Fluid and electrolytes nursing quiz. Below is a NCLEX exam practice quiz to test your knowledge on fluids and electrolytes. The NCLEX exam will test your knowledge on how to take care of patients with fluid and electrolyte problems. For example, what nursing interventions would you take when caring for a patient
with a magnesium level of 1.2 or what signs and symptoms would you expect to see in a patient with congestive heart failure? After you are done taking the quiz, you will be able to see what questions you got right and wrong with rationales. This NCLEX-RN practice test is designed to test your knowledge on fluids and electrolyte imbalances you may see in a patients in practice. For example, what
signs and symptoms would you see in a patient with hypernatremia? (NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.) 1. On morning assessment of your patient in room 2502 who has severe burns. You
notice that fluid is starting to accumulate in his abdominal tissue. You note that his weight has not changed and his intake and output is equal. What do you suspect? A. Third spacing The answer is A. You would suspect third spacing. Third-spacing is the accumulation of trapped extracellular fluid in a body space as a result in this case of a burn. Third spacing can occur in body spaces such as the pericardial, pleural, peritoneal, and joint cavities, bowel, and abdomen after a trauma or burn. It is normal not to see a change in weight or abnormal intake or output values. 2. Which patient is at more risk for an electrolyte imbalance? A. An 8 month old with a fever of 102.3 ‘F and diarrhea The answer is A. The 8 month old with a fever of 102.3 ‘F and diarrhea is the correct answer. Infants (age 1 and under) and older adults are at a higher risk of fluid-related problems than any other age group. This is because infants have the highest amount of total body fluid (80% of the body is made up of fluid) and if any type of illness especially GI effects the body this increases the chances of an electrolyte imbalance. 3. A patient is admitted to the ER with the following findings: heart rate of 110 (thready upon palpation), 80/62 blood pressue, 25 ml/hr urinary output, and Sodium level of 160. What interventions do you expect the medical doctor to order for this patient? A. Restrict fluid intake and monitor daily weights The answer is B. The patient must be re-hydrated and the sodium levels should be decreased at the same time. So a hypertonic solution of 5% dextrose and 0.45% NA will help do this. The solution is hypertonic because of the 5% Dextrose which will rapidly metabolize to the cells. When the dextrose metabolizes to the cells it leaves behind 0.9% NA which acts as a isotonic solution. This allows the 0.45% NA to act as a hypotonic solution to repair the vascular compartment. After these fluids are infused the patient’s NA level should decrease, BP increase, HR return to normal etc. It is a complicated physiological process because the Dextrose has unique capabilities when it is metabolized….although the solution is labeled as hypertonic it becomes a hypotonic solution when the Dextrose is metabolized by the cells. 4. After obtaining an EKG on a patient you notice that ST depression is present along with an inverted T wave and prominent U wave. What lab value would be the cause of this finding? A. Magnesium level of 2.2 The answer is C. Hypokalemia (normal potassium levels are 3.5 to 5.1) will present with these type of EKG findings. 5. Which patient below would have a potassium level of 5.5? A. A 76 year old who reports taking Lasix (Furosemide) four times a day The answer is B. A patient with Addison disease suffers from increased potassium levels due to adrenal insufficiency. Therefore, potassium levels higher than 5.1 may present in patients with Addison’s disease. 6. You are taking a patient’s blood pressure manually. As you pump up the cuff above the systolic pressure for a few minutes you notice that the patient develop a carpal spasm. Which of the following is true? A. The patient is having a normal nervous response to an inflating blood pressure cuff that is inflated above the systolic pressure The answer is D. The correct answer is “this is known as Trousseau’s Sign and is present in patients with hypocalcemia”. Patient’s with hypokalemia may present with a positive Trousseau’s and Chvostek sign. 7. Which patient is at most risk for hypomagnesemia? A. A 55 year old chronic alcoholic The answer is A. The correct answer is a 55 year old who is a chronic alcoholic. Patients who suffer from alcoholism have an increased secretion of magnesium and usually do not eat a proper diet, therefore, they are at risk for lower magnesium levels. 8. In report from a transferring facility you receive information that your patient’s Magnesium level is 1.2. When the patient arrives you are ordered by the doctor to administer Magnesium Sulfate via IV. Which of the following interventions takes priority? A. Set-up bedside suction The answer is C. As the nurse administering Magnesium sulfate IV, you must monitor for reduced deep tendon reflexes because the patient could quickly develop hypermagnesemia. In addition, seizure precautions should be initiated due to the patient’s low magnesium level. 9. Which patient is at most risk for fluid volume deficient? A. A patient who has been vomiting and having
diarrhea for 2 days. The answer is D. All the patients above are at risk for losing too much fluid volume. 10. A patient is admitted with exacerbation of congestive heart failure. What would you expect to find during your admission assessment? A. Flat neck and hand veins The answer is C. The correct answer is increased blood pressure and crackles throughout the lungs. Patients with CHF are in fluid volume overload and the heart can not compensate for the extra fluid volume, therefore, the fluid starts to “backup”. You would find an increased blood pressure and crackles in the lungs. You would also see pitting edema in the lower extremities but NOT bradycardia.  Don’t forget to tell your friends about this quiz by sharing it your Facebook, Twitter, and other social media. You can also take more fun nursing quizzes. *Disclaimer: While we do our best to provide students with accurate and in-depth study quizzes, this quiz/test is for educational and entertainment purposes only. Please refer to the latest NCLEX review books for the latest updates in nursing. This quiz is copyright RegisteredNurseRn.com. Please do not copy this quiz directly; however, please feel free to share a link to this page with students, friends, and others. What are signs of fluid volume excess?Signs of fluid overload may include:. Rapid weight gain.. Noticeable swelling (edema) in your arms, legs and face.. Swelling in your abdomen.. Cramping, headache, and stomach bloating.. Shortness of breath.. High blood pressure.. Heart problems, including congestive heart failure.. Which clinical finding would be seen in a patient having fluid volume excess?An elevated blood pressure and bounding pulses are often seen with fluid volume excess. Decreased blood pressure with an elevated heart rate and a weak or thready pulse are hallmark signs of fluid volume deficit.
Which of the following laboratory findings would you expect to a client with fluid volume excess?Assessment findings associated with fluid volume excess include cough, dyspnea, crackles, tachypnea, tachycardia, elevated blood pressure, bounding pulse, elevated CVP, weight gain, edema, neck and hand vein distention, altered level of consciousness, and decreased hematocrit.
What manifestation of extracellular fluid volume excess does the nurse anticipate finding?Fluid volume excess. Clinical manifestations for FVE include edema, distended neck veins, and crackles.
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Which of the following findings indicates that the client is experiencing fluid volume excess?
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