Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
1. What is the nurse's prima- Answer: 1
ry concern regarding flu-
id & electrolytes when car- Rationale 1: As an adult ages, the thirst mechanism declines. Adding
ing for an elderly pt who is this in a pt with an altered level of consciousness, there is an in-
intermittently confused? creased risk of dehydration & high serum osmolality.
1. risk of dehydration Rationale 2: The risks for kidney damage are not specifically related
2. risk of kidney damage to aging or fluid & electrolyte issues.
3. risk of stroke Rationale 3: The risk of stroke is not specifically related to aging or
4. risk of bleeding fluid & electrolyte issues.
Rationale 4: The risk of bleeding is not specifically related to aging
or fluid & electrolyte issues.
2. The nurse is planning care Answer: 1
for a pt with severe burns.
Which of the following is Rationale 1: Because this pt was severely burned, the fluid within the
this pt at risk for develop- cells is diminished, leading to an intracellular fluid deficit.
ing? Rationale 2: The intracellular fluid is all fluids that exist within the cell
1. intracellular fluid cytoplasm & nucleus. Because this pt was severely burned, the fluid
deficit within the cells is diminished, leading to an intracellular fluid deficit.
2. intracellular fluid over- Rationale 3: The extracellular fluid is all fluids that exist outside the
load cell, including the interstitial fluid between the cells. Because this pt
3. extracellular fluid was severely burned, the fluid within the cells is diminished, leading
deficit to an intracellular fluid deficit.
4. interstitial fluid deficit Rationale 4: The extracellular fluid is all fluids that exist outside the
cell, including the interstitial fluid between the cells. Because this pt
was severely burned, the fluid within the cells is diminished, leading
to an intracellular fluid deficit.
3. A pt, experiencing mul- Answer: 1
tisystem fluid volume
deficit, has the symptoms Rationale 1: The internal vasoconstrictive compensatory reactions
of tachycardia, pale, cool within the body are responsible for the symptoms exhibited. The
1 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
skin, & decreased urine body naturally attempts to conserve fluid internally specifically for
output. The nurse realizes the brain & heart.
these findings are most Rationale 2: A diuretic would cause further fluid loss, & is contraindi-
likely a direct result of cated.
which of the following? Rationale 3: Rapidly infused intravenous fluids would not cause a
1. the body's natural com- decrease in urine output.
pensatory mechanisms Rationale 4: The manifestations reported are not indicative of cardiac
2. pharmacological ef- failure in this pt.
fects of a diuretic
3. effects of rapidly in-
fused intravenous fluids
4. cardiac failure
4. A pregnant pt is admitted Answer: 1
with excessive thirst, in-
creased urination, & has a Rationale 1: The pt with excessive thirst, increased urination & a
medical diagnosis of dia- medical diagnosis of diabetes insipidus is at risk for Imbalanced
betes insipidus. The nurse Fluid Volume due to the pt &'s excess volume loss that can increase
chooses which of the fol- the serum levels of sodium.
lowing nursing diagnoses Rationale 2: Excess Fluid Volume is not an issue for pts with diabetes
as most appropriate? insipidus, especially during the early stages of treatment.
1. Risk for Imbalanced Flu- Rationale 3: Imbalanced Nutrition does not apply.
id Volume Rationale 4: Ineffective Tissue Perfusion does not apply
2. Excess Fluid Volume
3. Imbalanced Nutrition
4. Ineffective Tissue Perfu-
sion
5. A pt recovering from Answer: 1
surgery has an indwelling Rationale 1: A urine output of less than 30 mL per hour must be re-
urinary catheter. The ported to the primary healthcare provider. This indicates inadequate
nurse would contact the renal perfusion, placing the pt at increased risk for acute renal failure
2 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
pt's primary healthcare & inadequate tissue perfusion. A minimum of 720 mL over a 24-hour
provider with which of the period is desired (30 mL multiplied by 24 hours equals 720 mL per
following 24-hour urine 24 hours).
output volumes?
1. 600 mL
2. 750 mL
3. 1000 mL
4. 1200 mL
6. A pt is receiving intra- Answer: 1
venous fluids postoper- Rationale 1: Antidiuretic hormone & aldosterone levels are commonly
atively following cardiac increased following the stress response before, during, & immedi-
surgery. Nursing assess- ately after surgery. This increase leads to sodium & water retention.
ments should focus on Adding more fluids intravenously can cause a fluid volume excess &
which postoperative com- stress upon the heart & circulatory system.
plication? Rationale 2: Adding more fluids intravenously can cause a fluid
1. fluid volume excess volume excess, not fluid volume deficit, & stress upon the heart &
2. fluid volume deficit circulatory system.
3. seizure activity Rationale 3: Seizure activity would more commonly be associated
4. liver failure with electrolyte imbalances.
Rationale 4: Liver failure is not anticipated related to postoperative
intravenous fluid administration.
7. A pt is diagnosed with Answer: 1
severe hyponatremia. The Rationale 1: Severe hyponatremia can lead to seizures. Seizure pre-
nurse realizes this pt will cautions such as a quiet environment, raised side rails, & having an
mostly likely need which oral airway at the bedside would be included.
of the following precau- Rationale 2: Infection precautions not specifically indicated for a pt
tions implemented? with hyponatremia.
1. seizure Rationale 3: Neutropenic precautions not specifically indicated for a
2. infection pt with hyponatremia.
3 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
3. neutropenic Rationale 4: High-risk fall precautions not specifically indicated for a
4. high-risk fall pt with hyponatremia.
8. A pt is diagnosed with hy- Answer: 1
pokalemia. After review- Rationale 1: Excess potassium loss through the kidneys is often
ing the pt's current med- caused by such meds as corticosteroids, potassium-wasting diuret-
ications, which of the fol- ics, amphotericin B, & large doses of some antibiotics.
lowing might have con- Rationale 2: Excessive sodium is lost with the use of thiazide diuret-
tributed to the pt's health ics.
problem? Rationale 3: Narcotics do not typically affect electrolyte balance.
1. corticosteroid Rationale 4: Muscle relaxants do not typically affect electrolyte bal-
2. thiazide diuretic ance.
3. narcotic
4. muscle relaxer
9. A pt prescribed spirono- Answer: 1
lactone is demonstrating Rationale 1: Hyperkalemia is serum potassium level greater than 5.0
ECG changes & complain- mEq/L. Decreased potassium excretion is seen in potassium-sparing
ing of muscle weakness. diuretics such as spironolactone. Common manifestations of hyper-
The nurse realizes this kalemia are muscle weakness & ECG changes.
pt is exhibiting signs of Rationale 2: Hypokalemia is seen in non-potassium diuretics such as
which of the following? furosemide.
1. hyperkalemia Rationale 3: Hypercalcemia has been associated with thiazide diuret-
2. hypokalemia ics.
3. hypercalcemia Rationale 4: Hypocalcemia is seen in pts who have received many
4. hypocalcemia units of citrated blood & is not associated with diuretic use.
10. The nurse is planning care Answer: 1
for a pt with fluid volume Rationale 1: The nursing care for a pt with hyponatremia is depen-
overload & hyponatrem- dent on the cause. Restriction of fluids to 1,000 mL/day is usually
ia. Which of the following implemented to assist sodium increase & to prevent the sodium level
should be included in this from dropping further due to dilution.
4 of 39
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
1. What is the nurse's prima- Answer: 1
ry concern regarding flu-
id & electrolytes when car- Rationale 1: As an adult ages, the thirst mechanism declines. Adding
ing for an elderly pt who is this in a pt with an altered level of consciousness, there is an in-
intermittently confused? creased risk of dehydration & high serum osmolality.
1. risk of dehydration Rationale 2: The risks for kidney damage are not specifically related
2. risk of kidney damage to aging or fluid & electrolyte issues.
3. risk of stroke Rationale 3: The risk of stroke is not specifically related to aging or
4. risk of bleeding fluid & electrolyte issues.
Rationale 4: The risk of bleeding is not specifically related to aging
or fluid & electrolyte issues.
2. The nurse is planning care Answer: 1
for a pt with severe burns.
Which of the following is Rationale 1: Because this pt was severely burned, the fluid within the
this pt at risk for develop- cells is diminished, leading to an intracellular fluid deficit.
ing? Rationale 2: The intracellular fluid is all fluids that exist within the cell
1. intracellular fluid cytoplasm & nucleus. Because this pt was severely burned, the fluid
deficit within the cells is diminished, leading to an intracellular fluid deficit.
2. intracellular fluid over- Rationale 3: The extracellular fluid is all fluids that exist outside the
load cell, including the interstitial fluid between the cells. Because this pt
3. extracellular fluid was severely burned, the fluid within the cells is diminished, leading
deficit to an intracellular fluid deficit.
4. interstitial fluid deficit Rationale 4: The extracellular fluid is all fluids that exist outside the
cell, including the interstitial fluid between the cells. Because this pt
was severely burned, the fluid within the cells is diminished, leading
to an intracellular fluid deficit.
3. A pt, experiencing mul- Answer: 1
tisystem fluid volume
deficit, has the symptoms Rationale 1: The internal vasoconstrictive compensatory reactions
of tachycardia, pale, cool within the body are responsible for the symptoms exhibited. The
1 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
skin, & decreased urine body naturally attempts to conserve fluid internally specifically for
output. The nurse realizes the brain & heart.
these findings are most Rationale 2: A diuretic would cause further fluid loss, & is contraindi-
likely a direct result of cated.
which of the following? Rationale 3: Rapidly infused intravenous fluids would not cause a
1. the body's natural com- decrease in urine output.
pensatory mechanisms Rationale 4: The manifestations reported are not indicative of cardiac
2. pharmacological ef- failure in this pt.
fects of a diuretic
3. effects of rapidly in-
fused intravenous fluids
4. cardiac failure
4. A pregnant pt is admitted Answer: 1
with excessive thirst, in-
creased urination, & has a Rationale 1: The pt with excessive thirst, increased urination & a
medical diagnosis of dia- medical diagnosis of diabetes insipidus is at risk for Imbalanced
betes insipidus. The nurse Fluid Volume due to the pt &'s excess volume loss that can increase
chooses which of the fol- the serum levels of sodium.
lowing nursing diagnoses Rationale 2: Excess Fluid Volume is not an issue for pts with diabetes
as most appropriate? insipidus, especially during the early stages of treatment.
1. Risk for Imbalanced Flu- Rationale 3: Imbalanced Nutrition does not apply.
id Volume Rationale 4: Ineffective Tissue Perfusion does not apply
2. Excess Fluid Volume
3. Imbalanced Nutrition
4. Ineffective Tissue Perfu-
sion
5. A pt recovering from Answer: 1
surgery has an indwelling Rationale 1: A urine output of less than 30 mL per hour must be re-
urinary catheter. The ported to the primary healthcare provider. This indicates inadequate
nurse would contact the renal perfusion, placing the pt at increased risk for acute renal failure
2 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
pt's primary healthcare & inadequate tissue perfusion. A minimum of 720 mL over a 24-hour
provider with which of the period is desired (30 mL multiplied by 24 hours equals 720 mL per
following 24-hour urine 24 hours).
output volumes?
1. 600 mL
2. 750 mL
3. 1000 mL
4. 1200 mL
6. A pt is receiving intra- Answer: 1
venous fluids postoper- Rationale 1: Antidiuretic hormone & aldosterone levels are commonly
atively following cardiac increased following the stress response before, during, & immedi-
surgery. Nursing assess- ately after surgery. This increase leads to sodium & water retention.
ments should focus on Adding more fluids intravenously can cause a fluid volume excess &
which postoperative com- stress upon the heart & circulatory system.
plication? Rationale 2: Adding more fluids intravenously can cause a fluid
1. fluid volume excess volume excess, not fluid volume deficit, & stress upon the heart &
2. fluid volume deficit circulatory system.
3. seizure activity Rationale 3: Seizure activity would more commonly be associated
4. liver failure with electrolyte imbalances.
Rationale 4: Liver failure is not anticipated related to postoperative
intravenous fluid administration.
7. A pt is diagnosed with Answer: 1
severe hyponatremia. The Rationale 1: Severe hyponatremia can lead to seizures. Seizure pre-
nurse realizes this pt will cautions such as a quiet environment, raised side rails, & having an
mostly likely need which oral airway at the bedside would be included.
of the following precau- Rationale 2: Infection precautions not specifically indicated for a pt
tions implemented? with hyponatremia.
1. seizure Rationale 3: Neutropenic precautions not specifically indicated for a
2. infection pt with hyponatremia.
3 of 39
, Fluid & Electrolyte NCLEX Practice Questions 2026/2027 (Answered)
Fluid & Electrolyte NCLEX Practice Questions
Study online at https://quizlet.com/_1f4uog
3. neutropenic Rationale 4: High-risk fall precautions not specifically indicated for a
4. high-risk fall pt with hyponatremia.
8. A pt is diagnosed with hy- Answer: 1
pokalemia. After review- Rationale 1: Excess potassium loss through the kidneys is often
ing the pt's current med- caused by such meds as corticosteroids, potassium-wasting diuret-
ications, which of the fol- ics, amphotericin B, & large doses of some antibiotics.
lowing might have con- Rationale 2: Excessive sodium is lost with the use of thiazide diuret-
tributed to the pt's health ics.
problem? Rationale 3: Narcotics do not typically affect electrolyte balance.
1. corticosteroid Rationale 4: Muscle relaxants do not typically affect electrolyte bal-
2. thiazide diuretic ance.
3. narcotic
4. muscle relaxer
9. A pt prescribed spirono- Answer: 1
lactone is demonstrating Rationale 1: Hyperkalemia is serum potassium level greater than 5.0
ECG changes & complain- mEq/L. Decreased potassium excretion is seen in potassium-sparing
ing of muscle weakness. diuretics such as spironolactone. Common manifestations of hyper-
The nurse realizes this kalemia are muscle weakness & ECG changes.
pt is exhibiting signs of Rationale 2: Hypokalemia is seen in non-potassium diuretics such as
which of the following? furosemide.
1. hyperkalemia Rationale 3: Hypercalcemia has been associated with thiazide diuret-
2. hypokalemia ics.
3. hypercalcemia Rationale 4: Hypocalcemia is seen in pts who have received many
4. hypocalcemia units of citrated blood & is not associated with diuretic use.
10. The nurse is planning care Answer: 1
for a pt with fluid volume Rationale 1: The nursing care for a pt with hyponatremia is depen-
overload & hyponatrem- dent on the cause. Restriction of fluids to 1,000 mL/day is usually
ia. Which of the following implemented to assist sodium increase & to prevent the sodium level
should be included in this from dropping further due to dilution.
4 of 39
