ATI RN Targeted Medical-Surgical Fluid,
Electrolyte & Acid-Base Practice Exam
2026–2027| Complete Test Prep
Practice Questions With Answers &
Detailed Rationales |clinical Judgment
&Safety |A+ Rated
1. A nurse is assessing a client who has dehydration. Which finding
should the nurse expect?
A. Bounding pulse
B. Crackles
C. Flat neck veins
D. Peripheral edema
Answer: C. Flat neck veins
Dehydration decreases intravascular volume, causing flat neck veins,
tachycardia, hypotension, and concentrated urine.
2. Which finding is most indicative of fluid volume excess?
A. Weight loss
B. Dry mucous membranes
C. Orthostatic hypotension
D. Bilateral crackles
Answer: D. Bilateral crackles
Excess intravascular and pulmonary fluid can cause pulmonary
congestion and crackles.
3. A client has a sodium level of 128 mEq/L. Which manifestation
should the nurse expect?
A. Confusion
,B. Intense thirst
C. Flushed skin
D. Muscle rigidity
Answer: A. Confusion
Hyponatremia can cause neurologic manifestations such as
headache, confusion, seizures, and decreased level of consciousness.
4. Which urine finding indicates adequate hydration?
A. Dark amber urine
B. Specific gravity 1.035
C. Pale yellow urine
D. Specific gravity 1.040
Answer: C. Pale yellow urine
Pale yellow urine generally indicates adequate hydration, whereas
concentrated dark urine suggests fluid deficit.
5. A nurse is monitoring a client receiving IV fluids. Which finding
requires immediate intervention?
A. Urine output 45 mL/hr
B. Moist mucous membranes
C. New bilateral crackles
D. Blood pressure 118/72 mm Hg
Answer: C. New bilateral crackles
New crackles can indicate pulmonary edema from fluid overload and
require prompt assessment and intervention.
6. Which assessment is the most sensitive indicator of changes in
fluid volume?
A. Daily weight
B. Skin color
C. Temperature
D. Respiratory rate
,Answer: A. Daily weight
Daily weight provides a sensitive measurement of overall fluid gain or
loss; approximately 1 kg represents 1 L of fluid.
7. A client with vomiting and diarrhea is at greatest risk for which
imbalance?
A. Fluid volume deficit
B. Fluid volume excess
C. Hypercalcemia
D. Hypermagnesemia
Answer: A. Fluid volume deficit
Vomiting and diarrhea cause gastrointestinal fluid and electrolyte
losses.
8. Which finding is expected in a client with fluid volume deficit?
A. Hypertension
B. Tachycardia
C. Peripheral edema
D. Jugular venous distention
Answer: B. Tachycardia
The heart rate increases as the body attempts to maintain cardiac
output when circulating volume decreases.
9. Which client is at greatest risk for fluid volume excess?
A. Client with diabetes insipidus
B. Client receiving continuous IV fluids
C. Client with prolonged diarrhea
D. Client with excessive sweating
Answer: B. Client receiving continuous IV fluids
Rapid or excessive IV fluid administration can cause fluid volume
excess, particularly in clients with impaired renal or cardiac function.
10. A nurse is teaching a client about monitoring fluid status at
home. Which instruction is most appropriate?
, A. Weigh yourself weekly.
B. Weigh yourself at different times each day.
C. Weigh yourself daily at the same time.
D. Weigh yourself only when edema occurs.
Answer: C. Weigh yourself daily at the same time.
Consistent daily weights provide the most reliable trend in fluid
status.
11. Which finding is associated with fluid volume excess?
A. Poor skin turgor
B. Increased hematocrit
C. Neck vein distention
D. Decreased blood pressure
Answer: C. Neck vein distention
Increased intravascular volume can cause jugular venous distention.
12. A client has severe dehydration. Which prescription should the
nurse anticipate?
A. Restrict fluids
B. Administer isotonic IV fluids
C. Administer hypotonic fluids rapidly
D. Administer a loop diuretic
Answer: B. Administer isotonic IV fluids
Isotonic solutions expand intravascular volume and are commonly
used initially to treat significant fluid volume deficit.
13. Which finding should the nurse report for a client receiving IV
fluids?
A. Urine output 50 mL/hr
B. Heart rate 78/min
C. New dependent edema
D. Blood pressure 122/78 mm Hg
Electrolyte & Acid-Base Practice Exam
2026–2027| Complete Test Prep
Practice Questions With Answers &
Detailed Rationales |clinical Judgment
&Safety |A+ Rated
1. A nurse is assessing a client who has dehydration. Which finding
should the nurse expect?
A. Bounding pulse
B. Crackles
C. Flat neck veins
D. Peripheral edema
Answer: C. Flat neck veins
Dehydration decreases intravascular volume, causing flat neck veins,
tachycardia, hypotension, and concentrated urine.
2. Which finding is most indicative of fluid volume excess?
A. Weight loss
B. Dry mucous membranes
C. Orthostatic hypotension
D. Bilateral crackles
Answer: D. Bilateral crackles
Excess intravascular and pulmonary fluid can cause pulmonary
congestion and crackles.
3. A client has a sodium level of 128 mEq/L. Which manifestation
should the nurse expect?
A. Confusion
,B. Intense thirst
C. Flushed skin
D. Muscle rigidity
Answer: A. Confusion
Hyponatremia can cause neurologic manifestations such as
headache, confusion, seizures, and decreased level of consciousness.
4. Which urine finding indicates adequate hydration?
A. Dark amber urine
B. Specific gravity 1.035
C. Pale yellow urine
D. Specific gravity 1.040
Answer: C. Pale yellow urine
Pale yellow urine generally indicates adequate hydration, whereas
concentrated dark urine suggests fluid deficit.
5. A nurse is monitoring a client receiving IV fluids. Which finding
requires immediate intervention?
A. Urine output 45 mL/hr
B. Moist mucous membranes
C. New bilateral crackles
D. Blood pressure 118/72 mm Hg
Answer: C. New bilateral crackles
New crackles can indicate pulmonary edema from fluid overload and
require prompt assessment and intervention.
6. Which assessment is the most sensitive indicator of changes in
fluid volume?
A. Daily weight
B. Skin color
C. Temperature
D. Respiratory rate
,Answer: A. Daily weight
Daily weight provides a sensitive measurement of overall fluid gain or
loss; approximately 1 kg represents 1 L of fluid.
7. A client with vomiting and diarrhea is at greatest risk for which
imbalance?
A. Fluid volume deficit
B. Fluid volume excess
C. Hypercalcemia
D. Hypermagnesemia
Answer: A. Fluid volume deficit
Vomiting and diarrhea cause gastrointestinal fluid and electrolyte
losses.
8. Which finding is expected in a client with fluid volume deficit?
A. Hypertension
B. Tachycardia
C. Peripheral edema
D. Jugular venous distention
Answer: B. Tachycardia
The heart rate increases as the body attempts to maintain cardiac
output when circulating volume decreases.
9. Which client is at greatest risk for fluid volume excess?
A. Client with diabetes insipidus
B. Client receiving continuous IV fluids
C. Client with prolonged diarrhea
D. Client with excessive sweating
Answer: B. Client receiving continuous IV fluids
Rapid or excessive IV fluid administration can cause fluid volume
excess, particularly in clients with impaired renal or cardiac function.
10. A nurse is teaching a client about monitoring fluid status at
home. Which instruction is most appropriate?
, A. Weigh yourself weekly.
B. Weigh yourself at different times each day.
C. Weigh yourself daily at the same time.
D. Weigh yourself only when edema occurs.
Answer: C. Weigh yourself daily at the same time.
Consistent daily weights provide the most reliable trend in fluid
status.
11. Which finding is associated with fluid volume excess?
A. Poor skin turgor
B. Increased hematocrit
C. Neck vein distention
D. Decreased blood pressure
Answer: C. Neck vein distention
Increased intravascular volume can cause jugular venous distention.
12. A client has severe dehydration. Which prescription should the
nurse anticipate?
A. Restrict fluids
B. Administer isotonic IV fluids
C. Administer hypotonic fluids rapidly
D. Administer a loop diuretic
Answer: B. Administer isotonic IV fluids
Isotonic solutions expand intravascular volume and are commonly
used initially to treat significant fluid volume deficit.
13. Which finding should the nurse report for a client receiving IV
fluids?
A. Urine output 50 mL/hr
B. Heart rate 78/min
C. New dependent edema
D. Blood pressure 122/78 mm Hg
