Medical Surgical Testbank Updated
2026 Edition / Comprehensive
Questions With Verified Correct
Answers/100% Correct / Graded A+
Exam 1 - CORRECT ANSWES -- fluid and electrolyreacid base
thermoregulation
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances - CORRECT ANSWES -- ---
1. 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. - CORRECT ANSWES -- The blood
pressure is 90/40 mm Hg.
4. 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.
c.
when the patient feels thirsty.
d.
as soon as changes in level of consciousness (LOC) occur. - CORRECT ANSWES -- if
the oral mucosa feels dry.
Rationale: 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.
5. 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. - CORRECT ANSWES -- generalized weakness.
Rationale: 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.
,6. Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient as
a diuretic. Which statement by the patient indicates that the teaching about this
medication has been effective?
a.
I will try to drink at least 8 glasses of water every day.
b.
I will use a salt substitute to decrease my sodium intake.
c.
I will increase my intake of potassium-containing foods.
d.
I will drink apple juice instead of orange juice for breakfast. - CORRECT ANSWES -- I
will drink apple juice instead of orange juice for breakfast.
Rationale: Since spironolactone is a potassium-sparing diuretic, patients should be
taught to choose low potassium foods such as apple juice rather than foods that have
higher levels of potassium, such as citrus fruits. Because the patient is using
spironolactone as a diuretic, the nurse would not encourage the patient to increase fluid
intake. Teach patients to avoid salt substitutes, which are high in potassium.
7. When caring for a patient admitted with hyponatremia, which actions will the nurse
anticipate taking?
a.
Restrict patients oral free water intake.
b.
Avoid use of electrolyte-containing drinks.
c.
Infuse a solution of 5% dextrose in 0.45% saline.
d.
Administer vasopressin (antidiuretic hormone, [ADH]). - CORRECT ANSWES -- Restrict
patients oral free water intake.
, Rationale: To help improve serum sodium levels, water intake is restricted. Electrolyte-
containing beverages will improve the patients sodium level. Administration of
vasopressin or hypotonic IV solutions will decrease the serum sodium level further.
8. Intravenous potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient
with severe hypokalemia. Which action should the nurse take?
a.
Administer the KCl as a rapid IV bolus.
b.
Infuse the KCl at a rate of 20 mEq/hour.
c.
Give the KCl only through a central venous line.
d.
Add no more than 40 mEq/L to a liter of IV fluid. - CORRECT ANSWES -- Infuse the
KCl at a rate of 20 mEq/hour.
Rationale: Intravenous KCl is administered at a maximal rate of 20 mEq/hr. Rapid IV
infusion of KCl can cause cardiac arrest. Although the preferred concentration for KCl is
no more than 40 mEq/L, concentrations up to 80 mEq/L may be used for some patients.
KCl can cause inflammation of peripheral veins, but it can be administered by this route.
9. A postoperative patient who has been receiving nasogastric suction for 3 days has a
serum sodium level of 125 mEq/L (125 mmol/L). Which of these prescribed therapies
that the patient has been receiving should the nurse question?
a.
Infuse 5% dextrose in water at 125 ml/hr.
b.
Administer IV morphine sulfate 4 mg every 2 hours PRN.
c.
Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
2026 Edition / Comprehensive
Questions With Verified Correct
Answers/100% Correct / Graded A+
Exam 1 - CORRECT ANSWES -- fluid and electrolyreacid base
thermoregulation
Chapter 17: Fluid, Electrolyte, and Acid-Base Imbalances - CORRECT ANSWES -- ---
1. 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. - CORRECT ANSWES -- The blood
pressure is 90/40 mm Hg.
4. 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.
c.
when the patient feels thirsty.
d.
as soon as changes in level of consciousness (LOC) occur. - CORRECT ANSWES -- if
the oral mucosa feels dry.
Rationale: 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.
5. 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. - CORRECT ANSWES -- generalized weakness.
Rationale: 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.
,6. Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient as
a diuretic. Which statement by the patient indicates that the teaching about this
medication has been effective?
a.
I will try to drink at least 8 glasses of water every day.
b.
I will use a salt substitute to decrease my sodium intake.
c.
I will increase my intake of potassium-containing foods.
d.
I will drink apple juice instead of orange juice for breakfast. - CORRECT ANSWES -- I
will drink apple juice instead of orange juice for breakfast.
Rationale: Since spironolactone is a potassium-sparing diuretic, patients should be
taught to choose low potassium foods such as apple juice rather than foods that have
higher levels of potassium, such as citrus fruits. Because the patient is using
spironolactone as a diuretic, the nurse would not encourage the patient to increase fluid
intake. Teach patients to avoid salt substitutes, which are high in potassium.
7. When caring for a patient admitted with hyponatremia, which actions will the nurse
anticipate taking?
a.
Restrict patients oral free water intake.
b.
Avoid use of electrolyte-containing drinks.
c.
Infuse a solution of 5% dextrose in 0.45% saline.
d.
Administer vasopressin (antidiuretic hormone, [ADH]). - CORRECT ANSWES -- Restrict
patients oral free water intake.
, Rationale: To help improve serum sodium levels, water intake is restricted. Electrolyte-
containing beverages will improve the patients sodium level. Administration of
vasopressin or hypotonic IV solutions will decrease the serum sodium level further.
8. Intravenous potassium chloride (KCl) 60 mEq is prescribed for treatment of a patient
with severe hypokalemia. Which action should the nurse take?
a.
Administer the KCl as a rapid IV bolus.
b.
Infuse the KCl at a rate of 20 mEq/hour.
c.
Give the KCl only through a central venous line.
d.
Add no more than 40 mEq/L to a liter of IV fluid. - CORRECT ANSWES -- Infuse the
KCl at a rate of 20 mEq/hour.
Rationale: Intravenous KCl is administered at a maximal rate of 20 mEq/hr. Rapid IV
infusion of KCl can cause cardiac arrest. Although the preferred concentration for KCl is
no more than 40 mEq/L, concentrations up to 80 mEq/L may be used for some patients.
KCl can cause inflammation of peripheral veins, but it can be administered by this route.
9. A postoperative patient who has been receiving nasogastric suction for 3 days has a
serum sodium level of 125 mEq/L (125 mmol/L). Which of these prescribed therapies
that the patient has been receiving should the nurse question?
a.
Infuse 5% dextrose in water at 125 ml/hr.
b.
Administer IV morphine sulfate 4 mg every 2 hours PRN.
c.
Give IV metoclopramide (Reglan) 10 mg every 6 hours PRN for nausea.
