Fluid and Electrolyte Practice Test

The nurse is assisting in caring for a client who is receiving an intravenous infusion of 1000 mL of normal saline with 40 mEq of potassium chloride. The nurse is monitoring the client for signs of hyperkalemia. Which sign/symptom would be noted in the client if hyperkalemia is present? Mental confusion Muscle weakness Muscle pain Depressed deep tendon reflexes

Because potassium plays a major role in neuromuscular activity, elevation in serum potassium initially causes muscle weakness, not muscle pain. Mental status changes and confusion are most likely noted in the client experiencing hypocalcemia hyponatremia. Depressed deep tendon reflexes are noted in the client with hypermagnesemia.

The nurse is reviewing the health records of assigned clients. The nurse would plan care knowing that which client is at risk for fluid volume deficit? The client with heart failure The client with decreased kidney function The client with cirrhosis The client with an ileostomy

Causes of a fluid volume deficit include vomiting, diarrhea, conditions that cause increased respirations or increased urinary output, insufficient intravenous fluid replacement, draining fistulas, and ileostomy. A client with cirrhosis, heart failure, or decreased kidney function is at risk for fluid volume excess.

The nurse is reviewing the health records of assigned clients. The nurse would plan care knowing that which client is at the least likely risk for the development of third-spacing? The client with cirrhosis The client with sepsis The client with diabetes mellitus The client with kidney failure

Fluid that shifts into the interstitial space and remains there is referred to as third-space fluid. Common sites for third-spacing include the abdomen, pleural cavity, peritoneal cavity, and pericardial sac. Third-space fluid is physiologically useless because it does not circulate to provide nutrients for the cells. Risk factors include liver or kidney disease, major trauma, burns, sepsis, wound healing, major surgery, malignancy, malabsorption syndrome, malnutrition, alcoholism, and older age.

The nurse is caring for a client with a suspected diagnosis of hypercalcemia. Which sign/symptom would be an indication of this electrolyte imbalance? Hyperactive bowel sounds Generalized muscle weakness Positive Trousseau's sign Twitching

Generalized muscle weakness is seen in clients with hypercalcemia. Twitching, positive Trousseau's sign, and hyperactive bowel sounds are signs of hypocalcemia.

The nurse is planning to reinforce dietary teaching about following a diet that is low in potassium to a client receiving a potassium-retaining (sparing) diuretic. The nurse would be sure to include which strategies to avoid foods high in potassium in the diet? Select all that apply. Dried fruits are good for snacks. Avoid eating lunch meats and bolognas. Use eggs as a source for protein. Eat salads with cabbage and lettuce and avoid spinach. Limit cereals and bread products.

Potassium is in most foods. Eggs are a protein source that is not as high in potassium as meats, especially organ and preserved meats such as lunch meats and bolognas. Most common salad ingredients such as lettuce, cabbage, carrots, celery, and onions are not rich in potassium. Spinach, however, is a good source of potassium. The client should avoid dried fruits, which are high in potassium. The client may eat bread and cereals that are not rich in potassium.

The nurse is caring for a client with kidney failure. The laboratory results reveal a magnesium level of 3.6 mEq/L (1.8 mmol/L). Which sign would the nurse expect to note in the client, based on this magnesium level? Twitching Loss of deep tendon reflexes Hyperactive reflexes Irritability

The normal magnesium level is 1.3 to 2.1 mEq/L (0.65 to 1.05 mmol/L). A client with a magnesium level of 3.6 mEq/L (1.8 mmol/L) is experiencing hypermagnesemia. Loss of deep tendon reflexes is characteristic of this condition. Twitching, irritability, and hyperactive reflexes should be noted in a client with hypomagnesemia.

The nurse reviews electrolyte values and notes a sodium level of 130 mEq/L (130 mmol/L). The nurse expects that this sodium level would be noted in a client with which condition? The client with an inadequate daily water intake The client with diabetes insipidus The client with watery diarrhea The client with the syndrome of inappropriate secretion of antidiuretic hormone

Hyponatremia is a serum sodium level less than 135 mEq/L (135 mmol/L). Hyponatremia can occur secondary to syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The client with an inadequate daily water intake, watery diarrhea, or diabetes insipidus is at risk for hypernatremia.

The nurse who is caring for a client with kidney failure notes that the client is dyspneic, and crackles are heard when listening to breath sounds in the lungs. Which additional sign/symptom would the nurse expect to note in this client? Rapid weight loss A weak and thready pulse Flat hand and neck veins An increase in blood pressure

Impaired cardiac or kidney function can result in fluid volume excess. Findings associated with fluid volume excess include cough, dyspnea, crackles, tachypnea, tachycardia, an elevated blood pressure, a bounding pulse, an elevated central venous pressure, weight gain, edema, neck and hand vein distention, an altered level of consciousness, and a decreased hematocrit level.

The nurse is caring for a client with a diagnosis of hyperparathyroidism. Laboratory studies are performed, and the serum calcium level is 12.0 mg/dL (3.0 mmol/L). Based on this laboratory value, the nurse would take which action? Inform the registered nurse of the laboratory value. Place the laboratory result form in the client's record. Reassure the client that the laboratory result is normal. Document the value in the client's record.

The normal serum calcium level ranges from 9 to 10.5 mg/dL (2.25-2.75 mmol/L). The client is experiencing hypercalcemia, and the nurse would inform the registered nurse of the laboratory value. Because the client is experiencing hypercalcemia, the remaining options are incorrect actions.

The nurse reviews a client's electrolyte results and notes a potassium level of 5.5 mEq/L. The nurse understands that a potassium value at this level would be noted with which condition? Diarrhea Overuse of laxatives Cushing's syndrome Traumatic burn

A serum potassium level that exceeds 5.0 mEq/L is indicative of hyperkalemia. Clients who experience the cellular shifting of potassium, as in the early stages of massive cell destruction (i.e., with trauma, burns, sepsis, or metabolic or respiratory acidosis), are at risk for hyperkalemia. The client with Cushing's syndrome or diarrhea and the client who has been overusing laxatives are at risk for hypokalemia.