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WorksheetsFluid and Electrolytes NCLEX Style Questions
Total questions: 83
Worksheet time: 3hrs 48mins
A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Interstitial fluid
Intravascular fluid
Water movement between the ICF and ECF compartments is determined by:
Osmotic forces
Plasma oncotic pressure
Antidiuretic hormone
Buffer systems
A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by:
Increased serum potassium
Increased plasma osmolality
Decreased renal blood flow
Generalized edema
Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in:
Decreased plasma osmolality
Increased serum potassium levels
Increased blood volume
Localized edema
Which of the following patients is the most at risk for developing hypernatremia? A patient with:
Vomiting
Diuretic use
Dehydration
Hypoaldosteronism
A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected?
Symptoms subside quickly
Increased ICF volume
Decreased ECF volume
Intracellular dehydration
A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?
Weak pulse
Excessive thirst
Oliguria
Constipation
Which of the following buffer pairs is considered the major plasma buffering system?
Which of the following buffer pairs is considered the major plasma buffering system?
Carbonic acid/bicarbonate
Sodium/potassium
Amylase/albumin
A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Interstitial fluid
Intravascular fluid
While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):
Higher total body water volume
Decreased muscle mass
Increase in thirst
Increased tendency towards developing edema
Water movement between the ICF and ECF compartments is determined by:
Osmotic forces
Plasma oncotic pressure
Antidiuretic hormone
Buffer systems
When planning care for a dehydrated patient, the nurse remembers the principle of water balance is closely related to _____ balance.
Potassium
Chloride
Bicarbonate
Sodium
A nurse is teaching the staff about antidiuretic hormone (ADH). Which information should the nurse include? Secretion of ADH is stimulated by:
Increased serum potassium
Increased plasma osmolality
Decreased renal blood flow
Generalized edema
Which statement by the staff indicates teaching was successful concerning aldosterone? Secretion of aldosterone results in:
Decreased plasma osmolality
Increased serum potassium levels
Increased blood volume
Localized edema
A 5-year-old male presents to the ER with delirium and sunken eyes. After diagnosing him with severe dehydration, the primary care provider orders fluid replacement. The nurse administers a hypertonic intravenous solution. Which of the following would be expected?
Symptoms subside quickly
Increased ICF volume
Decreased ECF volume
Intracellular dehydration
Which of the following patients is the most at risk for developing hypernatremia? A patient with:
Vomiting
Diuretic use
Dehydration
Hypoaldosteronism
Which of the following conditions would cause the nurse to monitor for hyperkalemia?
Excess aldosterone
Acute acidosis
Insulin usage
Metabolic alkalosis
A 60-year-old female is diagnosed with hyperkalemia. Which assessment finding should the nurse expect to observe?
Weak pulse
Excessive thirst
Oliguria
Constipation
Which of the following buffer pairs is considered the major plasma buffering system?
Which of the following buffer pairs is considered the major plasma buffering system?
Carbonic acid/bicarbonate
Sodium/potassium
Amylase/albumin
Which patient is most prone to metabolic alkalosis? A patient with:
Retention of metabolic acids
Hypoaldosteronism
Excessive loss of chloride (Cl)
Hyperventilation
For a patient experiencing metabolic acidosis, the body will compensate by:
Excreting H+ through the kidneys
Hyperventilating
Retaining CO2 in the lungs
Secreting aldosterone
A client is brought to the Emergency Department after passing out in a local department store. The client has been fasting and has ketones in the urine. Which acid-base imbalance would the nurse expect to assess in this client?
Metabolic acidosis
Respiratory alkalosis
Metabolic alkalosis
Respiratory acidosis
The nurse uses a diagram to show that fluids in the interstitial and intravascular compartments are combined. What do they combine to form?
Intercellular compartment
Circulating compartment
Vertical compartment
Extracellular compartment
The nurse must keep an accurate intake and output record to assess kidney efficiency. In order for the kidneys to remove waste, what is the least amount of hourly urine output the kidneys must produce to remove waste?
10 mL
20 mL
30 mL
40 mL
The nurse explains to a patient that the drug Lasix reduces edema by drawing water from the interstitial space into the intravascular space. What is this process called?
Diffusion
Filtration
Osmosis
Homeostasis
What does actively transporting electrolytes from an area of higher concentration to an area of lower concentration require?
Hydrostatic pressure
Osmotic pressure
Blood pressure
Pulse pressure
Sodium is the most abundant electrolyte in the body. The location of electrolytes is important for maintaining homeostasis. Sodium is the major electrolyte in which fluid compartment?
Intracellular
Intravascular
Extracellular
Interstitial
The lactating mother is counseled by the nurse to eat adequate amounts of meat and legumes. What level will this help to increase?
Potassium
Chloride
Magnesium
Phosphorus
A nurse assesses an edematous cardiac patient. The nurse is aware that this condition is a result of retained fluid. What is the patient considered to be?
Hyponatremic
Hypokalemic
Hypernatremic
Hypercalcemic
What is the nurse closely assessing for in a patient with hypokalemia?
Systemic edema
Cardiac complications
Muscle cramping
Impaired kidney function
The nurse modifies the care plan for the immobilized patient after assessing a calcium level of 6.2 mEq/L. What nursing assessment should the nurse include when modifying this care plan?
Osteoporosis
Tooth loss
Renal calculi
Contractures
The nurse is educating a patient regarding the need to avoid foods high in potassium. What food choices led the nurse to conclude that teaching was not effective?
Apples and green beans
Kiwis and onions
Apricots and asparagus
Grapes and lima beans
A 10-month-old infant has had watery green stool for 2 days and refuses the bottle. The nurse is aware that the primary concern for this baby is:
metabolic acidosis.
metabolic alkalosis.
weight loss.
diaper rash.
An isotonic state exists within a patient’s body fluids when the solute concentration of:
interstitial fluid is less than the transcellular.
intracellular and extracellular fluid is equal.
intracellular fluid is greater than extracellular fluid.
extracellular fluid is lesser than intracellular fluid.
The nurse is aware that an infant is more at risk for dehydration because the infant:
has kidneys that reabsorb water from the intravascular space.
has a larger body surface compared with body weight.
urinates more frequently.
has fat that absorbs water.
A nurse gets a positive Chvostek’s sign on a young woman with bulimia who has been giving herself frequent enemas containing phosphate. The nurse anticipates a laboratory finding of _____ mEq/L.
sodium 140
potassium 4.5
magnesium 1.6
calcium 6.5
A patient has been identified as having a dietary deficiency of vitamin D. The nurse understands that this patient is also at risk for having a deficiency of:
calcium.
magnesium.
sodium.
potassium.
The nurse explains that the dehydrated patient’s urine is concentrated because:
renal tubules reabsorb more water and reduce urine output.
kidneys cease to function.
blood pressure drops.
the colon retains more fluid from the fecal waste.
The nurse is aware that small ions such as glucose, oxygen, and carbon dioxide redistribute themselves through semi-permeable membranes by a process called:
diffusion.
osmosis.
blood pressure.
rehydration.
A patient with congestive heart failure has gained 1.1 pounds over the last 24 hours. The nurse is aware that this weight gain represents a fluid retention of _____ L.
0.25
0.5
1.0
2.0
A patient drank a cup of coffee, a half glass of orange juice, and half a carton of milk with breakfast. Using common equivalents of food containers as a guide, the nurse notes on the intake column of the intake and output sheet that the patient consumed _____ mL. You have 15 minutes to calculate this question.
360
400
420
600
The nurse is aware that the patient who suffered a brain injury with cerebral edema will most likely receive a fluid that is:
isotonic.
hypertonic.
hypotonic.
enhanced with vitamin B.
The patient who is prescribed furosemide for fluid-volume excess is discharged home. The patient verbalizes understanding of his disease process when he says:
“I can put catsup on my scrambled eggs.”
“I can snack on salted popcorn.”
“I will snack on raisins.”
“I will avoid apricots.”
The nurse assessing a newly admitted patient with marked edema from severe congestive failure would anticipate that the patient would exhibit: (Select all that apply.)
a thready pulse.
concentrated urine.
hypertension.
weight gain.
crackles heard on auscultation.
The nurse assessing a patient with vomiting and diarrhea observes that the urine is scant and concentrated. The nurse explains that the compensatory reabsorption of water is controlled by:
osmoreceptors in the hypothalamus.
antidiuretic hormone in the posterior pituitary.
baroreceptors in the carotid sinus.
insulin from the pancreas.
Prior to hanging an IV containing potassium, the nurse will confirm that there is a:
blood pressure of at least 60 mm Hg diastolic.
urine output of at least 30 mL/hr.
filter on the IV line.
pulse of at least 50 beats/min.
Because the 80-year-old patient is prone to dehydration related to the age-related change of decreased thirst and kidney function, the nurse monitors for the earliest sign of dehydration, which is:
reduced skin turgor.
constipation.
increased temperature.
thirst.
The nurse can record that the compensatory mechanism for the correction of metabolic acidosis is in effect when the nurse observes:
increased urinary output.
reduced abdominal distention.
Kussmaul’s respirations.
decreased blood pressure.
The nurse is assessing the hydration status of the patient. The nurse demonstrates knowledge of proper assessment techniques by: (Select all that apply.)
monitoring the patient’s daily weight.
assessing the patient’s skin turgor on the back of the hand.
checking the patient’s blood glucose level 4 times a day.
assessing for skin tenting on the patient’s forehead.
asking the patient if he is experiencing thirst.
When caring for a patient admitted with hyponatremia, which actions will the nurse anticipate taking?
Restrict patient’s oral free water intake.
Avoid use of electrolyte-containing drinks.
Infuse a solution of 5% dextrose in 0.45% saline.
Administer vasopressin (antidiuretic hormone, [ADH]).
The home health nurse notes that an elderly patient has a low serum protein level. The nurse will plan to assess for
pallor.
edema.
confusion.
restlessness.
A patient is receiving 3% NaCl solution for correction of hyponatremia. During administration of the solution, the most important assessment for the nurse to monitor is
lung sounds.
urinary output.
peripheral pulses.
peripheral edema.
When teaching a patient with renal failure about a low phosphate diet, the nurse will include information to restrict
ingestion of dairy products.
the amount of high-fat foods.
the quantity of fruits and juices.
intake of green, leafy vegetables.
A patient receiving isoosmolar continuous tube feedings develops restlessness, agitation, and weakness. Which laboratory result is most important to report to the health care provider?
K+ 3.4 mEq/L (3.4 mmol/L)
Ca+2 7.8 mg/dl (1.95 mmol/L)
Na+ 154 mEq/L (154 mmol/L)
PO4-3 4.8 mg/dl (1.55 mmol/L)
A patient with renal failure who has been taking aluminum hydroxide/magnesium hydroxide suspension (Maalox) at home for indigestion is somnolent and has decreased deep tendon reflexes. Which action should the nurse take first?
Notify the patient’s health care provider.
Withhold the next scheduled dose of Maalox.
Review the magnesium level on the patient’s chart.
Check the chart for the most recent potassium level.
A postoperative patient who is receiving nasogastric suction is complaining of anxiety and incisional pain. The patient’s respiratory rate is 32 breaths/minute and the arterial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first?
Discontinue the nasogastric suctions for a few hours.
Notify the health care provider about the ABG results.
Teach the patient about the need to take slow, deep breaths.
Give the patient the PRN morphine sulfate 4 mg intravenously.
The following data are obtained by the nurse when assessing a pregnant patient with eclampsia who is receiving IV magnesium sulfate. Which finding is most important to report to the health care provider immediately?
The bibasilar breath sounds are decreased.
The patellar and triceps reflexes are absent.
The patient has been sleeping most of the day.
The patient reports feeling “sick to my stomach.”
A nurse is reviewing lab reports. The nurse recalls blood plasma is located in which of the following fluid compartments?
Intracellular fluid (ICF)
Extracellular fluid (ECF)
Interstitial fluid
Intravascular fluid
A client who has acute pancreatitis reports muscle spasms. Which of the following laboratory values is the highest priority for the nurse to report to the provider?
Calcium 6.8 mg/dL
Glucose 180 mg/dL
WBC count 11,800/mm3
Sodium 130 mg/dL
A nurse is caring for a client who has a central venous access device. Which of the following should the nurse know before performing a complete assessment of the device? (Select all that apply)
Health care professional who inserted the device
Length of the catheter
Insertion site
Form of anesthesia used for insertion
Location of the tip
A client presents to the emergency department with a history of vomiting and diarrhea for 3 days. The nurse should recognize that which of the following indicates fluid volume deficit?
Pulse rate 110
Blood pressure 160/90 mm Hg
Urine specific gravity < 1.001
BUN 5 mg/dL
A nurse is educating a client who has hypernatremia about nutrition. Which of the following food choices made by the client indicates an understanding of the teaching? Select all that apply.
Cheddar cheese
Orange wedges
Tomato slices
Canned beans
Brown rice
A nurse is assisting a client to choose foods high in magnesium. Which of the following foods is a good source of magnesium?
Peanuts
Cottage cheese
Almonds
Hot dogs
A nurse is administering an oral rehydration solution to a child who was admitted due to severe hypotonic dehydration. Which of the following laboratory results indicates that the child is responding to the treatment?
Urine pH 6.0
Urine specific gravity 1.035
Serum sodium 136 mEq/L
Serum potassium 3.5 mEq/L
A nurse is evaluating a client’s ABG results. Which of the following findings requires an action by the nurse?
SaO2 95%
PCO2 33 mm Hg
HCO3 22 mEq/L
pH 7.45
A client has chronic kidney disease and a low phosphate level. Which of the following foods should the nurse encourage the client to consume more frequently?
Whole wheat bread
Long-grain rice
Orange juice
Chocolate milk
What is primarily responsible for carrying fluids with nutrients and wastes on a random basis throughout the body?
Filtrates
Extracellular fluid
Intracellular fluid
Osmolytes
A patient has renal damage because of diabetes. What is the highest risk for this patient?
Hypercalcemia
Hypocalcemia
Hyperkalemia
Hypokalemia
A nurse has two newly admitted patients with dehydration. One patient is dehydrated from heat exhaustion, and the other is dehydrated from an overdose of Lasix. What finding should be present in both patients?
Increased skin turgor
Decreased pulse and respirations
Copious saliva and nasal secretions
Increased laboratory values of hemoglobin and hematocrit
A nurse understands that fluid balance is mainly monitored in the body by which two systems?
Circulatory and renal
Respiratory and circulatory
Renal and gastrointestinal
Hepatic and lymphatic
How does the healthy kidney adjust the volume and composition of filtrate that prevents excessive fluid loss?
Active transport
Filtration in the lymphatic system
Secretion of adrenalin
Tubular reabsorption
What percentage of blood volume is plasma?
20%
40%
60%
80%
True or False: Interstitial Colloid Osmotic Pressure tends to hold fluid inside a vessel
True
False
An isotonic fluid has an osmolality of:
28O mOsm/L
320 mOsm/L
360 mOsm/L
400 mOsm/L
Jugular venous distension is a sign of:
Hypovolemic hypernatremia
Hypervolemic hypernatremia
A CRNA decides to hyperventilate a patient. A decrease of 10 mmHg in paCO2 will cause a(n):
decrease in potassium of 0.5 mEq/L
increase in potassium of 1.0 mEq/L
decrease in potassium of 1.0 mEq/L
increase in potassium of 0.5 mEq/L
What does an increase in aldosterone level cause? (Select 2.)
Increase in serum sodium
Increase in serum potassium
Decrease in serum sodium
Decrease in serum potassium
Calcitonin causes:
Calcium to rise as it is removed from bone storage
Membrane exchange with hydrogen atoms
Decreases calcium excretion in bone
Calcium suppresses osteoclast activity in bone
Hyypermagnesemia is defined as:
> 0.5 mEq/L
>1 mEq/L
>2 mEq/L
>2.5 mEq/L
Which receptor causes the establishment of aquaporin 2 channels?
V1
V2
V3
V4
All the following can occur with hyperkalemia EXCEPT:
Peaked T waves
Narrowed PR interval
Widened QRS
Loss of P wave
