ATI MED-SURG EXAM QUESTIONS ON FLUID AND ELECTROLYTE BALANCE AND DISTURBANCES WITH FULLY VERIFIED ANSWERS 2025

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,Solution Guide
Question 1: An elderly patient is prescribed 40 mg of Lasix twice
daily. What is the most severe electrolyte imbalance that can result
from this diuretic use? Correct answer: Hypokalemia Explanation:
Hypokalemia (potassium level below 3.5 mEq/L) typically signifies
a reduction in total potassium levels. Potassium-wasting diuretics,
like loop diuretics, often lead to hypokalemia. Reference: Hinkle,
J.L., and Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 13th edition, p. 255.

Question 2: A nurse is assessing a patient's lab results to identify
critical values that need to be reported to the physician. Which
value requires immediate action? Correct answer: Potassium: 5.8
mEq/L Explanation: The normal potassium range is 3.5 to 5.5
mEq/L. Elevated potassium levels can cause muscle weakness,
tingling sensations, and heart rhythm problems. Reference: Hinkle,
J.L., and Cheever, K.H., Brunner & Suddarth's Textbook of
Medical-Surgical Nursing, 13th edition, p. 254.

Question 3: A patient with pancreatic cancer has a blood chemistry
profile showing: Glucose: 204 mg/dL, BUN: 12 mg/dL, Creatinine:
0.9 mg/dL, Sodium: 136 mEq/L, Potassium: 2.2 mEq/L, Chloride:
99 mEq/L, CO2: 33 mEq/L. Which value should be identified as
critical and reported immediately? Correct answer: Potassium
Explanation: A potassium level of 2.2 mEq/L is critically low since
the normal range is 3.8 to 5.5 mEq/L. Severe hypokalemia can lead
to cardiac and respiratory arrest. Elevated glucose and slightly low
chloride levels should be noted but are not life-threatening.
Reference: Hinkle, J.L., and Cheever, K.H., Brunner & Suddarth's
Textbook of Medical-Surgical Nursing, 13th edition, p. 255.

, Question b4: bWhich bnerve bis bassociated bwith bChvostek’s bsign?
bCorrect banswer: bFacial bnerve bExplanation: bChvostek’s bsign

binvolves bmuscle btwitching bwhen bthe bfacial bnerve bis btapped babout b2

bcm bin bfront bof bthe bearlobe, bjust bbelow bthe bcheekbone. bReference:

bHinkle, bJ.L., band bCheever, bK.H., bBrunner b& bSuddarth's

bTextbook bof bMedical-Surgical bNursing, b13th bedition, bp. b259.




Question b5: bA bclient bhas barterial bblood bgas b(ABG) bvalues bof bpH b7.12,
bPaCO2 b40 bmm bHg, band bbicarbonate b(HCO3–) b15 bmEq/L. bWhich bdisorder

bdo bthese bvalues bindicate? bCorrect banswer: bMetabolic bacidosis bExplanation:

bThe blow bpH bsuggests bacidosis, band bthe blow bbicarbonate blevel bindicates ban

bexcess bof bacids bor bloss bof bbase, bwhich bpoints bto bmetabolic bacidosis. bNormal

bPaCO2 bmeans bno brespiratory bcompensation bis bpresent, bruling bout bother

bdisorders. bReference: bHinkle, bJ.L., band bCheever, bK.H., bBrunner b&

bSuddarth's bTextbook bof bMedical- bSurgical bNursing, b13th bedition, bp. b268.




Question b6: bThe bnurse bis bcaring bfor ba bclient bwith blab bresults bindicating
bdehydration. bWhat bis ba bconsistent bclinical bsymptom bof bdehydration?

bCorrect banswer: bDark, bconcentrated burine bExplanation: bDark, bconcentrated

burine bsuggests ba bfluid bvolume bdeficit. bIncreasing bfluid bintake bwould bdilute bthe

burine, bindicating bimproved bhydration. bReference: bHinkle, bJ.L., band

bCheever, bK.H., bBrunner b& bSuddarth's bTextbook bof bMedical-Surgical

bNursing, b13th bedition, bp. b246.




Question b7: bHow bdoes bthe bbody btypically brespond bto bdecreased bfluid
bvolume b(hypovolemia)? bCorrect banswer: bTachycardia bExplanation:

bHypovolemia, bor bfluid bvolume bdeficit, bleads bto bsigns blike bdecreased burine

boutput, brapid bheart brate, bvasoconstriction, bcool bskin, band bmuscle

bweakness. bThe bnurse bshould bwatch bfor ba bquick, bweak bpulse band blow bblood

bpressure. bReference: bHinkle, bJ.L., band bCheever, bK.H., bBrunner b&

bSuddarth's bTextbook bof bMedical-Surgical bNursing, b13th bedition, bpp. b245-

246.

Question b8: bWhat bclinical bsymptom bshould ba bnurse bmonitor bfor bin ba bpatient
bwith ba bpossible bair bembolism bfrom bIV btherapy? bCorrect banswer: bChest

bpain bExplanation: bSymptoms bof ban bair bembolism binclude bdifficulty

bbreathing, blow bblood bpressure, brapid bweak bpulse, bloss bof bconsciousness,

band bpain bin bthe bchest, bshoulder, bor blower bback. bReference: bHinkle, bJ.L.,

band bCheever, bK.H., bBrunner b& bSuddarth's bTextbook bof bMedical-Surgical

bNursing, b13th bedition, bp. b280.




Question b9: bWhich bABG bvalues bindicate brespiratory bacidosis bin ba bpatient
bwith bsevere bpneumonia? bCorrect banswer: bpH: b7.20, bPaCO2: b65 bmm bHg,

bHCO3–: b26 bmEq/L bExplanation: bRespiratory bacidosis bis bidentified bwhen

bpH bis bbelow

7.35 band bPaCO2 bis babove b42 bmm bHg, bwith ba bcompensatory brise bin
bbicarbonate blevels. bReference: bHinkle, bJ.L., band bCheever, bK.H., bBrunner b&

bSuddarth's bTextbook bof bMedical-Surgical bNursing, b13th bedition, bp. b269.




Question b10: bAt bwhat bserum bsodium blevel bmight bconvulsions bor bcoma
boccur? bCorrect banswer: bBelow b135 bmEq/L bExplanation: bHyponatremia

boccurs bwhen bsodium blevels bdrop bbelow b135 bmEq/L. b Severe bdeficits bcan

bcause bsymptoms blike bconfusion, bmuscle bweakness, band bin bextreme bcases,

bconvulsions bor bcoma. bReference: bHinkle, bJ.L., band bCheever, bK.H., bBrunner

b& bSuddarth's bTextbook bof b Medical-Surgical bNursing, b13th bedition, bp. b253.