Fluids And Electrolytes Nclex Practice Questions

70 Questions  I  By Tgerdel on November 12, 2009
Practice questions for fluids and electrolytes

  

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1.  A client with hypoparathyroidism complains of numbness and tingling in his fingers and around the mouth. The nurse would assess for what electrolyte imbalance?
A.
B.
C.
D.
2.  The nurse evaluates which of the following clients to be at risk for developing hypernatremia?
A.
B.
C.
D.
3.  A client is admitted with diabetic ketoacidosis who, with treatment, has a normal blood glucose, pH, and serum osmolality. During assessment, the client complains of weakness in the legs. Which of the following is a priority nursing intervention?
A.
B.
C.
D.
4.  A client with a potassium level of 5.5 mEq/L is to receive sodium polystyrene sulfonate (Kayexalate) orally. After administering the drug, the priority nursing action is to monitor
A.
B.
C.
D.
5.  The nurse is caring for a client who has been in good health up to the present and is admitted with cellulitis of the hand. The client's serum potassium level was 4.5 mEq/L yesterday. Today the level is 7 mEq/L. Which of the following is the next appropriate nursing action?
A.
B.
C.
D.
6.  A client is receiving an intravenous magnesium infusion to correct a serum level of 1.4 mEq/L. Which of the following assessments would alert the nurse to immediately stop the infusion?
A.
B.
C.
D.
7.  A client with chronic renal failure reports a 10 pound weight loss over 3 months and has had difficulty taking calcium supplements. The total calcium is 6.9 mg/dl. Which of the following would be the first nursing action?
A.
B.
C.
D.
8.  A client with heart failure is complaining of nausea. The client has received IV furosemide (Lasix), and the urine output has been 2500 ml over the past 12 hours. The client's home drugs include metoprolol (Lopressor), digoxin (Lanoxin), furosemide, and multivitamins. Which of the following are the appropriate nursing actions before administering the digoxin? Select all that apply.
A.
B.
C.
D.
E.
9.  The nurse is caring for a bedridden client admitted with multiple myeloma and a serum calcium level of 13 mg/dl. Which of the following is the most appropriate nursing action?
A.
B.
C.
D.
10.  An older adult client admitted with heart failure and a sodium level of 113 mEq/L is behaving aggressively toward staff and does not recognize family members. When the family expresses concern about the client's behavior, the nurse would respond most appropriately by stating
A.
B.
C.
D.
11.  A client with a serum sodium of 115 mEq/L has been receiving 3% NS at 50 ml/hr for 16 hours. This morning the client feels tired and short of breath. Which of the following interventions is a priority?
A.
B.
C.
D.
12.  A client with chronic renal failure receiving dialysis complains of frequent constipation. When performing discharge teaching, which over-the-counter products should the nurse instruct the client to avoid at home?
A.
B.
C.
D.
13.  A client is receiving intravenous potassium supplementation in addition to maintenance fluids. The urine output has been 120 ml every 8 hours for the past 16 hours and the next dose is due. Before administering the next potassium dose, which of the following is the priority nursing action?
A.
B.
C.
D.
14.  The nurse should monitor for clinical manifestations of hypophosphatemia in which of the following clients?
A.
B.
C.
D.
15.  A client admitted with squamous cell carcinoma of the lung has a serum calcium level of 14 mg/dl. The nurse should instruct the client to avoid which of the following foods upon discharge? Select all that apply.
A.
B.
C.
D.
E.
16.  A client with pancreatitis has been receiving potassium supplementation for four days since being admitted with a serum potassium of 3.0 mEq/L. Today the potassium level is 3.1 mEq/L. Which of the following laboratory values should the nurse check before notifying the physician of the client's failure to respond to treatment?
A.
B.
C.
D.
17.  The nurse should include which of the following instructions to assist in controlling phosphorus levels for a client in renal failure?
A.
B.
C.
D.
18.  A client with pneumonia presents with the following arterial blood gases: pH of 7.28, PaCO2 of 74, HCO3 of 28 mEq/L, and PO2 of 45, which of the following is the most appropriate nursing intervention?
A.
B.
C.
D.
19.  A client with COPD feels short of breath after walking to the bathroom on 2 liters of oxygen nasal cannula. The morning's ABGs were pH of 7.36, PaCO2 of 62, HCO3 of 35 mEq/L, O2 at 88% on 2 liters. Which of the following should be the nurse's first intervention?
A.
B.
C.
D.
20.  A client who had a recent surgery has been vomiting and becomes dizzy while standing up to go to the bathroom. After assisting the client back to bed, the nurse notes that the blood pressure is 55/30 and the pulse is 140. The nurse hangs which of the following IV fluids to correct this condition?
A.
B.
C.
D.
21.  A client with renal failure enters the emergency room after skipping three dialysis treatments to visit family out of town. Which set of ABGs would indicate to the nurse that the client is in a state of metabolic acidosis?
A.
B.
C.
D.
22.  A client with a small bowel obstruction has had an NG tube connected to low intermittent suction for two days. The nurse should monitor for clinical manifestations of which acid-base disorder?
A.
B.
C.
D.
23.  A client who suffers from an anxiety disorder is very upset, has a respiratory rate of 32, and is complaining of lightheadedness and tingling in the fingers. ABG values are pH of 7.48, PaCO2 of 29, HCO3 of 24, and O2 is at 93% on room air. The nurse performs which of the following as a priority nursing intervention?
A.
B.
C.
D.
24.  Which of the following assessment findings would indicate to the nurse that a client's diabetic ketoacidosis is deteriorating?
A.
B.
C.
D.
25.  A client who is admitted with malnutrition and anorexia secondary to chemotherapy is also exhibiting generalized edema. The client asks the nurse for an explanation for the edema. Which of the following is the most appropriate response by the nurse?
A.
B.
C.
D.
26.  A client with a recent thyroidectomy complains of numbness and tingling around the mouth. Which of the following findings indicates the serum calcium is low?
A.
B.
C.
D.
27.  A client recently diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) complains of headache, weight gain, and nausea. Which of the following is an appropriate nursing diagnosis for this client?
A.
B.
C.
D.
28.  The registered nurse is delegating nursing tasks for the day. WHich of the following tasks may the nurse delegate to a licensed practical nurse?
A.
B.
C.
D.
29.  A client who is post-gallbladder surgery has a nasogastric tube, decreased reflexes, pulse of 110 weak and irregular, and blood pressure of 80/50 and is weak, mildly confused, and has a serum of potassium of 3.0 mEq/L. Based on the assessment data, which of the following is the priority intervention?
A.
B.
C.
D.
30.  The nurse is admitting a client with a potassium level of 6.0 mEq/L. The nurse reports this finding as a result of
A.
B.
C.
D.
31.  Which of the following should the nurse include in the diet teaching for a client with a sodium level of 158 mEq/L?
A.
B.
C.
D.
E.
32.  The nurse assesses a client to be experiencing muscle cramps, numbness, and tingling of the extremities, and twitching of the facial muscle and eyelid when the facial nerve is tapped. THe nurse reports this assessment as consistent with which of the following?
A.
B.
C.
D.
33.  Which of the following should the nurse include when preparing to teach a class on the regulation and functions of electrolytes?
A.
B.
C.
D.
34.  The nurse assists a client with a serum potassium of 3.2 mEq/L to make which of the following menu selections? Select all that apply.
A.
B.
C.
D.
E.
35.  The nurse evaluates which of the following clients to have hypermagnesemia?
A.
B.
C.
D.
36.  The nurse is evaluating the serum laboratory results on the following four clients. Which of the following laboratory results is a priority for the nurse to report first?
A.
B.
C.
D.
37.  The registered nurse is delegating client assignments to unlicensed assistive personnel. Which of the following clients does not require additional monitoring and assessment and may be delegated to unlicensed assistive personnel?
A.
B.
C.
D.
38.  The client is admitted to a nursing unit from a long-term care facility with a hematocrit of 56% and a serum sodium level of 152 mEq/L. Which condition would be a cause for these findings?
A.
B.
C.
D.
39.  The client who has undergone an exploratory laparotomy and subsequent removal of a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at 150 mL/hr via an IV pump. Which data should be reported to the health care provider?
A.
B.
C.
D.
40.  The client diagnosed with diabetes insipidus weighed 180 pounds when the daily weight was taken yesterday. This morning's weight is 175.6 pounds. One liter of fluid weighs approximately 2.2 pounds. How much fluid has the client lost (in milliliters)?
A.
B.
C.
D.
41.  The nurse writes the nursing problem of "fluid volume excess" (FVE). Which intervention should be included in the plan of care?
A.
B.
C.
D.
42.  The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention should be implemented?
A.
B.
C.
D.
43.  The telemetry monitor technician notifies the nurse of the morning telemetry readings. Which client should the nurse assess first?
A.
B.
C.
D.
44.  The client post-thyroidectomy complains of numbness and tingling around the mouth and the tips of the fingers. Which intervention should be implemented first?
A.
B.
C.
D.
45.  Which statement best explains the scientific rationale for Kussmaul's respirations in the client diagnosed with diabetic ketoacidosis (DKA)?
A.
B.
C.
D.
46.  The client is NPO and is receiving total parenteral nutrition (TPN) via a subclavian line. Which precautions should the nurse implement? Select all that apply.
A.
B.
C.
D.
E.
47.  The client has received IV solutions for three (3) days through a 20-gauge IV catheter placed in the left cephalic vein. On morning rounds the nurse notes the IV site is tender to palpation and a red streak has formed. Which action should the nurse implement first?
A.
B.
C.
D.
48.  The nurse and an unlicensed nursing assistant are caring for a group of clients. Which nursing intervention should the nurse perform?
A.
B.
C.
D.
1 comment
49.  The client has been vomiting and has had numerous episodes of diarrhea. Which laboratory test should the nurse monitor?
A.
B.
C.
D.
50.  A nurse is reading a physician's progress notes in the client's record and reads that the physician has documented "insensible fluid loss of approximately 800 mL daily." The nurse understands that this type of fluid loss can occur through:
A.
B.
C.
D.
51.  A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for deficient fluid volume?
A.
B.
C.
D.
52.  A nurse caring for a client who has been receiving intravenous diuretics suspects that the client is experiencing a deficient fluid volume. Which assessment finding would the nurse note in a client with this condition?
A.
B.
C.
D.
53.  A nurse is assigned to care for a group of clients. On review of the clients' medical records, the nurse determines that which client is at risk for excess fluid volume?
A.
B.
C.
D.
54.  The nurse is caring for a client with congestive heart failure. On assessment, the nurse notes that the client is dyspneic and that crackles are audible on auscultation. The nurse suspects excess fluid volume. What additional signs would the nurse expect to note in this client if excess fluid volume is present?
A.
B.
C.
D.
55.  A nurse is preparing to care for a client with a potassium deficit. The nurse reviews the client's record and determines that the client was at risk for developing the potassium deficit because the client:
A.
B.
C.
D.
56.  A nurse reviews a client's electrolyte laboratory report and notes that the potassium level is 3.2 mEq/L. Which of the following would the nurse note on the electrocardiogram as a result of the laboratory value?
A.
B.
C.
D.
57.  A nursing student needs to administer potassium chloride intravenously as prescribed to a client with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure if the student states that which of the following is part of the plan for preparation and administration of the potassium?
A.
B.
C.
D.
58.  A nurse instructs a client at risk for hypokalemia about the foods high in potassium that should be included in the daily diet. The nurse determines that the client understands the food sources of potassium if the client states that the food item lowest in potassium is:
A.
B.
C.
D.
59.  A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a potassium level of 5.5 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a potassium value at this level?
A.
B.
C.
D.
60.  A nurse reviews the electrolyte results of an assigned client and notes that the potassium level is 5.4 mEq/L. Which of the following would the nurse expect to note on the electrocardiogram as a result of the laboratory value?
A.
B.
C.
D.
61.  A nurse caring for a group of clients reviews the electrolyte laboratory results and notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse understands that which client is at highest risk for the development of a sodium value at this level?
A.
B.
C.
D.
62.  A nurse is caring for a client with acute congestive heart failure who is receiving high doses of a diuretic. On assessment, the nurse notes that the client has flat neck veins, generalized muscle weakness, and diminished deep tendon reflexes. The nurse suspects hyponatremia. What additional signs would the nurse expect to note in this client if hyponatremia were present?
A.
B.
C.
D.
63.  A nurse is caring for a client with a nasogastric tube. Nasogastric tube irrigations are prescribed to be performed once every shift. The client's serum electrolyte results indicate a potassium level of 4.5 mEq/L and a sodium level of 132 mEq/L. Based on these laboratory findings, the nurse selects which solution to use for the nasogastric tube irrigation?
A.
B.
C.
D.
64.  A nurse is reviewing laboratory results and notes that a client's serum sodium level is 150 mEq/L. The nurse reports the serum sodium level to the physician and the physician prescribes dietary instructions based on the sodium level. Which food item does the nurse instruct the client to avoid?
A.
B.
C.
D.
65.  A nurse is reviewing a client's laboratory report and notes that the serum calcium level is 4.0 mg/dL. The nurse understands that which condition most likely caused this serum calcium level?
A.
B.
C.
D.
66.  A nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which of the following clinical manifestations would the nurse expect to note in the client?
A.
B.
C.
D.
67.  A nurse caring for a client with hypocalcemia would expect to note which of the following changes on the electrocardiogram?
A.
B.
C.
D.
68.  A nurse caring for a client with severe malnutrition reviews the laboratory results and notes a magnesium level of 1.0 mg/dL. Which electrocardiographic change would the nurse expect to note based on the magnesium level?
A.
B.
C.
D.
69.  A nurse reviews a client's laboratory report and notes that the client's serum phosphorus level is 2.0 mg/dL. Which condition most likely caused this serum phosphorus level?
A.
B.
C.
D.
70.  The nurse provides instructions to a client with a low magnesium level about the foods that are high in magnesium and tells the client to consume which foods? Select all that apply.
A.
B.
C.
D.
E.
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Quiz Comments (13)
the lewis med surg nursing book 8th edition says that oranges are a good source of magnesium. pg. 321.
I would lie to be able to print the rationales to study by
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I can't find answers and rationals??
you have to hit start button, do these questions and put your email at the end to get the score and rationale
Where are the answers?
what are the answers and rational to the following questions
i need the answers & rationals to these questions above

what are the correct answers for these questions?
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