FLUIDS AND ELECTROLYTES

1. The major cation found in the extracellular fluid is:

a. Sodium
b. Potassium
c. Calcium
d. Magnesium

2. Which electrolyte plays a major role in maintaining osmotic pressure in the extracellular fluid?
a. Sodium
b. Potassium
c. Calcium
d. Magnesium

3. The normal serum potassium range is:

a. 2.5–3.5 mEq/L
b. 3.5–5.0 mEq/L
c. 4.5–6.0 mEq/L
d. 5.0–6.5 mEq/L

4. Which fluid type is classified as hypertonic?

a. 0.45% Sodium Chloride
b. 0.9% Sodium Chloride
c. 3% Sodium Chloride
d. Lactated Ringer’s

5. A patient with fluid volume deficit will likely present with:

a. Bradycardia
b. Hypertension
c. Tachycardia
d. Moist skin

6. Which hormone promotes water retention by the kidneys?

a. Aldosterone
b. Antidiuretic hormone
c. Parathyroid hormone
d. Calcitonin

7. Which electrolyte is most closely associated with cardiac dysrhythmias when levels are
abnormal?
a. Sodium
b. Potassium
c. Calcium
d. Chloride

8. A low serum magnesium level often occurs concurrently with:

a. Hypokalemia
b. Hypernatremia
c. Hypercalcemia
d. Hyperphosphatemia

9. Which symptom is common in severe hypernatremia?

a. Peripheral edema
b. Restlessness
c. Muscle cramping
d. Increased salivation

10. A positive Trousseau’s sign is indicative of:

a. Hypernatremia
b. Hypocalcemia
c. Hyperkalemia
d. Hypophosphatemia
11. Which electrolyte is primarily responsible for the neuromuscular activity of the heart?
a. Sodium
b. Potassium
c. Calcium
d. Magnesium

12. Lactated Ringer’s solution is contraindicated in which condition?

a. Dehydration
b. Hyperkalemia
c. Hypovolemia
d. Acidosis

13. What is the primary route of water loss in the body under normal conditions?
a. Feces
b. Urine
c. Sweat
d. Respirations

14. The main function of calcium in the body is to:

a. Regulate fluid balance
b. Maintain bone structure
c. Promote oxygen transport
d. Balance acid-base levels

15. Which condition can cause hypercalcemia?

a. Renal failure
b. Vitamin D deficiency
c. Hyperparathyroidism
d. Chronic diarrhea

16. Hypomagnesemia can result from:

a. Chronic alcoholism
b. Hypothyroidism
c. Hypercalcemia
d. Renal failure

17. Which of the following is an early sign of fluid volume deficit?

a. Increased blood pressure
b. Decreased heart rate
c. Dry mucous membranes
d. Edema

18. The primary function of albumin in maintaining fluid balance is:

a. Osmotic pressure regulation
b. Blood coagulation
c. Energy metabolism
d. Oxygen transport

19. Hyperkalemia is commonly associated with:

a. Hypoparathyroidism
b. Diabetes insipidus
c. Renal failure
d. Prolonged vomiting

20. Which organ is the primary regulator of sodium levels in the body?
a. Heart
b. Kidneys
c. Liver
d. Lungs

21. A patient with severe burns is most at risk for which type of fluid imbalance?
a. Fluid volume excess
b. Fluid volume deficit
c. Hypernatremia
d. Hypokalemia

22. Which electrolyte imbalance is characterized by flattened T waves on an ECG?

a. Hypocalcemia
b. Hypermagnesemia
c. Hyperkalemia
d. Hypokalemia

23. The primary buffer system of the body is:

a. Hemoglobin buffer system
b. Phosphate buffer system
c. Bicarbonate buffer system
d. Protein buffer system

24. Hypermagnesemia is most commonly caused by:

a. Chronic kidney disease
b. Severe diarrhea
c. Alcoholism
d. Diuretic use

25. Which of the following is a common symptom of hypercalcemia?

a. Muscle twitching
b. Increased deep tendon reflexes
c. Nausea and vomiting
d. Tetany

26. Which IV fluid is contraindicated in a patient with cerebral edema?

a. 0.9% Sodium Chloride
b. 3% Sodium Chloride
c. 5% Dextrose in Water
d. Lactated Ringer’s

27. Which electrolyte is inversely related to calcium levels in the body?

a. Sodium
b. Potassium
c. Phosphorus
d. Magnesium

28. What is the primary concern when administering potassium IV?

a. Fluid overload
b. Phlebitis
c. Cardiac arrhythmias
d. Hypotension

29. Which of the following is a symptom of hypophosphatemia?

a. Confusion
b. Tetany
c. Hyperreflexia
d. Abdominal cramping

30. A nurse is monitoring a patient with syndrome of inappropriate antidiuretic hormone

(SIADH). Which electrolyte imbalance is most likely?
a. Hypernatremia
b. Hyponatremia
c. Hyperkalemia
d. Hypocalcemia

31. Which of the following fluids is appropriate for correcting severe hyponatremia?
a. 0.45% Sodium Chloride
b. 0.9% Sodium Chloride
c. 3% Sodium Chloride
d. 5% Dextrose in Water

32. What is the primary function of potassium in the body?

a. Maintain blood clotting
b. Regulate acid-base balance
c. Facilitate cardiac and muscle contraction
d. Enhance calcium absorption

33. Which clinical manifestation is associated with hypocalcemia?

a. Absent reflexes
b. Positive Chvostek’s sign
c. Hyperactivity
d. Bradycardia

34. What is the most common cause of fluid volume overload?

a. Renal failure
b. Diarrhea
c. Fever
d. Excessive sweating

35. Which electrolyte imbalance should the nurse suspect in a patient with tall, peaked T waves
on an ECG?
a. Hypernatremia
b. Hypokalemia
c. Hyperkalemia
d. Hypercalcemia

36. In metabolic acidosis, which electrolyte is commonly lost?

a. Calcium
b. Sodium
c. Potassium
d. Bicarbonate

37. A patient with diabetes insipidus is most likely to experience:

a. Hyperkalemia
b. Hypercalcemia
c. Hypernatremia
d. Hyponatremia

38. The body’s compensatory response to respiratory acidosis is:

a. Increased respiratory rate
b. Decreased bicarbonate excretion
c. Increased bicarbonate reabsorption
d. Decreased carbon dioxide retention

39. Which laboratory result supports the diagnosis of dehydration?

a. Decreased urine specific gravity
b. Elevated hematocrit
c. Decreased serum sodium
d. Low blood urea nitrogen (BUN)

40. What is the main concern when administering hypertonic solutions?

a. Pulmonary edema
b. Hyperkalemia
c. Hypotension
d. Fluid shift into cells

41. Which electrolyte is a major component of gastric secretions?

a. Chloride
b. Potassium
c. Sodium
d. Phosphorus

42. A patient receiving loop diuretics is at risk for which electrolyte imbalance?
a. Hyperkalemia
b. Hypernatremia
c. Hypokalemia
d. Hypocalcemia

43. Which condition is most likely to cause hypochloremia?

a. Dehydration
b. Prolonged vomiting
c. Renal failure
d. Excessive sodium intake

44. Which of the following foods is high in potassium?

a. White rice
b. Chicken breast
c. Cheese
d. Bananas

45. Which laboratory finding indicates dehydration?

a. Decreased sodium
b. Increased urine specific gravity
c. Decreased hematocrit
d. Low serum creatinine

46. Hypernatremia most commonly results from:

a. Excessive water loss
b. Sodium loss
c. Increased fluid intake
d. Decreased protein intake

47. A patient with hypokalemia may exhibit which ECG finding?

a. Peaked T waves
b. Flattened T waves
c. Shortened QT interval
d. Prolonged PR interval

48. What is the most effective way to monitor fluid volume status in a patient?
a. Measure urine output
b. Monitor vital signs
c. Assess skin turgor
d. Record daily weights

49. A patient presents with confusion, dry mucous membranes, and increased serum sodium. The
most likely diagnosis is:
a. Fluid volume deficit
b. Fluid volume overload
c. Hypernatremia
d. Hyponatremia

50. The major role of phosphate in the body is:

a. Muscle contraction
b. Nerve impulse transmission
c. Bone and teeth formation
d. Fluid balance

51. Which of the following is a symptom of severe hypermagnesemia?

a. Tetany
b. Respiratory depression
c. Increased reflexes
d. Bradycardia

52. A nurse administers IV calcium gluconate. What is the most important parameter to monitor?
a. Respiratory rate
b. Heart rate
c. Oxygen saturation
d. Serum potassium

53. Which of the following patients is at highest risk for fluid volume overload?
a. A patient with diarrhea
b. A patient with heart failure
c. A patient on diuretics
d. A patient with pneumonia

54. Which electrolyte imbalance is associated with alcohol withdrawal?

a. Hypophosphatemia
b. Hypernatremia
c. Hypercalcemia
d. Hypermagnesemia

55. A nurse is caring for a patient with hyperkalemia. What is the priority nursing intervention?
a. Administer potassium supplements
b. Administer sodium polystyrene sulfonate
c. Monitor cardiac function
d. Encourage potassium-rich foods

56. A patient with prolonged diarrhea is at risk for:

a. Hypercalcemia
b. Metabolic alkalosis
c. Hypokalemia
d. Hypernatremia

57. Which condition increases the risk of hypomagnesemia?

a. Chronic alcoholism
b. Renal failure
c. Hyperparathyroidism
d. Addison’s disease

58. The primary intracellular cation is:

a. Sodium
b. Potassium
c. Magnesium
d. Calcium

59. A patient with end-stage renal disease develops hyperphosphatemia. Which electrolyte is
most likely to decrease as a result?
a. Potassium
b. Sodium
c. Calcium
d. Magnesium

60. Which symptom indicates fluid volume overload?

a. Dry skin
b. Increased urine output
c. Crackles in the lungs
d. Tachycardia

61. Which of the following conditions can cause respiratory acidosis?

a. Hyperventilation
b. Diarrhea
c. Chronic obstructive pulmonary disease (COPD)
d. Prolonged vomiting

62. The main function of magnesium is:

a. To promote blood clotting
b. To maintain osmotic balance
c. To regulate muscle and nerve function
d. To transport oxygen

63. A nurse notes a serum sodium level of 128 mEq/L. Which intervention is most appropriate?
a. Encourage water intake
b. Administer a hypertonic saline solution
c. Provide a potassium supplement
d. Monitor for bradycardia

64. The most common cause of hyperkalemia is:

a. Excessive dietary potassium intake
b. Dehydration
c. Renal failure
d. Diabetic ketoacidosis

65. A patient with diarrhea is at risk for which acid-base imbalance?

a. Metabolic acidosis
b. Metabolic alkalosis
c. Respiratory acidosis
d. Respiratory alkalosis

66. What is the primary electrolyte imbalance in a patient with excessive water intake?
a. Hyperkalemia
b. Hypercalcemia
c. Hyponatremia
d. Hypophosphatemia

67. A low serum chloride level is often seen with:

a. Hypernatremia
b. Metabolic alkalosis
c. Hypokalemia
d. Hyperphosphatemia

68. Which condition is most associated with hypercalcemia?

a. Pancreatitis
b. Prolonged immobilization
c. Chronic diarrhea
d. Addison’s disease

69. In metabolic alkalosis, which electrolyte is typically low?

a. Potassium
b. Sodium
c. Calcium
d. Magnesium

70. The primary concern for a patient with hypocalcemia is:

a. Seizures
b. Cardiac arrest
c. Renal failure
d. Muscle cramps

71. A nurse caring for a patient with hypomagnesemia should monitor for which complication?
a. Cardiac arrhythmias
b. Hyperactive reflexes
c. Increased respiratory rate
d. Muscle rigidity
72. Which electrolyte is commonly monitored in a patient receiving insulin for diabetic
ketoacidosis?
a. Calcium
b. Magnesium
c. Potassium
d. Sodium

73. A serum potassium level of 2.8 mEq/L may cause which symptom?
a. Muscle cramps
b. Diarrhea
c. Decreased reflexes
d. Bradycardia

74. Which electrolyte imbalance can cause prolonged QT intervals on an ECG?

a. Hyperkalemia
b. Hypocalcemia
c. Hypernatremia
d. Hypophosphatemia

75. The best indicator of fluid balance in the body is:

a. Blood pressure
b. Daily weight
c. Urine output
d. Skin turgor

76. A serum sodium level of 115 mEq/L is most likely to result in:
a. Increased blood pressure
b. Seizures
c. Muscle weakness
d. Nausea and vomiting

77. Which of the following electrolyte imbalances is most commonly caused by diuretic therapy?
a. Hypokalemia
b. Hypernatremia
c. Hypercalcemia
d. Hypermagnesemia

78. Which electrolyte imbalance is most associated with muscle twitching and spasms?
a. Hypocalcemia
b. Hyperkalemia
c. Hyponatremia
d. Hypomagnesemia

79. A patient receiving intravenous fluids develops jugular vein distension and crackles in the
lungs. What is the nurse’s priority intervention?
a. Increase the IV fluid rate
b. Administer a diuretic
c. Discontinue the IV fluids
d. Notify the healthcare provider

80. Which electrolyte imbalance can result from an overuse of phosphate-containing laxatives?
a. Hypernatremia
b. Hypocalcemia
c. Hyperkalemia
d. Hypomagnesemia

Select All That Apply (81–100)

81. Which symptoms are associated with fluid volume deficit?

a. Dry mucous membranes
b. Increased urine output
c. Hypotension
d. Tachycardia
e. Peripheral edema

82. Which interventions are appropriate for a patient with hyperkalemia?

a. Administering calcium gluconate
b. Administering IV insulin with glucose
c. Encouraging a high-potassium diet
d. Administering sodium polystyrene sulfonate
e. Initiating a potassium-sparing diuretic

83. Which foods are rich in magnesium?

a. Spinach
b. Avocados
c. Bananas
d. Almonds
e. White bread

84. A nurse is caring for a patient with hypocalcemia. Which symptoms should the nurse monitor
for?
a. Positive Trousseau’s sign
b. Muscle twitching
c. Numbness in fingers
d. Constipation
e. Seizures

85. Which conditions may cause metabolic acidosis?

a. Renal failure
b. Diabetic ketoacidosis
c. Prolonged vomiting
d. Severe diarrhea
e. Hyperventilation

86. What are common signs of hypernatremia?

a. Dry tongue
b. Increased thirst
c. Restlessness
d. Muscle weakness
e. Weight gain

87. Which nursing interventions are appropriate for a patient with fluid volume overload?
a. Restricting sodium intake
b. Administering diuretics
c. Encouraging fluids
d. Monitoring daily weights
e. Elevating the head of the bed

88. Which symptoms indicate hypokalemia?

a. Muscle weakness
b. Paralytic ileus
c. Bradycardia
d. Positive Chvostek’s sign
e. Shallow respirations

89. Which conditions can cause hypercalcemia?

a. Hyperparathyroidism
b. Prolonged immobilization
c. Renal failure
d. Vitamin D toxicity
e. Severe diarrhea

90. What are signs of hypomagnesemia?

a. Positive Trousseau’s sign
b. Seizures
c. Hyperactive reflexes
d. Respiratory depression
e. Muscle weakness

91. Which electrolyte imbalances are commonly seen in patients with chronic kidney disease?
a. Hyperphosphatemia
b. Hyperkalemia
c. Hypocalcemia
d. Hyponatremia
e. Hypomagnesemia

92. What are potential causes of hyponatremia?

a. Excessive sweating
b. SIADH
c. Heart failure
d. Prolonged diarrhea
e. High sodium intake

93. Which symptoms are associated with hypophosphatemia?

a. Confusion
b. Bone pain
c. Muscle weakness
d. Tetany
e. Increased bleeding risk

94. Which conditions may lead to respiratory alkalosis?

a. Anxiety
b. Hypoventilation
c. Fever
d. Pain
e. Aspirin overdose

95. Which interventions are appropriate for a patient with metabolic alkalosis?
a. Administering potassium chloride
b. Monitoring for tetany
c. Administering sodium bicarbonate
d. Monitoring for shallow respirations
e. Administering antiemetics

96. Which symptoms are associated with fluid volume excess?

a. Edema
b. Weight gain
c. Decreased urine output
d. Crackles in the lungs
e. Increased heart rate

97. What are the primary functions of potassium in the body?

a. Regulation of acid-base balance
b. Transmission of nerve impulses
c. Blood clotting
d. Muscle contraction
e. Regulation of fluid volume

98. Which conditions can cause hypokalemia?

a. Prolonged diarrhea
b. Loop diuretic use
c. Chronic alcoholism
d. Hyperaldosteronism
e. Diabetic ketoacidosis
99. Which symptoms are indicative of hypermagnesemia?
a. Decreased reflexes
b. Hypotension
c. Increased respiratory rate
d. Flushing
e. Tachycardia

100. Which electrolyte disturbances are likely to be seen in a patient with pancreatitis?
a. Hypocalcemia
b. Hypernatremia
c. Hypomagnesemia
d. Hyperphosphatemia
e. Hyperkalemia