Fluid, Electrolyte, and Acid-Base Balance
Quiz Comprehensive Questions with
Detailed Answers and Explanations for
Medical-Surgical Nursing
Medical-Surgical Nursing Study Guide
Compiled for Educational Purposes
September 2025
,Fluid, Electrolyte, and Acid-Base Balance Quiz
1. Introduction
This document provides a comprehensive quiz on fluid, electrolyte, and acid-base balance,
tailored for medical-surgical nursing. It includes questions sourced from key educational ma-
terials, supplemented with 100 additional relevant questions. Each question is followed by a
concise answer and a clear explanation to enhance understanding. The content is designed to
support nursing students and professionals in mastering critical concepts for clinical practice.
2. Core Questions from Key Sources
2.1 ATI RN Targeted Medical Surgical Fluid, Electrolyte, and Acid-Base
Practice
1. A nurse is caring for a client on a medical-surgical unit. The nurse should first address
the client’s:
• Answer: ECG; calf circumference
• Explanation: Using the airway, breathing, circulation framework, address ECG
first due to hypercalcemia manifestations like dysrhythmias and impaired circula-
tion. Monitor for deep vein thrombosis.
2. A nurse is reviewing the medical record of a client who has diabetes mellitus and is
receiving regular insulin by continuous IV infusion to treat diabetic ketoacidosis. Which
finding should the nurse report to the provider?
• Answer: Serum potassium 3.0 mEq/L
• Explanation: This level is below normal. Hypokalemia is a serious complication
in diabetic ketoacidosis treatment with insulin.
3. A nurse in a provider’s office is caring for a client at risk for:
• Answer: Hyponatremia; hypomagnesemia
• Explanation: Based on client-specific risks identified in the scenario.
4. A nurse is caring for a client in the emergency department at risk for seizures due to:
• Answer: Sodium level
• Explanation: Symptoms like dizziness and nausea after exercise indicate hypona-
tremia. Administer sodium replacement and monitor for neurological changes.
5. A nurse is caring for a client reporting difficulty breathing and tingling in both hands,
with a respiratory rate of 36/min and appearing restless. Which value is outside the
expected range in respiratory alkalosis?
• Answer: PaCO2
• Explanation: Decreased PaCO2 due to hyperventilation in respiratory alkalosis.
6. A nurse is assessing a client with a calcium level of 8.1 mg/dL. What is the priority
assessment?
Page 1 of 17
, Fluid, Electrolyte, and Acid-Base Balance Quiz
• Answer: Cardiac rhythm
• Explanation: Hypocalcemia can cause ECG changes, bradycardia, or tachycardia.
7. A nurse is assessing a client with dehydration. What is the priority assessment?
• Answer: Mental status
• Explanation: Risk of injury from fall due to decline in mental status.
8. A nurse is planning care for a client with a potassium level of 3 mEq/L. What should the
nurse monitor?
• Answer: Orthostatic hypotension
• Explanation: Manifestation of hypokalemia, risk for falls.
9. A nurse is reviewing the laboratory report of a female client with fluid volume excess.
What value should the nurse expect?
• Answer: Hct 34%
• Explanation: Below normal range due to fluid excess.
2.2 Medical Surgical Nursing Chapter 17
1. A patient asks why the provider prescribed a B-type natriuretic peptide (BNP). What is
the accurate response?
• Answer: It shows if there is excess fluid in the heart.
• Explanation: BNP indicates atrial pressure increase in CHF.
2. A nurse is caring for a patient with diarrhea and vomiting for five days, developing severe
hypokalemia. The provider prescribes IV potassium chloride (KCl). How can the nurse
ensure safety? Select all that apply.
• Answer: Monitor cardiac function, check for phlebitis hourly, monitor urine out-
put.
• Explanation: Ensures heart stability, IV site safety, and kidney function.
3. A nurse is caring for a patient with heat stroke and urine output of 4000 mL/day. What
is the most appropriate action?
• Answer: Administer lactated Ringer’s solution.
• Explanation: Addresses dehydration from high output.
4. A patient has headache, increased blood pressure, edema, dyspnea, and jugular venous
distention. What causes excess fluid volume? Select all that apply.
• Answer: Heart failure, long-term corticosteroids, SIADH.
• Explanation: These conditions cause water retention.
5. A nurse is teaching nursing assistants about accurate weighing. What should be in-
cluded? Select all that apply.
Page 2 of 17
Quiz Comprehensive Questions with
Detailed Answers and Explanations for
Medical-Surgical Nursing
Medical-Surgical Nursing Study Guide
Compiled for Educational Purposes
September 2025
,Fluid, Electrolyte, and Acid-Base Balance Quiz
1. Introduction
This document provides a comprehensive quiz on fluid, electrolyte, and acid-base balance,
tailored for medical-surgical nursing. It includes questions sourced from key educational ma-
terials, supplemented with 100 additional relevant questions. Each question is followed by a
concise answer and a clear explanation to enhance understanding. The content is designed to
support nursing students and professionals in mastering critical concepts for clinical practice.
2. Core Questions from Key Sources
2.1 ATI RN Targeted Medical Surgical Fluid, Electrolyte, and Acid-Base
Practice
1. A nurse is caring for a client on a medical-surgical unit. The nurse should first address
the client’s:
• Answer: ECG; calf circumference
• Explanation: Using the airway, breathing, circulation framework, address ECG
first due to hypercalcemia manifestations like dysrhythmias and impaired circula-
tion. Monitor for deep vein thrombosis.
2. A nurse is reviewing the medical record of a client who has diabetes mellitus and is
receiving regular insulin by continuous IV infusion to treat diabetic ketoacidosis. Which
finding should the nurse report to the provider?
• Answer: Serum potassium 3.0 mEq/L
• Explanation: This level is below normal. Hypokalemia is a serious complication
in diabetic ketoacidosis treatment with insulin.
3. A nurse in a provider’s office is caring for a client at risk for:
• Answer: Hyponatremia; hypomagnesemia
• Explanation: Based on client-specific risks identified in the scenario.
4. A nurse is caring for a client in the emergency department at risk for seizures due to:
• Answer: Sodium level
• Explanation: Symptoms like dizziness and nausea after exercise indicate hypona-
tremia. Administer sodium replacement and monitor for neurological changes.
5. A nurse is caring for a client reporting difficulty breathing and tingling in both hands,
with a respiratory rate of 36/min and appearing restless. Which value is outside the
expected range in respiratory alkalosis?
• Answer: PaCO2
• Explanation: Decreased PaCO2 due to hyperventilation in respiratory alkalosis.
6. A nurse is assessing a client with a calcium level of 8.1 mg/dL. What is the priority
assessment?
Page 1 of 17
, Fluid, Electrolyte, and Acid-Base Balance Quiz
• Answer: Cardiac rhythm
• Explanation: Hypocalcemia can cause ECG changes, bradycardia, or tachycardia.
7. A nurse is assessing a client with dehydration. What is the priority assessment?
• Answer: Mental status
• Explanation: Risk of injury from fall due to decline in mental status.
8. A nurse is planning care for a client with a potassium level of 3 mEq/L. What should the
nurse monitor?
• Answer: Orthostatic hypotension
• Explanation: Manifestation of hypokalemia, risk for falls.
9. A nurse is reviewing the laboratory report of a female client with fluid volume excess.
What value should the nurse expect?
• Answer: Hct 34%
• Explanation: Below normal range due to fluid excess.
2.2 Medical Surgical Nursing Chapter 17
1. A patient asks why the provider prescribed a B-type natriuretic peptide (BNP). What is
the accurate response?
• Answer: It shows if there is excess fluid in the heart.
• Explanation: BNP indicates atrial pressure increase in CHF.
2. A nurse is caring for a patient with diarrhea and vomiting for five days, developing severe
hypokalemia. The provider prescribes IV potassium chloride (KCl). How can the nurse
ensure safety? Select all that apply.
• Answer: Monitor cardiac function, check for phlebitis hourly, monitor urine out-
put.
• Explanation: Ensures heart stability, IV site safety, and kidney function.
3. A nurse is caring for a patient with heat stroke and urine output of 4000 mL/day. What
is the most appropriate action?
• Answer: Administer lactated Ringer’s solution.
• Explanation: Addresses dehydration from high output.
4. A patient has headache, increased blood pressure, edema, dyspnea, and jugular venous
distention. What causes excess fluid volume? Select all that apply.
• Answer: Heart failure, long-term corticosteroids, SIADH.
• Explanation: These conditions cause water retention.
5. A nurse is teaching nursing assistants about accurate weighing. What should be in-
cluded? Select all that apply.
Page 2 of 17
