FCCN LEVEL 1 EXAM QUESTIONS AND
WELL DETAILED ANSWERS . EXAM
ELABORATION. .DISTINCTION
GUARANTEE.NEW!!! LATEST UPDATE
2025.
minimum urine output for adult - : ANSWER :0.5mL/kg/hr : QUESTION :ADH (antidiuretic
hormone) - : ANSWER :- water retainer - vasoconstrictor (also called Vasopressin) - produced
by hypothalamus - store and released from posterior pituitary : QUESTION :ADH pathway - :
ANSWER :- hypothalamus senses low blood volumed and increased serum osmolality - signal
pituitary to release ADH - ADH causes kidney to retain water - water retention increases blood
volume and decreases serum osmolality : QUESTION :ANP (atrial natriuretic peptide) - :
ANSWER :- cardiac hormone stored in atria - released when atrial pressure increases *works
opposite of RAAS by decreasing BP and reducing intravascular volume - important diagnostic
marker in CHF : QUESTION :hydrostatic pressure - : ANSWER :- forces fluids and solutes
,through the capillary wall and into the tissue spaces : QUESTION :colloid osmotic pressure - :
ANSWER :- pulling force of albumin in the intravascular spaces - pull fluid into vasculature :
QUESTION :maintenance fluid therapy - : ANSWER :- replaces normal ongoing losses of water
and electrolytes (urine, sweat, respiration, stool) : QUESTION :replacement therapy - :
ANSWER :- corrects any existing water and or electrolyte deficits : QUESTION :isotonic fluids
- : ANSWER :- tonicity equal to plasma in the body - no fluid shifts because the solutions are
equally concentrated - LR - NS - D5W : QUESTION :hypotonic fluids - : ANSWER :- lower
concentration of solutes in the vasculature than in the cell - fluid shifts into the cell to dilute the
electrolytes (CELL SWELLS) - 0.45NS : QUESTION :hypertonic fluid - : ANSWER :- higher
concentration of solutes in the vasculature than in the cell - pulls fluid out of cells and into the
vessels (CELL SHRINKS) - D5 .45NS - D5NS - D5LR - 3%, 7%, 23.4% NaCl : QUESTION
:colloids - : ANSWER :- pull fluid into bloodstream Albumin - 5% is osmotically equal to
plasma - 25% draws 4 times the normal volume into the circulation : QUESTION :blood - :
ANSWER :- not a risk free fluid replacement - this is liquid transplant : QUESTION :third
spacing - : ANSWER :- fluid is not lost from the body but the fluid is not available for use in the
intracellular or extracellular compartments (fluid is in between tissues/cells) - this patient is
intravascularly dry and still needs more fluid - : QUESTION :can you give platelets through the
ranger - : ANSWER :- no it will aggreggate the platelets : QUESTION :hyponatremia - :
ANSWER :- less than 135 -145 - weakness - abdominal cramping/leg cramps - dizzy - change in
LOC - seizures : QUESTION :different ways to treat hyponatremia - : ANSWER :- hypovolemic
(give IV fluid) - euvolemic (fluid restriction) - hypervolemic (diuretic) : QUESTION :severe
hyponatremia - : ANSWER :- EMERGENCY - below 115 - give hypertonic saline if patient is
symptomatic - in ICU setting *infused slowly in small amounts....be prepared to handle
, seizures* : QUESTION :hypokalemia ECG changes - : ANSWER :- prolonged QT - ST
depression *U WAVE is hallmark sign* if you see a U wave then YOU need K+ : QUESTION
:hypokalemia - : ANSWER :- 3.5 to 5 - muscle weakness : QUESTION :hyperkalemia ECG
changes - : ANSWER :- tall tented T waves is the earliest sign - AV blocks : QUESTION
:treating hyperkalemia - : ANSWER :- Calcium chloric or gluconate to antagonize cardiac
abnormalities - Bicarbonate for pt with acidosis - IV insulin and 50% dextrose to shift K into
cells - kayexelate (fecal excretion of K) - dialysis for ARF : QUESTION :hypocalcemia - :
ANSWER :8.5 - 10.2 - tetany - muscle cramps - trousseau's and chvosteks sign - colicky
abdominal pain : QUESTION :treating hypocalcemia - : ANSWER :- IV calcium gluconate or
calcium chloride (CENTRAL LINE) - consider seizure precautions - replace Mg in addition to
Ca because pt might not respond to Ca treatment : QUESTION :hypercalcemia - : ANSWER
:caused by - cancers and hyperparathyroidism - excessive Ca and Vit. D supplements - muscle
weakness - depressed CNS (confusion) - dysrhythmias (prolong QT, AV block) - abdominal pain
: QUESTION :treating hypercalcemia - : ANSWER :- administer IV NS to promote diuresis -
administer loop diuretics - corticosteroids to decrease absorption from GI - phosphates to
decrease breakdown of bones by inhibiting release - dialysis : QUESTION :hypomagnesemia - :
ANSWER :- tetany - weakness - confusion - ECG changes (wide QRS, prolong PR/QT) :
QUESTION :treating hypomagnesemia - : ANSWER :- CPR - magnesium - shock : QUESTION
:hypomagnesemia and digoxin - : ANSWER :- low MG increases pharmacologic action of
digoxin - look for N/V, bradycardia, AV block, yellow tinged vision : QUESTION
:hypermagenesemia - : ANSWER :- take too many antacids or laxatives - respiratory depression
- muscle relaxation : QUESTION :hypophosphatemia - : ANSWER :- cause by
hyperparathyroidism, chronic diarrhea, long term diuretic use, malnutrition and severe burns -
WELL DETAILED ANSWERS . EXAM
ELABORATION. .DISTINCTION
GUARANTEE.NEW!!! LATEST UPDATE
2025.
minimum urine output for adult - : ANSWER :0.5mL/kg/hr : QUESTION :ADH (antidiuretic
hormone) - : ANSWER :- water retainer - vasoconstrictor (also called Vasopressin) - produced
by hypothalamus - store and released from posterior pituitary : QUESTION :ADH pathway - :
ANSWER :- hypothalamus senses low blood volumed and increased serum osmolality - signal
pituitary to release ADH - ADH causes kidney to retain water - water retention increases blood
volume and decreases serum osmolality : QUESTION :ANP (atrial natriuretic peptide) - :
ANSWER :- cardiac hormone stored in atria - released when atrial pressure increases *works
opposite of RAAS by decreasing BP and reducing intravascular volume - important diagnostic
marker in CHF : QUESTION :hydrostatic pressure - : ANSWER :- forces fluids and solutes
,through the capillary wall and into the tissue spaces : QUESTION :colloid osmotic pressure - :
ANSWER :- pulling force of albumin in the intravascular spaces - pull fluid into vasculature :
QUESTION :maintenance fluid therapy - : ANSWER :- replaces normal ongoing losses of water
and electrolytes (urine, sweat, respiration, stool) : QUESTION :replacement therapy - :
ANSWER :- corrects any existing water and or electrolyte deficits : QUESTION :isotonic fluids
- : ANSWER :- tonicity equal to plasma in the body - no fluid shifts because the solutions are
equally concentrated - LR - NS - D5W : QUESTION :hypotonic fluids - : ANSWER :- lower
concentration of solutes in the vasculature than in the cell - fluid shifts into the cell to dilute the
electrolytes (CELL SWELLS) - 0.45NS : QUESTION :hypertonic fluid - : ANSWER :- higher
concentration of solutes in the vasculature than in the cell - pulls fluid out of cells and into the
vessels (CELL SHRINKS) - D5 .45NS - D5NS - D5LR - 3%, 7%, 23.4% NaCl : QUESTION
:colloids - : ANSWER :- pull fluid into bloodstream Albumin - 5% is osmotically equal to
plasma - 25% draws 4 times the normal volume into the circulation : QUESTION :blood - :
ANSWER :- not a risk free fluid replacement - this is liquid transplant : QUESTION :third
spacing - : ANSWER :- fluid is not lost from the body but the fluid is not available for use in the
intracellular or extracellular compartments (fluid is in between tissues/cells) - this patient is
intravascularly dry and still needs more fluid - : QUESTION :can you give platelets through the
ranger - : ANSWER :- no it will aggreggate the platelets : QUESTION :hyponatremia - :
ANSWER :- less than 135 -145 - weakness - abdominal cramping/leg cramps - dizzy - change in
LOC - seizures : QUESTION :different ways to treat hyponatremia - : ANSWER :- hypovolemic
(give IV fluid) - euvolemic (fluid restriction) - hypervolemic (diuretic) : QUESTION :severe
hyponatremia - : ANSWER :- EMERGENCY - below 115 - give hypertonic saline if patient is
symptomatic - in ICU setting *infused slowly in small amounts....be prepared to handle
, seizures* : QUESTION :hypokalemia ECG changes - : ANSWER :- prolonged QT - ST
depression *U WAVE is hallmark sign* if you see a U wave then YOU need K+ : QUESTION
:hypokalemia - : ANSWER :- 3.5 to 5 - muscle weakness : QUESTION :hyperkalemia ECG
changes - : ANSWER :- tall tented T waves is the earliest sign - AV blocks : QUESTION
:treating hyperkalemia - : ANSWER :- Calcium chloric or gluconate to antagonize cardiac
abnormalities - Bicarbonate for pt with acidosis - IV insulin and 50% dextrose to shift K into
cells - kayexelate (fecal excretion of K) - dialysis for ARF : QUESTION :hypocalcemia - :
ANSWER :8.5 - 10.2 - tetany - muscle cramps - trousseau's and chvosteks sign - colicky
abdominal pain : QUESTION :treating hypocalcemia - : ANSWER :- IV calcium gluconate or
calcium chloride (CENTRAL LINE) - consider seizure precautions - replace Mg in addition to
Ca because pt might not respond to Ca treatment : QUESTION :hypercalcemia - : ANSWER
:caused by - cancers and hyperparathyroidism - excessive Ca and Vit. D supplements - muscle
weakness - depressed CNS (confusion) - dysrhythmias (prolong QT, AV block) - abdominal pain
: QUESTION :treating hypercalcemia - : ANSWER :- administer IV NS to promote diuresis -
administer loop diuretics - corticosteroids to decrease absorption from GI - phosphates to
decrease breakdown of bones by inhibiting release - dialysis : QUESTION :hypomagnesemia - :
ANSWER :- tetany - weakness - confusion - ECG changes (wide QRS, prolong PR/QT) :
QUESTION :treating hypomagnesemia - : ANSWER :- CPR - magnesium - shock : QUESTION
:hypomagnesemia and digoxin - : ANSWER :- low MG increases pharmacologic action of
digoxin - look for N/V, bradycardia, AV block, yellow tinged vision : QUESTION
:hypermagenesemia - : ANSWER :- take too many antacids or laxatives - respiratory depression
- muscle relaxation : QUESTION :hypophosphatemia - : ANSWER :- cause by
hyperparathyroidism, chronic diarrhea, long term diuretic use, malnutrition and severe burns -
