Fluid & Electrolytes question with
answers new edition (Q1–Q30)
1. A client has a serum sodium of 155 mEq/L. Which clinical manifestation should the
nurse assess for first?
A. Jugular vein distention
B. Confusion and muscle twitching
C. Periorbital edema
D. Tachycardia and hypotension
Answer: B
Rationale: Hypernatremia (>145 mEq/L) causes intracellular dehydration, primarily affecting
the central nervous system. Early signs include confusion, restlessness, and muscle
twitching. Jugular vein distention and edema indicate hypervolemia, not hypernatremia.
2. The nurse identifies 0.45% sodium chloride as which type of intravenous solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: B
Rationale: 0.45% NaCl is hypotonic, with an osmolality lower than plasma. It shifts water
into cells and is used for hypernatremia.
3. The #1 sign of fluid volume deficit is:
A. Hypotension
B. Decreased urine output
C. Tachycardia
D. Dry mucous membranes
Answer: C
Rationale: Tachycardia is the earliest compensatory mechanism for hypovolemia, as the
heart rate increases to maintain cardiac output. Blood pressure drops later.
4. A client with a potassium level of 5.2 mEq/L. The nurse should monitor for which
priority complication?
A. Cardiac dysrhythmias
,B. Polyuria
C. Hypotension
D. Tetany
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves, widened
QRS, and potentially fatal arrhythmias.
5. A patient with fluid volume excess would most likely exhibit which assessment finding?
A. Dry mucous membranes and poor skin turgor
B. Jugular vein distention and crackles on auscultation
C. Orthostatic hypotension and tachycardia
D. Sunken eyes and decreased urine output
Answer: B
Rationale: Fluid volume excess leads to increased venous pressure (JVD) and pulmonary
congestion (crackles). Options A, C, and D are characteristic of fluid volume deficit.
6. In caring for a client with SIADH, the nurse monitors specific gravity every 4 hours to
assess:
A. Nutritional status
B. Potassium balance
C. Fluid volume status
D. Calcium balance
Answer: C
Rationale: SIADH causes water retention, diluting body fluids and decreasing specific gravity.
Tracking specific gravity helps detect fluid volume excess or deficit.
7. A client's serum sodium is 130 mEq/L. Which signs should the nurse monitor for? (Select
all that apply.)
A. Convulsions
B. Decreased LOC
C. Thirst
D. Dry mucous membranes
E. Hypertension
Answer: A, B
Rationale: Hyponatremia (<135 mEq/L) leads to water movement into brain cells, causing
, cerebral edema. This can result in confusion, convulsions, and decreased LOC. Thirst and dry
mucous membranes are signs of hypernatremia.
8. Which statement best describes oncotic pressure?
A. Oncotic pressure eliminates the need for reassessment
B. Plasma oncotic pressure, largely generated by albumin, pulls water into the vascular space
C. Oncotic pressure should be determined without laboratory assessment
D. Oncotic pressure is unrelated to fluid management
Answer: B
Rationale: Plasma oncotic pressure, primarily from albumin, pulls water into the vascular
space.
9. A nurse is administering 3% saline to a client with severe hyponatremia. This solution is
classified as:
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: C
Rationale: 3% saline is hypertonic and is used cautiously for severe hyponatremia to draw
water out of cells.
10. Which food should the nurse recommend for a client with hypocalcemia? (Select all
that apply.)
A. Sardines
B. Milk
C. Cheese
D. Apples
E. Bananas
Answer: A, B, C
Rationale: Sardines, milk, and cheese are rich sources of calcium. Apples and bananas are
not significant sources of calcium.
11. A client with a potassium level of 5.2 mEq/L is at risk for which ECG change?
A. Flattened T waves
B. Prominent U waves
answers new edition (Q1–Q30)
1. A client has a serum sodium of 155 mEq/L. Which clinical manifestation should the
nurse assess for first?
A. Jugular vein distention
B. Confusion and muscle twitching
C. Periorbital edema
D. Tachycardia and hypotension
Answer: B
Rationale: Hypernatremia (>145 mEq/L) causes intracellular dehydration, primarily affecting
the central nervous system. Early signs include confusion, restlessness, and muscle
twitching. Jugular vein distention and edema indicate hypervolemia, not hypernatremia.
2. The nurse identifies 0.45% sodium chloride as which type of intravenous solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: B
Rationale: 0.45% NaCl is hypotonic, with an osmolality lower than plasma. It shifts water
into cells and is used for hypernatremia.
3. The #1 sign of fluid volume deficit is:
A. Hypotension
B. Decreased urine output
C. Tachycardia
D. Dry mucous membranes
Answer: C
Rationale: Tachycardia is the earliest compensatory mechanism for hypovolemia, as the
heart rate increases to maintain cardiac output. Blood pressure drops later.
4. A client with a potassium level of 5.2 mEq/L. The nurse should monitor for which
priority complication?
A. Cardiac dysrhythmias
,B. Polyuria
C. Hypotension
D. Tetany
Answer: A
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves, widened
QRS, and potentially fatal arrhythmias.
5. A patient with fluid volume excess would most likely exhibit which assessment finding?
A. Dry mucous membranes and poor skin turgor
B. Jugular vein distention and crackles on auscultation
C. Orthostatic hypotension and tachycardia
D. Sunken eyes and decreased urine output
Answer: B
Rationale: Fluid volume excess leads to increased venous pressure (JVD) and pulmonary
congestion (crackles). Options A, C, and D are characteristic of fluid volume deficit.
6. In caring for a client with SIADH, the nurse monitors specific gravity every 4 hours to
assess:
A. Nutritional status
B. Potassium balance
C. Fluid volume status
D. Calcium balance
Answer: C
Rationale: SIADH causes water retention, diluting body fluids and decreasing specific gravity.
Tracking specific gravity helps detect fluid volume excess or deficit.
7. A client's serum sodium is 130 mEq/L. Which signs should the nurse monitor for? (Select
all that apply.)
A. Convulsions
B. Decreased LOC
C. Thirst
D. Dry mucous membranes
E. Hypertension
Answer: A, B
Rationale: Hyponatremia (<135 mEq/L) leads to water movement into brain cells, causing
, cerebral edema. This can result in confusion, convulsions, and decreased LOC. Thirst and dry
mucous membranes are signs of hypernatremia.
8. Which statement best describes oncotic pressure?
A. Oncotic pressure eliminates the need for reassessment
B. Plasma oncotic pressure, largely generated by albumin, pulls water into the vascular space
C. Oncotic pressure should be determined without laboratory assessment
D. Oncotic pressure is unrelated to fluid management
Answer: B
Rationale: Plasma oncotic pressure, primarily from albumin, pulls water into the vascular
space.
9. A nurse is administering 3% saline to a client with severe hyponatremia. This solution is
classified as:
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Answer: C
Rationale: 3% saline is hypertonic and is used cautiously for severe hyponatremia to draw
water out of cells.
10. Which food should the nurse recommend for a client with hypocalcemia? (Select all
that apply.)
A. Sardines
B. Milk
C. Cheese
D. Apples
E. Bananas
Answer: A, B, C
Rationale: Sardines, milk, and cheese are rich sources of calcium. Apples and bananas are
not significant sources of calcium.
11. A client with a potassium level of 5.2 mEq/L is at risk for which ECG change?
A. Flattened T waves
B. Prominent U waves
