ATI Medical-Surgical Fluid & Electrolyte Imbalances Practice Pack
2026/2027 Questions |Answers |Rationales
1. A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL.
Which of the following findings should the nurse expect?
A. Negative Chvostek’s sign
B. Polyuria and polydipsia
C. Decreased deep tendon reflexes
D. Muscle tremors and tingling in the extremities
Answer: D
Rationale: A calcium level of 8.1 mg/dL indicates hypocalcemia (normal range 9.0-10.5
mg/dL). Clinical manifestations include muscle tremors, tingling around the mouth or in
extremities, and positive Chvostek’s or Trousseau’s signs.
2. Which of the following cardiac changes should the nurse monitor for in a
client with a potassium level of 2.8 mEq/L?
A. Prominent U waves
B. Widened QRS complex
C. Peaked T waves
D. Prolonged PR interval
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically shows flattened T waves and
the appearance of U waves on an ECG.
,3. A nurse is caring for a client with hypernatremia. Which of the following IV
fluids should the nurse expect to administer?
A. Lactated Ringer’s
B. 3% Sodium Chloride
C. 0.45% Sodium Chloride
D. 10% Dextrose in Water
Answer: C
Rationale: Hypernatremia is treated with hypotonic solutions such as 0.45% Sodium
Chloride to gradually lower serum sodium levels.
4. A client is diagnosed with hypomagnesemia. Which of the following
assessment findings is consistent with this diagnosis?
A. Lethargy
B. Hyperactive deep tendon reflexes
C. Bradycardia
D. Hypotension
Answer: B
Rationale: Hypomagnesemia causes increased neuromuscular irritability, resulting in
hyperactive deep tendon reflexes (DTRs), tremors, and seizures.
5. A nurse is evaluating a client’s arterial blood gas (ABG) results: pH 7.30,
PaCO2 50 mmHg, HCO3 24 mEq/L. The nurse should interpret these results as:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: A
Rationale: The pH is low (< 7.35) and the PaCO2 is high (> 45 mmHg), which indicates
respiratory acidosis.
, 6. Which of the following is the most reliable indicator of fluid volume status in
a client?
A. Skin turgor
B. Intake and output
C. Presence of edema
D. Daily weights
Answer: D
Rationale: Daily weight is the most accurate indicator of fluid gain or loss, as it reflects
changes in fluid status more precisely than I&O or skin turgor.
7. A client who has been vomiting for 24 hours is at risk for which acid-base
imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting results in the loss of gastric acid (hydrochloric acid), which leads to an
increase in bicarbonate and metabolic alkalosis.
8. A nurse is reviewing the lab results for a client with fluid volume deficit.
Which finding should the nurse expect?
A. BUN 32 mg/dL
B. Hematocrit 35%
C. Urine specific gravity 1.005
D. Serum sodium 130 mEq/L
Answer: A
Rationale: In fluid volume deficit (dehydration), the BUN is typically elevated due to
hemoconcentration and decreased renal perfusion.
2026/2027 Questions |Answers |Rationales
1. A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL.
Which of the following findings should the nurse expect?
A. Negative Chvostek’s sign
B. Polyuria and polydipsia
C. Decreased deep tendon reflexes
D. Muscle tremors and tingling in the extremities
Answer: D
Rationale: A calcium level of 8.1 mg/dL indicates hypocalcemia (normal range 9.0-10.5
mg/dL). Clinical manifestations include muscle tremors, tingling around the mouth or in
extremities, and positive Chvostek’s or Trousseau’s signs.
2. Which of the following cardiac changes should the nurse monitor for in a
client with a potassium level of 2.8 mEq/L?
A. Prominent U waves
B. Widened QRS complex
C. Peaked T waves
D. Prolonged PR interval
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically shows flattened T waves and
the appearance of U waves on an ECG.
,3. A nurse is caring for a client with hypernatremia. Which of the following IV
fluids should the nurse expect to administer?
A. Lactated Ringer’s
B. 3% Sodium Chloride
C. 0.45% Sodium Chloride
D. 10% Dextrose in Water
Answer: C
Rationale: Hypernatremia is treated with hypotonic solutions such as 0.45% Sodium
Chloride to gradually lower serum sodium levels.
4. A client is diagnosed with hypomagnesemia. Which of the following
assessment findings is consistent with this diagnosis?
A. Lethargy
B. Hyperactive deep tendon reflexes
C. Bradycardia
D. Hypotension
Answer: B
Rationale: Hypomagnesemia causes increased neuromuscular irritability, resulting in
hyperactive deep tendon reflexes (DTRs), tremors, and seizures.
5. A nurse is evaluating a client’s arterial blood gas (ABG) results: pH 7.30,
PaCO2 50 mmHg, HCO3 24 mEq/L. The nurse should interpret these results as:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: A
Rationale: The pH is low (< 7.35) and the PaCO2 is high (> 45 mmHg), which indicates
respiratory acidosis.
, 6. Which of the following is the most reliable indicator of fluid volume status in
a client?
A. Skin turgor
B. Intake and output
C. Presence of edema
D. Daily weights
Answer: D
Rationale: Daily weight is the most accurate indicator of fluid gain or loss, as it reflects
changes in fluid status more precisely than I&O or skin turgor.
7. A client who has been vomiting for 24 hours is at risk for which acid-base
imbalance?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: B
Rationale: Vomiting results in the loss of gastric acid (hydrochloric acid), which leads to an
increase in bicarbonate and metabolic alkalosis.
8. A nurse is reviewing the lab results for a client with fluid volume deficit.
Which finding should the nurse expect?
A. BUN 32 mg/dL
B. Hematocrit 35%
C. Urine specific gravity 1.005
D. Serum sodium 130 mEq/L
Answer: A
Rationale: In fluid volume deficit (dehydration), the BUN is typically elevated due to
hemoconcentration and decreased renal perfusion.
