Nursing 354 Fluid and Electrolyte
Balance Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
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1. A nurse is assessing a client with dehydration. Which finding is most
consistent with a fluid volume deficit?
A. Bounding peripheral pulses
B. Crackles in the lungs
C. Orthostatic hypotension
D. Jugular venous distention
Answer: Orthostatic hypotension
Rationale: Orthostatic hypotension occurs when circulating blood volume is
reduced, causing blood pressure to fall when the client changes position.
2. Which assessment finding is most concerning in a client with severe fluid
volume excess?
A. Dry mucous membranes
B. Pulmonary crackles
C. Poor skin turgor
D. Flat neck veins
,Answer: Pulmonary crackles
Rationale: Pulmonary crackles can indicate pulmonary edema caused by
excessive intravascular fluid and require prompt intervention.
3. Which laboratory value is most useful for evaluating the body's sodium
balance?
A. Hemoglobin
B. Creatinine
C. Serum sodium
D. Hematocrit
Answer: Serum sodium
Rationale: Serum sodium is the primary laboratory measurement used to
evaluate sodium concentration and helps assess water and sodium balance.
4. A client has a serum sodium level of 128 mEq/L. How should the nurse
interpret this finding?
A. Hypernatremia
B. Normal sodium level
C. Hyponatremia
D. Hyperkalemia
Answer: Hyponatremia
Rationale: A serum sodium level below approximately 135 mEq/L indicates
hyponatremia.
5. Which clinical manifestation is commonly associated with severe
hyponatremia?
A. Excessive thirst only
B. Muscle rigidity without neurologic changes
C. Confusion and seizures
D. Hypertension
Answer: Confusion and seizures
,Rationale: Severe hyponatremia can cause cerebral edema, producing
neurologic manifestations such as confusion, altered consciousness, and
seizures.
6. Which client is at greatest risk for hypernatremia?
A. A client receiving excessive free water
B. A client with syndrome of inappropriate antidiuretic hormone secretion
C. A client with significant water loss and inadequate replacement
D. A client receiving hypotonic fluids
Answer: A client with significant water loss and inadequate replacement
Rationale: Hypernatremia commonly develops when water loss exceeds sodium
loss, particularly when adequate water replacement is unavailable.
7. Which symptom is most characteristic of hypernatremia?
A. Positive Chvostek sign
B. Intense thirst
C. Bradycardia
D. Hyporeflexia
Answer: Intense thirst
Rationale: Thirst is a major compensatory response to increased serum sodium
concentration and cellular dehydration.
8. A client has a serum potassium level of 6.2 mEq/L. Which finding requires
immediate attention?
A. Increased bowel sounds
B. Mild thirst
C. Cardiac dysrhythmia
D. Warm skin
Answer: Cardiac dysrhythmia
Rationale: Hyperkalemia can cause life-threatening cardiac conduction
abnormalities and dysrhythmias.
, 9. Which electrocardiographic change is commonly associated with
hyperkalemia?
A. Prolonged QT interval
B. Peaked T waves
C. Prominent U waves
D. ST elevation in all leads
Answer: Peaked T waves
Rationale: Peaked, narrow T waves are a classic early electrocardiographic
manifestation of hyperkalemia.
10.Which client is at increased risk for hyperkalemia?
A. A client taking a loop diuretic
B. A client with prolonged vomiting
C. A client with severe renal impairment
D. A client with excessive sweating
Answer: A client with severe renal impairment
Rationale: The kidneys excrete potassium. Renal impairment can therefore cause
potassium retention and hyperkalemia.
11.A client has a potassium level of 2.8 mEq/L. Which finding should the nurse
expect?
A. Peaked T waves
B. Hyperactive deep tendon reflexes
C. Muscle weakness
D. Severe hypertension
Answer: Muscle weakness
Rationale: Hypokalemia can cause skeletal muscle weakness, fatigue,
constipation, and potentially cardiac dysrhythmias.
12.Which electrocardiographic finding may occur with hypokalemia?
Balance Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
1. A nurse is assessing a client with dehydration. Which finding is most
consistent with a fluid volume deficit?
A. Bounding peripheral pulses
B. Crackles in the lungs
C. Orthostatic hypotension
D. Jugular venous distention
Answer: Orthostatic hypotension
Rationale: Orthostatic hypotension occurs when circulating blood volume is
reduced, causing blood pressure to fall when the client changes position.
2. Which assessment finding is most concerning in a client with severe fluid
volume excess?
A. Dry mucous membranes
B. Pulmonary crackles
C. Poor skin turgor
D. Flat neck veins
,Answer: Pulmonary crackles
Rationale: Pulmonary crackles can indicate pulmonary edema caused by
excessive intravascular fluid and require prompt intervention.
3. Which laboratory value is most useful for evaluating the body's sodium
balance?
A. Hemoglobin
B. Creatinine
C. Serum sodium
D. Hematocrit
Answer: Serum sodium
Rationale: Serum sodium is the primary laboratory measurement used to
evaluate sodium concentration and helps assess water and sodium balance.
4. A client has a serum sodium level of 128 mEq/L. How should the nurse
interpret this finding?
A. Hypernatremia
B. Normal sodium level
C. Hyponatremia
D. Hyperkalemia
Answer: Hyponatremia
Rationale: A serum sodium level below approximately 135 mEq/L indicates
hyponatremia.
5. Which clinical manifestation is commonly associated with severe
hyponatremia?
A. Excessive thirst only
B. Muscle rigidity without neurologic changes
C. Confusion and seizures
D. Hypertension
Answer: Confusion and seizures
,Rationale: Severe hyponatremia can cause cerebral edema, producing
neurologic manifestations such as confusion, altered consciousness, and
seizures.
6. Which client is at greatest risk for hypernatremia?
A. A client receiving excessive free water
B. A client with syndrome of inappropriate antidiuretic hormone secretion
C. A client with significant water loss and inadequate replacement
D. A client receiving hypotonic fluids
Answer: A client with significant water loss and inadequate replacement
Rationale: Hypernatremia commonly develops when water loss exceeds sodium
loss, particularly when adequate water replacement is unavailable.
7. Which symptom is most characteristic of hypernatremia?
A. Positive Chvostek sign
B. Intense thirst
C. Bradycardia
D. Hyporeflexia
Answer: Intense thirst
Rationale: Thirst is a major compensatory response to increased serum sodium
concentration and cellular dehydration.
8. A client has a serum potassium level of 6.2 mEq/L. Which finding requires
immediate attention?
A. Increased bowel sounds
B. Mild thirst
C. Cardiac dysrhythmia
D. Warm skin
Answer: Cardiac dysrhythmia
Rationale: Hyperkalemia can cause life-threatening cardiac conduction
abnormalities and dysrhythmias.
, 9. Which electrocardiographic change is commonly associated with
hyperkalemia?
A. Prolonged QT interval
B. Peaked T waves
C. Prominent U waves
D. ST elevation in all leads
Answer: Peaked T waves
Rationale: Peaked, narrow T waves are a classic early electrocardiographic
manifestation of hyperkalemia.
10.Which client is at increased risk for hyperkalemia?
A. A client taking a loop diuretic
B. A client with prolonged vomiting
C. A client with severe renal impairment
D. A client with excessive sweating
Answer: A client with severe renal impairment
Rationale: The kidneys excrete potassium. Renal impairment can therefore cause
potassium retention and hyperkalemia.
11.A client has a potassium level of 2.8 mEq/L. Which finding should the nurse
expect?
A. Peaked T waves
B. Hyperactive deep tendon reflexes
C. Muscle weakness
D. Severe hypertension
Answer: Muscle weakness
Rationale: Hypokalemia can cause skeletal muscle weakness, fatigue,
constipation, and potentially cardiac dysrhythmias.
12.Which electrocardiographic finding may occur with hypokalemia?
