Preview Extract
ATI Fluid and Electrolyte Proctored Exam 2023 With Questions and
Answers/A+ Grade
The nurse is caring for a patient who is experiencing possible third spacing. A delay in
recognizing and treating third spacing can lead to what patient complication?
A. Peripheral edema
B. Nausea and vomiting
C. Multi-organ system failure
D. Confusion
Answer: C
The nurse is reviewing the patient's laboratory tests. What laboratory value indicates that
the patient is experiencing fluid volume excess?
A. Chloride, 102 mEq/L
B. Sodium, 142 mEq/L
C. Hemoglobin, 9.9 g/dL
D. Serum osmolality, 290 mOsm/kg
Answer: C
The nurse is completing discharge teaching with a patient diagnosed with congestive
heart failure. What findings should the patient notify his/her health care provider about
regarding fluid volume excess? (SATA)
A. Dizziness when standing
B. Five-pound weight gain in a week
C. Urine output of 320 mL in 8 hours
D. Dry mouth
E. Cough with increased sputum production
Answer: B, E
The nurse is caring for a patient experiencing diarrhea. What data indicate that the patient
is experiencing fluid volume deficit? (SATA)
A. Increased heart rate
B. Orthostatic hypotension
C. Increased urine output
D. Poor skin turgor
E. Weight gain
Answer: A, B, D
The nurse is caring for a patient admitted for renal failure. What assessment findings
indicate that the patient is experiencing fluid volume excess? (SATA)
A. Edema
B. Decreased systolic blood pressure
C. Poor skin turgor
D. Altered mental status
E. Orthopnea
Answer: A, B, E
The nurse is observing assigned patients for fluid volume excess. This is essential to
prevent patients from developing what potential complication?
A. Gastroesophageal reflux disease
B. Congestive heart failure
C. Acute renal failure
D. Pneumonia
Answer: B
The nurse is planning care for a patient who has a nasogastric tube and is recovering from
abdominal surgery. What interventions will the nurse identify for addressing the problem
of ineffective tissue perfusion? (SATA)
A. Observing mental status
B. Turning the patient every 2 hours
C. Instructing the patient to stand slowly
D. Monitoring for evidence of skin breakdown
E. Obtaining daily weight
Answer: A, B, D
patients who have been diagnosed with hypernatremia are at risk for injury. What is an
appropriate intervention for the nurse to include in the plan of care for this patient?
A. Ask the family to keep the patient's personal items at home.
B. Keep visitors away.
C. Keep the bed at waist level.
D. Monitor neurologic status.
Answer: D
A patient was admitted to the ICU earlier today. The patient had an extensive workup
revealing a sodium level of 113 mEq/L. The nurse would anticipate the health care
provider ordering what intravenous solutions for a patient who was symptomatic with
this sodium level?
A. 3% normal saline
B. D5.45 NS
C. D5W
D. 0.9% NS
Answer: D
A nurse is reviewing lab date of 4 patients. Which of the following serum lab values
should the nurse expect for a patient experiencing 2+ pitting edema?
A. Sodium 138
B. Hematocrit 34%
C. BUN 22
D. Protein 9g
Answer: B
A nurse is caring for a patient who has dehydration and is receiving IV fluids. When
assessing for complications, the nurse should recognize which of the following
manifestations as a sign of fluid overload?
A. Increased urine specific gravity
B. Hypoactive bowel sounds
C. Bounding peripheral pulses
D. Decreased respiratory rate
Answer: C
A nurse is assessing a patient who has respiratory acidosis. Which of the following
findings should the nurse expect?
A. Hypotension
B. Peripheral edema
C. Facial flushing
D. Hyperreflexia
Answer: A
A nurse is assessing a patient who is receiving hydrochlorothiazide and notes that the
patient is confused and lethargic. Which of the following laboratory values should the
nurse report to the provider?
A. Sodium 128 mEq/L
B. Potassium 4.8 mEq/L
C. Calcium 9.1 mg/dL
D. Magnesium 2.0 mEq/L
Answer: A
A nurse is caring for a patient who reports difficulty breathing and tingling in both hands.
His respirations are 36/min and he appears very restless. Which of the following values
should the nurse anticipate to be outside the expected reference range if the patient is
experiencing respiratory alkalosis?
A. PaO2
B. PaCO2
C. Sodium
D. Bicarbonate
Answer: B
A nurse is planning dietary teaching for a patient who has hypermagnesemia. Which of
the following food choices contains the most magnesium and is, therefore, a food the
nurse should plan to instruct the patient to avoid?
A. Hard-boiled eggs
B. Cheddar cheese
C. Raw rhubarb
D. Raw spinach
Answer: D
A nurse is admitting a patient who has status asthmaticus. The patient's ABG results are
pH 7.32, PaO2 74 mm Hg, PaCO2 56 mm Hg, and HCO3- 26 mEq/L. The nurse should
interpret these laboratory values as which of the following imbalances?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: A
A nurse is caring for a patient who requires continuous cardiac monitoring. The nurse
identifies a prolonged PR interval and a widened QRS complex. Which of the following
laboratory values supports this finding?
A. Sodium 152 mEq/L
B. Chloride 102 mEq/L
C. Magnesium 1.8 mEq/L
D. Potassium 6.1 mg/L
Answer: D
A nurse is assessing a patient who is using PCA following a thoracotomy. The patient is
short of breath, appears restless, and has respirations of 28/min. The patient's ABG
results are pH 7.52, PaO2 89 mm Hg, PaCO2 28 mm Hg, and HCO3- 24 mEq/L. Which of
the following actions should the nurse take?
A. Instruct the patient to cough forcefully.
B. Assist the patient with ambulation.
C. Provide calming interventions.
D. Discontinue the PCA.
Answer: C
A nurse is planning care for a patient who has a serum potassium level of 3.0 mEq/L. The
nurse should plan to monitor the patient for which of the following findings?
A. Hyperactive deep-tendon reflexes
B. Orthostatic hypotension
C. Rapid, deep respirations
D. Strong, bounding pulse
Answer: B
A nurse is preparing to administer oral potassium for a patient who has a potassium level
of 5.5 mEq/L. Which of the following actions should the nurse take first?
A. Administer a hypertonic solution.
B. Repeat the potassium level.
C. Withhold the medication.
D. Monitor for paresthesia.
Answer: C
While reviewing a patient's laboratory results, a nurse notes a serum calcium level of 8.0
mg/dL. Which of the following actions should the nurse take?
A. Implement seizure precautions
B. Administer phosphate
C. Initiate diuretic therapy
D. Prepare patient for hemodialysis
Answer: A
A nurse is reviewing the medical record of a patient who has diabetes mellitus and is
receiving regular insulin by continuous IV infusion to treat diabetic ketoacidosis. Which
of the following findings should the nurse report to the provider?
A. Urine output of 30 mL/hr
B. Blood glucose of 180 mg/dL
C. Serum potassium 3.0 mEq/L
D. BUN 18 mg/dL
Answer: C
A nurse is caring for a patient who requires nasogastric suctioning. Which of the
following sets of laboratory results indicates that the patient has metabolic alkalosis?
A. pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3- 31 mEq/L
B. pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 26 mEq/L
C. pH 7.31, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 23 mEq/L
D. pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L
Answer: A
A nurse is assessing a patient who has dehydration. Which of the following assessments
is the priority?
A. Skin turgor
B. Urine output
C. Weight
D. Mental status
Answer: D
A nurse is caring for a patient who is receiving furosemide daily. During the morning
assessment, the patient tells the nurse that he is "feeling weak in the legs." Which of the
following actions should the nurse take first?
A. Monitor the patient's bowel sounds.
B. Review the patient's daily laboratory results.
C. Auscultate the patient's lungs.
D. Palpate the patient's peripheral pulses.
Answer: C
A nurse is providing teaching for a patient who has venous insufficiency of the lower
extremities. Which of the following statements by the patient indicates an understanding
of the instructions?
A. "If my stockings feel tight, I'll just roll them down for a while."
B. "I'll put on my elastic stockings at the first sign of swelling."
C. "When I sit down to watch television, I'll be sure to put my feet up."
D. "It's okay to cross my legs as long as it's for less than an hour."
Answer: C
A nurse is reviewing the ABG results for four patients. Which of the following findings
should the nurse identify as metabolic acidosis?
A. pH 7.51, PaO2 94 mm Hg, PaCO2 38 mm Hg, HCO3- 29 mEq/L
B. pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 24 mEq/L
C. pH 7.36, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 26 mEq/L
D. pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L
Answer: D
A nurse is caring for a patient who has a serum sodium level of 155 mEq/L. Which of the
following IV fluid prescriptions should the nurse anticipate administering?
A. 1,000 mL dextrose 5% in 0.9% sodium chloride
B. 1,000 mL dextrose 5% in lactated Ringer's
C. 1,000 mL dextrose 10% in water
D. 1,000 mL 0.225% sodium chloride
Answer: D
A nurse is caring for a patient who has heart failure and is receiving furosemide. The
patient is experiencing irritability and anxiety. Which of the following actions should the
nurse anticipate taking?
A. Offer whole grain wheat breads with meals.
B. Recommend a potassium-sparing diuretic.
C. Give potassium 20 mEq/L by IV bolus.
D. Restrict oral fluids.
Answer: B
A nurse is admitting a patient who takes 40 mg furosemide daily for heart failure and has
experienced 3 days of vomiting. The nurse suspects hypokalemia. Which of the following
medications should the nurse prepare to administer?
A. Sodium polystyrene sulfonate 30 g/day
B. 0.9% sodium chloride with 10 mEq/L of potassium chloride at 100 mL/hr
C. Bumetanide 8 mg/day
D. 100 mL of dextrose 10% in water with 10 units of insulin
Answer: B
A nurse is planning care for a patient who has experienced excessive fluid loss. Which of
the following interventions should the nurse include in the plan of care? (SATA)
A. Administer IV fluids evenly over 24 hr.
B. Provide the patient with a salt substitute.
C. Assess for pitting edema.
D. Encourage the patient to rise slowly when standing up.
E. Weigh the patient every 8 hr.
Answer: A,D,E
A nurse is assessing a patient who has hyperkalemia. Which of the following findings
should the nurse expect?
A. Decreased muscle strength
B. Decreased gastric motility
C. Increased heart rate
D. Increased blood pressure
Answer: A
A nurse is teaching nutritional strategies to a patient who has a low serum calcium level
and an allergy to milk. Which of the following statements by the patient indicates an
understanding of the teaching?
A. "I will eat extra cheese because I can't drink milk."
B. "I need to avoid foods with vitamin D because I am allergic to milk."
C. "I will stop taking my calcium supplements if they irritate my stomach."
D. "I will add broccoli and kale to my diet."
Answer: D
A nurse is assessing a patient who has hypomagnesemia. Which of the following findings
should the nurse expect?
A. Hyperactive Deep-tendon reflexes
B. Increased bowel sounds
C. Drowsiness
D. Decreased blood pressure
Answer: A
A nurse is caring for a patient who is experiencing respiratory distress as a result of acute
pulmonary edema. Which of the following actions should the nurse take first?
A. Assist with intubation.
B. Initiate high-flow oxygen therapy.
C. Administer a rapid-acting diuretic.
D. Administer morphine IV.
Answer: B
A nurse is assessing a patient who has a serum calcium level of 8.1 mg/dL. Which of the
following findings is the priority for the nurse to assess?
A. Deep-tendon reflexes
B. Cardiac rhythm
C. Peripheral sensation
D. Bowel sounds
Answer: B
A nurse is providing teaching for a patient who is at risk for developing respiratory
acidosis following surgery. Which of the following statements by the patient indicates an
understanding of the teaching?
A. "I should conserve energy by limiting my physical activity."
B. "I will wait until my pain is at least 6 out of 10 before I use the PCA."
C. "I will limit my daily fluid intake to 2 to 3 glasses."
D. "I will use the incentive spirometer every hour."
Answer: D
A nurse is assessing a patient who has a serum phosphorus level of 2.4 mg/dL. Which of
the following findings should the nurse expect?
A. Hepatic failure
B. Abdominal pain
C. Slow peripheral pulsations
D. Increase in cardiac output
Answer: C
A nurse is evaluating a patient who is receiving IV fluids to treat isotonic dehydration.
Which of the following laboratory findings indicates that the fluid therapy has been
effective?
A. BUN 26 mg/dL
B. Serum sodium 138 mEq/L
C. Hct 56%
D. Urine specific gravity 1.035
Answer: B
The nurse is caring for a patient who is complaining of a headache, thirst, and decreased
urination. What would the nurse anticipate finding on the patient's laboratory work?
A. Hypernatremia
B. Hyponatremia
C. Decreased specific gravity
D. Normal specific gravity
Answer: A
The nurse is providing care to a patient who was recently admitted to rehabilitation after
a motor vehicle crash. The patient sustained a traumatic brain injury. The patient was
progressing well but is now complaining of muscle cramps and abdominal cramps. What
electrolyte imbalance would the nurse consider as a cause of the cramping?
A. Hypoglycemia
B. Hyponatremia
C. Hyperosmolality
D. Hypernatremia
Answer: B
Which of the following can lead to hypernatremia? (SATA)
A. Hyperventilation
B. Gastrointestinal suctioning
C. Diabetes insipidus
D. Water deprivation
E. Excessive administration of tap water enemas
Answer: A, C, D
Which of the following is an early manifestation of hyponatremia?
A. Decreased BUN
B. Increased hematocrit
C. Increased serum osmolality
D. Decreased serum creatinine
Answer: A
Which IV fluid would you expect to be ordered in a patient who is hyponatremic?
A. 0.45% saline
B. Ringer solution
C. D5W with 0.9% saline
D. D5W with 0.45% saline
Answer: B
What IV fluid replacement would you expect in a patient with hypernatremia?
A. Ringer solution
B. D5W with 0.9% saline
C. 0.45% saline
D. 9% saline
Answer: C
A patient was admitted to the MICU after being found lying on the floor for an unknown
amount of time but estimated to be 3 to 4 days. The patient was unable to move because
of a right hip fracture. Upon admission, the patient was found to be severely
hypernatremic. What are the manifestations of late hypernatremia? (SATA)
A. Hypotension
B. Coma
C. Tachycardia
D. Vascular collapse
E. Hypertension
Answer: A, B, C, D
The nurse is caring for a patient with hyponatremia. During morning rounds, the nurse
will complete an assessment. What are the early manifestations of hyponatremia? (SATA)
A. Muscle cramps
B. Nausea and vomiting
C. Hypotension
D. Weakness
E. Anorexia
Answer: A, B, D, E
The nurse has received report from the emergency department. A patient is being
admitted with hypernatremia but with a normal blood pressure and pulse. The nurse is
preparing for the patient. The nurse is aware that the health care provider could order
what intravenous fluids for the patient upon admission? (SATA)
A. 5% NS
B. D5W
C. 0.45% NS
D. 0.9% NS
E. 3% NS
Answer: B, C
The nurse is caring for a patient with a potassium level of 5.3 mEq/L. The nurse should
assess the patient for which cardiac change?
A. Delayed depolarization
B. Shortened PR interval
C. Narrowing of QRS complex
D. Peaked T wave
Answer: D
Which of the following are manifestations of hypokalemia? (SATA)
A. Lethargy
B. Anorexia
C. Peaked T waves
D. Development of U waves
E. Muscle tremors
Answer: A, B, D
Which of the following can be used as a temporary emergency treatment for
hyperkalemia?
A. Calcium chloride
B. Diuretics
C. Sodium polystyrene sulfonate
D. Sorbitol
Answer: A
Which of the following should be monitored for a patient with hypokalemia? (SATA)
A. Muscle weakness
B. Muscle tremors
C. Paresthesia
D. Orthostatic hypotension
E. Cardiac rhythm
Answer: A, D, E
After reviewing a patient's laboratory values that were completed upon admission to the
hospital, the nurse notes that the patient's serum calcium level is 7.5 mg/dL. For what
manifestation should the nurse monitor?
A. Anorexia
B. Acute abdominal pain
C. Constipation
D. Nausea and vomiting
Answer: B
Which of the following assessment findings may present if a patient is hypocalcemic?
(SATA)
A. Confusion
B. Hypotension
C. Hypoactive deep tendon reflexes
D. Acute abdominal pain
E. Numbness and muscle spasm of the face, hands and feet
Answer: B, D, E
Which of the following assessment findings are associated with hypercalcemia? (SATA)
A. Seizures
B. Tachycardia
C. Dysrhythmias
D. Behavioral changes
E. Polyuria
Answer: C, D, E
The nurse is caring for a patient experiencing hypocalcemia. For which complications
should the nurse monitor the patient? (SATA)
A. Heart failure
B. Kidney stones
C. Peptic ulcer
D. Airway obstruction
E. Convulsions
Answer: A, D, E
The nurse reviews a patient's electrolyte laboratory report and notes that the magnesium
level is decreased at 1.4 mg/dL. Which of the following would indicate neuromuscular
effects as a result of the magnesium level?
A. Flaccidity
B. Paresthesias
C. Negative Trousseau sign
D. Drowsiness
Answer: B
The nurse is administering intravenous magnesium to correct a low magnesium level.
Which assessment finding would alert the nurse that the medication must be
discontinued?
A. Insomnia
B. Hypertension
C. Weak deep tendon reflexes
D. Nausea and vomiting
Answer: C
The nurse is caring for a patient admitted with hypermagnesemia. Which of the following
assessments would indicate that the magnesium levels are unchanged? (SATA)
A. Serum magnesium level 3.0 mg/dL
B. Decreased heart rate
C. Insomnia
D. Neuromuscular excitability
E. Decreased blood pressure
Answer: A, B, E.
Which of the following are central nervous system effects of hypomagnesemia? (SATA)
A. Hallucinations
B. Tremors
C. Seizures
D. Depression
E. Confusion
Answer: A, D, E
Which of the following is the most significant complication of hypomagnesemia?
A. Respiratory distress
B. Diarrhea
C. Renal insufficiency
D. Ventricular dysrhythmias
Answer: D
Which of the following medications is used to reverse the neuromuscular and
cardiovascular effects of hypermagnesemia?
A. Potassium
B. Magnesium citrate
C. Sodium bicarbonate
D. Calcium gluconate
Answer: D
The nurse is educating a group of nursing students on the complications of
hypomagnesemia. Which of the following assessment data reflect hypomagnesemia?
(SATA)
A. Bradyarrhythmias
B. Increased respiratory rate
C. Hypertension
D. Elevated heart rate
E. Sudden death
Answer: C, D, E
The nurse is administering magnesium sulfate therapy. Which of the following
interventions would be performed during the administration of the drug? (SATA)
A. Assess deep tendon reflexes.
B. Maintain a constantly stimulating environment.
C. Monitor serum magnesium, potassium, and calcium levels.
D. Reporting and treating electrocardiographic changes
E. Report lethargy and weakness to the primary health care provider.
Answer: A, C, D, E
The nurse assesses a patient who is experiencing hypotension, facial flushing, and
sweating. The nurse reports this assessment as consistent with which of the following?
A. Hypermagnesemia
B. Hypomagnesemia
C. Hyponatremia
D. Hypernatremia
Answer: A
The nurse is caring for a patient with hyperphosphatemia. For which symptoms does the
nurse assess the patient? (SATA)
A. Tetany
B. Chvostek sign
C. Trousseau sign
D. Intention tremor
E. Seizures
Answer: A, B, C, E
The nurse is caring for a patient with hypophosphatemia and is reinforcing the teaching
on foods high in phosphorus. Which foods does the nurse encourage the patient to eat?
(SATA)
A. Peas
B. Beets
C. Poultry
D. Brazil nuts
E. Organ meats
Answer: A, C, D, E
The nurse is caring for a patient with hypophosphatemia. Understanding that
hypophosphatemia can have systemic consequences, which body systems should the
nurse assess? (SATA)
A. Cardiovascular
B. Integumentary
C. Hematologic
D. Gastrointestinal
E. Musculoskeletal
Answer: A, C, D, E
Which of the following is a central nervous system manifestation of hypophosphatemia?
(SATA)
A. Lack of coordination
B. Hyperreflexia
C. Intention tremor
D. Positive Chvostek sign
E. Seizures
Answer: A, C, E
Which of the following is the most profound manifestation of hyperphosphatemia?
A. Ileus
B. Coma
C. Coronary artery calcification
D. Platelet dysfunction
Answer: C
The nurse is concerned that a patient with chronic renal failure is developing
hyperphosphatemia. For which manifestation should the nurse assess the patient?
A. Confusion
B. Chest pain
C. Joint stiffness
D. Muscle spasms
Answer: D
A patient has a serum phosphorous level of 2.0 mg/dL. What would the nurse most likely
assess in this patient? (SATA)
A. Lack of coordination
B. Hypotension
C. Bone pain
D. Decreased bowel sounds
E. Seizures
Answer: A, C, D
A patient is diagnosed with metabolic alkalosis. What action by the nurse will assist in
restoring this imbalance?
A. Administer potassium chloride.
B. Administer sodium bicarbonate.
C. Administer a bronchodilator.
D. Administer IV insulin.
Answer: A
The nurse is caring for a patient admitted with COPD complaining of a dull headache,
impaired memory, and personality changes. Which aciddash-base imbalance might this
patient be experiencing?
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
A 28-year-old male patient is admitted with diabetic ketoacidosis. Which electrolyte
should the nurse expect to be replaced in this patient?
A. potassium
B. magnesium
C. sodium
D. calcium
Answer: B
A patient newly diagnosed with diabetes mellitus is admitted to the emergency
department with nausea, vomiting, and abdominal pain. ABG results reveal a pH of 7.2
and a bicarbonate level of 20 mEq/L. What other assessment findings should the nurse
anticipate in this patient? (SATA)
A. dysrhythmias
B. tachycardia
C. weakness
D. Kussmaul respirations
E. cold, clammy skin
Answer: A, C, D
A patient is admitted for treatment of hypercalcemia. Which type of intravenous fluid
should the nurse expect to be prescribed for this patient?
A. dextrose 5% and 0.9% normal saline
B. dextrose 5% and 0.45% normal saline
C. dextrose 5% and water
D. normal saline
Answer: D
An older patient with peripheral neuropathy has been taking magnesium supplements.
The nurse realizes that which symptoms indicate hypermagnesemia?
A. excessive urination
B. hypotension, warmth, and sweating
C. nausea and vomiting
D. hyperreflexia
Answer: B
A nurse is caring for a patient with congestive heart failure whose EKG shows a
flattening of the T wave. Which of the following lab results should the nurse anticipate
with this EKG change?
A. Potassium 2.8
B. Digitalis level of 2
C. Hemoglobin of 9.8
D. Serum calcium 8
Answer: A
A nurse assess a patient with fluid volume excess. Which of the following manifestations
indicates fluid volume excess? (SATA)
A. Jugular vein distention
B. Decreased hematocrit
C. Postural hypotension
D. Increased heart rate
E. Fever
Answer: A, B, D
A nurse is caring for a patient with a history of congestive heart failure at risk for
developing fluid volume excess. The nurse realizes that a late manifestation of fluid
volume overload is which of the following?
A. Weight gain of 1 kg in 1 day
B. Pitting edema 3+
C. Urine output of 20mL/hr
D. Blood pressure of 170/84 mm Hg
Answer: B
A nurse is caring for a patient with suspected hypovolemic shock. Which solution is
appropriate for the nurse to administer in this circumstance?
A. 0.45% sodium chloride
B. D5% in 0.9% sodium chloride
C. D10% in water
D. 0.9% sodium chloride
Answer: D
