ATI Medical-Surgical Fluid, Electrolyte &
Acid-Base Regulation Practice Exam
2026 | 100 Questions & Answers with
Detailed Rationales | Complete Exam
Prep & Study Guide
1. A nurse is assessing a client who has fluid volume deficit. Which finding
should the nurse expect?
A. Bounding pulse
B. Crackles in the lungs
C. Decreased blood pressure
D. Jugular vein distention
Answer: Decreased blood pressure
Rationale: Fluid volume deficit reduces circulating blood volume, which can
cause hypotension, tachycardia, weak pulses, and poor skin turgor.
2. Which assessment finding is most indicative of fluid volume excess?
A. Flat neck veins
B. Peripheral edema
C. Dry mucous membranes
D. Decreased blood pressure
,Answer: Peripheral edema
Rationale: Fluid volume excess causes increased hydrostatic pressure and fluid
movement into tissues, producing peripheral edema.
3. A client has severe vomiting and diarrhea. Which electrolyte imbalance is
the nurse most concerned about?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Gastrointestinal losses can cause significant potassium depletion,
increasing the risk for muscle weakness and cardiac dysrhythmias.
4. Which laboratory value should the nurse identify as within the expected
reference range for serum sodium?
A. 120 mEq/L
B. 128 mEq/L
C. 140 mEq/L
D. 155 mEq/L
Answer: 140 mEq/L
Rationale: Normal serum sodium is generally 135 to 145 mEq/L.
5. A client has a serum sodium level of 124 mEq/L. Which finding should the
nurse expect?
A. Excessive thirst with flushed skin
B. Confusion and headache
C. Increased deep tendon reflexes only
D. Severe constipation
,Answer: Confusion and headache
Rationale: Hyponatremia can cause neurologic manifestations such as
headache, confusion, lethargy, seizures, and decreased level of consciousness.
6. Which client is at greatest risk for hypernatremia?
A. A client receiving hypotonic IV fluids
B. A client with excessive water intake
C. A client with diabetes insipidus
D. A client with renal failure and fluid retention
Answer: A client with diabetes insipidus
Rationale: Diabetes insipidus causes excessive water loss, which can increase
serum sodium concentration.
7. A nurse is caring for a client with hypernatremia. Which intervention is
appropriate?
A. Restrict all fluids
B. Administer concentrated sodium solutions
C. Encourage or administer water as prescribed
D. Administer potassium immediately
Answer: Encourage or administer water as prescribed
Rationale: Hypernatremia generally reflects a relative water deficit. Treatment
may include carefully replacing free water while correcting the underlying
cause.
8. Which ECG change is commonly associated with hypokalemia?
A. Peaked T waves
B. Widened QRS complex only
C. Flattened T waves and prominent U waves
D. ST-segment elevation
, Answer: Flattened T waves and prominent U waves
Rationale: Hypokalemia can produce flattened T waves, ST depression, and
prominent U waves and may lead to dysrhythmias.
9. A client has a potassium level of 6.4 mEq/L. Which finding requires
immediate attention?
A. Mild nausea
B. Muscle fatigue
C. Cardiac dysrhythmia
D. Increased bowel sounds
Answer: Cardiac dysrhythmia
Rationale: Hyperkalemia can cause life-threatening cardiac conduction
abnormalities and dysrhythmias.
10.Which food should the nurse recommend to a client who needs to increase
dietary potassium?
A. White rice
B. Applesauce
C. Baked potato
D. White bread
Answer: Baked potato
Rationale: Potatoes, bananas, oranges, tomatoes, spinach, and other foods can
provide substantial potassium.
11.A nurse is preparing to administer IV potassium chloride. Which action is
appropriate?
A. Administer it by IV push
B. Give it undiluted
C. Administer it using an infusion pump as prescribed
D. Administer it rapidly for severe hypokalemia
Acid-Base Regulation Practice Exam
2026 | 100 Questions & Answers with
Detailed Rationales | Complete Exam
Prep & Study Guide
1. A nurse is assessing a client who has fluid volume deficit. Which finding
should the nurse expect?
A. Bounding pulse
B. Crackles in the lungs
C. Decreased blood pressure
D. Jugular vein distention
Answer: Decreased blood pressure
Rationale: Fluid volume deficit reduces circulating blood volume, which can
cause hypotension, tachycardia, weak pulses, and poor skin turgor.
2. Which assessment finding is most indicative of fluid volume excess?
A. Flat neck veins
B. Peripheral edema
C. Dry mucous membranes
D. Decreased blood pressure
,Answer: Peripheral edema
Rationale: Fluid volume excess causes increased hydrostatic pressure and fluid
movement into tissues, producing peripheral edema.
3. A client has severe vomiting and diarrhea. Which electrolyte imbalance is
the nurse most concerned about?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: Hypokalemia
Rationale: Gastrointestinal losses can cause significant potassium depletion,
increasing the risk for muscle weakness and cardiac dysrhythmias.
4. Which laboratory value should the nurse identify as within the expected
reference range for serum sodium?
A. 120 mEq/L
B. 128 mEq/L
C. 140 mEq/L
D. 155 mEq/L
Answer: 140 mEq/L
Rationale: Normal serum sodium is generally 135 to 145 mEq/L.
5. A client has a serum sodium level of 124 mEq/L. Which finding should the
nurse expect?
A. Excessive thirst with flushed skin
B. Confusion and headache
C. Increased deep tendon reflexes only
D. Severe constipation
,Answer: Confusion and headache
Rationale: Hyponatremia can cause neurologic manifestations such as
headache, confusion, lethargy, seizures, and decreased level of consciousness.
6. Which client is at greatest risk for hypernatremia?
A. A client receiving hypotonic IV fluids
B. A client with excessive water intake
C. A client with diabetes insipidus
D. A client with renal failure and fluid retention
Answer: A client with diabetes insipidus
Rationale: Diabetes insipidus causes excessive water loss, which can increase
serum sodium concentration.
7. A nurse is caring for a client with hypernatremia. Which intervention is
appropriate?
A. Restrict all fluids
B. Administer concentrated sodium solutions
C. Encourage or administer water as prescribed
D. Administer potassium immediately
Answer: Encourage or administer water as prescribed
Rationale: Hypernatremia generally reflects a relative water deficit. Treatment
may include carefully replacing free water while correcting the underlying
cause.
8. Which ECG change is commonly associated with hypokalemia?
A. Peaked T waves
B. Widened QRS complex only
C. Flattened T waves and prominent U waves
D. ST-segment elevation
, Answer: Flattened T waves and prominent U waves
Rationale: Hypokalemia can produce flattened T waves, ST depression, and
prominent U waves and may lead to dysrhythmias.
9. A client has a potassium level of 6.4 mEq/L. Which finding requires
immediate attention?
A. Mild nausea
B. Muscle fatigue
C. Cardiac dysrhythmia
D. Increased bowel sounds
Answer: Cardiac dysrhythmia
Rationale: Hyperkalemia can cause life-threatening cardiac conduction
abnormalities and dysrhythmias.
10.Which food should the nurse recommend to a client who needs to increase
dietary potassium?
A. White rice
B. Applesauce
C. Baked potato
D. White bread
Answer: Baked potato
Rationale: Potatoes, bananas, oranges, tomatoes, spinach, and other foods can
provide substantial potassium.
11.A nurse is preparing to administer IV potassium chloride. Which action is
appropriate?
A. Administer it by IV push
B. Give it undiluted
C. Administer it using an infusion pump as prescribed
D. Administer it rapidly for severe hypokalemia
