Here are videos going over each Fluid & Electrolyte topic. After the videos, you will be able to see nursing exam/NCLEX style questions.
Introduction to Fluid & Electrolytes:
Introduction to Electrolytes:
Here are some Nursing Exam or NCLEX style questions pertaining to Fluid & Electrolytes!
1. In surgical clients, which of the following can cause fluid and electrolyte imbalance? Select all that apply:
A. Intraoperative fluid and blood loss
B. Preoperative fluid and food restrictions
C. Bowel preparations
D. Nasogastric suctioning
F. Recovery from anesthesia
Ans.: A, B, C, D, E, F can cause fluid and electrolyte imbalance in the surgical client.
2. What is the most appropriate explanation on why men generally have higher water content than women?
A. Because men eat more than women
B. Because they do not undergo menstruation
C. Because they have more lean body mass
D. Because they have more androgen than women
Ans.: C. Muscle contains more water than the same amount of body adipose tissue and since men have more muscular tissue than women, they generally have higher water content.
3. The nurse explains to her trainee the importance of fluid regulation on fluids and electrolyte imbalance. Which of the following are the essential functions of fluids and electrolytes? Select all that apply:
A. Maintaining body temperature
B. Regulating acid-base balance
C. Maintaining contractility of muscles
D. Transporting oxygen to cells
E. Transmission of nerve impulses
F. Removing waste products of cellular metabolism
Ans.: A, B, C, D, E, F are all functions of fluids and electrolytes in maintaining homeostasis.
4. Which of the following is known as a positively charged electrolyte?
Ans.: B. Cations are positively charged electrolytes and the major cations are sodium and potassium just to name a few. Anions are negatively charged electrolytes and. Chloride and phosphate areincluded in the major anions.
5. Which major cations and anions dominate in the extracellular fluid?
A. Potassium and Phosphorus
B. Sodium and Potassium
C. Chloride and Bicarbonate
D. Sodium and Chloride
Ans.: D. Sodium and chloride are the major cation and anion that dominate in the ECF. Potassium and Phosphorus dominate in the ICF; Sodium and Potassium are both cations and Chloride and Bicarbonate areboth anions.
6. Which of the following is/are theimportance of fluid replacement during surgery ?
A. To provide maintenance fluids
B. to replace lost fluid due to anesthesia
C. To correct electrolyte imbalance
D. All of the above
Ans: D. al are considered goals of fluid therapy during surgery.
7. Which of the following blood component is the most commonly administered?
A. Fresh Frozen Plasma
B. Packed Red Blood Cells
C. Whole Blood
D. Platelet Concentrate
Ans.: B. is the most commonly administered blood product for they maintain intravascular blood volume and improve the oxygen-carrying capacity and oxygen transport to the tissues.
8. The nurse is monitoring the output of a four clients post cesarean section, which among the following 24-hour urine output should be reported to the attending physician?
A. 1500 ml
B. 720 ml
C. 1000 ml
D. 690 ml
Ans.: D is an indication of an inadequate urine output that needs to be reported to the physician. 720 ml is still within the normal ranges since 30 ml is the normal urine output per hour. All other choices does not need to be reported to the physician for they are within the normal ranges.
9. Which of the following is an isotonic solution that expands the extracellular fluid volume and can be used in diabetic ketoacidosis, metabolic alkalosis and hypercelcemia.
A. 3% NaCl
B. 0.9% NaCl
C. Dextran 40 in NS
D. 0.45% NaCl
Ans.: B is an isotonic solution which is also called normal saline and can be used in hypovolemic states. D is a hypotonic solution, A is a hypertonic solution and D is a colloid solution.
10.The nurse known that which of the following fluids is contraindicated for use in clients with head injury?
A. 5% Dextrose in water
B. 0.9% NaCl
C. Lactated Ringer’s Solution
D. None of the above
Ans.: A should not be used in clients with head injury because it can cause increased intracranial pressure. All the other options are safe for use with this particular client.
11. The nurse notes that the clients random blood sugar is 35 mg/dl, which of the following solutions is expected to be administered in this condition?
A. 0.9% NaCl
B. Lactated Ringer’s Solution
C. D 50% W
D. None of the above
Ans. C contains 50% of Dextrose and is used in the management of hypoglycaemia. Other options are incorrect and are not applicable for this client.
12. Which of the following are the actions of colloid solutions? Select all that apply:
A. Increases pulse pressure
B. Decreases arterial blood pressure
C. Increases the ability of platelets to clot
D. Improves microcirculation by deceasing RBC aggregation
E. Leaves the circulatory system immediatelys
F. Increases cardiac output
Ans.: A, D, F are all actions of colloid solutions. It also increases arterial blood pressure, decreases the platelets ability to clot, and remains in the circulatory system for 6 hours.
13. Which of the following are signs and symptoms of fluid volume excess? Select all that apply:
A. Decreased blood pressure
C. Distended neck veins
F. Shortness of breath
Ans.: B, C, D, F can be noted in fluid volume excess, other signs and symptoms are increased blood pressure and tachycardia.
14. The client with fluid volume excess is ordered Furosemide (Lasix) 40 mf IV every 8 hours. The following are correct nursing interventions while on this medication, except?
A. Weigh client daily
B. Note for blood pressure prior to administration
C. Facilitate a potassium restricted diet
D. Monitor intake and output
Ans.: C. For clients on Furosemide, potassium rich diet is needed for the replacement of potassium losses through dieresis. All the other options are correct interventions.
15. The client with Chronic Renal Failure is prescribed with Furosemide (Lasix) 20 mg od during discharge? As the nurse gives the discharge instructions, which of the following statements made by the client indicated the need for further teaching?
A. “I should not forget monitoring my blood glucose when I get home.”
B. “I should contact my physician if I experience diarrhea”
C. “I should take this medication with food.”
D. “Ringing in the ears is an expected side effect of this medication.”
Ans.: D. This medication can cause irreversible hearing loss and ringing in the ears should be reported to the physician by the client.
16. The nurse describes signs and symptoms of having fluid volume excess that needs the immediate attention of the physician. The following are correct signs of fluid volume excess, except?
A. Pressure felt on the diaphragm
B. Weight gain of 2 lbs per day
C. Shortness of breath
D. None of the above
Ans.: D. all options are signs and symptoms of having fluid volume excess.
17. The nurse is caring for a client that needs correction for hypokalemia. Which of the following nursing interventions are incorrect?
A. Informing the physician when the urine output is 15 mL then 18 mL for 2 consecutive hours.
B. Noting for impaired renal function
C. Taking blood samples for the repeat potassium determination on the arm without an IV infusion
D. Preparing the KCl for IV push administration
Ans.: D. Potassium is never administered IV push or intramuscularly. IV potassium must be administered using an infusion pump. It should be administered after adequate urine flow has been established and clients should be assessed for impaired renal function and decreased ability to excrete potassium. Blood sampled should be taken on the free arm for accuracy of results.
18. All of the following except one are true about Trosseau’s sign:
A. It is a sign of hypercalcemia.
B. It can be elicited by inflating a blood pressure cuff on the upper arm to about 20 mm Hg above systolic pressure.
C. It is describes as an adducted thumb, flexed wrist and metacarpophalangeal joints, extended interphalangeal joints with fingers together.
D. None of the above
Ans.: A. Trosseau’s sign can occur with hypocalcemia or hypomagnesemia.
19. The emergency room nurse is about to start an IV line to the client for admission, she takes note of the following factors to consider when selecting a site for venipuncture, except?
A. Duration of therapy
B. Type of fluid and medication to be infused
C. Whether the client is right- or left-handed
D. none of the above
Ans.: D. All of the above are to be considered when choosing a site for venipuncture.
20. The emergency room nurse is about to insert an IV cannula to the trauma client who is scheduled for exploratory laparotomy after 3 hours? Which of the following IV cannula should she choose for this type of client?
A. Gauge 16
B. Gauge 18
C. Gauge 20
D. Gauge 22
Ans.: B. Gauge 18 is the standard and most appropriate cannula for this client because there is a possibility that this client would need blood transfusion, and transfusion of large volumes of fluid during surgery which requires a large bore needle. Gauge 16 used for rapid blood transfusions, while gauge 20 is used for just simple rehydration and administration of medications while gauge 22 is used for pediatric clients.
21. The attending physician orders for a PICC line to be inserted to the client? The nurse notes that the following are indications for this type of access, except?
A. Long-term parenteral therapy
B. Limited peripheral access
C. Obese clients
D. Short duration of hospitalization
Ans.: D. Clients with a short hospital say would normally require cannulas instead of PICC not unless home administration of antibiotics are required when discharged.
22. The nurse explains the discharge instructions to a client who will be administering his own antibiotics at home through the PICC line. Which of the following statements made by the client indicates further teaching?
A. “I need to keep the site clean and wash my hands before touching it or administering any medication.”
B. “Once I feel a resistance, I should keep pushing until I feel the medication pass through.”
C. “I should contact my physician if I am running a fever of 100.4 F and above.”
D. “I should flush the PICC line with saline as ordered.”
Ans.: B. Once resistance is felt, the client should not try to push the medication because the blockage can be caused by an embolus and forcing the fluid in may cause the embolus to be dislodged and can be potentially dangerous for the client.
23. The physician has ordered the removal of the IV line of his client for discharge. As the nurse inspects the cannula, she notices that the IV catheter has been severed, which of the following interventions should be done immediately?
A. Apply a tourniquet above the site
B. Palpate the path of the vein to locate the severed cannula
C. Contact the attending physician
D. instruct the client to place his arm above his head
Ans.: A. When the nurse inspects the cannula and notes that it has decreased in length or that it has been severed, she should immediately attempt to occlude the vein above the site by applying a tourniquet to prevent the catheter from entering the central circulation. Once the tourniquet has been applied, she should then contact the attending physician. Palpating the path of the vein or instructing the client to lift his arm should not be done for it can be potentially dangerous and have the severed cannula enter the central circulation.
24. To deliver safe care and prevent catheter embolism, which of the following interventions should the nurse do when discontinuing an infusion and removing an IV cannula?
A. Use scissors when removing the IV catheter.
B. Withdraw the catheter through the insertion needle
C. Withdraw plastic catheters carefully
D. All of the above
Ans.: C. Plastic catheters should be withdrawn carefully and their lengths measured to make certain that no fragment has broken off. The use of scissors should be avoided near the catheter, and the withdrawing the catheter through the insertion needle should be avoided as well.
25. The nurse should implement the following actions to prevent IV catheter-related infection, except?
A. Examining the IV containers for cracks, leaks or cloudiness that can indicate a contaminated solution.
B. Discarding medication or solution within 24 hours of its addition to an administration set
C. Replacing the adhesives when signs of local inflammation or complication occurs
D. Replacing the IV cannula every 48 to 72 hours or as indicated.
Ans.: C The IV cannula together with the tubings and adhesives should be replaced when signs of local inflammation or complication occurs.