NCLEX-Style Test Bank
Chapter 3: Fluids, Electrolytes, Acid-Base
Balance, and Intravenous Therapy
Unit II: Medical–Surgical Patient Care Problems
Based on: Medical-Surgical Nursing – Concepts and Practice
5th Edition by Holly K. Stromberg
✔ 50 Original NCLEX-Style Questions
✔ Detailed Rationales for Every Answer
✔ Based on 2025 NCLEX-PN® Test Plan
✔ Ideal for ATI, HESI, and Nursing School Prep
Released: 2025
,NCLEX Test Bank – Chapter 3: Fluids, Electrolytes, Acid-Base Balance &
IV Therapy (Unit II) | 50 Questions + Rationales | Stromberg 5th
Edition (2025)
1. A patient is admitted with dehydration. Which laboratory value would most likely support
this diagnosis?
A. Serum sodium 132 mEq/L
B. Hematocrit 48%
C. Urine specific gravity 1.002
D. BUN 8 mg/dL
Answer: B
Rationale: Hemoconcentration from dehydration typically raises hematocrit. Elevated
hematocrit is a classic lab finding in volume depletion.
2. Which electrolyte abnormality is most concerning in a patient taking furosemide (Lasix)?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that promotes potassium loss. Hypokalemia increases
the risk for cardiac dysrhythmias and must be addressed promptly.
3. A nurse is caring for a patient with a serum potassium level of 2.9 mEq/L. What is the priority
intervention?
A. Encourage fluid intake
B. Restrict potassium-rich foods
C. Monitor cardiac rhythm and notify the RN
D. Administer furosemide as prescribed
Answer: C
Rationale: Hypokalemia can lead to life-threatening cardiac arrhythmias. Monitoring heart
rhythm and notifying the team are top priorities.
4. A patient is receiving 0.9% normal saline IV. This solution is considered:
A. Hypotonic
B. Hypertonic
, NCLEX Test Bank – Chapter 3: Fluids, Electrolytes, Acid-Base Balance &
IV Therapy (Unit II) | 50 Questions + Rationales | Stromberg 5th
Edition (2025)
C. Isotonic
D. Colloid
Answer: C
Rationale: Normal saline is isotonic, meaning it has the same osmolality as plasma and expands
the extracellular fluid without shifting fluid between compartments.
5. A patient with heart failure is on fluid restriction. Which nursing intervention best supports
this order?
A. Offer large volumes of fluid twice daily
B. Provide salty snacks to reduce thirst
C. Record all oral intake and educate the patient
D. Encourage oral hydration to prevent electrolyte loss
Answer: C
Rationale: Monitoring intake and patient education help ensure compliance with fluid
restrictions to avoid volume overload in heart failure.
6. A patient receiving D5W (5% dextrose in water) is at risk for which complication?
A. Dehydration
B. Hyponatremia
C. Hyperchloremia
D. Hyperkalemia
Answer: B
Rationale: D5W becomes hypotonic in the body and can dilute sodium, increasing the risk of
hyponatremia — especially in patients with SIADH or fluid retention.
7. Which clinical sign suggests fluid volume overload?
A. Dry mucous membranes
B. Flat neck veins
C. Bounding pulse and crackles on auscultation
D. Increased hematocrit
Chapter 3: Fluids, Electrolytes, Acid-Base
Balance, and Intravenous Therapy
Unit II: Medical–Surgical Patient Care Problems
Based on: Medical-Surgical Nursing – Concepts and Practice
5th Edition by Holly K. Stromberg
✔ 50 Original NCLEX-Style Questions
✔ Detailed Rationales for Every Answer
✔ Based on 2025 NCLEX-PN® Test Plan
✔ Ideal for ATI, HESI, and Nursing School Prep
Released: 2025
,NCLEX Test Bank – Chapter 3: Fluids, Electrolytes, Acid-Base Balance &
IV Therapy (Unit II) | 50 Questions + Rationales | Stromberg 5th
Edition (2025)
1. A patient is admitted with dehydration. Which laboratory value would most likely support
this diagnosis?
A. Serum sodium 132 mEq/L
B. Hematocrit 48%
C. Urine specific gravity 1.002
D. BUN 8 mg/dL
Answer: B
Rationale: Hemoconcentration from dehydration typically raises hematocrit. Elevated
hematocrit is a classic lab finding in volume depletion.
2. Which electrolyte abnormality is most concerning in a patient taking furosemide (Lasix)?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Furosemide is a loop diuretic that promotes potassium loss. Hypokalemia increases
the risk for cardiac dysrhythmias and must be addressed promptly.
3. A nurse is caring for a patient with a serum potassium level of 2.9 mEq/L. What is the priority
intervention?
A. Encourage fluid intake
B. Restrict potassium-rich foods
C. Monitor cardiac rhythm and notify the RN
D. Administer furosemide as prescribed
Answer: C
Rationale: Hypokalemia can lead to life-threatening cardiac arrhythmias. Monitoring heart
rhythm and notifying the team are top priorities.
4. A patient is receiving 0.9% normal saline IV. This solution is considered:
A. Hypotonic
B. Hypertonic
, NCLEX Test Bank – Chapter 3: Fluids, Electrolytes, Acid-Base Balance &
IV Therapy (Unit II) | 50 Questions + Rationales | Stromberg 5th
Edition (2025)
C. Isotonic
D. Colloid
Answer: C
Rationale: Normal saline is isotonic, meaning it has the same osmolality as plasma and expands
the extracellular fluid without shifting fluid between compartments.
5. A patient with heart failure is on fluid restriction. Which nursing intervention best supports
this order?
A. Offer large volumes of fluid twice daily
B. Provide salty snacks to reduce thirst
C. Record all oral intake and educate the patient
D. Encourage oral hydration to prevent electrolyte loss
Answer: C
Rationale: Monitoring intake and patient education help ensure compliance with fluid
restrictions to avoid volume overload in heart failure.
6. A patient receiving D5W (5% dextrose in water) is at risk for which complication?
A. Dehydration
B. Hyponatremia
C. Hyperchloremia
D. Hyperkalemia
Answer: B
Rationale: D5W becomes hypotonic in the body and can dilute sodium, increasing the risk of
hyponatremia — especially in patients with SIADH or fluid retention.
7. Which clinical sign suggests fluid volume overload?
A. Dry mucous membranes
B. Flat neck veins
C. Bounding pulse and crackles on auscultation
D. Increased hematocrit
