STUVIA 2024/2025
Ch 12: Fluid Volume and Electrolytes
ANS: 100
Rationale: (200 mL x 15 gtt/mL) ÷ 30 min = 100 gtt/min. - ✔✔A patient with cirrhosis is noted to have
low serum albumin levels. The patient is to receive 200 mL of albumin in 30 minutes. The drop factor
for the IV set is 15 gtt/mL. The nurse correctly adjusts the IV rate to what rate? _______________
gtt/min
ANS: A
Rationale: Calcium gluconate is given to treat hyperkalemia in order to decrease irritability of the
myocardium. When administered to a patient taking digitalis, it can cause digitalis toxicity. The other
drugs may affect potassium levels but are not a cause for concern with calcium gluconate. - ✔✔The
nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level
of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by
the patient would cause concern?
a. Digitalis
b. Hydrochlorothiazide
c. Hydrocortisone
%
d. Vitamin D
ANS: A
Rationale: If the patient is receiving potassium and the urine output is <25 mL/h or <600 mL/d,
potassium accumulation may occur. Patients with a low urine output should not receive IV potassium.
Arterial blood gases are not necessary prior to IV potassium administration. Potassium should never
be given as a bolus. Patients should be put on a potassium-enriched diet when foods are tolerated. -
✔✔The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient's
electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L.
The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium
chloride to infuse at 125 mL/h. Which action is necessary prior to administering this fluid?
a. Evaluate the patient's urine output.
b. Contact the provider to order arterial blood gases.
c. Request an order for an initial potassium bolus.
d. Suggest a diet low in sodium and potassium.
ANS: A
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, STUVIA 2024/2025
Rationale: Mild hyperkalemia may be treated with dietary restriction of potassium-rich foods. The
patient's sodium level is normal, so sodium bicarbonate is not indicated. Kayexalate is used for
severe hyperkalemia. Salt substitutes contain potassium and would only compound the hyperkalemia.
- ✔✔The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium
level is 5.4 mEq/L. The nurse will contact the patient's provider to discuss an order for:
a. a low-potassium diet.
b. intravenous sodium bicarbonate.
c. Sodium polystyrene sulfonate (Kayexalate).
d. salt substitutes.
ANS: A
Rationale: Oliguria, tachycardia, and abdominal cramping are signs of hyperkalemia, so the nurse
should request an order for serum electrolytes. This patient should increase fluid intake. The patient
is not exhibiting signs of hyperchloremia; the patient is showing signs of hyperkalemia, and an
increased potassium dose is not indicated. - ✔✔The nurse is caring for a patient who is receiving
oral potassium chloride supplements. The nurse notes that the patient has a heart rate of 120 beats
per minute and has had a urine output of 200 mL in the past 12 hours. The patient reports abdominal
cramping. Which action will the nurse take?
a. Contact the provider to request an order for serum electrolytes.
%
b. Encourage the patient to consume less fluids.
c. Report symptoms of hyperchloremia to the provider.
d. Request an order to increase the patient's potassium dose.
ANS: A
Rationale: Patients who are hyponatremic will have tachycardia and hypotension along with lethargy
and muscle weakness. The normal range for serum sodium is 135 to 145 mEq/L; a serum sodium
level of 126 mEq/L would be considered hyponatremic. - ✔✔The nurse is caring for a patient who
has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg. The patient is
lethargic, is complaining of muscle weakness, and has had gastroenteritis for several days. Based on
this patient's vital signs, which sodium value would the nurse expect?
a. 126 mEq/L
b. 140 mEq/L
c. 145 mEq/L
d. 158 mEq/L
ANS: A
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Ch 12: Fluid Volume and Electrolytes
ANS: 100
Rationale: (200 mL x 15 gtt/mL) ÷ 30 min = 100 gtt/min. - ✔✔A patient with cirrhosis is noted to have
low serum albumin levels. The patient is to receive 200 mL of albumin in 30 minutes. The drop factor
for the IV set is 15 gtt/mL. The nurse correctly adjusts the IV rate to what rate? _______________
gtt/min
ANS: A
Rationale: Calcium gluconate is given to treat hyperkalemia in order to decrease irritability of the
myocardium. When administered to a patient taking digitalis, it can cause digitalis toxicity. The other
drugs may affect potassium levels but are not a cause for concern with calcium gluconate. - ✔✔The
nurse is caring for a patient who will receive 10% calcium gluconate to treat a serum potassium level
of 5.9 mEq/L. The nurse performs a drug history prior to beginning the infusion. Which drug taken by
the patient would cause concern?
a. Digitalis
b. Hydrochlorothiazide
c. Hydrocortisone
%
d. Vitamin D
ANS: A
Rationale: If the patient is receiving potassium and the urine output is <25 mL/h or <600 mL/d,
potassium accumulation may occur. Patients with a low urine output should not receive IV potassium.
Arterial blood gases are not necessary prior to IV potassium administration. Potassium should never
be given as a bolus. Patients should be put on a potassium-enriched diet when foods are tolerated. -
✔✔The nurse is caring for a newly admitted patient who has severe gastroenteritis. The patient's
electrolytes reveal a serum sodium level of 140 mEq/L and a serum potassium level of 3.5 mEq/L.
The nurse receives an order for intravenous 5% dextrose and normal saline with 20 mEq/L potassium
chloride to infuse at 125 mL/h. Which action is necessary prior to administering this fluid?
a. Evaluate the patient's urine output.
b. Contact the provider to order arterial blood gases.
c. Request an order for an initial potassium bolus.
d. Suggest a diet low in sodium and potassium.
ANS: A
stuvia
, STUVIA 2024/2025
Rationale: Mild hyperkalemia may be treated with dietary restriction of potassium-rich foods. The
patient's sodium level is normal, so sodium bicarbonate is not indicated. Kayexalate is used for
severe hyperkalemia. Salt substitutes contain potassium and would only compound the hyperkalemia.
- ✔✔The nurse is caring for a patient whose serum sodium level is 140 mEq/L and serum potassium
level is 5.4 mEq/L. The nurse will contact the patient's provider to discuss an order for:
a. a low-potassium diet.
b. intravenous sodium bicarbonate.
c. Sodium polystyrene sulfonate (Kayexalate).
d. salt substitutes.
ANS: A
Rationale: Oliguria, tachycardia, and abdominal cramping are signs of hyperkalemia, so the nurse
should request an order for serum electrolytes. This patient should increase fluid intake. The patient
is not exhibiting signs of hyperchloremia; the patient is showing signs of hyperkalemia, and an
increased potassium dose is not indicated. - ✔✔The nurse is caring for a patient who is receiving
oral potassium chloride supplements. The nurse notes that the patient has a heart rate of 120 beats
per minute and has had a urine output of 200 mL in the past 12 hours. The patient reports abdominal
cramping. Which action will the nurse take?
a. Contact the provider to request an order for serum electrolytes.
%
b. Encourage the patient to consume less fluids.
c. Report symptoms of hyperchloremia to the provider.
d. Request an order to increase the patient's potassium dose.
ANS: A
Rationale: Patients who are hyponatremic will have tachycardia and hypotension along with lethargy
and muscle weakness. The normal range for serum sodium is 135 to 145 mEq/L; a serum sodium
level of 126 mEq/L would be considered hyponatremic. - ✔✔The nurse is caring for a patient who
has a heart rate of 98 beats per minute and a blood pressure of 82/58 mm Hg. The patient is
lethargic, is complaining of muscle weakness, and has had gastroenteritis for several days. Based on
this patient's vital signs, which sodium value would the nurse expect?
a. 126 mEq/L
b. 140 mEq/L
c. 145 mEq/L
d. 158 mEq/L
ANS: A
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