NCLEX Fluid & electrolytes Questions and Answers with verified Solution

NCLEX Fluid & electrolytes Questions and Answers with verified Solution 1. A family member voices concern about a patient's status. On assessment, the patient is found to be irritable, lethargic, weak, and complaining of thirst. What is the likely electrolyte imbalance? a. Hypophosphatemia b. Hypokalemia c. Hypernatremia d. Hypercalcemia: c. Hypernatremia 2. A patient admitted from a homeless shelter is a poor historian. The patient appears malnourished and has a history of drug and alcohol abuse. What abnormal finding would be anticipated for this patient? a. Pitting edema b. Hypomagnesemia c. Pleural effusion d. Hypernatremia: b. Hypomagnesemia 3. Shortly after waking up in the morning, a 73-year-old patient comes to the emergency department (ED) by ambulance after slipping on a small carpet at home. The patient has a hip fracture that will require surgery. Currently, the patient is alert and oriented, PERLA is intact, heart rate is 99, blood pressure is 118/50. The patient is anxious and thirsty. A urinary catheter is placed, and drains 40 mL of concentrated urine. What is the nurse's most likely rationale (explanation) for the urine output? a. There is likely a brain injury from the fall causing a deficiency of antidiuretic hormone (ADH). b. The patient urinated prior to his arrival to the ED and the urinary catheter is not necessary. c. The patient has a history of heart failure and is releasing adenosine triphosphate (ATP). d. The renin-angiotensin I - angiotensin II - aldosterone system has been activated by the kidneys: d. The renin-angiotensin I - angiotensin II - aldosterone system has been activated by the kidneys 4. The home health nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The nurse notes that the woman seems a little confused and has poor skin turgor. When asked about her fluid intake, the patient states, "I stop drinking fluids early in the day because it is just too difficult to get up during the night to go to the bathroom." What would be the nurse's best response? a. "It is normal to be a little confused following surgery due to expected electrolyte imbalances" b. "Limiting your fluids can create imbalances in your body that can result in confusion." c. "Confusion following surgery is common in the elderly after your return home" d. "I will discuss with your healthcare provide to have your current blood pressure medication changed": b. "Limiting your fluids can create imbalances in your body that can result in confusion." 5. The nurse educator is teaching a class for newly licensed nurses. The edu- cator states "A patient in renal failure, which is an acidotic state, has difficulty regulating changes in pH." The nurses understand that when functioning normally, the kidneys a. Release and reabsorb bicarbonate to maintain a stable pH. b. Buffer acids through the retention or excretion of carbon dioxide. c. Excrete or retain urine to maintain a stable homeostasis. d. Reabsorb carbonic acid to change and maintain pH.: a. Release and reabsorb bicarbonate to maintain a stable pH. 6. The nurse is assessing the patient for the presence of a Chvostek's sign. What electrolyte imbalance does a positive Chvostek's sign indicate? a. Hyperkalemia b. Hypermagnesemia c. Hypocalcemia d. Hypercalcemia: c. Hypocalcemia 7. The nurse is caring for a 65-year-old patient who takes diuretics on a regular basis. During the shift assessment, the patient complains of tingling of the lips and fingers and a painful spasm in the wrist and hand whenever the blood pressure is taken. What condition is expected? a. Hypocalcemia b. Hypophosphatemia c. Hyperkalemia d. Hypermagnesemia: a. Hypocalcemia 8. The nurse is caring for a 77-year-old patient who fell off a roof. The patient's labs indicate elevated serum creatinine levels and a BUN (blood urea nitrogen) level within normal limits. What does this indicate? a. Alterations in muscle mass b. Stable protein levels c. Increased cardiac irritability d. Reduced renal function: d. Reduced renal function 9. The nurse is caring for a patient a day after intestinal surgery for an obstruc- tion. The nasogastric tube (NG) continues draining at low intermittent wall suction. The intravenous (IV) is patent and infusing at 125 mL per hour. The patient reports pain at the incision site rated at a three on a zero-to-ten rating scale. During the initial shift assessment, the patient complains of lethargy and weakness. You review the labs and notice an abnormal digoxin level and electrolyte imbalances. What other signs or symptoms is this patient likely to exhibit? a. Decreased kidney function b. Increased bowel motility c. Excessive thirst d. Abnormal cardiac rhythm: d. Abnormal cardiac rhythm 10. The nurse is evaluating a new patient's laboratory results. Based upon the laboratory findings, what will cause the release of antidiuretic hormone (ADH)? a. Decrease in thirst b. Increased serum sodium c. Decrease in serum osmolality d. Increased serum potassium: b. Increased serum sodium 11. The physician has ordered an isotonic intravenous fluid for a client who is NPO and is going for surgery. The nurse anticipates the order will include? a. Lactated Ringers b. Dextrose 5% and 0.45% Sodium c. 0.45% Sodium Chloride d. Dextrose 5% and Ringers Lactate: a. Lactated Ringers 12. The nurse is caring for a patient admitted with a diagnosis of renal failure. The patient's laboratory report reveals a high potassium level. What would be a priority assessment for this patient? a. Hyponatremia b. Respiratory rate c. Cardiac rhythm d. Hypercalcemia: c. Cardiac rhythm