Fluid & Electrolyte Nclex Questions
Nurse would be most concerned about which lab values obtained fro ma client receiving
furosemide (Lasix) therapy?
a. BUN 20
b. K 3.4
c. Creatinine 1.1
d. K 3.2 -
d. K = 3.2
Furosemide inhibits reabsorption of sodium, water, and K leading to diuresis. ** The most
common electrolyte disturbance associated with furosemde admin is hypokalemia
Nurse inserts a nasogastric tube, and it immediately drains 1000 mL of fluid. Which of the
follwoing electrolyte level is of greatest concern at this time?
a. Na
b. K
c. Cl
d. CO2 -
b. K
Hypokalemia is almost universal complication of loss of gastric hydrochloric acid. Metabolic
alkalosis results. Other electrolytes may be affected, but not to the degree of potassium
homeostasis is altered.
The nurse should observe for a Trousseau sign in the client with which of the following
electrolyte abnormalities?
a. Hypokalemia
b. Hyponatremia
c. Hypochloremia
d. Hypocalcemia -
d. Hypocalcemia
Hypocalcemia causes excitability of skeletal, cardiac, and smooth muscle tissues. Evidence of
this is seen in the Trousseau sign, a carpopedal spasm.
The WBC count of a client is 18,000. the nurse attributes this value to which of the following
health problems of this client?
a. arthritis
b. alcoholism
c. viral infection
d. wound dehisience -
d. wound dehisience
Tissue injury can cause an increase in WBC
The majority of the body's water is contained in which of the following fluid compartments?
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,A. interstitial
B. intracellular
C. extracellular
D. intravascular -
B. intracellular
If the blood plasma has a higher osmolality than the fluid within a red blood cell, the
mechanism involved in equalizing the fluid concentration is
A. osmosis.
B. diffusion.
C. active transport.
D. facilitated diffusion. -
A. osmosis.
An elderly woman was admitted to the medical unit with dehydration. A clinical indication of
this problem is
A. weight loss.
B. full bounding pulse.
C. engorged neck veins.
D. Kussmaul respiration. -
A. weight loss.
Implementation of nursing care for the patient with hyponatremia includes
A. fluid restriction.
B. administration of hypotonic IV fluids.
C. administration of a cation exchange resin.
D. increased water intake for patients on nasogastric suction. -
A. fluid
A patient is receiving a loop diuretic. The nurse should be alert to which of the following
symptoms?
A. restlessness and agitation
B. paresthesias and irritability
C. weak, irregular pulse and poor muscle tone
D. increased blood pressure and muscle spasms -
C. weak, irregular pulse and poor muscle tone
Which of the following patients would be at greatest risk for the potential development of
hypermagnesemia?
A. 83-year-old man with lung cancer and hypertension
B. 65-year-old woman with hypertension taking -adrenergic blockers
C. 42-year-old woman with systemic lupus erythematosus and renal failure
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,D. 50-year-old man with benign prostatic hyperplasia and a urinary tract infection -
C. 42-year-old woman with systemic lupus erythematosus and renal failure
It is especially important for the nurse to assess for which of the following in a patient who
has just undergone a total thyroidectomy?
A. weight gain
B. depressed reflexes
C. positive Chvostek's sign
D. confusion and personality changes -
C. positive Chvostek's sign
The nurse anticipates that the patient with hyperphosphatemia secondary to renal failure will
require
A. calcium supplements.
B. potassium supplements.
C. magnesium supplements.
D. fluid replacement therapy. -
A. calcium supplements.
The lungs act as an acid-base buffer by
A. increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid
load.
B. increasing respiratory rate and depth when CO2 levels in the blood are low, reducing base
load.
C. decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid
load.
D. decreasing respiratory rate and depth when CO2 levels in the blood are low, increasing
acid load. -
A. increasing respiratory rate and depth when CO2 levels in the blood are high,
reducing acid load
The typical fluid replacement for the patient with an ICF fluid volume deficit is
A. isotonic.
B. hypotonic.
C. hypertonic.
D. a plasma expander. -
B. hypotonic.
A client with a history of cardiac disease is taking a potassium-wasting diuretic (furosemide)
and is seen in the emergency department for complaints of weakness. The nurse expects to
evaluate which laboratory values?
A. Albumin and protein levels
B. Sodium and chloride levels
C. Potassium and blood glucose levels
D. Hemoglobin level and hematocrit -
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, C. Potassium and blood glucose levels
Individuals taking potassium-wasting diuretics are at risk for hypokalemia. Evaluating blood
glucose level when the client reports weakness is important to ensure that low blood glucose
level is not an issue. Levels of the other substances would not be affected by a potassium-
wasting diuretic.
The following four clients are all at risk for fluid volume excess. Which of the clients should
the nurse see first?
A. 88-year-old client with a fractured femur scheduled for surgery
B. 20-year-old client with a 5-year history of type 1 diabetes mellitus
C. 65-year-old client recently diagnosed with congestive heart failure
D. 50-year-old client with second-degree burns on the ankles and feet -
C. 65-year-old client recently diagnosed with congestive heart failure
The 65-year-old client with congestive heart failure is at the greatest risk for problems from
fluid volume excess. Fluid overload in this client could quickly cause life-threatening
problems. The 50-year-old client with second degree burns is at risk for fluid volume deficit.
The nurse assesses four clients. Which client is at greatest risk for the development of
hypocalcemia?
A. 56-year-old client with acute renal failure
B. 40-year-old client with systemic lupus erythematosus
C. 28-year-old client who has just undergone a total thyroidectomy
D. 65-year-old client with hypertension taking beta-adrenergic blockers -
A. 56-year-old client with acute renal failure
The client with acute renal failure is at the highest risk of hypocalcemia. While the patient
who underwent a thyroidectomy is at risk, the client with acute renal failure is at a higher
risk.
Clinical assessment of dehydration would be confirmed if the nurse identified:
A. 1-lb weight loss
B. Engorged neck vessels
C. Dry mucous membranes
D. Full bounding radial pulse -
C. Dry mucous membranes
Dry mucous membranes are a clinical sign of dehydration. Weight loss can be associated
with dehydration but is not a confirming sign. Engorged neck vessels and bounding pulse are
signs of fluid overload.
The nurse anticipates that the physician will order which intravenous (IV) fluid for a client
who is dehydrated?
A. Ringer's lactate
B. 3% Sodium chloride
C. 0.9% Sodium chloride
D. 0.45% Sodium chloride -
D. 0.45% Sodium chloride
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Nurse would be most concerned about which lab values obtained fro ma client receiving
furosemide (Lasix) therapy?
a. BUN 20
b. K 3.4
c. Creatinine 1.1
d. K 3.2 -
d. K = 3.2
Furosemide inhibits reabsorption of sodium, water, and K leading to diuresis. ** The most
common electrolyte disturbance associated with furosemde admin is hypokalemia
Nurse inserts a nasogastric tube, and it immediately drains 1000 mL of fluid. Which of the
follwoing electrolyte level is of greatest concern at this time?
a. Na
b. K
c. Cl
d. CO2 -
b. K
Hypokalemia is almost universal complication of loss of gastric hydrochloric acid. Metabolic
alkalosis results. Other electrolytes may be affected, but not to the degree of potassium
homeostasis is altered.
The nurse should observe for a Trousseau sign in the client with which of the following
electrolyte abnormalities?
a. Hypokalemia
b. Hyponatremia
c. Hypochloremia
d. Hypocalcemia -
d. Hypocalcemia
Hypocalcemia causes excitability of skeletal, cardiac, and smooth muscle tissues. Evidence of
this is seen in the Trousseau sign, a carpopedal spasm.
The WBC count of a client is 18,000. the nurse attributes this value to which of the following
health problems of this client?
a. arthritis
b. alcoholism
c. viral infection
d. wound dehisience -
d. wound dehisience
Tissue injury can cause an increase in WBC
The majority of the body's water is contained in which of the following fluid compartments?
1|Page
,A. interstitial
B. intracellular
C. extracellular
D. intravascular -
B. intracellular
If the blood plasma has a higher osmolality than the fluid within a red blood cell, the
mechanism involved in equalizing the fluid concentration is
A. osmosis.
B. diffusion.
C. active transport.
D. facilitated diffusion. -
A. osmosis.
An elderly woman was admitted to the medical unit with dehydration. A clinical indication of
this problem is
A. weight loss.
B. full bounding pulse.
C. engorged neck veins.
D. Kussmaul respiration. -
A. weight loss.
Implementation of nursing care for the patient with hyponatremia includes
A. fluid restriction.
B. administration of hypotonic IV fluids.
C. administration of a cation exchange resin.
D. increased water intake for patients on nasogastric suction. -
A. fluid
A patient is receiving a loop diuretic. The nurse should be alert to which of the following
symptoms?
A. restlessness and agitation
B. paresthesias and irritability
C. weak, irregular pulse and poor muscle tone
D. increased blood pressure and muscle spasms -
C. weak, irregular pulse and poor muscle tone
Which of the following patients would be at greatest risk for the potential development of
hypermagnesemia?
A. 83-year-old man with lung cancer and hypertension
B. 65-year-old woman with hypertension taking -adrenergic blockers
C. 42-year-old woman with systemic lupus erythematosus and renal failure
2|Page
,D. 50-year-old man with benign prostatic hyperplasia and a urinary tract infection -
C. 42-year-old woman with systemic lupus erythematosus and renal failure
It is especially important for the nurse to assess for which of the following in a patient who
has just undergone a total thyroidectomy?
A. weight gain
B. depressed reflexes
C. positive Chvostek's sign
D. confusion and personality changes -
C. positive Chvostek's sign
The nurse anticipates that the patient with hyperphosphatemia secondary to renal failure will
require
A. calcium supplements.
B. potassium supplements.
C. magnesium supplements.
D. fluid replacement therapy. -
A. calcium supplements.
The lungs act as an acid-base buffer by
A. increasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid
load.
B. increasing respiratory rate and depth when CO2 levels in the blood are low, reducing base
load.
C. decreasing respiratory rate and depth when CO2 levels in the blood are high, reducing acid
load.
D. decreasing respiratory rate and depth when CO2 levels in the blood are low, increasing
acid load. -
A. increasing respiratory rate and depth when CO2 levels in the blood are high,
reducing acid load
The typical fluid replacement for the patient with an ICF fluid volume deficit is
A. isotonic.
B. hypotonic.
C. hypertonic.
D. a plasma expander. -
B. hypotonic.
A client with a history of cardiac disease is taking a potassium-wasting diuretic (furosemide)
and is seen in the emergency department for complaints of weakness. The nurse expects to
evaluate which laboratory values?
A. Albumin and protein levels
B. Sodium and chloride levels
C. Potassium and blood glucose levels
D. Hemoglobin level and hematocrit -
3|Page
, C. Potassium and blood glucose levels
Individuals taking potassium-wasting diuretics are at risk for hypokalemia. Evaluating blood
glucose level when the client reports weakness is important to ensure that low blood glucose
level is not an issue. Levels of the other substances would not be affected by a potassium-
wasting diuretic.
The following four clients are all at risk for fluid volume excess. Which of the clients should
the nurse see first?
A. 88-year-old client with a fractured femur scheduled for surgery
B. 20-year-old client with a 5-year history of type 1 diabetes mellitus
C. 65-year-old client recently diagnosed with congestive heart failure
D. 50-year-old client with second-degree burns on the ankles and feet -
C. 65-year-old client recently diagnosed with congestive heart failure
The 65-year-old client with congestive heart failure is at the greatest risk for problems from
fluid volume excess. Fluid overload in this client could quickly cause life-threatening
problems. The 50-year-old client with second degree burns is at risk for fluid volume deficit.
The nurse assesses four clients. Which client is at greatest risk for the development of
hypocalcemia?
A. 56-year-old client with acute renal failure
B. 40-year-old client with systemic lupus erythematosus
C. 28-year-old client who has just undergone a total thyroidectomy
D. 65-year-old client with hypertension taking beta-adrenergic blockers -
A. 56-year-old client with acute renal failure
The client with acute renal failure is at the highest risk of hypocalcemia. While the patient
who underwent a thyroidectomy is at risk, the client with acute renal failure is at a higher
risk.
Clinical assessment of dehydration would be confirmed if the nurse identified:
A. 1-lb weight loss
B. Engorged neck vessels
C. Dry mucous membranes
D. Full bounding radial pulse -
C. Dry mucous membranes
Dry mucous membranes are a clinical sign of dehydration. Weight loss can be associated
with dehydration but is not a confirming sign. Engorged neck vessels and bounding pulse are
signs of fluid overload.
The nurse anticipates that the physician will order which intravenous (IV) fluid for a client
who is dehydrated?
A. Ringer's lactate
B. 3% Sodium chloride
C. 0.9% Sodium chloride
D. 0.45% Sodium chloride -
D. 0.45% Sodium chloride
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