Wk. 1 - Fluid & Electrolyte Review Practice Questions

Which electrolyte is found in the highest concentration within the intracellular fluid (ICF)? A. Sodium B. Potassium C. Calcium D. Chloride

B

Which statement best describes the extracellular fluid (ECF)? A. It accounts for ~40% of total body weight. B. It includes plasma, interstitial, and transcellular fluid. C. It is rich in potassium and phosphate. D. It is unaffected by IV fluid administration.

B

True or False: Osmoreceptors in the hypothalamus trigger the thirst mechanism when serum osmolality increases.

True

Which hormones act to increase sodium and water retention? Select all that apply. A. Aldosterone B. Antidiuretic hormone (ADH) C. Atrial natriuretic peptide (ANP) D. Cortisol

A,B,D

The nurse is reviewing lab results for a patient with dehydration. Which findings are most consistent with fluid volume deficit (Select All That Apply)? A. Hematocrit 60% B. Urine specific gravity 1.030 C. BUN 32 mg/dL D. Sodium 132 mEq/L

A,B,C

Which is a common cause of fluid volume deficit? A. Congestive heart failure B. Renal failure C. Diuretic overuse D. Excess sodium intake

C

(Select all that apply) Which assessment findings support fluid volume excess? A. Jugular venous distension B. Crackles in the lungs C. Weak, thready pulse D. Weight gain of 3 kg in 2 days E. Dry mucous membranes

A,B,D

A patient has fluid volume excess. Which lab result would the nurse expect? A. Elevated hematocrit B. Elevated BUN C. Decreased hematocrit D. Increased urine specific gravity

C

Which condition is most likely to cause hypernatremia? A. SIADH B. Excessive sweating C. Use of loop diuretics D. CHF with fluid overload

B

The nurse is monitoring a patient with hyponatremia. Which clinical manifestation requires immediate attention? A. Muscle cramps B. Headache C. Confusion D. Nausea

C

True or False: Treatment of severe symptomatic hyponatremia may include administration of 3% saline.

True

A patient’s ECG shows peaked T waves and widened QRS complexes. Which electrolyte imbalance is most likely? A. Hypokalemia B. Hyperkalemia C. Hypocalcemia D. Hypermagnesemia

B

Which of the following are clinical manifestations of hypokalemia? Select all that apply. A. Muscle weakness B. Fatigue C. Flat T waves on ECG D. Abdominal cramps E. Hyperreflexia

A,B,C,D

The nurse is preparing to administer IV potassium chloride for a patient with serum K⁺ of 2.9 mEq/L. Which action is correct? A. Administer IV push over 5 minutes. B. Dilute in IV fluid and infuse via pump. C. Infuse at 50 mEq/hr for rapid correction. D. Mix with IV dextrose to promote absorption.

B

Hypomagnesemia is most likely to cause which life-threatening complication? A. Seizures B. Pulmonary embolism C. Torsades de pointes D. Myocardial infarction

C

(Select all that apply) Which findings are consistent with hypermagnesemia? A. Bradycardia B. Hypertension C. Hyporeflexia D. Lethargy E. Tremors

A,C,D

Which patient is at greatest risk for hypermagnesemia? A. Post-thyroidectomy patient B. Patient in renal failure using magnesium-containing antacids C. Patient with chronic alcoholism D. Patient with Crohn’s disease and diarrhea

B

Hypocalcemia is commonly seen in which condition? A. Hyperparathyroidism B. Vitamin D deficiency C. Prolonged immobilization D. Thiazide diuretic therapy

B

Which are clinical manifestations of hypocalcemia? Select all that apply: A. tetany B. Positive Chvostek Sign C. Constipation D. Seizures E. Laryngospasm

A,B,D,E

Which nursing intervention is appropriate for severe symptomatic hypercalcemia? A. Encourage bedrest B. Administer loop diuretics with IV fluids C. Give calcium gluconate IV D. Increase dietary calcium intake

B

True or False: Hypophosphatemia can lead to decreased myocardial contractility and respiratory muscle weakness.

True

Which condition is most often associated with hyperphosphatemia? A. Malnutrition B. Chronic kidney disease C. Chronic diarrhea D. Hyperparathyroidism

B

A patient with hypophosphatemia may present with which manifestations? A. Bone pain B. Muscle weakness C. Bleeding tendency D. Confusion E. All of the above

E

Which treatment is appropriate for hyperkalemia with ECG changes? A. IV calcium gluconate B. D5W alone C. Oral potassium supplements D. Hydrochlorothiazide

A

A patient with hypomagnesemia is ordered magnesium sulfate IV. Which nursing action is essential? A. Monitor reflexes and cardiac rhythm. B. Encourage dairy products. C. Give IV push undiluted. D. Check urine output once daily.

A

(Select all that apply) Treatment for hypercalcemia includes: A. IV normal saline B. Calcitonin C. Bisphosphonates D. Bed rest E. Sodium polystyrene sulfonate

A,B,C

Which is an appropriate intervention for hyperphosphatemia? A. Administer phosphate supplements B. Restrict dietary phosphate C. Provide vitamin D supplementation D. Encourage dairy products

B

Which IV solution is most appropriate for a patient with hyponatremia due to fluid overload? A. D5W B. 0.9% NaCl C. 3% NaCl D. 0.45% NaCl

C

Which IV fluid is isotonic and commonly used to treat hypovolemia? A. 0.9% NaCl B. 0.45% NaCl C. D5W (after metabolism) D. 3% NaCl

A

True or False: Lactated Ringer’s solution is contraindicated in patients with liver failure.

True

Which IV fluid is hypotonic and moves water into cells? A. 0.45% NaCl B. 0.9% NaCl C. 3% NaCl D. Albumin

A

A patient has cerebral edema. Which IV solution is appropriate? A. 0.9% NaCl B. D5W C. 3% NaCl D. 0.45% NaCl

C

(Select all that apply) Colloid solutions include: A. Albumin B. Dextran C. Hetastarch D. Lactated Ringer’s E. 5% dextrose

A,B,C

A malnourished alcoholic presents with tremors, confusion, and positive Chvostek’s sign. Labs show low Mg²⁺. Which complication is the nurse most concerned about? A. Hyperglycemia B. Ventricular arrhythmias C. Constipation D. Fluid overload

B

A patient receiving parenteral nutrition develops muscle weakness, bone pain, and confusion. Which electrolyte imbalance is likely? A. Hypernatremia B. Hypophosphatemia C. Hyperkalemia D. Hypocalcemia

B

A patient with DKA has been aggressively rehydrated with IV fluids. Which electrolyte imbalance is the nurse most concerned about developing? A. Hyponatremia B. Hypokalemia C. Hypercalcemia D. Hypermagnesemia

B

True or False: Trousseau’s sign and Chvostek’s sign are clinical indicators of hypocalcemia and hypomagnesemia.

True

Which clinical finding is most concerning in a patient with hyperkalemia? A. Muscle cramps B. Paresthesias C. ECG with peaked T waves D. Nausea

C

A patient with hypocalcemia is placed on seizure precautions. Which rationale supports this nursing action? A. Hypocalcemia increases excitability of neurons and muscle cells. B. Hypocalcemia depresses CNS activity. C. Hypocalcemia increases cardiac output. D. Hypocalcemia causes severe dehydration.

A

(Select all that apply) Which patients are most at risk for fluid volume deficit? A. Patient with burns B. Patient with CHF C. Patient with severe vomiting and diarrhea D. Patient on high-dose diuretics E. Patient with renal failure

A,C,D