NCLEX FLUID AND ELECTROLYTES ALL REVISION QUESTIONS AND CORRECT ANSWERS (GRADED A+) (2024 UPDATE)
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Course
Nclex
Institution
Nclex
When caring for a group of pts, the nurse realizes that which of the following health problems
increases the risk for metabolic alkalosis?
1. bulimia
2. dialysis
3. venous stasis ulcer
4. COPD - ANSWER- Answer: 1
Rationale 1: Metabolic alkalosis is cause by vomiting, diuretic therapy or nasog...
When caring for a group of pts, the nurse realizes that which of the following health problems
increases the risk for metabolic alkalosis?
1. bulimia
2. dialysis
3. venous stasis ulcer
4. COPD - ANSWER- Answer: 1
Rationale 1: Metabolic alkalosis is cause by vomiting, diuretic therapy or nasogastric suction,
among others. A pt with bulimia may engage in vomiting or indiscriminate use of diuretics.
Rationale 2: A pt receiving dialysis has kidney failure, which causes metabolic acidosis.
Rationale 3: A venous stasis ulcer does not result in an acid-base disorder.
Rationale 4: The pt diagnosed with COPD typically has hypercapnea & respiratory acidosis.
The nurse is caring for a pt who is anxious & dizzy following a traumatic experience. The arterial
blood gas findings include: pH 7.48, PaO2 110, PaCO2 25, & HCO3 24. The nurse would
anticipate which initial intervention to correct this problem?
1. Encourage the pt to breathe in & out slowly into a paper bag.
2. Immediately administer oxygen via a mask & monitor oxygen saturation.
,3. Prepare to start an intravenous fluid bolus using isotonic fluids.
4. Anticipate the administration of intravenous sodium bicarbonate. - ANSWER- Answer: 1
Rationale 1: This pt is exhibiting signs of hyperventilation that is confirmed with the blood gas
results of respiratory alkalosis. Breathing into a paper bag will help the pt to retain carbon dioxide
& lower oxygen levels to normal, correcting the cause of the problem.
Rationale 2: The oxygen levels are high, so oxygen is not indicated, & would exacerbate the
problem if given. Intravenous fluids would not be the initial intervention.
Rationale 3: Not enough information is given to determine the need for intravenous fluids.
Rationale 4: Bicarbonate would be contraindicated as the pH is already high.
A pt is prescribed 20 mEq of potassium chloride. The nurse realizes that the reason the pt is
receiving this replacement is
1. to sustain respiratory function.
2. to help regulate acid-base balance.
3. to keep a vein open.
4. to encourage urine output. - ANSWER- Answer: 2
Rationale 1: Potassium does not sustain respiratory function.
Rationale 2: Electrolytes have many functions. They assist in regulating water balance, help
regulate & maintain acid-base balance, contribute to enzyme reactions, & are essential for
neuromuscular activity.
, Rationale 3: Intravenous fluids are used to keep venous access not potassium.
Rationale 4: Urinary output is impacted by fluid intake not potassium.
An elderly pt does not complain of thirst. What should the nurse do to assess that this pt is not
dehydrated?
1. Ask the physician for an order to begin intravenous fluid replacement.
2. Ask the physician to order a chest x-ray.
3. Assess the urine for osmolality.
4. Ask the physician for an order for a brain scan. - ANSWER- Answer: 3
Rationale 1: It is inappropriate to seek an IV at this stage.
Rationale 2: There is no indication the pt is experiencing pulmonary complications thus a cheat x-
ray is not indicated.
Rationale 3: The thirst mechanism declines with aging, which makes older adults more vulnerable
to dehydration & hyperosmolality. The nurse should check the pt's urine for osmolality as a 1st
step in determining hydration status before other detailed & invasive testing is done.
Rationale 4: There is no data to support the need for a brain scan.
An elderly pt who is being medicated for pain had an episode of incontinence. The nurse realizes
that this pt is at risk for developing
1. dehydration.
2. over-hydration.
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