Electrolyte Quiz: Can You Spot The Imbalance?

1. A patient receiving normal saline develops hypernatremia. Which mechanism explains this?

Excessive free water intake

Water loss exceeds sodium loss

Aldosterone deficiency

Antidiuretic hormone excess

2. A patient with severe hyponatremia (110 mEq/L) presents with seizures. What is the immediate treatment approach?

Rapid normal saline infusion

Slow hypertonic saline with seizure precautions

Free water restriction alone

Diuretics and fluid bolus

3. Chronic diarrhea causes which pattern of electrolyte loss?

Sodium, potassium, and bicarbonate

Calcium, magnesium, and chloride

Phosphate and sulfate only

Chloride and sodium only

4. A patient on digoxin develops hyperkalemia. Why is this combination dangerous?

Digoxin toxicity increases with high potassium

Hyperkalemia blocks digoxin absorption

Potassium antagonizes digoxin effects

Both increase calcium levels

5. Respiratory acidosis with hypokalemia suggests which underlying condition?

Pulmonary fibrosis

Chronic use of diuretics with respiratory depression

Pneumonia alone

Hyperventilation

6. A patient with third-degree burns loses significant electrolytes. Which imbalance develops earliest?

Hyponatremia

Hyperkalemia

Hypocalcemia

Hypomagnesemia

7. Hypermagnesemia depresses which system most significantly?

Gastrointestinal

Respiratory

Nervous system

Endocrine

8. A patient has a serum chloride of 88 mEq/L with normal sodium. What is the likely cause?

Volume depletion

Metabolic alkalosis

Hyperglycemia

Acute kidney injury

9. Which condition causes both hypokalemia and metabolic alkalosis?

Diarrhea

Renal tubular acidosis

Vomiting with loop diuretic use

Diabetic ketoacidosis

10. Hypocalcemia causes tetany through which mechanism?

Decreased muscle glycogen

Increased neuronal excitability

Reduced ATP availability

Myelin degradation

11. A patient presents with serum sodium of 120 mEq/L. Which clinical sign is most likely?

Muscle weakness and confusion

Tachycardia and dry mouth

Tremors and irritability

Thirst and polyuria

12. Hyperchloremic acidosis develops when there is loss of which ion?

Sodium

Bicarbonate

Magnesium

Calcium

13. A patient with SIADH has a serum osmolality of 260 mOsm/kg. What is the expected urine osmolality?

Less than 100 mOsm/kg

100–200 mOsm/kg

Greater than 600 mOsm/kg

Equal to serum osmolality

14. Severe hypophosphatemia can impair which cellular process?

Oxygen transport

ATP production

Protein synthesis

Nerve conduction

15. A patient on loop diuretics develops weakness and polyuria. What electrolyte is most likely depleted?

Sodium and potassium

Calcium and magnesium

Chloride and bicarbonate

Phosphate and sulfate

16. Which symptom is characteristic of hypomagnesemia?

Muscle rigidity

Tremors and personality changes

Bradycardia

Increased bone density

17. A patient with chronic kidney disease has a serum potassium of 6.8 mEq/L. What is the priority intervention?

Administer normal saline IV

Give calcium gluconate and insulin with dextrose

Encourage high-potassium diet

Hold all medications

18. Hypercalcemia causes which cardiac dysrhythmia?

Prolonged QT interval

Shortened QT interval

Widened QRS complex

ST elevation

19. A patient with acute vomiting has a blood pH of 7.52 and serum HCO3 of 32 mEq/L. What acid-base disturbance is present?

Metabolic acidosis