ATI - Fluid and Electrolytes Practice Questions

A nurse is reviewing the laboratory results of a client who is dehydrated. Which of the following BUN lab values should the nurse report to the provider? A.) 25 mg/dL B.) 13 mg/dL C.) 10 mg/dL D.) 18 mg/dL

A.) 25 mg/dL Rationale: The expected reference range for BUN values is 10 to 20 mg/dL. If the BUN is above this range, the kidneys might be having difficulty excreting urea & nitrogen. Elevation can be seen in dehydration & might require the use of intravenous fluids

A nurse is providing dietary teaching for a client who takes furosemide. The nurse should recommend which of the following foods as the best source of potassium? A.) Bananas B.) Cooked carrots C.) Cheddar cheese D.) 2% milk

A.) Bananas

A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss? A.) Body weight B.) Skin integrity C.) Blood pressure D.) Respiratory rate

A.) Body weight Rationale: Body weight is the most reliable indicator of fluid loss for infants & young children

A nurse is preparing to administer potassium chloride (KCL) to a client who is receiving diuretic therapy. The nurse reviews the client's serum potassium level results & discovers the client's potassium level is 3.2 mEq/L. Which of the following actions should the nurse take? A.) Give the ordered KCL as prescribed B.) Omit the KCL dose & document that it was not given C.) Hold the prescribed dose & notify the provider of the serum potassium level D.) Call the lab to verify the client's results.

A.) Give the ordered KCL as prescribed

A nurse is assessing a client who has fluid overload. Which of the following findings should the nurse expect? (SATA) A.) Increased heart rate B.) Increase blood pressure C.) Increased respiratory rate D.) Increase hematocrit E.) Increased temperature

A.) Increased heart rate B.) Increased blood pressure C.) Increased respiratory rate

A nurse is assessing a client who has a sodium level of 116 mEq/L. Which of the following findings should the nurse expect? A.) Nausea & vomiting B.) Extreme thirst C.) Flushed skin D.) Fever

A.) Nausea & vomiting

A nurse is assessing a client who reports frequent vomiting & diarrhea for the past 3 days. Which of the following findings should the nurse expect? (SATA) A.) Poor skin turgor B.) Bradycardia C.) Hypotension D.) Pale yellow urine E.) Flat neck veins

A.) Poor skin turgor C.) Hypotension E.) Flat neck veins

A nurse is reviewing the laboratory results of a client who takes furosemide. Which of the following results should the nurse identify as the priority finding? A.) Potassium 2.9 mEq/L B.) Phosphorous 4.5 mEq/L C.) Sodium 145 mEq/L D.) Calcium 8.2 mg/dL

A.) Potassium 2.9 mEq/L

A nurse is reviewing a client's lab results. Which of the following lab values should the nurse report to the provider? A.) Sodium 126 mEq/L B.) Potassium 3.6 mEq/L C.) Magnesium 1.9 mEq/L D.) Chloride 99 mEq/L

A.) Sodium 126 mEq/L

A nurse is admitting a 6-mon-old infant who has dehydration. Which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance? A.) 0.5 mL/kg/hr B.) 2 mL/kg/hr C.) 7.5 mL/kg/hr D.) 15 mL/kg/hr

B.) 2 mL/kg/hr Rationale: The expected urinary output for infants up the age of 1 year is 2 mL/kg/hr. An infant who is not dehydrated should produce this amount of urine.

A nurse is caring for a client who has a postoperative ileus and an NG tube that has drained 2, 500 mL in the past 6 hr. Which of the following electrolyte imbalances should the nurse monitor the client for? A.) Elevated sodium level B.) Decreased potassium level C.) Elevated magnesium level D.) Decreased calcium level

B.) Decreased potassium level Rationale: Hypokalemia is an electrolyte imbalance in which the serum potassium level is less than 3.5 mEq/L. Hypokalemia may be the result of diuretic use, diarrhea, vomiting, & prolonged nasogastric suctioning.

A nurse is caring for a client who has end-stage kidney disease (ESKD) & reports having shortness of breath & swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs & elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations? A.) Hypovolemia B.) Hypervolemia C.) Hyperkalemia D.) Hyponatremia

B.) Hypervolemia Rationale: A client who has ESKD experiences excess fluid volume.

A nurse is caring for a client who has hypernatremia and requires IV fluid therapy due to his NPO status. Which of the following solution should the nurse prepare to infuse for this client? A.) Lactated Ringer's B.) Dextrose 5% in 0.9% sodium chloride C.) 0.45% sodium chloride D.) Dextrose 10% in water

C.) 0.45% sodium chloride Rationale: A client who has an elevated sodium level and is NPO requires a hypotonic IV solution, such as 0.45% sodium chloride or 0.225% sodium chloride

A nurse is reviewing a client's laboratory values & discovers the client has a serum potassium of 6.2 mEq/L. Which of the following interventions should the nurse anticipate? A.) Initiating an IV potassium infusion B.) Encouraging the client to eat bananas C.) Administering sodium polystyrene sulfonate D.) Administering a potassium-sparing diuretic

C.) Administering sodium polystyrene sulfonate Rationale: Sodium polystyrene sulfonate absorbs excessive potassium & excretes it through the stool.

A nurse is caring for a client who has a prescription of potassium chloride (KCL) 20 mEq PO daily. The nurse reviews the client's most recent laboratory results & finds the client's potassium level is 5.2 mEq/L. Which of the following actions should the nurse take? A.) Give the ordered KCL as prescribed B.) Omit the KCL dose & document it was not given C.) Call the prescribing physician & inform her of the client's serum potassium level results D.) Call the lab to verify the client's results

C.) Call the prescribing physician & inform her of the client's serum potassium level results Rationale: As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication & notify the provider of the client's serum potassium level.

A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. Which of the following scheduled medications should the nurse plan to administer? A.) Lisinopril B.) Digoxin C.) Furosemide D.) Potassium iodide

C.) Furosemide Rationale: The medication can be given when a client has an elevated potassium level & can lower the potassium level.

A nurse is caring for a client who has heart failure and a new prescription for furosemide. Which of the following laboratory values should the nurse review before administering furosemide? A.) Bicarbonate B.) Carbon dioxide C.) Potassium D.) Phosphate

C.) Potassium Rationale: Furosemide is a loop diuretic & therefore promotes excretion of potassium. The nurse should monitor the client's serum potassium level before administering it to prevent hypokalemia

A nurse is caring for a client who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the client is effectively responding to treatment? A.) Sodium 165 mEq/L B.) Potassium 5.2 mEq/L C.) Urine specific gravity 1.020 D.) HcT 62%

C.) Urine specific gravity 1.020 Rationale: In cases of dehydration the kidney reabsorbs all available water, making the urine more concentrated & increasing the urine specific gravity. A level of 1.020 is within expected reference range of 1.005 to 1.030.

A nurse in a community clinic is assessing an older adult client for manifestations of dehydration. Which of the following findings should the nurse expect? A.) Hypothermia B.) Protruding eyeballs C.) Elevated blood pressure D.) Furrows in the tongue

D.) Furrows in the tongue

A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluid? A.) Broth B.) Water C.) Diluted apple juice D.) Oral rehydration solution

D.) Oral rehydration solution Rationale: The fluid of choice for infants & children who have dehydration due diarrhea

A nurse is caring for four clients who have drainage tubes. Which of the following clients should the nurse recognize as being at risk for hypokalemia? A.) The client who has a tracheostomy tube attached to humidified oxygen B.) The client who has an indwelling urinary catheter to gravity drainage C.) The client who has a chest tube to water seal D.) The client who has a nasogastric (NG) tube to suction

D.) The client who has a nasogastric (NG) tube to suction Rationale: A NG tube is used to decompress the stomach. When attached to suction, NG tube will remove gastric contents, which are high in electrolytes, especially potassium, & this loss places the client at risk for hypokalemia.

A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit? A.) The client who has been NPO since midnight for endoscopy B.) The client who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL C.) The client who has end-stage renal failure and is scheduled for dialysis today D.) The client who has gastroenteritis and is febrile

D.) The client who has gastroenteritis and is febrile. Rationale: Gastroenteritis is characterized by diarrhea & may be associated with vomiting, so it can be a significant source of fluid loss. A fever raises the metabolic rate, further putting the client at increased risk for dehydration.

A nurse is caring for a client who sustained blood loss. Which of the following is a manifestation of hypovolemia? A.) Decreased heart rate B.) Dyspnea C.) Increased blood pressure D.) Weak pulse

D.) Weak pulse