Electrolyte Practice Questions PDF

**Question 31: Hyperkalemia Emergency Treatment** A patient with severe hyperkalemia (7.2 mEq/L) is experiencing ventricular fibrillation. What is the priority intervention? A. Administer IV calcium gluconate.\ B. Administer IV insulin and glucose.\ C. Begin continuous renal replacement therapy (C...

**Question 31: Hyperkalemia Emergency Treatment** A patient with severe hyperkalemia (7.2 mEq/L) is experiencing ventricular fibrillation. What is the priority intervention? A. Administer IV calcium gluconate.\ B. Administer IV insulin and glucose.\ C. Begin continuous renal replacement therapy (CRRT).\ D. Administer sodium polystyrene sulfonate (Kayexalate). **Answer:** A. Administer IV calcium gluconate.\ **Rationale:** IV calcium gluconate stabilizes cardiac membranes and is the priority in life-threatening cardiac dysrhythmias due to hyperkalemia. **Question 32: Magnesium's Role in Hypokalemia** A patient has hypokalemia that is not responding to potassium supplementation. What additional lab value should the nurse assess? A. Serum sodium.\ B. Serum calcium.\ C. Serum phosphate.\ D. Serum magnesium. **Answer:** D. Serum magnesium.\ **Rationale:** Magnesium deficiency can impair potassium absorption and retention, making potassium supplementation less effective. **Question 33: Fluid Restriction in Hyponatremia** For a patient with hyponatremia caused by water intoxication, what is the best nursing intervention? A. Administer 0.9% sodium chloride IV.\ B. Restrict fluid intake.\ C. Administer diuretics.\ D. Provide oral sodium supplements. **Answer:** B. Restrict fluid intake.\ **Rationale:** Fluid restriction is the primary intervention for hyponatremia caused by water excess to prevent further dilution of sodium levels. **Question 34: Hypercalcemia Complications** A patient with prolonged hypercalcemia is at risk for which complication? A. Tetany.\ B. Increased cardiac output.\ C. Renal calculi.\ D. Hyperactive reflexes. **Answer:** C. Renal calculi.\ **Rationale:** Hypercalcemia increases calcium filtration in the kidneys, leading to stone formation. **Question 35: IV Phosphate Administration Precaution** What is the most important consideration when administering IV phosphate to treat severe hypophosphatemia? A. Monitor for hypercalcemia.\ B. Monitor for symptomatic hypocalcemia.\ C. Infuse rapidly to correct levels quickly.\ D. Avoid simultaneous magnesium supplementation. **Answer:** B. Monitor for symptomatic hypocalcemia.\ **Rationale:** Rapid phosphate administration can bind calcium and cause symptomatic hypocalcemia. **Question 36: Trousseau's Sign** How should the nurse assess for Trousseau's sign in a patient with suspected hypocalcemia? A. Tap the facial nerve and observe for facial twitching.\ B. Inflate a blood pressure cuff above systolic pressure and observe for carpal spasm.\ C. Check deep tendon reflexes for hyperactivity.\ D. Observe for a positive Babinski reflex. **Answer:** B. Inflate a blood pressure cuff above systolic pressure and observe for carpal spasm.\ **Rationale:** Trousseau's sign is a carpal spasm elicited by inflating a blood pressure cuff and is indicative of hypocalcemia. **Question 37: Hypernatremia Symptoms** Which symptom would the nurse expect in a patient with hypernatremia? A. Confusion and agitation.\ B. Tetany and muscle cramps.\ C. Positive Chvostek's sign.\ D. Peripheral edema and bradycardia. **Answer:** A. Confusion and agitation.\ **Rationale:** Hypernatremia leads to cellular dehydration, particularly in the brain, causing neurologic symptoms like confusion and agitation. **Question 38: Hypermagnesemia Prevention** Which teaching is most appropriate for a patient with chronic kidney disease to prevent hypermagnesemia? A. \"Increase your intake of green leafy vegetables.\"\ B. \"Take over-the-counter antacids as needed for heartburn.\"\ C. \"Avoid magnesium-containing medications such as milk of magnesia.\"\ D. \"Drink at least 3 liters of water daily.\" **Answer:** C. \"Avoid magnesium-containing medications such as milk of magnesia.\"\ **Rationale:** Patients with impaired renal function are at risk for magnesium toxicity from magnesium-containing medications. **Question 39: Hypophosphatemia Symptoms** What symptoms should the nurse monitor for in a patient with severe hypophosphatemia? *(Select all that apply.)* A. CNS depression.\ B. Muscle weakness.\ C. Hyperreflexia.\ D. Confusion.\ E. Dysrhythmias. **Answer:** A, B, D, E.\ **Rationale:** Severe hypophosphatemia affects cellular energy and oxygen delivery, leading to CNS depression, muscle weakness, confusion, and dysrhythmias. **Question 40: Potassium Administration** When administering IV potassium chloride to a patient with severe hypokalemia, which nursing action is a priority? A. Dilute potassium to a maximum concentration of 80 mEq/L.\ B. Administer potassium at a rate of 30 mEq/hour.\ C. Monitor the patient's ECG continuously during infusion.\ D. Administer potassium via IV push for rapid correction. **Answer:** C. Monitor the patient's ECG continuously during infusion.\ **Rationale:** Continuous ECG monitoring is critical to detect dysrhythmias during potassium replacement therapy.