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Fluids and electrolyte balance

Total questions: 31

Worksheet time: 30mins

Name
Class
Date
1.

A 72-year-old client on NG suctioning has sodium of 126 mEq/L. They are restless and complaining of a headache. What’s your priority action?

a)

Administer 3% NaCl IV as ordered

b)

Place the client in Trendelenburg

c)

Encourage free water intake

d)

Restrict fluids and monitor neuro status

2.

A post-op client is on furosemide. They complain of muscle weakness and an irregular heartbeat. Labs: K⁺ 2.8 mEq/L. What intervention should the nurse anticipate?

a)

Administer IV potassium bolus over 5 minutes

b)

Give oral potassium supplement and monitor ECG

c)

Restrict dietary potassium

d)

Stop fluids immediately

3.

A client with hypoparathyroidism develops tingling around the mouth and a positive Trousseau’s sign. What is the most urgent nursing action?

a)

Administer IV calcium gluconate

b)

Encourage weight-bearing exercise

c)

Increase fluid intake

d)

Place client on fluid restriction

4.

What is the primary risk of administering fluids too rapidly?

a)

Dehydration

b)

Hypothermia

c)

Fluid overload

d)

Electrolyte imbalance

5.

A client presents with sodium 155 mEq/L, dry mucous membranes, and confusion. Which fluid would you expect to administer?

a)

0.9% NS

b)

D5W or 0.45% NS

c)

3% NS

d)

Lactated Ringer’s bolus

6.

A client with CKD has potassium 6.8 mEq/L and peaked T waves on ECG. What is the priority treatment?

a)

Give IV calcium gluconate

b)

Encourage potassium-rich foods

c)

Administer hypotonic fluids

d)

Stop dialysis

7.

While planning care for elderly individuals, the nurse remembers the elderly are at a higher risk for developing dehydration because they have a(n):

a)

Higher total body water volume

b)

Decreased muscle mass

c)

Increase in thirst

d)

Increased tendency towards developing edema

8.

Electrolytes are the same as ____ in the body.

a)

electrical movement

b)

salts

c)

carbohydrates

d)

sweat

9.

Loop diuretics like furosemide increase excretion of _____ and _____, which can lead to muscle weakness and arrhythmias.

(a)  

10.

A U wave on the ECG is a classic sign of (a)   .

11.

Which of the following findings in Mr. Lopez are consistent with hypokalemia? (Select all that apply.)

A. Muscle weakness
B. U waves on ECG
C. Hyperactive bowel sounds
D. Irregular heartbeat/PVCs
E. Fruity breath odor

a)

Muscle weakness

b)

U waves on ECG

c)

Hyperactive bowel sounds

d)

Irregular heartbeat/PVCs

e)

Fruity breath odor

12.

Which finding indicates fluid volume overload?

a)

Orthostatic hypotension

b)

Flat neck veins

c)

Crackles in lungs

d)

Dry mucous membranes

13.

Which interventions are appropriate for a client with SIADH?

a)

Administer hypertonic saline as prescribed

b)

Fluid restriction

c)

Daily weights

d)

Encourage high sodium diet

e)

Place client on seizure precautions

14.

The hormone that conserves water by increasing renal reabsorption is (a)   .

15.

A client with fluid volume excess gained 2.5 kg in the last 24 hours. Estimate the fluid retention in milliliters.

(a)  

16.

A client on furosemide complains of leg cramps. ECG shows U waves. K⁺ is 2.9 mEq/L.

Which nursing action is appropriate?

a)

Administer rapid IV potassium bolus

b)

Encourage foods like bananas and potatoes

c)

Restrict oral potassium intake

d)

Discontinue cardiac monitoring

17.

Which findings are consistent with fluid volume deficit? (Select all that apply.)

a)

Orthostatic hypotension

b)

Bounding pulse

c)

Flat neck veins

d)

Dry mucous membranes

e)

Crackles in lungs

18.

A client with chronic alcoholism has Mg²⁺ 1.0 mg/dL, tremors, and hyperactive reflexes.
Which finding is most concerning?

a)

Vomiting

b)

Seizures

c)

Hypertension

d)

Constipation

19.

What is the main concern when administering fluids to a patient with heart disease?

a)

Dehydration

b)

Fluid overload

c)

Electrolyte deficiency

d)

Hypothermia

20.

What is the potential complication of using hypotonic fluids in fluid therapy?

a)

Cellular dehydration

b)

Cellular overhydration

c)

Increased blood pressure

d)

Decreased blood pressure

21.

What is the role of bicarbonate in fluid therapy?

a)

To provide energy

b)

To maintain acid-base balance

c)

To increase blood pressure

d)

To decrease blood pressure

22.

ADH is created in the:

a)

Hypothalamus

b)

Posterior Pituitary Gland

c)

Brain

d)

Kidney

23.

What is the main function of the Loop of Henle?

a)

Filtration of blood

b)

Reabsorption of water and ions

c)

Secretion of waste

d)

Production of urine

24.

What is the role of aldosterone in the kidneys?

a)

Increases glucose reabsorption

b)

Decreases sodium reabsorption

c)

Increases sodium reabsorption

d)

Decreases potassium secretion

25.

Px 2 has what condition?

a)

Uncompensated respiratory acidosis

b)

Compensated respiratory acidosis

c)

Uncompensated metabolic acidosis

d)

Compensated metabolic acidosis

26.

A 52-year-old client is admitted with a serum calcium of 7.0 mg/dL. Which assessment findings should the nurse expect? (Select all that apply.)

a)

Positive Chvostek’s sign

b)

Positive Trousseau’s sign

c)

Numbness and tingling around the mouth

d)

Hyperactive deep tendon reflexes

e)

Constipation

27.

Where will the water move?

a)

Into the cell

b)

Out of the cell

c)

Equally in & out - it's isotonic

d)

There is no water

28.

A nurse cares for a patient with diabetes insipidus. Which finding should the nurse expect?

a)

Large amounts of dilute urine

b)

Very concentrated urine

c)

Low urine output

d)

High blood sugar

29.

Question:
A nurse is caring for a client with severe diarrhea for 3 days. The client’s labs show sodium 130 mEq/L, potassium 3.0 mEq/L, and chloride 94 mEq/L. Which IV fluid prescription would the nurse expect to help correct these losses?

a)

0.9% normal saline with potassium chloride added

b)

D5W (5% dextrose in water)

c)

0.45% normal saline (half-normal saline)

d)

Lactated Ringer’s without potassium

30.

Question:
While assessing a client, the nurse taps over the facial nerve just in front of the ear and observes twitching of the facial muscles. This finding indicates which electrolyte imbalance?

a)

Hyperkalemia

b)

Hypocalcemia

c)

Hypernatremia

d)

Hypercalcemia

31.

A client with chronic alcoholism is admitted with tremors and confusion. The ECG shows torsades de pointes. Which electrolyte imbalance does the nurse suspect?

a)

Hyperkalemia

b)

Hypomagnesemia

c)

Hypercalcemia

d)

Hyponatremia