WorksheetsFluids & Electrolytes — NCLEX Practice (30 Questions)
Total questions: 60
Worksheet time: 30mins
A nurse is assessing a client with fluid volume deficit (FVD). Which finding requires immediate action?
Dry mucous membranes
Weak, thready pulse of 120 bpm
Poor skin turgor
Fatigue and thirst
Which is the most reliable indicator of a patient’s overall fluid balance?
Blood pressure
Heart rate
Daily weights
Intake and output
Which action should the nurse avoid when caring for a client with fluid volume overload (FVE)?
Restrict fluids as ordered
Encourage ambulation
Monitor lung sounds every 2 hours
Encourage high-sodium snacks
A patient with CHF has 2+ pitting edema, crackles in both lung bases, and an O2 sat of 91%. What should the nurse do first?
Apply oxygen at 2 L/min
Administer prescribed diuretic
Elevate the head of the bed
Obtain a stat chest X-ray
Which finding indicates effective treatment for a client with FVE?
Decreased urine output
Weight loss and clear breath sounds
Distended neck veins
Bounding pulse
Which statement by a client with hyponatremia indicates a need for further teaching?
I will avoid drinking too much water.
I can eat canned soup to help with sodium levels.
I will report confusion or seizures right away.
I understand my IV fluid will help raise sodium levels.
A client with serum sodium of 128 mEq/L is confused and drowsy. Which is the priority nursing intervention?
Restrict sodium intake
Administer 3% normal saline as ordered
Encourage oral fluids
Provide hypotonic IV fluids
Which lab result requires the nurse to hold a potassium supplement?
3.2 mEq/L
4.0 mEq/L
5.6 mEq/L
3.8 mEq/L
A client on furosemide reports leg cramps and weakness. Which assessment should the nurse perform first?
Check serum potassium level
Assess lung sounds
Check daily weight
Assess sodium level
Which food should the nurse avoid recommending to a client with hyperkalemia?
Spinach
Carrots
Apples
White rice
Which statement indicates understanding of potassium-sparing diuretics (spironolactone)?
I will eat plenty of bananas.
I’ll avoid salt substitutes containing potassium.
I should drink extra fluids daily.
I can take this with over-the-counter potassium pills.
The nurse notes a client with potassium of 2.8 mEq/L. Which action takes highest priority?
Administer IV potassium slowly as prescribed
Restrict potassium-rich foods
Notify the provider only if muscle weakness occurs
Discontinue cardiac monitoring
Which finding suggests hypercalcemia?
Chvostek’s sign
Muscle weakness and constipation
Tetany and tremors
Tingling around the mouth
Which nursing intervention should the nurse avoid when managing a client with hypercalcemia?
Encourage ambulation
Encourage fluids
Administer phosphorus supplements
Restrict movement and bed rest
A client with a history of parathyroid surgery develops numbness around the mouth and carpal spasms. Which electrolyte imbalance is suspected?
Hypercalcemia
Hypocalcemia
Hypernatremia
Hypokalemia
Which assessment finding supports hypomagnesemia?
Weak, flaccid muscles
Shallow respirations
Hyperactive reflexes and tremors
Vasodilation and flushing
The nurse notes a magnesium level of 6.0 mg/dL and shallow respirations. Which is the priority intervention?
Administer calcium gluconate
Encourage magnesium-rich foods
Prepare for dialysis
Encourage deep breathing
Which statement should the nurse correct regarding hypomagnesemia teaching?
I should eat spinach and nuts.
I will avoid alcohol.
I will take magnesium supplements as prescribed.
I can take antacids daily to help increase my magnesium.
A client with chronic kidney disease has phosphate of 5.2 mg/dL. Which intervention is appropriate?
Increase dairy products
Avoid phosphate-containing laxatives
Increase antacid use
Eat more beef and chicken
A client with hypophosphatemia has muscle weakness and confusion. Which action is the priority?
Notify provider and administer phosphate supplements
Encourage ambulation
Restrict calcium-rich foods
Monitor urine output
Which IV solution should the nurse avoid giving to a client with cerebral edema?
3% sodium chloride
0.9% sodium chloride
0.45% sodium chloride
D5W
Which IV solution is isotonic?
0.9% NaCl
D5 ½ NS
3% NaCl
0.45% NaCl
A client receiving IV therapy develops redness, warmth, and a palpable cord along the vein. What should the nurse do first?
Stop the infusion
Apply warm compress
Flush with 10 mL normal saline
Continue the IV at a slower rate
Which nursing action should the nurse avoid when extravasation is suspected?
Stop the infusion immediately
Leave the IV catheter in place
Apply heat to the affected area
Notify the provider
Which client is at highest risk for fluid volume overload?
25-year-old marathon runner
45-year-old on IV isotonic fluids post-surgery
60-year-old with CHF receiving IV fluids rapidly
30-year-old NPO for surgery
A client with dehydration has BP 86/50 mm Hg and HR 122 bpm. Which IV fluid should the nurse anticipate?
0.9% NaCl
D5W
3% NaCl
0.45% NaCl
Which symptom would the nurse expect in a patient with hypernatremia?
Hypertension and bounding pulse
Dry mouth and poor skin turgor
Muscle spasms and tremors
Edema and confusion
Which finding should the nurse not ignore in a client with hyponatremia?
Confusion
Full bounding pulse
Seizure activity
Fatigue
A client with potassium 6.2 mEq/L has peaked T-waves on ECG. What should the nurse do first?
Prepare to administer calcium gluconate
Encourage potassium-rich foods
Monitor urine output
Hold loop diuretics
Which nursing assessment is most appropriate before starting any IV infusion?
Check blood pressure
Verify vein patency and assess for infiltration
Ask about pain level
Review the medication order
A patient presents with a weak, thready pulse and tachycardia. What is the priority for hypovolemia?
Administer high sodium foods
Assess for poor perfusion
Monitor for hypervolemia
Encourage fluid intake
Which of the following best reflects true fluid balance in a patient?
Intake and output
Blood pressure
Daily weights
Heart rate
Which type of foods should be avoided to prevent worsening fluid overload?
Low sodium foods
High potassium foods
High protein foods
High sodium foods
What intervention improves oxygenation before giving medications?
Increasing IV fluids
Administering oxygen
Positioning the patient
Giving diuretics
Which of the following indicates effective diuresis?
Weight gain and clear lungs
Weight loss and clear lungs
Weight loss and crackles
Weight gain and crackles
Which of the following is incorrect teaching regarding sodium content in foods?
Fresh fruits are high in sodium
Canned foods are high in sodium
Fresh vegetables are high in sodium
Canned foods are low in sodium
What is the effect of 3% saline on serum sodium and cerebral swelling?
Decreases serum sodium and increases swelling
Increases serum sodium and reduces swelling
Decreases serum sodium and reduces swelling
Increases serum sodium and increases swelling
Why should K+ >5.0 supplements be held?
To prevent dehydration
To prevent cardiac arrhythmias
To prevent hypokalemia
To prevent hypernatremia
What does hypokalemia cause?
Cramps and weakness
Hypertension
Bradycardia
Hyperreflexia
Which food should be avoided in hyperkalemia?
Spinach
Apples
Rice
Chicken
Why should salt substitutes be avoided in hyperkalemia?
They contain sodium
They contain potassium
They contain calcium
They contain magnesium
Why should potassium be replaced carefully?
To prevent arrhythmias
To prevent dehydration
To prevent hypertension
To prevent hypocalcemia
What do depressed reflexes and constipation indicate?
Hypokalemia
Hypercalcemia
Hypocalcemia
Hypernatremia
What is a risk of immobility related to calcium?
Hypocalcemia
Hypercalcemia
Hypokalemia
Hyperkalemia
What do Chvostek’s and Trousseau’s signs indicate?
Hyperkalemia
Hypocalcemia
Hypercalcemia
Hypokalemia
What does low magnesium cause?
Decreased reflexes
Hyperexcitability and increased reflexes
Bradycardia
Hypotension
What reverses magnesium toxicity?
Potassium chloride
Calcium gluconate
Sodium bicarbonate
Magnesium sulfate
Why should antacids be avoided in excess?
They can raise potassium
They can raise sodium
They can raise magnesium
They can raise calcium
What should be avoided in hyperphosphatemia?
Phosphate-containing products
Calcium-containing products
Sodium-containing products
Potassium-containing products
Why is phosphate replaced?
To restore muscle/neurologic function
To increase blood pressure
To decrease edema
To prevent arrhythmias
What is the effect of D5W on cerebral edema?
Becomes hypertonic and reduces edema
Becomes hypotonic and worsens edema
Becomes isotonic and has no effect
Becomes hypotonic and reduces edema
Which solution is isotonic?
0.45% NaCl
0.9% NaCl
D5W
3% NaCl
What should be done immediately to prevent further injury in extravasation?
Stop infusion
Apply heat
Elevate limb
Flush IV
What effect does heat have on tissue damage in extravasation?
Reduces damage
Worsens damage
No effect
Heals tissue
What is the risk of CHF with IV fluids?
Low overload risk
High overload risk
No risk
Dehydration
What is the effect of isotonic fluids in hypovolemia?
Decrease intravascular volume
Restore intravascular volume
Increase potassium
Decrease sodium
What does fluid deficit cause?
Edema
Dry mucosa and poor turgor
Hypertension
Tachycardia
What is a medical emergency related to severe hyponatremia?
Arrhythmias
Seizures
Hypotension
Hyperreflexia
How does calcium gluconate protect the myocardium?
From sodium effects
From potassium effects
From magnesium effects
From phosphate effects
What must be ensured before IV infusion?
IV site is patent and free of infiltration
IV site is warm
IV site is red
IV site is swollen
