Fluid & Electrolyte Imbalances Questions and Answers 2025 Tests, Exams of Nursing

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Fluid & Electrolyte Imbalances Questions and Answers 2025 Tests

The nurse is assessing the patient at risk for fluid volume excess. Which findings indicate that the patient has fluid volume excess? (Select all that apply) a. Increased, bounding pulse b. Jugular venous distention c. Diminished peripheral pulses d. Presence of crackles e. Excessive thirst f. Elevated blood pressure g. Orthostatic hypotension h. Skin pale and cool to touch - ANSWER-a. Increased, bounding pulse b. Jugular venous distention d. Presence of crackles f. Elevated blood pressure h. Skin pale and coal to touch Which analogy best approximates the principles of diffusion and concentration gradient? a. Game with four players on one side and eight on the other; two move over to create six per side b. Community fun run where 2000 participants move across the line in a mass start. c. Basketball game of five players per side: all players move across the court. t where 1000 people are trying to enter through a single gate. - ANSWER-a. Game with four players on one side and eight on the other; two move over to create six per side. The patient’s blood osmolality is 302 mOsm/L. What manifestation does the nurse expect to see in the patient? a. Increased urine output b. Thirst c. Peripheral edema d. Nausea - ANSWER. Thirst The patient is at risk for fluid volume exc For selfmanagement at home, what does the nurse teach the patient to do? a. Increase diuretic dose if swelling occurs. b. Limit the amount of free water in relation to sodium intake. ¢. Monitor his or her skin Lurgor. dy gh self each day on the same scale. - ANSWER-d. gh self each day on the same scale. The older adult patient at risk for fluid and electrolyte problems is vigilantly monitored by the nurse for the first indication ofa Mnid balance problem. What is this indication? a. Fever b. Mental stalus change ¢. Poor skin turgor d. Dry mucous membranes - ANSWER. Mental status change Which person is most likely to have symptoms related to poor lymph circulation? d. Bradycardia and decreased nitrogen level. - ANSWER-c. Lethal electrolyte imbalance and acidosis What is the minimum amount of urine per day needed to excrete toxic waste products? a. 200 to 300 mL b. 400 to 600 mL ¢. 509 to 1000 mL d. 1000 ta 1a00 mL - ANSWER-b. 400 to 600 mL Which patient in the medical surgical unit is most likely to have increased aldosterone secretion? a. Pationt who has excessive salt ingestion b. Patient who drinks a lot of water c. Patient who loses a lot of fluid and sodium d. Patient who loses potassium and water - ANSWER-c. Patient who loses a lot of fluid and sodium The patients with which conditions are at great risk for deficient fluid volume? (Select all that apply) a. Fever of 103 degrees F b. Extensive burns c. Thyroid crisis d. Walor intoxication e, Continuous fistula drainage f. Diabetes insipidus - ANSWER-a. Fover of 103 degrees F b. Extensive burns d. Thyroid crisis e, Continuous fistula drainage f. Diabetes insipidus The nurse is working in a long-term care facility where there are numerous patients who are immobile and at risk for dehydration. Which task is best to delegate to the unlicensed assistive personnel (UAP)? a. Offer patients a choice of fluids every 1 to 2 hours. b. Check patients at the beginning of the shift to see who is thirsty. c. Give patients extra fluids around medication times. d. Evaluate oral intake and urinary output. - ANSWERa. Offer patients a choice of fluids every 1 to 2 hours The nurse is assisting a community group to plan a family sports day. In order to prevent dehydration, what beverage docs the nurse suggest be supplied? a. Iced tea b. Light beer c. Diet soda d. Bottled wal ANSWER-d. batiled water The nurse is assessing the weight of the patient wilh chronic renal failure. The paticnt shows a 2 kg weight gain since the last clinic appointment. This is equivalent to how many liters of fluid? a. 0.3 bl d.3- ANSWER-c. 2 The emergency department (ED) nurse is caring for the patient who was brought in for significant alcohol intoxication and minor trauma to the wrist. What will serial hematocrits for this patient likely show? a. Hemoconcentration b. Normal and stable hematocrits c. Progressively lower hematocrits d. Decreasing osmolality - ANSWER-a. Hemoconcentration vomiting, and The nurse is caring for the child at risk for dehydration secondary to diarrhea, fever. The child is alert, quiet, and clinging to the parent. What is the best nursing intervention to rehydrate this patient? a. Give an oral rehydration solution such as oralyte or rehydralyte. b. Have the parent give small sips of preferred diluted fluids every 5 to 10 minutes. ¢. Obtain an order for IV access and an isotonic solution such as normal saline. d. Encourage the child to take as much water as possible and offer popsicles. - ANSWER-b. Have the parent give small sips of preferred diluted fluids every 5 to 19 minutes. Which statements about the function of the lymphatic system are true? (Select all that apply) a. Lymph fluid contains more protein than plasma. b. Lymph flow is slower than bload flaw c. Lymph flow is enhanced by a pump system d. Lymphatic vessels carry lymph Munid toward the heart e. Lymph fluid is filtered by lymph nodes. f. The lymphatic syslom takes lymph to the kidnoys for cxerclion.- ANSWER-b. Lymph [low is slower than blood flow. d. Lymphatic v carry lympth fluid toward the heart e. Lymph fluid is filtered by lymph nodes The nurse is caring for several older adult patients who are at risk for dehydration. Which task can be delegated to the UAP? a. Withhold fluids if patients are incontinent of bowels or bladder. b. Assess for and report any difficulties that patients are having in swallowing. c. Stay with patients while they drink and note the exact amount ingested. d. Divide the total amount of fluids needed over a 24-hour period and post a note. - ANSWER-c. Stay with patients while they drink and note the exact amount ingested. The nurse assessing the patient notes a bounding pulse quality, neck vein distention when supine, presence of crackles in the hings, and inercasing peripheral edema. What. condilion docs the nurse suspect? a. Fhud cxeess b. Fluid deficit ¢. Electrolyte imbalance d. Serum protein increase - ANSWEFa. Fluid excess The patient is at risk for fluid volume excess and dependent edema. Which task does the nurse delegate to the VAP? a. Massage the legs and heels to stimulate circulation. b. Evaluate the cffoclivencss of a pressure-reducing-maltress. c. Assess the coccyx, elbows, and hips daily for signs of redness. sl the paticnt to change position every 2 hours. - ANSWER-d. Assis the paticnt to change position every 2 hours. The nurse is giving discharge instructions to the patient with advanced congestive heart failure who is at continued risk for fluid volume excess. For which physical change does the nurse instruct the patient to call the health care provider? a. Greater than 3 lbs gained in a week or greater than 1 to 2 lbs gained in a 24-hour period. b. Greater than 5 lbs gained in a week or greater than 1 to 2 lbs gained in a 24-hour period. c. Greater than 15 lbs gained in a month or greater than 5 Ibs gained in a week. d. Greater than 20 lbs gained in a month or greater than 5 lbs gained in a week. - ANSWER-a. Greater than 3 lbs gained in a week or greater than 1 to 2 Ibs gained in a 24-hour period. The nurse is caring for several patients at risk for falls because of fluid and electrolyte imbalances. Which task related to patient safety and fall prevention does the nurse delegate to the UAP? a. Assess for orthostatic hypotension b. Orient the palicnt to lhe environment. c. Help the incontinent patient to toilet y 1 to 2 hours. d. Encourage family mombers or significant other to stay with the patient. - ANSWER. Help the incontinent patient to toilet every 1 to 2 hours. The nurse is assessing the patient's urine specific gravity. The value is 1.035. How does the nurse interpret this result? a. Overhydration b. Dehydration c. Normal value for an adult d. Renal disease - ANSWER. Dehydration The patient is talking to the nurse about sodium intake. Which statement by the patient indicates an understanding of high sodium food sources? a. “I have bacon and eggs every morning for breakfast.” b. “We never eat seafood because of the salt water." c. “Llove Chinese food, but I gave it up because of the soy sauce.” d. “Pickled herring is a fish and my doctor told me to eat alot of fish. - ANSWER-c. "l love Chinese food, but I gave it up because of the soy sauce.” Whish statement best explains how antidiuretic hormone (ADH) affects urine output? a. It increases permeability to water in the tubules causing a decrease in urine output. b. It increases urine output as a result of water being absorbed by the tubules. c. Urine output is reduced as the posterior pituitary decreases ADH production. d. Increased urine oulpul results from inereased osmolarity and fluid in the extracellular space. - ANSWER-a. It increases permeability to water in the tubules causing a decrease in urine output. The nurse is assessing the patient’s neuromuscular status to obtain a baseline because the palienl is al. risk for clectrolytc imbalances. Whal. tocknique does the nurse use Lo assess tnmsclo strength in the legs? a. Ask the palicnt to push the fect against a flat surface and apply resislance to Lhe opposile side of the flat surlacc. b. Ask the patient to walk around the room and observe for stride, gait, balance, and endurance. c. Instruct the patient to stand at the side of the bed and abduct each leg as high as possible. d. Support the palient’s lower leg with the palm and move the knee through flexion and extension. - ANSWER-a. Ask the patient to push the feet against a flat surface and apply resistance to the opposite side of the flat surface. During the shift report, the nurse discovers that the patient has low sodium. What gastrointestinal change does the nurse expect to find during the physical assessment? a. Minimal bowel sounds with frequent episodes of vomitting. The nurse is assessing the patient with a mild increase in sodium level. What early manifestation does the nurse observe in this patient? a. Muscle twitching and irregular muscle contractions. b. Inability of muscles and nerves to respond to a stimulus c. Muscle weakness occurring bilaterally with no specific pattern. d. Reduced or absent deep tendon reflexes. - ANSWERa. Muscle twitching and irregular muscle contractions. The nurse is caring for the patient with hypernatremia caused by fluid and sodium losses. What type of IV solution is best for treating this patient? a. Hypotonic 0.225% sodium chloride. b. Small-volume infusions of hypertonic (2% to 3%) saline. c. Isolonic sodinum chloride (NaCl a. Isotonic Ringer's lactate - ANSWER-c. Isotonic sodium chloride NaCl) Which serum value does the nurse expect to see in the patient with hyponatremia? a. Sodium less than 136 mEq/L b. Chloride less than 95 mEq/L c. Sodium less than 145 mEq/L. d. Chloride less than 103 mEq/L - ANSWER-a. Sodium less than 136 mEq/L The palient has a serum sodium level of 126 mEq/L. What assessment. findings docs the nurse expect to see in this patient? a. ConsLipauion and paralytic ileus b. Watery diarrhea with abdominal cramping c. Muscle cramping and spasticity d. Tachypnea and diminished breath sounds - ANSWER-b. cramping atery diarrhea with abdominal The nurse is caring for the psychiatric patient who is continuously drinking water. The nurse monitors for which complication related to potential hyponatremia? a. Proteinuria/prerenal failure b. Change in mental status/increased intracranial pressure c. Pitting edema/circulatory failure d. Possible stool for occult blood/gastrointestinal bleeding - ANSWER-b. Change in mental status/increased intracranial pressure What is the inlervention of choice for the patient wilh mild hypernatremia caused by excessive fluid loss? a. TV infusion of 10 units of insulin in 50 mL of 10% dextrose. b. Replacement of table salt with salt subst c. Furosemide (Lasix) 20 ng TV d. Increased oral water intake - ANSWER-d. Increased oral water intake the nurse is caring for several patients at risk for fluid and electrolyte imbalances. Which patient problem or condilion can result in a relative hypernatremia? a. Use of salt substitute b, Diarrhea ¢. Drinking too much water d. NPO status for a prolonged period - ANSWEF-d. NPO status for a prolonged period Which precaution or intervention does the nurse teach the patient at continued risk for hypernatremia? a. Avoid salt substitutes b. Avoid aspirin and aspirin-containing products c. Read labels on canned or packaged foods to determine sodium content d. Increase daily intake of caffeine-containing foods and beverages - ANSWER-c. Read labels on canned or packaged foods to determine sodium content The nurse identifies the nursing diagnosis of Risk for Injury for the patient with hyponatremia. What is the etiology of this diagnosis? a. Altered mental capabilities b. Fragility of bones ¢. Immobility d. Altered senses - ANSWER-a. Altered mental capabilities Which serum laboratory value indicates the patient has hypernatremia? a. Chloride greater than 95 mEq/L b. Sodium greater than 135 mEq/L c. Chloride greater than 193 mEq/L d. Sodium greater than 145 mEg/L - ANSWER-d. Sodium greater than 145 mEq/L The nurse is teaching the patient 1o recognize food sthal are high in sodinm. Which food ilems does the nurse use as examples? (Select all that apply) a. Egg roll with soy sauce b. Whate rice c. Salad with oil and vinegar dressing d. Bacon and eggs e. Cottage cheese and tomato f. Steak g. Soup with saltine crackers h. Steamed vegetable - ANSWET-a. Egg roll with soy sauce d. Bacon and cggs e. Cottage cheese and tomato ae Soup with salline ¢: Which scrum laboratory value docs the nurse expect Lo see in the patient with hypokalemia? a. Calcium less than 8.0 mg/dL b. Potassium less than 3.0 mEq/L c. Calcium less than 11.0 mg/dL d. Potassium less than 3.5 mEq/L - ANSWER-d. Potassium less than 3.5 mEq/L The patient's potassium level is 2.5 mEq/L. Which clinical findings does the nurse expect to see when assessing this patient? a. Hypertension, bounding pulses, and bradycardia b. Moist crackles, tachypnea, and diminished breath sounds c. General skeletal muscle weakness, lethargy, and weak hand grasps d. Increased specific gravity and decreased urine output - ANSWER-c. General skeletal muscle weakness, lethargy, and weak hand grasps c. Digoxin may cause potassium levels to rise to toxic levels d. Hypokalemia causes the cardiac muscle to be less sensitive to digoxin - ANSWEF-b. Digoxin toxicity can result if hypokalemia is present Which serum laboratory value does the nurse expect to see in the patient with hyperkalemia? a. Calcium greater than 8.0 mg/dL b. Potassium greater than 3.5 mEq/L ¢. Calcium greater than 11.0 mg/dL d. Potassium greater than 5.0 mEq/L - ANSWER-d. Potassium greater than 5.0 mEq/L The patient has an clovaled polassium lovel. Which assessment findings arc associated wilh hyperkalemia? (Select all that apply) a. Wheezing on exhalation b. Numbness in hands, feet, and around the mouth c. Frequent, explosive diarrhea stools d. Irregular heart rate and hypotension e. Circumoral cyanosis - ANSWER-b. Numbness in hands, feet, and around the mouth c. Frequent, explosive diarrhea stools d. Irregular heart rate and hypotension The nurse is teaching the patient about foods high in potassium. Which food item does the nurse use as the best example? a. Bread b. Eges c. Cereal grains d. Meat - ANSWER-d. Meat The patient’s serum potassium value is below 2.8 mEg/L. The patient is also on digoxin. The nurse quickly assesses the patient for which cardiac problem before notifying the physician? a. Cardiac murmur b. Cardiac dysrhythmia c. Congestive heart failure d. Cardiac tamponade - ANSWER. Cardiac dysthythmia Which potassium levels are within normal limits? (Select all that apply) a. 2.0 mmol/L b. 3.3 mmol/L ¢. 4.5 mmol/L d. 5.0 mmol/L €. 6.0 mmol/L - ANSWER-D. 3.5 mmol/L ¢. 4.5 mmol/L d. 5.0 mmol/L The patient has hy; does the nurse anticipate for this patient? erkalemia resulting from dehydration. Which additional laboratory findings a. Increased hematocrit and hemoglobin levels b. Decreased serum electrolyte levels c. Increased urine potassium levels d. Decreased serum creatinine - ANSWEF-a. Increased hematocrit and hemoglobin levels