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Fluid and Electrolytes NCLEX questions
and Answers with Rationales
The nurse obtains all of the following assessment data about a patient with deficient fluid volume
caused by a massive burn injury. Which of the following assessment data will be of greatest concern?
a. The blood pressure is 90/40 mm Hg.
b. Urine output is 30 ml over the last hour.
c. Oral fluid intake is 100 ml for the last 8 hours.
d. There is prolonged skin tenting over the sternum.
a. The blood pressure is 90/40 mm Hg.
The blood pressure indicates that the patient may be developing hypovolemic shock as a result of fluid
loss. This will require immediate intervention to prevent the complications associated with systemic
hypoperfusion. The poor oral intake, decreased urine output, and skin tenting all indicate the need for
increasing the patients fluid intake but not as urgently as the hypotension.
A recently admitted patient has a small cell carcinoma of the lung, which is causing the syndrome of
inappropriate antidiuretic hormone (SIADH). The nurse will monitor carefully for
a. increased total urinary output.
b. elevation of serum hematocrit.
c. decreased serum sodium level.
d. rapid and unexpected weight loss.
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c. decreased serum sodium level.
SIADH causes water retention and a decrease in serum sodium level. Weight loss, increased urine
output, and elevated serum hematocrit may be associated with excessive loss of water, but not with
SIADH and water retention.
When the nurse is evaluating the fluid balance for a patient admitted for hypovolemia associated with
multiple draining wounds, the most accurate assessment to include is
a. skin turgor.
b. daily weight.
c. presence of edema.
d. hourly urine output.
b. daily weight.
Daily weight is the most easily obtained and accurate means of assessing volume status. Skin turgor
varies considerably with age. Considerable excess fluid volume may be present before fluid moves into
the interstitial space and causes edema. Hourly urine outputs do not take account of fluid intake or of
fluid loss through insensible loss, sweating, or loss from the gastrointestinal tract or wounds.
When caring for an alert and oriented elderly patient with a history of dehydration, the home health
nurse will teach the patient to increase fluid intake
a. in the late evening hours.
b. if the oral mucosa feels dry.
Fluid and ElectrolytesFluid
NCLEXand questions
Electrolytes
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questions
2026/2027
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Page 2 questions, verified answers, and detailed solutions.
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c. when the patient feels thirsty.
d. as soon as changes in level of consciousness (LOC) occur.
b. if the oral mucosa feels dry.
An alert, elderly patient will be able to self-assess for signs of oral dryness such as thick oral secretions
or dry-appearing mucosa. The thirst mechanism decreases with age and is not an accurate indicator of
volume depletion. Many older patients prefer to restrict fluids slightly in the evening to improve sleep
quality. The patient will not be likely to notice and act appropriately when changes in LOC occur.
A patient is taking a potassium-wasting diuretic for treatment of hypertension. The nurse will teach the
patient to report symptoms of adverse effects such as
a. personality changes.
b. frequent loose stools.
c. facial muscle spasms.
d. generalized weakness.
d. generalized weakness.
Generalized weakness progressing to flaccidity is a manifestation of hypokalemia. Facial muscle spasms
might occur with hypocalcemia. Loose stools are associated with hyperkalemia. Personality changes are
not associated with electrolyte disturbances, although changes in mental status are common
manifestations with sodium excess or deficit.
Fluid and ElectrolytesFluid
NCLEXand questions
Electrolytes
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Page 3 questions, verified answers, and detailed solutions.
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Fluid and Electrolytes NCLEX questions
and Answers with Rationales
The nurse obtains all of the following assessment data about a patient with deficient fluid volume
caused by a massive burn injury. Which of the following assessment data will be of greatest concern?
a. The blood pressure is 90/40 mm Hg.
b. Urine output is 30 ml over the last hour.
c. Oral fluid intake is 100 ml for the last 8 hours.
d. There is prolonged skin tenting over the sternum.
a. The blood pressure is 90/40 mm Hg.
The blood pressure indicates that the patient may be developing hypovolemic shock as a result of fluid
loss. This will require immediate intervention to prevent the complications associated with systemic
hypoperfusion. The poor oral intake, decreased urine output, and skin tenting all indicate the need for
increasing the patients fluid intake but not as urgently as the hypotension.
A recently admitted patient has a small cell carcinoma of the lung, which is causing the syndrome of
inappropriate antidiuretic hormone (SIADH). The nurse will monitor carefully for
a. increased total urinary output.
b. elevation of serum hematocrit.
c. decreased serum sodium level.
d. rapid and unexpected weight loss.
Fluid and ElectrolytesFluid
NCLEXand questions
Electrolytes
and
NCLEX
Answers
questions
2026/2027
with Rationales.pdf
and Updated
Answers with
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Rationales
Guide/ -2026/2027-
Page 1 questions, verified answers, and detailed solutions.
,2026/2027 comprehensive resource
/2026:
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Fluid
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and
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Electrolytes NCLEX
questions,
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andwith
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Rationales
questions,
solutionsverified
| answers, and detailed solutions.
c. decreased serum sodium level.
SIADH causes water retention and a decrease in serum sodium level. Weight loss, increased urine
output, and elevated serum hematocrit may be associated with excessive loss of water, but not with
SIADH and water retention.
When the nurse is evaluating the fluid balance for a patient admitted for hypovolemia associated with
multiple draining wounds, the most accurate assessment to include is
a. skin turgor.
b. daily weight.
c. presence of edema.
d. hourly urine output.
b. daily weight.
Daily weight is the most easily obtained and accurate means of assessing volume status. Skin turgor
varies considerably with age. Considerable excess fluid volume may be present before fluid moves into
the interstitial space and causes edema. Hourly urine outputs do not take account of fluid intake or of
fluid loss through insensible loss, sweating, or loss from the gastrointestinal tract or wounds.
When caring for an alert and oriented elderly patient with a history of dehydration, the home health
nurse will teach the patient to increase fluid intake
a. in the late evening hours.
b. if the oral mucosa feels dry.
Fluid and ElectrolytesFluid
NCLEXand questions
Electrolytes
and
NCLEX
Answers
questions
2026/2027
with Rationales.pdf
and Updated
Answers with
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Rationales
Guide/ -2026/2027-
Page 2 questions, verified answers, and detailed solutions.
, 2026/2027 comprehensive resource
/2026:
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Fluid
chapter-by-chapter
and
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Electrolytes NCLEX
questions,
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andwith
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Rationales
questions,
solutionsverified
| answers, and detailed solutions.
c. when the patient feels thirsty.
d. as soon as changes in level of consciousness (LOC) occur.
b. if the oral mucosa feels dry.
An alert, elderly patient will be able to self-assess for signs of oral dryness such as thick oral secretions
or dry-appearing mucosa. The thirst mechanism decreases with age and is not an accurate indicator of
volume depletion. Many older patients prefer to restrict fluids slightly in the evening to improve sleep
quality. The patient will not be likely to notice and act appropriately when changes in LOC occur.
A patient is taking a potassium-wasting diuretic for treatment of hypertension. The nurse will teach the
patient to report symptoms of adverse effects such as
a. personality changes.
b. frequent loose stools.
c. facial muscle spasms.
d. generalized weakness.
d. generalized weakness.
Generalized weakness progressing to flaccidity is a manifestation of hypokalemia. Facial muscle spasms
might occur with hypocalcemia. Loose stools are associated with hyperkalemia. Personality changes are
not associated with electrolyte disturbances, although changes in mental status are common
manifestations with sodium excess or deficit.
Fluid and ElectrolytesFluid
NCLEXand questions
Electrolytes
and
NCLEX
Answers
questions
2026/2027
with Rationales.pdf
and Updated
Answers with
A+ Study
Rationales
Guide/ -2026/2027-
Page 3 questions, verified answers, and detailed solutions.
