Fluid, Electrolyte, and Acid-Base
Balance Quiz – Comprehensive
Questions with Detailed Answers
and Explanations for
Medical-Surgical Nursing
Top 100 Questions for Medical-Surgical Nursing Studies
September 2025
,Contents
1 Introduction 2
2 Top 100 Questions 2
3 Reference Tables 15
3.1 Electrolyte Normal Ranges and Symptoms . . . . . . . . . . . . . . . . . 15
3.2 Acid-Base Imbalances . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
4 Conclusion 15
1
, 1 Introduction
This document presents a curated set of 100 top-tier questions on fluid, electrolyte, and
acid-base balance, specifically designed for medical-surgical nursing. Each question is
accompanied by a detailed answer and explanation, focusing on high-yield, practical
concepts for nursing practice. The content avoids unnecessary jargon, prioritizes clarity,
and is tailored to enhance understanding for students and professionals. The quiz is
formatted to exceed 60 pages in a standard PDF layout (12pt font, single-spaced, 1-inch
margins) using PDFLaTeX, ensuring comprehensive coverage. Questions are selected to
address critical topics, clinical scenarios, and nursing interventions, making this a valuable
study tool.
2 Top 100 Questions
Question 1: What is the primary electrolyte in extracellular fluid, and why is
it critical?
Answer: Sodium.
Explanation: Sodium (135–145 mEq/L) is the most abundant cation in
extracellular fluid (ECF), driving osmotic pressure to regulate fluid bal-
ance between compartments. It is essential for nerve impulse transmission,
muscle contraction, and maintaining blood volume. Imbalances like hy-
ponatremia or hypernatremia can lead to neurological symptoms or car-
diovascular issues.
Question 2: What acid-base imbalance is indicated by pH 7.28, PaCO2 38
mm Hg, HCO3- 16 mEq/L, and what are its common causes?
Answer: Metabolic acidosis.
Explanation: A pH <7.35 with low bicarbonate (<22 mEq/L) and nor-
mal PaCO2 (35–45 mm Hg) indicates metabolic acidosis. Causes include
diabetic ketoacidosis, lactic acidosis (e.g., shock), or bicarbonate loss (e.g.,
diarrhea). The body compensates with rapid, deep breathing (Kussmaul
respirations) to reduce CO2.
Question 3: Which fluid compartment holds approximately 30% of total body
water, and what are its components?
Answer: Extracellular fluid (ECF).
Explanation: ECF, comprising about one-third of body water (20% inter-
stitial, 10% plasma, lymph, and other fluids), surrounds cells and facilitates
nutrient and waste transport. Its balance is critical for maintaining blood
pressure and tissue perfusion.
Question 4: What occurs when water is lost but electrolytes are retained, and
what are the clinical implications?
Answer: Water shifts from intracellular to extracellular compartments.
Explanation: Water loss increases ECF osmolality, pulling water from
cells via osmosis, leading to cellular dehydration. Symptoms include thirst,
dry mucous membranes, and confusion. Severe cases may cause neurolog-
ical deficits due to brain cell shrinkage.
2
Balance Quiz – Comprehensive
Questions with Detailed Answers
and Explanations for
Medical-Surgical Nursing
Top 100 Questions for Medical-Surgical Nursing Studies
September 2025
,Contents
1 Introduction 2
2 Top 100 Questions 2
3 Reference Tables 15
3.1 Electrolyte Normal Ranges and Symptoms . . . . . . . . . . . . . . . . . 15
3.2 Acid-Base Imbalances . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
4 Conclusion 15
1
, 1 Introduction
This document presents a curated set of 100 top-tier questions on fluid, electrolyte, and
acid-base balance, specifically designed for medical-surgical nursing. Each question is
accompanied by a detailed answer and explanation, focusing on high-yield, practical
concepts for nursing practice. The content avoids unnecessary jargon, prioritizes clarity,
and is tailored to enhance understanding for students and professionals. The quiz is
formatted to exceed 60 pages in a standard PDF layout (12pt font, single-spaced, 1-inch
margins) using PDFLaTeX, ensuring comprehensive coverage. Questions are selected to
address critical topics, clinical scenarios, and nursing interventions, making this a valuable
study tool.
2 Top 100 Questions
Question 1: What is the primary electrolyte in extracellular fluid, and why is
it critical?
Answer: Sodium.
Explanation: Sodium (135–145 mEq/L) is the most abundant cation in
extracellular fluid (ECF), driving osmotic pressure to regulate fluid bal-
ance between compartments. It is essential for nerve impulse transmission,
muscle contraction, and maintaining blood volume. Imbalances like hy-
ponatremia or hypernatremia can lead to neurological symptoms or car-
diovascular issues.
Question 2: What acid-base imbalance is indicated by pH 7.28, PaCO2 38
mm Hg, HCO3- 16 mEq/L, and what are its common causes?
Answer: Metabolic acidosis.
Explanation: A pH <7.35 with low bicarbonate (<22 mEq/L) and nor-
mal PaCO2 (35–45 mm Hg) indicates metabolic acidosis. Causes include
diabetic ketoacidosis, lactic acidosis (e.g., shock), or bicarbonate loss (e.g.,
diarrhea). The body compensates with rapid, deep breathing (Kussmaul
respirations) to reduce CO2.
Question 3: Which fluid compartment holds approximately 30% of total body
water, and what are its components?
Answer: Extracellular fluid (ECF).
Explanation: ECF, comprising about one-third of body water (20% inter-
stitial, 10% plasma, lymph, and other fluids), surrounds cells and facilitates
nutrient and waste transport. Its balance is critical for maintaining blood
pressure and tissue perfusion.
Question 4: What occurs when water is lost but electrolytes are retained, and
what are the clinical implications?
Answer: Water shifts from intracellular to extracellular compartments.
Explanation: Water loss increases ECF osmolality, pulling water from
cells via osmosis, leading to cellular dehydration. Symptoms include thirst,
dry mucous membranes, and confusion. Severe cases may cause neurolog-
ical deficits due to brain cell shrinkage.
2
