Fluids And Electrolytes Past Paper PDF

FLUIDS AND ELECTROLYTES 1.0 1. **A patient is admitted with severe diarrhea and vomiting. Which of the following assessments would most likely indicate a fluid volume deficit?** - A. Increased blood pressure - B. Bounding pulse - C. Decreased skin turgor *(Correct Answer)* - D. Peripheral edem...

FLUIDS AND ELECTROLYTES 1.0 1. **A patient is admitted with severe diarrhea and vomiting. Which of the following assessments would most likely indicate a fluid volume deficit?** - A. Increased blood pressure - B. Bounding pulse - C. Decreased skin turgor *(Correct Answer)* - D. Peripheral edema 2. **When assessing a patient with fluid volume excess, which of the following findings is most concerning?** - A. Weight gain of 2 kg over 48 hours - B. Bilateral crackles in the lungs *(Correct Answer)* - C. Increased urinary output - D. Bounding peripheral pulses 3. **A patient with heart failure is at risk for excess fluid volume. Which nursing diagnosis would be most appropriate?** - A. Risk for Deficient Fluid Volume - B. Imbalanced Nutrition: Less than Body Requirements - C. Impaired Skin Integrity - D. Excess Fluid Volume *(Correct Answer)* 4. **A patient is experiencing hypokalemia. Which clinical manifestation is most likely to be observed?** - A. Muscle cramps and weakness *(Correct Answer)* - B. Increased deep tendon reflexes - C. Hyperactive bowel sounds - D. Hypertension 5. **During the initial assessment, a patient reports fatigue, muscle weakness, and nausea. Which electrolyte imbalance is most consistent with these symptoms?** - A. Hypernatremia - B. Hypocalcemia - C. Hyperkalemia - D. Hypokalemia *(Correct Answer)* 6. **A patient presents with confusion, irritability, and dry mucous membranes. Which of the following electrolyte imbalances is most likely?** - A. Hyponatremia - B. Hypercalcemia - C. Hypomagnesemia - D. Hypernatremia *(Correct Answer)* 7. **Which of the following nursing interventions is the most appropriate for a patient with a nursing diagnosis of Risk for Impaired Skin Integrity due to fluid volume excess?** - A. Restricting fluid intake *(Correct Answer)* - B. Applying moisturizing lotion - C. Administering a diuretic as prescribed - D. Turning the patient every 2 hours 8. **Which patient is at the highest risk for fluid volume deficit?** - A. A patient with congestive heart failure - B. A patient with end-stage renal disease - C. A patient with severe burns *(Correct Answer)* - D. A patient with liver cirrhosis 9. **A patient with severe burns is at risk for third-space fluid loss. What is the most appropriate initial intervention?** - A. Encourage oral fluid intake - B. Administer intravenous fluids *(Correct Answer)* - C. Apply ice packs to burn areas - D. Insert a urinary catheter 10. **A patient with a potassium level of 2.8 mEq/L is at risk for which of the following complications?** - A. Metabolic acidosis - B. Cardiac arrhythmias *(Correct Answer)* - C. Seizures - D. Hypertension 11. **Which nursing intervention should be prioritized for a patient with a sodium level of 120 mEq/L?** - A. Administering hypertonic saline *(Correct Answer)* - B. Restricting fluid intake - C. Administering loop diuretics - D. Encouraging oral sodium intake 12. **A patient with fluid volume deficit is likely to exhibit which of the following clinical signs?** - A. Hypertension - B. Bradycardia - C. Oliguria *(Correct Answer)* - D. Jugular vein distention 13. **Which of the following lab results would you expect in a patient with a fluid volume deficit?** - A. Decreased hematocrit - B. Decreased blood urea nitrogen (BUN) - C. Increased serum sodium *(Correct Answer)* - D. Decreased serum osmolality 14. **A patient is diagnosed with metabolic acidosis. Which electrolyte imbalance is most likely to be associated with this condition?** - A. Hyperkalemia *(Correct Answer)* - B. Hypokalemia - C. Hypercalcemia - D. Hyponatremia 15. **A patient with ascites is at risk for which of the following nursing diagnoses?** - A. Deficient Fluid Volume - B. Risk for Decreased Cardiac Output *(Correct Answer)* - C. Impaired Oral Mucous Membrane - D. Risk for Activity Intolerance FLUIDS AND ELECTROLYTES 2.0 1. **A patient with hypokalemia is prescribed IV potassium chloride (KCl). Which of the following actions is the nurse's priority when administering this medication?** - A. Administering the KCl as a rapid IV bolus - B. Diluting the KCl in a large volume of fluid before administration *(Correct Answer)* - C. Administering KCl via intramuscular injection - D. Monitoring the patient’s respiratory rate every hour **Rationale:** KCl must always be diluted in a large volume of fluid to prevent irritation of the veins and avoid potential fatal cardiac arrhythmias. 2. **Which of the following statements indicates that a patient understands the dietary modifications needed for managing hyperkalemia?** - A. "I will eat more bananas and oranges." - B. "I should avoid foods like spinach, tomatoes, and potatoes." *(Correct Answer)* - C. "I need to increase my intake of dairy products." - D. "I can continue to use salt substitutes freely." **Rationale:** Patients with hyperkalemia should avoid high-potassium foods like spinach, tomatoes, and potatoes to prevent further elevation of potassium levels. 3. **A patient is receiving calcium chloride (CaCl) intravenously for hypocalcemia. Which of the following symptoms would indicate a positive response to the treatment?** - A. Muscle cramps and twitching - B. Positive Chvostek’s sign - C. Decreased numbness and tingling in extremities *(Correct Answer)* - D. Development of Trousseau’s sign **Rationale:** Decreased numbness and tingling are signs of improvement in hypocalcemia as calcium levels normalize. 4. **Which of the following is the most appropriate dietary advice for a patient with hyponatremia?**  - A. "Increase your intake of water-rich fruits like watermelon." - B. "Limit your intake of salty foods." - C. "Include more processed foods in your diet." *(Correct Answer)* - D. "Avoid canned soups and snacks." **Rationale:** Processed foods are high in sodium, which can help raise sodium levels in a patient with hyponatremia. 5. **A patient with renal failure is at risk for hyperkalemia. Which food should the nurse instruct the patient to avoid?** - A. Apples - B. Bananas *(Correct Answer)* - C. Rice - D. Cucumber **Rationale:** Bananas are high in potassium and should be avoided by patients with hyperkalemia to prevent further complications. 6. **When educating a patient on the side effects of magnesium sulfate (MgSO4), which of the following should be included?** - A. Increased blood pressure - B. Hyperactive deep tendon reflexes - C. Respiratory depression *(Correct Answer)* - D. Diarrhea **Rationale:** Magnesium sulfate can cause respiratory depression, especially in high doses, and this should be closely monitored. 7. **Which of the following intravenous solutions is most appropriate for a patient with severe hyponatremia?** - A. 0.9% Normal Saline - B. Dextrose 5% in Water (D5W) - C. 3% Hypertonic Saline *(Correct Answer)* - D. Lactated Ringer's **Rationale:** 3% hypertonic saline is used in severe cases of hyponatremia to quickly raise sodium levels. 8. **A patient with hypocalcemia is prescribed oral calcium supplements. What should the nurse advise the patient regarding the timing of this medication?** - A. Take with meals to enhance absorption - B. Take on an empty stomach - C. Take with a full glass of water *(Correct Answer)* - D. Take at bedtime **Rationale:** Oral calcium supplements are best taken with a full glass of water to aid absorption and prevent gastrointestinal discomfort. 9. **For a patient on dextran therapy for plasma volume expansion, which of the following is the most important to monitor?** - A. Blood glucose levels - B. Coagulation profile *(Correct Answer)* - C. Urinary output - D. Serum calcium levels **Rationale:** Dextran can affect blood clotting, so monitoring the coagulation profile is essential to prevent bleeding complications. 10. **Which food should be included in the diet of a patient with hypokalemia to help increase potassium levels?** - A. Apples - B. Carrots - C. Avocado *(Correct Answer)* - D. Chicken **Rationale:** Avocados are high in potassium and are beneficial for patients with hypokalemia. 11. **A patient receiving bicarbonate therapy for metabolic acidosis should be closely monitored for which of the following electrolyte imbalances?** - A. Hypocalcemia - B. Hypernatremia  - C. Hypokalemia *(Correct Answer)* - D. Hypermagnesemia **Rationale:** Bicarbonate therapy can lead to hypokalemia as potassium shifts into cells when the acidosis is corrected. 12. **Which of the following client education points is crucial for a patient taking oral potassium supplements?** - A. "Crush the tablets for easier swallowing." - B. "Take the supplement on an empty stomach." - C. "Report any tingling or numbness to your healthcare provider immediately." *(Correct Answer)* - D. "Avoid drinking water immediately after taking the supplement." **Rationale:** Tingling or numbness may indicate hyperkalemia, a serious condition that needs prompt medical attention. 13. **A patient on colloid therapy with albumin should be monitored for which potential complication?** - A. Hyperglycemia - B. Fluid volume overload *(Correct Answer)* - C. Hypokalemia - D. Metabolic acidosis **Rationale:** Colloid therapy with albumin can cause fluid volume overload, especially in patients with compromised cardiac function. 14. **A nurse is teaching a patient about the risks associated with excessive sodium intake. Which condition is the patient most at risk for developing?** - A. Hypotension - B. Hypocalcemia - C. Hypernatremia *(Correct Answer)* - D. Hyperkalemia **Rationale:** Excessive sodium intake can lead to hypernatremia, which can have severe neurological effects. 15. **Which of the following foods should a patient with hypercalcemia avoid?** - A. Leafy green vegetables - B. Fortified cereals - C. Dairy products *(Correct Answer)* - D. Citrus fruits **Rationale:** Dairy products are high in calcium and should be avoided by patients with hypercalcemia to prevent further increases in calcium levels. FLUIDS AND ELECTROLYTES 3.0 1. **When evaluating a patient’s response to IV therapy for dehydration, which of the following findings would indicate effective treatment?** - A. Persistent hypotension - B. Clear lung sounds *(Correct Answer)* - C. Decreased urine output - D. Dry mucous membranes **Rationale:** Clear lung sounds indicate that fluid overload has not occurred and the dehydration is being appropriately corrected. 2. **Which of the following should be documented when discontinuing a peripheral IV line?** - A. The patient’s pain level at the IV site - B. The length of time the IV was in place - C. The appearance of the IV site and condition of the catheter *(Correct Answer)* - D. The brand of the IV catheter used **Rationale:** Documentation should include the appearance of the IV site and the condition of the catheter to ensure that no complications, such as phlebitis or catheter breakage, occurred. 3. **In the evaluation of a patient receiving Total Parenteral Nutrition (TPN), which lab value should the nurse prioritize monitoring?**  - A. Serum calcium - B. Blood glucose *(Correct Answer)* - C. Hemoglobin - D. Serum sodium **Rationale:** Blood glucose levels are crucial to monitor in patients receiving TPN because the high glucose content can lead to hyperglycemia. 4. **A patient with acute gastroenteritis is being evaluated for hydration status. Which finding would most likely indicate a need for further intervention?** - A. Decreased skin turgor *(Correct Answer)* - B. Urine output of 50 mL/hour - C. Heart rate of 80 bpm - D. Moist mucous membranes **Rationale:** Decreased skin turgor is a sign of dehydration, indicating that the patient may need additional fluid replacement. 5. **When administering a blood transfusion, what should be documented in the patient’s chart immediately after starting the transfusion?** - A. The blood type of the patient - B. The start time of the transfusion *(Correct Answer)* - C. The patient’s weight - D. The patient’s next scheduled lab test **Rationale:** Documenting the start time of the transfusion is critical for monitoring the duration of the transfusion and identifying any delayed reactions. 6. **A patient receiving IV therapy develops phlebitis at the insertion site. Which of the following is the most appropriate immediate action?** - A. Increase the infusion rate - B. Apply a cold compress to the site - C. Discontinue the IV and restart it in another site *(Correct Answer)* - D. Elevate the extremity **Rationale:** Discontinuing the IV and restarting it in another site is the best action to prevent further irritation and potential complications. 7. **Which evaluation finding would suggest that a patient with acute gastroenteritis has achieved adequate hydration?** - A. Dry oral mucosa - B. Urine specific gravity of 1.025 *(Correct Answer)* - C. Tachycardia - D. Increased thirst **Rationale:** A urine specific gravity of 1.025 is within the normal range and suggests that the patient is adequately hydrated. 8. **A nurse is evaluating a patient's response to a blood transfusion. Which of the following symptoms would most likely indicate a transfusion reaction?** - A. Sudden chills and fever *(Correct Answer)* - B. Bradycardia - C. Hypertension - D. Mild headache **Rationale:** Sudden chills and fever are common signs of a transfusion reaction and require immediate intervention. 9. **Which of the following should be included in the documentation after a patient receives Total Parenteral Nutrition (TPN)?** - A. The patient’s daily weight *(Correct Answer)* - B. The type of IV catheter used - C. The patient’s next meal time - D. The brand of TPN solution **Rationale:** Documenting the patient’s daily weight is important to monitor for fluid overload or malnutrition. 10. **In the evaluation phase of nursing care for a patient with acute gastroenteritis, which outcome would indicate a successful intervention?** - A. Persistent diarrhea - B. Elevated heart rate - C. Normal bowel sounds *(Correct Answer)* - D. Decreased urine output **Rationale:** Normal bowel sounds suggest that the gastrointestinal system is returning to normal function after an episode of gastroenteritis. 11. **What is the most critical nursing intervention during the first 15 minutes of a blood transfusion?** - A. Measuring the patient’s urine output - B. Monitoring the patient’s vital signs *(Correct Answer)* - C. Administering prescribed antihistamines - D. Preparing the next unit of blood **Rationale:** The first 15 minutes are crucial for detecting any immediate transfusion reactions, so close monitoring of vital signs is essential. 12. **A patient receiving IV fluids is at risk for fluid volume overload. Which assessment finding would be most concerning?** - A. Peripheral edema *(Correct Answer)* - B. Increased urine output - C. Decreased blood pressure - D. Clear lung sounds **Rationale:** Peripheral edema is a sign of fluid volume overload and may indicate that the IV fluid rate needs to be adjusted. 13. **During evaluation of a patient receiving TPN, the nurse notes hyperglycemia. What should be the nurse’s next action?** - A. Stop the TPN infusion immediately - B. Administer insulin as prescribed *(Correct Answer)* - C. Increase the TPN infusion rate - D. Notify the healthcare provider to discontinue TPN **Rationale:** Administering insulin as prescribed can help manage hyperglycemia while continuing the essential nutrition provided by TPN. 14. **A patient with acute gastroenteritis is being prepared for discharge. Which statement by the patient indicates the need for further teaching?** - A. "I should drink plenty of fluids to stay hydrated." - B. "I will avoid dairy products until I feel better." - C. "I can return to my normal diet immediately." *(Correct Answer)* - D. "I should rest and gradually resume my normal activities." **Rationale:** The patient should avoid returning to a normal diet immediately and should instead gradually reintroduce foods to avoid exacerbating symptoms. 15. **When documenting care for a patient receiving IV therapy, which of the following is most important to include?** - A. The time and date the IV site was assessed *(Correct Answer)* - B. The patient’s activity level - C. The patient’s daily caloric intake - D. The next scheduled dose of IV medication **Rationale:** Documenting the time and date of IV site assessments is critical for monitoring potential complications like infection or infiltration.