Nclex Style: Nursing Fundamentals - Fluids
and Electrolytes
The nurse reviews the care needs for a group of clients. Which condition should the nurse
realize occurs from a fluid volume deficit?
A.
Diarrhea
B.
Water intoxication
C.
Hypertension
D.
Kidney failure -
A.
Diarrhea
The school nurse notes that a school-age child is experiencing mild heat exhaustion after
playing outside during recess. Which recommendation should the nurse make to help prevent
future occurrences of heat-related illness?
A.
Teach children to drink water only before recess.
B.
Move afternoon recess to a cooler morning hour.
C.
Encourage children to drink water when they feel thirsty.
D.
Provide a time for children to rest after recess. -
B.
Move afternoon recess to a cooler morning hour.
The nurse is completing a physical assessment with a client. On which part of the body
should the nurse focus when determining fluid and electrolyte status? (Select all that apply.)
A.
Ears
B.
Skin
C.
Endocrine system
D.
Oral cavity
E.
Cardiovascular system -
skin, oral cavity and cardiovascular system
1|Page
,The nurse is teaching a marathon runner about the importance of maintaining fluid and
electrolyte balance. Which situation puts runners at a higher risk for fluid and electrolyte
imbalances?
A.
The use of electrolyte replacement fluids during a race
B.
The significant loss of water during a lengthy exercise session
C.
The additional calcium taken by using calcium tablets to strengthen bones
D.
The increase of protein intake prior to a race -
A.
The use of electrolyte replacement fluids during a race
Rationale: It is common for athletes to use electrolyte replacement fluids during exercise. The
nurse should be sure that the athlete understands that these fluids could alter the delicate
balance of individual electrolytes. Supplemental protein and calcium intake do not typically
affect fluid and electrolyte balance. Although water is lost during sweating, it does not
usually create issues during exercise.
A nurse is caring for a client who has lost a large percentage of circulating body fluids as a
result of excessive diuresis. Which medication would the nurse anticipate this client needing?
A.
Diuretic
B.
Crystalloid
C.
Electrolyte supplement
D.
Colloid -
B.
Crystalloid
Rationale: Colloids expand fluid volume by the replacement of proteins or other large
molecules. Diuretics are used to promote urine output, particularly associated with fluid
overload. Electrolyte supplements are used to replace lost electrolytes. Crystalloids contain
both electrolytes and other substances that mimic the body's extracellular fluid. These
medications will assist in the replacement of depleted fluids while promoting urine output.
The nurse is administering a blood transfusion to a client who is hemorrhaging. In which
fluid compartment should the nurse identify that the client is experiencing a deficit?
A.
Intravascular fluid
B.
Transcellular fluid
C.
Intracellular fluid
2|Page
,D.
Interstitial fluid -
A.
Intravascular fluid
Rationale: Blood loss causes a deficit in the intravascular fluid compartment, which is a
subcompartment of extracellular fluid (ECF). Transcellular and interstitial fluids, along with
lymph, make up the other compartments of ECF. Intracellular fluid is the other major fluid
compartment in the body.
The nurse reviews the care needs for a group of clients. Which condition should the nurse
realize occurs from a fluid volume deficit?
A.
Diarrhea
B.
Water intoxication
C.
Kidney failure
D.
Hypertension -
A.
Diarrhea
Rationale: Fluid volume deficit, or dehydration, can occur when excessive amounts of fluids
are lost through diarrhea or vomiting. Kidney failure causes water retention, leading to fluid
volume excess, not deficit. Water intoxication results from excessive fluid intake and leads to
fluid volume excess. Fluid volume excess, not deficit, can result in hypertension.
The nurse is reviewing the fluid needs for a group of clients. Which characteristic of the
intracellular fluid compartment of the body should the nurse identify?
A.
Makes about one third of total body fluid in adults
B.
Includes cerebrospinal and peritoneal fluids
C.
Serves as a medium for metabolic processes
D.
Divides into intravascular, interstitial, and transcellular fluids -
C.
Serves as a medium for metabolic processes
Rationale: The intracellular fluid compartment makes up about two thirds of total body fluid
in adults and is found within cells. It is a medium for metabolic processes. Extracellular fluid
makes up the other one third of total body fluid and is divided into intravascular, interstitial,
and transcellular fluids. Cerebrospinal and peritoneal fluids are examples of transcellular
fluids.
The nurse is preparing material on fluid compartments in the body. Which fluids should the
nurse identify as the components of extracellular fluid?
3|Page
, A.
Intracellular, interstitial, and intravascular fluids
B.
Intravascular, interstitial, and intracellular fluids
C.
Intravascular, interstitial, and transcellular fluids
D.
Transcellular, intracellular, and extracellular fluids -
C.
Intravascular, interstitial, and transcellular fluids
Rationale: Body fluids found outside of the cell include intravascular, interstitial, and
transcellular fluids. Conversely, intracellular fluids are found inside the cell.
The nurse prepares intravenous fluid for a client. Which mechanism should the nurse recall
that represents the movement of fluid across cell membranes from an area of less
concentration to an area of higher concentration?
A.
Diffusion
B.
Active transport
C.
Filtration
D.
Osmosis -
D.
Osmosis
Rationale: Osmosis is the movement of water across cell membranes, from the less-
concentrated solution to the more-concentrated solution. Filtration is the process by which
fluid and solutes move together across a membrane from one compartment to another. Active
transport is a process by which substances move across the cell membrane and must combine
with a carrier for transportation, requiring metabolic energy. With diffusion, the molecules
move from a solution of higher concentration to a solution of lower concentration.
The nurse is caring for a hospitalized client who is experiencing anxiety-related
hyperventilation. When calculating the client's intake and output, where would the nurse
anticipate the need for an adjustment in fluid loss?
A.
Insensible loss
B.
Feces
C.
Urine
D.
Sweat -
A.
Insensible loss
4|Page
and Electrolytes
The nurse reviews the care needs for a group of clients. Which condition should the nurse
realize occurs from a fluid volume deficit?
A.
Diarrhea
B.
Water intoxication
C.
Hypertension
D.
Kidney failure -
A.
Diarrhea
The school nurse notes that a school-age child is experiencing mild heat exhaustion after
playing outside during recess. Which recommendation should the nurse make to help prevent
future occurrences of heat-related illness?
A.
Teach children to drink water only before recess.
B.
Move afternoon recess to a cooler morning hour.
C.
Encourage children to drink water when they feel thirsty.
D.
Provide a time for children to rest after recess. -
B.
Move afternoon recess to a cooler morning hour.
The nurse is completing a physical assessment with a client. On which part of the body
should the nurse focus when determining fluid and electrolyte status? (Select all that apply.)
A.
Ears
B.
Skin
C.
Endocrine system
D.
Oral cavity
E.
Cardiovascular system -
skin, oral cavity and cardiovascular system
1|Page
,The nurse is teaching a marathon runner about the importance of maintaining fluid and
electrolyte balance. Which situation puts runners at a higher risk for fluid and electrolyte
imbalances?
A.
The use of electrolyte replacement fluids during a race
B.
The significant loss of water during a lengthy exercise session
C.
The additional calcium taken by using calcium tablets to strengthen bones
D.
The increase of protein intake prior to a race -
A.
The use of electrolyte replacement fluids during a race
Rationale: It is common for athletes to use electrolyte replacement fluids during exercise. The
nurse should be sure that the athlete understands that these fluids could alter the delicate
balance of individual electrolytes. Supplemental protein and calcium intake do not typically
affect fluid and electrolyte balance. Although water is lost during sweating, it does not
usually create issues during exercise.
A nurse is caring for a client who has lost a large percentage of circulating body fluids as a
result of excessive diuresis. Which medication would the nurse anticipate this client needing?
A.
Diuretic
B.
Crystalloid
C.
Electrolyte supplement
D.
Colloid -
B.
Crystalloid
Rationale: Colloids expand fluid volume by the replacement of proteins or other large
molecules. Diuretics are used to promote urine output, particularly associated with fluid
overload. Electrolyte supplements are used to replace lost electrolytes. Crystalloids contain
both electrolytes and other substances that mimic the body's extracellular fluid. These
medications will assist in the replacement of depleted fluids while promoting urine output.
The nurse is administering a blood transfusion to a client who is hemorrhaging. In which
fluid compartment should the nurse identify that the client is experiencing a deficit?
A.
Intravascular fluid
B.
Transcellular fluid
C.
Intracellular fluid
2|Page
,D.
Interstitial fluid -
A.
Intravascular fluid
Rationale: Blood loss causes a deficit in the intravascular fluid compartment, which is a
subcompartment of extracellular fluid (ECF). Transcellular and interstitial fluids, along with
lymph, make up the other compartments of ECF. Intracellular fluid is the other major fluid
compartment in the body.
The nurse reviews the care needs for a group of clients. Which condition should the nurse
realize occurs from a fluid volume deficit?
A.
Diarrhea
B.
Water intoxication
C.
Kidney failure
D.
Hypertension -
A.
Diarrhea
Rationale: Fluid volume deficit, or dehydration, can occur when excessive amounts of fluids
are lost through diarrhea or vomiting. Kidney failure causes water retention, leading to fluid
volume excess, not deficit. Water intoxication results from excessive fluid intake and leads to
fluid volume excess. Fluid volume excess, not deficit, can result in hypertension.
The nurse is reviewing the fluid needs for a group of clients. Which characteristic of the
intracellular fluid compartment of the body should the nurse identify?
A.
Makes about one third of total body fluid in adults
B.
Includes cerebrospinal and peritoneal fluids
C.
Serves as a medium for metabolic processes
D.
Divides into intravascular, interstitial, and transcellular fluids -
C.
Serves as a medium for metabolic processes
Rationale: The intracellular fluid compartment makes up about two thirds of total body fluid
in adults and is found within cells. It is a medium for metabolic processes. Extracellular fluid
makes up the other one third of total body fluid and is divided into intravascular, interstitial,
and transcellular fluids. Cerebrospinal and peritoneal fluids are examples of transcellular
fluids.
The nurse is preparing material on fluid compartments in the body. Which fluids should the
nurse identify as the components of extracellular fluid?
3|Page
, A.
Intracellular, interstitial, and intravascular fluids
B.
Intravascular, interstitial, and intracellular fluids
C.
Intravascular, interstitial, and transcellular fluids
D.
Transcellular, intracellular, and extracellular fluids -
C.
Intravascular, interstitial, and transcellular fluids
Rationale: Body fluids found outside of the cell include intravascular, interstitial, and
transcellular fluids. Conversely, intracellular fluids are found inside the cell.
The nurse prepares intravenous fluid for a client. Which mechanism should the nurse recall
that represents the movement of fluid across cell membranes from an area of less
concentration to an area of higher concentration?
A.
Diffusion
B.
Active transport
C.
Filtration
D.
Osmosis -
D.
Osmosis
Rationale: Osmosis is the movement of water across cell membranes, from the less-
concentrated solution to the more-concentrated solution. Filtration is the process by which
fluid and solutes move together across a membrane from one compartment to another. Active
transport is a process by which substances move across the cell membrane and must combine
with a carrier for transportation, requiring metabolic energy. With diffusion, the molecules
move from a solution of higher concentration to a solution of lower concentration.
The nurse is caring for a hospitalized client who is experiencing anxiety-related
hyperventilation. When calculating the client's intake and output, where would the nurse
anticipate the need for an adjustment in fluid loss?
A.
Insensible loss
B.
Feces
C.
Urine
D.
Sweat -
A.
Insensible loss
4|Page
