NCLEX License Exam: Fluids And Electrolytes Practice Test
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Below are Fluids and Electrolytes NCLEX Practice Trivia Questions. If you are practicing to become a nurse, you need to have some information regarding fluids and electrolytes in the human body and how the food and fluids we take up come into play. By taking this quiz, you will get to learn some new facts about all this. Do give it a try!
- 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.
Hyponatremia
- B.
Hypocalcemia
- C.
Hyperkalemia
- D.
Hypermagnesemia
- 2.The nurse evaluates which of the following clients to be at risk for developing hypernatremia?
- A.
50-year-old with pneumonia, diaphoresis, and high fevers
- B.
62-year-old with congestive heart failure taking loop diuretics
- C.
39-year-old with diarrhea and vomiting
- D.
60-year-old with lung cancer and syndrome of inappropriate antidiuretic hormone (SIADH)
- 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.
Request a physical therapy consult from the physician
- B.
Ensure the client is safe from falls and check the most recent potassium level
- C.
Allow uninterrupted rest periods throughout the day
- D.
Encourage the client to increase intake of dairy products and green leafy vegetables.
- 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.
Urine output.
- B.
Blood pressure.
- C.
Bowel movements.
- D.
ECG for tall, peaked T waves.
- 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.
Call the physician and report results
- B.
Question the results and redraw the specimen
- C.
Encourage the client to increase the intake of bananas
- D.
Initiate seizure precautions
- 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.
Absent patellar reflex
- B.
Diarrhea
- C.
Premature ventricular contractions
- D.
Increase in blood pressure
- 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.
Assess for depressed deep tendon reflexes
- B.
Call the physician to report calcium level
- C.
Place an intravenous catheter in anticipation of administering calcium gluconate
- D.
Check to see if a serum albumin level is available
- 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.
Administer an antiemetic prior to giving the digoxin
- B.
Encourage the client to increase fluid intake
- C.
Call the physician
- D.
Report the urine output
- E.
Report indications of nausea
- 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.
Provide passive ROM exercises and encourage fluid intake
- B.
Teach the client to increase intake of whole grains and nuts
- C.
Place a tracheostomy tray at the bedside
- D.
Administer calcium gluconate IM as ordered
- 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.
"The client may be suffering from dementia, and the hospitalization has worsened the confusion."
- B.
"Most older adults get confused in the hospital."
- C.
"The sodium level is low, and the confusion will resolve as the levels normalize."
- D.
"The sodium level is high and the behavior is a result of dehydration."
- 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.
Turn down the infusion
- B.
Check the latest sodium level
- C.
Assess for signs of fluid overload
- D.
Place a call to the physician
- 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.
Bisacodyl (Dulcolax) suppository
- B.
Fiber supplements
- C.
Docusate sodium
- D.
Milk of magnesia
- 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.
Encourage the client to increase fluid intake
- B.
Administer the dose as ordered
- C.
Draw a potassium level and administer the dose if the level is low or normal
- D.
Notify the physician of the urine output and hold the dose
- 14.The nurse should monitor for clinical manifestations of hypophosphatemia in which of the following clients?
- A.
A client with osteoporosis taking vitamin D and calcium supplements
- B.
A client who is alcoholic receiving total parenteral nutrition
- C.
A client with chronic renal failure awaiting the first dialysis run
- D.
A client with hypoparathyroidism secondary to thyroid surgery
- 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.
Eggs
- B.
Broccoli
- C.
Organ meats
- D.
Nuts
- E.
Canned salmon
- 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.
Sodium
- B.
Phosphorus
- C.
Calcium
- D.
Magnesium
- 17.The nurse should include which of the following instructions to assist in controlling phosphorus levels for a client in renal failure?
- A.
Increase intake of dairy products and nuts
- B.
Take aluminum-based antacids such as aluminum hydroxide (Amphojel) with or after meals
- C.
Reduce intake of chocolate, meats, and whole grains
- D.
Avoid calcium supplements
- 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.
Administer a sedative
- B.
Place client in left lateral position
- C.
Place client in high-Fowler's position
- D.
Assist the client to breathe into a paper bag
- 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.
Call the physician and report the change in client's condition
- B.
Turn the client's O2 up to 4 liters nasal cannula
- C.
Encourage the client to sit down and to take deep breaths
- D.
Encourage the client to rest and to use pursed-lip breathing technique
- 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.
D5.45 NS at 50 ml/hr
- B.
0.9 NS at an open rate
- C.
D5W at 125 ml/hr
- D.
0.45 NS at open rate
- 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.
PH of 7.43, PCO2 of 36, HCO3 of 26
- B.
PH of 7.41, PCO2 of 49, HCO3 of 30
- C.
PH of 7.33, PCO2 of 35, HCO3 of 17
- D.
PH of 7.25, PCO2 of 56, HCO3 of 28
- 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.
Respiratory alkalosis
- B.
Respiratory acidosis
- C.
Metabolic alkalosis
- D.
Metabolic acidosis
- 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.
Monitor intake and output
- B.
Encourage client to increase activity
- C.
Institute deep breathing exercises every hour
- D.
Provide reassurance to the client and administer sedatives
- 24.Which of the following assessment findings would indicate to the nurse that a client's diabetic ketoacidosis is deteriorating?
- A.
Deep tendon reflexes decreasing from +2 to +1
- B.
Bicarbonate rising from 20 mEq/L to 22 mEq/L
- C.
Urine pH less than 6
- D.
Serum potassium decreasing from 6.0 mEq/L to 4.5 mEq/L
- 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.
"The fluid is an adverse reaction to chemotherapy."
- B.
"A decrease in activity has allowed extra fluid to accumulate in the tissues."
- C.
"Poor nutrition has caused decreased blood protein levels, and fluid has moved from the blood vessels into the tissues."
- D.
"Chemotherapy has increased your blood pressure, and fluid was forced out into the tissues."
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