution does what in the body? - correct answer ✔✔- goes into the vascular space and then
shifts out into the cells to REPLACE CELLULAR FLUID
hypotonic solution rehydrates but does not cause _____________ - correct answer ✔✔hypertension
what are some examples of hypotonic solutions ? - correct answer ✔✔- 1/2 NS
- 0.33 % NS
when and on who do you use hypotonic solutions? - correct answer ✔✔- pt's who have hypertension,
renal, or cardiac disease and needs fluid replacement because of nausea, vomiting, burns, hemorrhage,
etc.
- also used for dilution when a client has hypernatremia and cellular dehydration
what should you watch out for when adminstering HYPOtonic solutions? - correct answer ✔✔- watch for
cellular edema because this fluid is moving out to the cells, which could lead to fluid volume DEFICET
and decreased blood pressure
HYPERtonic solutions does what in the body ? - correct answer ✔✔- volume expanders that will draw
fluid into the VASCULAR SPACE from the CELL
what are some examples of hypertonic solutions? - correct answer ✔✔- TPN, albumin
what do you use hypertonic solutions for ? - correct answer ✔✔- clients with HYPONATREMIA or a client
who has shifted large amts of vascular volume to a 3rd space or has severe edema, burns, or ascites
- hypertonic solutions will return the fluid volume to the vascular space
what should you watch out for when adminstering hypertonic solutions? - correct answer ✔✔- watch for
fluid volume EXCESS
- monitor ICU setting with frequent monitoring of blood pressure , pulse, and CVP, esp. if they are
receiving 3% NS or 5% NS
what are the top 5 joint commission high alert mediciations? - correct answer ✔✔- insulin
- opiods/narcotics
- injectable potassium chloride or phosphate concentrate
- intravenous anticoagulants ( heparin)
REVIEW STUDY GUIDE 2026/2027
fluid volume excess also another word for ? - correct answer ✔✔- Hypervolemia
definition of fluid volume excess - correct answer ✔✔- too much fluid in the vascular space ( any vessel
in our body ex: vein , artery)
what are 2 causes of fluid volume excess? - correct answer ✔✔- heart failure
- renal failure
heart failure ( HF) means what? - correct answer ✔✔- the heart is weak
- the cardiac output is DOWN
- kidney perfusion is DOWN
- urinary output is DOWN
- the volume stays in the vascular space
renal failure( RF) means what? - correct answer ✔✔- kidneys arent working
what are three things that contain A LOT of sodium? - correct answer ✔✔- canned process foods
- IVF with sodium
- fleet enemas
Aldosterone ( steroid, mineralocorticoid) is found where? - correct answer ✔✔- adrenal glands ( on top
of the kidneys)
what is the normal action of aldosterone ? - correct answer ✔✔When your blood volume gets low
through for example vomiting or hemorrhage, the aldosterone secretion increases and makes your body
retain sodium and water and therefore increases the blood volume
aldosterone makes us retain what? - correct answer ✔✔SODIUM AND WATER
when aldosterone secretion increases ----> retain sodium/water---> blood volume goes ________ ---->
retain in ______________________ - correct answer ✔✔- up
- vascular space
what two diseases have too much aldosterone? - correct answer ✔✔- cushings ( too much steroids)
- hyperaldosterosteronism ( aka: CONNS)
what disease has too little aldosterone? - correct answer ✔✔- Addisons disease ( not enough
aldosterone means you lose NA & water directly from the vascular space)
when taking a Anti-diuretic hormone ( ADH) do you retain or diurese? - correct answer ✔✔- retain
when taking a anti-diuretic what do you retain ? - correct answer ✔✔- water
,when you have too much ADH what happens in the body ? - correct answer ✔✔- RETAIN water
- fluid volume EXCESS
- Syndrome of inappropriate ADH ( TOO MANY LETTERS TOO MUCH WATER )
- urine is CONCENTRATED ( too much ADH and NA )
- blood is DILUTED
when you have not enough ADH what happens in the body ? - correct answer ✔✔- DIURESE water
- fluid volume DEFICIT
- DI ( diabetes insipidus) DIurese
- urine is DILUTED
- blood is CONCENTRATED
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine
is concentrated will it make the numbers go up or down? - correct answer ✔✔- UP
when checking the urine specific gravity, sodium, and hematocrit on lets say a urine test strip if the urine
is diluted will it make the numbers go up or down? - correct answer ✔✔- down
where is ADH found ? - correct answer ✔✔- pituitary gland
what should you think about first when you think your patient has a ADH problem? - correct answer
✔✔head injuries ( craniotomy, increase ICP )
transsphenoidhypophysisectomy - correct answer ✔✔all the way through ( across) sinus pituitary
removal
what are some drugs that are anti diuretic hormones ( ADH) - correct answer ✔✔- vasoPRESSIN
*ends in PRESSINS)
what are some S?S of fluid volume excess? - correct answer ✔✔- distended neck veins/ peripheral veins
( VESSELS ARE FULL)
- third spacing
- lungs are CRACKLED
- polyuria
- pulse INCREASED ( palpate the artery)
- Blood pressure INCREASES ( more volume = more pressure )
- weight INCREASES
what is the treatment for fluid volume excess? - correct answer ✔✔- low NA diet
- restrict fluids
- daily I& Os and weights
what are some diuretics you can give to help FVE? - correct answer ✔✔- FurosemIDE ( lasix )
( DECREASES K+)
- drugs that end in IDE !!!!!
what is an example of a potassium spraing drug ? - correct answer ✔✔- spironolactone ( retain K+)
,when thinking of fluid retention you should think what first? - correct answer ✔✔- HEART PROBLEMS
bed rest induces _________ by the release of ___________- and lowers the production of
____________- - correct answer ✔✔- diurese
- ANP
- ADH
what is another word for fluid volume deficit? - correct answer ✔✔- HYPOvolemia
when you have a big time deficit you should think what first ? - correct answer ✔✔- SHOCK
what are the three causes of Fluid volume deficit? - correct answer ✔✔- loss of fluid from annywhere
- third spacing
- diseases with polyuria
what is third spacing? - correct answer ✔✔- when fluid is in a place that does you no good
ex: burns, ascites ( measure abdominal girth daily/ worry about HYPOtension)
what is an example of a disease that deals with polyuria? - correct answer ✔✔- diabetes mellitus
when you see the word POLYURIA what should you think of first? - correct answer ✔✔- SHOCK
what are some S/S of fluid volume deficit ? - correct answer ✔✔- weight DOWN
- decreased skin turgor
- dry mucous membranes
- urine output DECREASED ( kidneys arent being profused or they are trying to hold on to fluid
( compensate))
- blood pressure is DOWN ( less volume, less pressure )
- pulse is INCREASED ( heart is trying to pump what little fluid is left ) ( weak and thready in FVD)
respirations are INCREASED ( hypoxia)
- veins are CONSTRICTED
- urine specific gravity is INCREASED and CONCENTRATED
what is the treatment for FVD ? - correct answer ✔✔- prevent further losses
- replace volume
ex: mild deficit- PO fluids
severe deficit- IV fluids
what are patients are higher risk for when they are dealing with FVD? - correct answer ✔✔- falls b/c of
changes in V/S & mental status
what happens in the body when you are given isotonic solutions? - correct answer ✔✔- goes into the
vascular space and stays there
what are some examples of isotonic solutions? - correct answer ✔✔- normal saline
- lactated ringers
- D5W
, which fluid is best for shock patients? - correct answer ✔✔- Lactated ringers
what do you use isotonic solutions for ? - correct answer ✔✔- pt's that lost fluids through nausea,
vomiting, burns, sweating, trauma
- normal saline is the basic solution when administering blood
DO NOT use isotonic solutions in clients with what? - correct answer ✔✔- hypertensions, cardiac disease
or renal disease
isotonic solutions can cause what? - correct answer ✔✔- FVE, hypertensions, or hypernatremia ( high
concentration of sodium in the blood)
hypotonic solution does what in the body? - correct answer ✔✔- goes into the vascular space and then
shifts out into the cells to REPLACE CELLULAR FLUID
hypotonic solution rehydrates but does not cause _____________ - correct answer ✔✔hypertension
what are some examples of hypotonic solutions ? - correct answer ✔✔- 1/2 NS
- 0.33 % NS
when and on who do you use hypotonic solutions? - correct answer ✔✔- pt's who have hypertension,
renal, or cardiac disease and needs fluid replacement because of nausea, vomiting, burns, hemorrhage,
etc.
- also used for dilution when a client has hypernatremia and cellular dehydration
what should you watch out for when adminstering HYPOtonic solutions? - correct answer ✔✔- watch for
cellular edema because this fluid is moving out to the cells, which could lead to fluid volume DEFICET
and decreased blood pressure
HYPERtonic solutions does what in the body ? - correct answer ✔✔- volume expanders that will draw
fluid into the VASCULAR SPACE from the CELL
what are some examples of hypertonic solutions? - correct answer ✔✔- TPN, albumin
what do you use hypertonic solutions for ? - correct answer ✔✔- clients with HYPONATREMIA or a client
who has shifted large amts of vascular volume to a 3rd space or has severe edema, burns, or ascites
- hypertonic solutions will return the fluid volume to the vascular space
what should you watch out for when adminstering hypertonic solutions? - correct answer ✔✔- watch for
fluid volume EXCESS
- monitor ICU setting with frequent monitoring of blood pressure , pulse, and CVP, esp. if they are
receiving 3% NS or 5% NS
what are the top 5 joint commission high alert mediciations? - correct answer ✔✔- insulin
- opiods/narcotics
- injectable potassium chloride or phosphate concentrate
- intravenous anticoagulants ( heparin)
