Practice questions(fluid and electrolytes)

1) A nurse is reading a physician’s progress notes in the client’s record and

reads that the physician has documented insensible fluid loss of
approximately 800 ml daily”. The nurse understands that this type of fluid
loss can occur through:

1. the skin

2. urinary output

3. wound drainage

4. the gastrointestinal tract

2) A nurse is assigned to care for a group of clients. On review of the client’s

medical records, the nurse determines that which client is at risk for deficient
fluid volume?

1. A client with a colostomy

2. A client with congestive heart failure

3. A client with decreased kidney function

4. A client receiving frequent wound irrigations

3) A nurse caring for a client who has been receiving intravenous diuretics
suspects that the client is experiencing a deficient fluid volume. Which
assessment finding would the nurse note in a client with this condition?

1. Lung congestion

2. Decreased hematocrit

3. Increased blood pressure

4. Decreased central venous pressure(CVP)

4) A nurse is assigned to care for a group of clients. On review of the client’s

medical records, the nurse determines that which client is at risk for excess
fluid volume.

1. The client taking diuretics

2. The client with renal failure

3. The client with an ileostomy

4. The client who requires gastrointestinal suctioning

5) The nurse is caring for a client with congestive heart failure. On assessment,
the nurse notes that the client is dyspneic and that the crackles are audible
on auscultation. The nurse suspects excess fluid volume. What additional
 signs would the nurse expect to note in this client if excess fluid volume is
present?

1. Weight loss

2. Flat neck and hand veins

3. An increase in blood pressure

4. A decreased central venous pressure(CVP)

6) A nurse is preparing to care for a client with a potassium deficit. The nurse
reviews the client’s record and determines that the client was at risk for
developing the potassium deficit because the client:

1. Has renal failure

2. Requires nasogastric suction

3. Has a history of addison’s disease

4. Is taking a potassium-sparing diuretic

7) A nurse reviews a client electrolyte laboratory report and notes that the
potassium level is 3.2 mEq/L. which of the following would the nurse note on
the electrocardiogram as a result of the laboratory value?

1. U waves

2. Absent P waves

3. Elevated T waves

4. Elevated ST segment

8) A nursing student needs to administer potassium chloride intravenously as

prescribed to a client with hypokalemia. The nursing instructor determines
that the student is unprepared for this procedure if the student states that
which of the following is part of the plan for preparation and administration of
the potassium?

1. Obtaining a controlled IV infusion pump

2. Monitoring urine output during admistration

3. Diluting in appropriate amount of normal saline

4. Preparing the medication for bolus administration

9) A nurse instructs a client at risk for hypokalemia about the foods rich in
potassium that should be included in the daily diet. The nurse determines
that the client understands the food sources of potassium if the client states
that the food item lowest in potassium is:
 1. Apples

2. Carrots

3. Spinach

4. Avocado

10) A nurse caring for a group of clients reviews the electrolyte laboratory
results and notes a potassium level of 5.5 mEq/L on one client’s laboratory
report. The nurse understands that which client is at highest risk for the
development of a potassium value at this level.

1. The client with colitis

2. The client with Cushing’s syndrome

3. The client who has been overusing laxatives

4. The client who has sustained a traumatic burn

11) A nurse reviews the electrolyte results of an assigned client and notes that
the potassium level is 5.4 mEq/L. which of the following would the nurse
expect to note on the electrocardiogram as a result of the laboratory value?

1. ST depression

2. Inverted T wave

3. Prominent U wave

4. Tall peaked T waves

12) A nurse caring for a group of clients reviews the electrolyte laboratory
results and notes a sodium level of 130 mEq/L on one client’s laboratory
report. The nurse understands that which client is at highest risk for the
development of a sodium value at this level?

1. The client with renal failure

2. The client who is taking diuretics

3. The client with hyperaldosteronism

4. The client who is taking corticosteroids

13) A nurse is caring for a client with acute congestive heart failure who is
receiving high doses of a diuretic. On assessment, the nurse notes that the
client has flat neck veins, generalized muscle weakness, and diminished deep
tendon reflexes. The nurse suspects hyponatremia. What additional signs
would the nurse expect to note in this client if hyponatremia were present?

1. Dry skin
 2. Decreased urinary output

3. Hyperactive bowel sounds

4. Increased specific gravity of the urine

14) A nurse is caring for a client with a nasogastric tube. Nasogastric tume
irrigations are prescribed to be performed once every shift. The client’s serum
electrolyte results indicate a potassium level of 4.5 mEq/L and a sodium level
of 132 mEq/L. based on these laboratory findings, the nurse selects which
solution to use for the nasogastric tube irrigation?

1. Tap water

2. Sterile water

3. Sodium chloride

4. Distilled water

15) A nurse is reviewing laboratory results and notes that a client’s serum
sodium level is 150 mEq/L. the nurse reports the serum sodium level to the
physicianand the physician prescribes a dietary instructions based on the
sodium level. Which food item does the nurse instruct the client to avoid?

1. Peas

2. Cauliflower

3. Low-fat yogurt

4. Processed oat cereals

16) A nurse is reviewing a client’s laboratory report and notes that the serum
calcium level is 4.0 mg/dL. The nurse understands that which condition most
likely caused this serum calcium level?

1. Prolonged bed rest

2. Renal insufficiency

3. Hyperparathyroidism

4. Excessive ingestion of Vitamin D

17) A nurse is assessing a client with a suspected diagnosis of hypocalcemia.

Which of the following clinical manifestations would the nurse expect to note
which of the following clinical manifestations would the nurse expect to note
in the client?

1. Twitching

2. Negative Trousseau’s sign

 3. Hypoactive bowel sounds

4. Hypoactive deep tendon reflexes

18) A nurse caring for a client with hypocalcemia would expect to note which
of the following changes on the electrocardiogram?

1. Widened T wave

2. Prominent U wave

3. Prolonged QT interval

4. Shortened ST segment

19) A nurse caring for a client with severe malnutrition reviews the laboratory
results and notes a magnesium level of 1.0 mg/dL. Which electrocardiogram
change would the nurse expect to note based on the magnesium level?

1. Prominent U waves

2. Prolonged PR interval

3. Depressed ST segment

4. Widened QRS complexes

20) A nurse reviews a client’s laboratory report and notes that the client’s
serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this
serum phosphorus level?

1. Alcoholism

2. Renal insufficiency

3. Hypoparathyrodism

4. Tumor lysis syndrome