Fluid and Electrolytes Balance and
Disturbance
1. A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204
mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L;
Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse
identify as critical and report immediately?
• Potassium, since 2.2 mEq/L as critical because a normal potassium level is 3.8 to 5.5
mEq/L.
2. Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:
• muscle weakness.
3. A client in the emergency department reports that he has been vomiting excessively for the past
2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon
dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and
bicarbonate (HCO3–) of 42 mEq/L. Based on these findings, the nurse documents that the client
is experiencing which type of acid-base imbalance?
• Metabolic alkalosis as indicated by a pH over 7.45 with a HCO3– level over 26 mEq/L.
4. Which set of arterial blood gas (ABG) results requires further investigation?
• pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3– 18 mEq/L
5. Which electrolyte is a major cation in body fluid?
• Potassium is a major cation that affects cardiac muscle functioning.
6. A group of nursing students are studying for a test over acid-base imbalance. One student asks
another what the major chemical regulator of plasma pH is. What should the second student
respond?
• Bicarbonate–carbonic acid buffer system
7. Which of the following arterial blood gas results would be consistent with metabolic alkalosis?
• Serum bicarbonate of 28 mEq/L
8. Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical
manifestation associated with air embolism?
• Chest pain
9. The nurse is caring for a patient with hypernatremia. What complication of hypernatremia
should the nurse continuously monitor for?
• Cerebral edema
10. The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea.
What condition that exhibits blood values with a low pH and a low plasma bicarbonate
concentration should the nurse assess for?
• Metabolic acidosis
11. A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium
level is 6 mEq/L. For this client, the nurse's priority should be to assess her:
• electrocardiogram (ECG) results, ECG results should take priority because changes can
indicate potentially lethal arrhythmias such as ventricular fibrillation.
12. A client with a suspected overdose of an unknown drug is admitted to the emergency
department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do
first?
• Prepare to assist with ventilation.
13. A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes;
decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145
, mEq/l (145 mmol/L). Should the nurse start salt tablets when caring for this client?
Disturbance
1. A client with pancreatic cancer has the following blood chemistry profile: Glucose, fasting: 204
mg/dl; blood urea nitrogen (BUN): 12 mg/dl; Creatinine: 0.9 mg/dl; Sodium: 136 mEq/L;
Potassium: 2.2 mEq/L; Chloride: 99 mEq/L; CO2: 33 mEq/L. Which result should the nurse
identify as critical and report immediately?
• Potassium, since 2.2 mEq/L as critical because a normal potassium level is 3.8 to 5.5
mEq/L.
2. Following a unilateral adrenalectomy, a nurse should assess for hyperkalemia as indicated by:
• muscle weakness.
3. A client in the emergency department reports that he has been vomiting excessively for the past
2 days. His arterial blood gas analysis shows a pH of 7.50, partial pressure of arterial carbon
dioxide (PaCO2) of 43 mm Hg, partial pressure of arterial oxygen (PaO2) of 75 mm Hg, and
bicarbonate (HCO3–) of 42 mEq/L. Based on these findings, the nurse documents that the client
is experiencing which type of acid-base imbalance?
• Metabolic alkalosis as indicated by a pH over 7.45 with a HCO3– level over 26 mEq/L.
4. Which set of arterial blood gas (ABG) results requires further investigation?
• pH 7.49, PaCO2 30 mm Hg, PaO2 89 mm Hg, and HCO3– 18 mEq/L
5. Which electrolyte is a major cation in body fluid?
• Potassium is a major cation that affects cardiac muscle functioning.
6. A group of nursing students are studying for a test over acid-base imbalance. One student asks
another what the major chemical regulator of plasma pH is. What should the second student
respond?
• Bicarbonate–carbonic acid buffer system
7. Which of the following arterial blood gas results would be consistent with metabolic alkalosis?
• Serum bicarbonate of 28 mEq/L
8. Air embolism is a potential complication of IV therapy. The nurse should be alert to which clinical
manifestation associated with air embolism?
• Chest pain
9. The nurse is caring for a patient with hypernatremia. What complication of hypernatremia
should the nurse continuously monitor for?
• Cerebral edema
10. The nurse is caring for a patient with diabetes type I who is having severe vomiting and diarrhea.
What condition that exhibits blood values with a low pH and a low plasma bicarbonate
concentration should the nurse assess for?
• Metabolic acidosis
11. A client is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium
level is 6 mEq/L. For this client, the nurse's priority should be to assess her:
• electrocardiogram (ECG) results, ECG results should take priority because changes can
indicate potentially lethal arrhythmias such as ventricular fibrillation.
12. A client with a suspected overdose of an unknown drug is admitted to the emergency
department. Arterial blood gas values indicate respiratory acidosis. What should the nurse do
first?
• Prepare to assist with ventilation.
13. A 64-year-old client is brought in to the clinic feeling thirsty with dry, sticky mucous membranes;
decreased urine output; fever; a rough tongue; and is lethargic. Serum sodium level is above 145
, mEq/l (145 mmol/L). Should the nurse start salt tablets when caring for this client?
