Fluid & Electrolyte Rapid Review Practice Questions

A patient with SIADH is most likely to develop which electrolyte imbalance?

• Hyperkalemia

• Hyponatremia

• Hypercalcemia

• Hypophosphatemia

Answer explanation

SIADH (Syndrome of Inappropriate Antidiuretic Hormone secretion) leads to excessive water retention, diluting serum sodium levels, which results in hyponatremia. Therefore, the most likely electrolyte imbalance is hyponatremia.

Which clinical finding would the nurse expect in a patient with hypernatremia?

• Muscle twitching and seizures

• Dry mucous membranes and increased thirst

• Decreased blood pressure and bradycardia

• Hypoactive reflexes

Answer explanation

In hypernatremia, the body loses water, leading to dehydration. This results in dry mucous membranes and increased thirst as the body attempts to restore fluid balance.

Which is a priority nursing action when administering IV potassium?

• Give IV push slowly over 5 minutes

• Ensure IV site patency before infusion

• Administer via IM injection if patient cannot tolerate oral

• Mix with dextrose solution to prevent vein irritation

Answer explanation

Ensuring IV site patency before infusion is crucial to prevent complications such as infiltration or phlebitis when administering IV potassium, which can be irritating to veins.

A patient receiving Lasix (furosemide) is at risk for which imbalance?

(a)  

Answer explanation

Lasix (furosemide) is a loop diuretic that promotes the excretion of potassium, leading to a risk of hypokalemia, not hyperkalemia. Therefore, the correct answer is that the patient is at risk for hypokalemia.

Which clinical sign indicates hypocalcemia?

• Decreased deep tendon reflexes

• Chvostek’s sign

• Hypoactive bowel sounds

• Flushed, dry skin

Answer explanation

Chvostek’s sign is a clinical indicator of hypocalcemia, characterized by facial muscle twitching when the facial nerve is tapped. This sign reflects neuromuscular excitability due to low calcium levels.

Which electrolyte imbalance is commonly associated with chronic alcoholism?

• Hypomagnesemia

• Hyperkalemia

• Hyperphosphatemia

• Hypernatremia

Answer explanation

Hypomagnesemia is commonly seen in chronic alcoholism due to poor dietary intake and malabsorption. Alcohol can also lead to renal losses of magnesium, making this electrolyte imbalance prevalent in alcoholics.

A patient has been vomiting for 3 days. Which electrolyte imbalance is most likely?

• Hyperchloremia

• Hypochloremia

• Hypermagnesemia

• Hyperkalemia

Answer explanation

Vomiting leads to loss of gastric acid, which contains hydrochloric acid. This results in decreased chloride levels in the body, causing hypochloremia, making it the most likely electrolyte imbalance in this scenario.

Which nursing intervention is essential for a patient with hyperkalemia?

• Encourage intake of orange juice and bananas

• Place the patient on continuous cardiac monitoring

• Restrict sodium intake only

• Monitor for tetany and spasms

Answer explanation

Continuous cardiac monitoring is essential for a patient with hyperkalemia due to the risk of life-threatening arrhythmias. Other options do not address the immediate cardiac risks associated with elevated potassium levels.

A patient with renal failure is at greatest risk for which electrolyte imbalance?

• Hypophosphatemia

• Hyperphosphatemia

• Hypokalemia

• Hypocalcemia only

Answer explanation

In renal failure, the kidneys cannot excrete phosphate effectively, leading to an accumulation of phosphate in the blood, resulting in hyperphosphatemia. This makes hyperphosphatemia the most likely electrolyte imbalance in these patients.

Which treatment is appropriate for severe symptomatic hypocalcemia?

• Fluid restriction

• IV calcium gluconate

• Oral potassium

• Sodium bicarbonate

Answer explanation

IV calcium gluconate is the appropriate treatment for severe symptomatic hypocalcemia as it provides rapid correction of calcium levels, unlike the other options which do not address hypocalcemia directly.