FLUID AND ELECTROLYTE NCLEX
PRACTICE QUESTIONS 2026 COMPLETE
REVIEW WITH VERIFIED ANSWERS|
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Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A pt, experiencing multisystem fluid volume deficit, has Answer: 1
the symptoms of tachycardia, pale, cool skin, &
decreased urine output. The nurse realizes these findings Rationale 1: The internal vasoconstrictive compensatory reactions within the body
are most likely a direct result of which of the following? are responsible for the symptoms exhibited. The body naturally attempts to
1. the body's natural compensatory mechanisms conserve fluid internally specifically for the brain & heart.
2. pharmacological effects of a diuretic Rationale 2: A diuretic would cause further fluid loss, & is contraindicated.
3. effects of rapidly infused intravenous fluids Rationale 3: Rapidly infused intravenous fluids would not cause a decrease in
4. cardiac failure urine output.
Rationale 4: The manifestations reported are not indicative of cardiac failure in this
pt.
A pregnant pt is admitted with excessive thirst, increased Answer: 1
urination, & has a medical diagnosis of diabetes insipidus.
The nurse chooses which of the following nursing Rationale 1: The pt with excessive thirst, increased urination & a medical diagnosis
diagnoses as most appropriate? of diabetes insipidus is at risk for Imbalanced Fluid Volume due to the pt &'s
1. Risk for Imbalanced Fluid Volume excess volume loss that can increase the serum levels of sodium.
2. Excess Fluid Volume Rationale 2: Excess Fluid Volume is not an issue for pts with diabetes insipidus,
3. Imbalanced Nutrition especially during the early stages of treatment.
4. Ineffective Tissue Perfusion Rationale 3: Imbalanced Nutrition does not apply.
Rationale 4: Ineffective Tissue Perfusion does not apply
A pt recovering from surgery has an indwelling urinary Answer: 1
catheter. The nurse would contact the pt's primary Rationale 1: A urine output of less than 30 mL per hour must be reported to the
healthcare provider with which of the following 24-hour primary healthcare provider. This indicates inadequate renal perfusion, placing the
urine output volumes? pt at increased risk for acute renal failure & inadequate tissue perfusion. A
1. 600 mL minimum of 720 mL over a 24-hour period is desired (30 mL multiplied by 24
2. 750 mL hours equals 720 mL per 24 hours).
3. 1000 mL
4. 1200 mL
A pt is receiving intravenous fluids postoperatively Answer: 1
following cardiac surgery. Nursing assessments should Rationale 1: Antidiuretic hormone & aldosterone levels are commonly increased
focus on which postoperative complication? following the stress response before, during, & immediately after surgery. This
1. fluid volume excess increase leads to sodium & water retention. Adding more fluids intravenously can
2. fluid volume deficit cause a fluid volume excess & stress upon the heart & circulatory system.
3. seizure activity Rationale 2: Adding more fluids intravenously can cause a fluid volume excess, not
4. liver failure fluid volume deficit, & stress upon the heart & circulatory system.
Rationale 3: Seizure activity would more commonly be associated with electrolyte
imbalances.
Rationale 4: Liver failure is not anticipated related to postoperative intravenous
fluid administration.
A pt is diagnosed with severe hyponatremia. The nurse Answer: 1
realizes this pt will mostly likely need which of the Rationale 1: Severe hyponatremia can lead to seizures. Seizure precautions such
following precautions implemented? as a quiet environment, raised side rails, & having an oral airway at the bedside
1. seizure would be included.
2. infection Rationale 2: Infection precautions not specifically indicated for a pt with
3. neutropenic hyponatremia.
4. high-risk fall Rationale 3: Neutropenic precautions not specifically indicated for a pt with
hyponatremia.
Rationale 4: High-risk fall precautions not specifically indicated for a pt with
hyponatremia.
, A pt is diagnosed with hypokalemia. After reviewing the Answer: 1
pt's current medications, which of the following might Rationale 1: Excess potassium loss through the kidneys is often caused by such
have contributed to the pt's health problem? meds as corticosteroids, potassium-wasting diuretics, amphotericin B, & large
1. corticosteroid doses of some antibiotics.
2. thiazide diuretic Rationale 2: Excessive sodium is lost with the use of thiazide diuretics.
3. narcotic Rationale 3: Narcotics do not typically affect electrolyte balance.
4. muscle relaxer Rationale 4: Muscle relaxants do not typically affect electrolyte balance.
A pt prescribed spironolactone is demonstrating ECG Answer: 1
changes & complaining of muscle weakness. The nurse Rationale 1: Hyperkalemia is serum potassium level greater than 5.0 mEq/L.
realizes this pt is exhibiting signs of which of the Decreased potassium excretion is seen in potassium-sparing diuretics such as
following? spironolactone. Common manifestations of hyperkalemia are muscle weakness &
1. hyperkalemia ECG changes.
2. hypokalemia Rationale 2: Hypokalemia is seen in non-potassium diuretics such as furosemide.
3. hypercalcemia Rationale 3: Hypercalcemia has been associated with thiazide diuretics.
4. hypocalcemia Rationale 4: Hypocalcemia is seen in pts who have received many units of citrated
blood & is not associated with diuretic use.
The nurse is planning care for a pt with fluid volume Answer: 1
overload & hyponatremia. Which of the following should Rationale 1: The nursing care for a pt with hyponatremia is dependent on the
be included in this pt's plan of care? cause. Restriction of fluids to 1,000 mL/day is usually implemented to assist sodium
1. Restrict fluids. increase & to prevent the sodium level from dropping further due to dilution.
2. Administer intravenous fluids. Rationale 2: The administration of intravenous fluids would be indicated in fluid
3. Provide Kayexalate. volume deficit & hypernatremia.
4. Administer intravenous normal saline with furosemide. Rationale 3: Kayexalate is used in pts with hyperkalemia.
Rationale 4: The administration of normal saline with furosemide is used to
increase calcium secretion.
When caring for a pt diagnosed with hypocalcemia, Answer: 1
which of the following should the nurse additionally Rationale 1: The pt diagnosed with hypocalcemia may also have high phosphorus
assess in the pt? or decreased magnesium levels.
1. other electrolyte disturbances Rationale 2: The pt with hypocalcemia may exhibit hypotension, & not
2. hypertension hypertension.
3. visual disturbances Rationale 3: Visual disturbances do not occur with hypocalcemia.
4. drug toxicity Rationale 4: Hypercalcemia is more commonly caused by drug toxicities.
A pt with a history of stomach ulcers is diagnosed with Answer: 1
hypophosphatemia. Which of the following interventions Rationale 1: Treatment of hypophosphatemia includes treating the underlying
should the nurse include in this pt's plan of care? cause & promoting a high phosphate diet, especially milk, if it is tolerated. Other
1. Request a dietitian consult for selecting foods high in foods high in phosphate are dried beans & peas, eggs, fish, organ meats, Brazil
phosphorous. nuts & peanuts, poultry, seeds & whole grains.
2. Provide aluminum hydroxide antacids as prescribed. Rationale 2: Phosphate-binding antacids, such as aluminum hydroxide, should be
3. Instruct pt to avoid poultry, peanuts, & seeds. avoided.
4. Instruct to avoid the intake of sodium phosphate. Rationale 3: Poultry, peanuts, & seeds are part of a high phosphate diet.
Rationale 4: Mild hypophosphatemia may be corrected by oral supplements, such
as sodium phosphate.
PRACTICE QUESTIONS 2026 COMPLETE
REVIEW WITH VERIFIED ANSWERS|
GRADED A+ | GUARANTEED SUCCESS
Updated 2026 Questions and Answers | 100% Verified
Exam Prep and Comprehensive Rationales Included
,A pt, experiencing multisystem fluid volume deficit, has Answer: 1
the symptoms of tachycardia, pale, cool skin, &
decreased urine output. The nurse realizes these findings Rationale 1: The internal vasoconstrictive compensatory reactions within the body
are most likely a direct result of which of the following? are responsible for the symptoms exhibited. The body naturally attempts to
1. the body's natural compensatory mechanisms conserve fluid internally specifically for the brain & heart.
2. pharmacological effects of a diuretic Rationale 2: A diuretic would cause further fluid loss, & is contraindicated.
3. effects of rapidly infused intravenous fluids Rationale 3: Rapidly infused intravenous fluids would not cause a decrease in
4. cardiac failure urine output.
Rationale 4: The manifestations reported are not indicative of cardiac failure in this
pt.
A pregnant pt is admitted with excessive thirst, increased Answer: 1
urination, & has a medical diagnosis of diabetes insipidus.
The nurse chooses which of the following nursing Rationale 1: The pt with excessive thirst, increased urination & a medical diagnosis
diagnoses as most appropriate? of diabetes insipidus is at risk for Imbalanced Fluid Volume due to the pt &'s
1. Risk for Imbalanced Fluid Volume excess volume loss that can increase the serum levels of sodium.
2. Excess Fluid Volume Rationale 2: Excess Fluid Volume is not an issue for pts with diabetes insipidus,
3. Imbalanced Nutrition especially during the early stages of treatment.
4. Ineffective Tissue Perfusion Rationale 3: Imbalanced Nutrition does not apply.
Rationale 4: Ineffective Tissue Perfusion does not apply
A pt recovering from surgery has an indwelling urinary Answer: 1
catheter. The nurse would contact the pt's primary Rationale 1: A urine output of less than 30 mL per hour must be reported to the
healthcare provider with which of the following 24-hour primary healthcare provider. This indicates inadequate renal perfusion, placing the
urine output volumes? pt at increased risk for acute renal failure & inadequate tissue perfusion. A
1. 600 mL minimum of 720 mL over a 24-hour period is desired (30 mL multiplied by 24
2. 750 mL hours equals 720 mL per 24 hours).
3. 1000 mL
4. 1200 mL
A pt is receiving intravenous fluids postoperatively Answer: 1
following cardiac surgery. Nursing assessments should Rationale 1: Antidiuretic hormone & aldosterone levels are commonly increased
focus on which postoperative complication? following the stress response before, during, & immediately after surgery. This
1. fluid volume excess increase leads to sodium & water retention. Adding more fluids intravenously can
2. fluid volume deficit cause a fluid volume excess & stress upon the heart & circulatory system.
3. seizure activity Rationale 2: Adding more fluids intravenously can cause a fluid volume excess, not
4. liver failure fluid volume deficit, & stress upon the heart & circulatory system.
Rationale 3: Seizure activity would more commonly be associated with electrolyte
imbalances.
Rationale 4: Liver failure is not anticipated related to postoperative intravenous
fluid administration.
A pt is diagnosed with severe hyponatremia. The nurse Answer: 1
realizes this pt will mostly likely need which of the Rationale 1: Severe hyponatremia can lead to seizures. Seizure precautions such
following precautions implemented? as a quiet environment, raised side rails, & having an oral airway at the bedside
1. seizure would be included.
2. infection Rationale 2: Infection precautions not specifically indicated for a pt with
3. neutropenic hyponatremia.
4. high-risk fall Rationale 3: Neutropenic precautions not specifically indicated for a pt with
hyponatremia.
Rationale 4: High-risk fall precautions not specifically indicated for a pt with
hyponatremia.
, A pt is diagnosed with hypokalemia. After reviewing the Answer: 1
pt's current medications, which of the following might Rationale 1: Excess potassium loss through the kidneys is often caused by such
have contributed to the pt's health problem? meds as corticosteroids, potassium-wasting diuretics, amphotericin B, & large
1. corticosteroid doses of some antibiotics.
2. thiazide diuretic Rationale 2: Excessive sodium is lost with the use of thiazide diuretics.
3. narcotic Rationale 3: Narcotics do not typically affect electrolyte balance.
4. muscle relaxer Rationale 4: Muscle relaxants do not typically affect electrolyte balance.
A pt prescribed spironolactone is demonstrating ECG Answer: 1
changes & complaining of muscle weakness. The nurse Rationale 1: Hyperkalemia is serum potassium level greater than 5.0 mEq/L.
realizes this pt is exhibiting signs of which of the Decreased potassium excretion is seen in potassium-sparing diuretics such as
following? spironolactone. Common manifestations of hyperkalemia are muscle weakness &
1. hyperkalemia ECG changes.
2. hypokalemia Rationale 2: Hypokalemia is seen in non-potassium diuretics such as furosemide.
3. hypercalcemia Rationale 3: Hypercalcemia has been associated with thiazide diuretics.
4. hypocalcemia Rationale 4: Hypocalcemia is seen in pts who have received many units of citrated
blood & is not associated with diuretic use.
The nurse is planning care for a pt with fluid volume Answer: 1
overload & hyponatremia. Which of the following should Rationale 1: The nursing care for a pt with hyponatremia is dependent on the
be included in this pt's plan of care? cause. Restriction of fluids to 1,000 mL/day is usually implemented to assist sodium
1. Restrict fluids. increase & to prevent the sodium level from dropping further due to dilution.
2. Administer intravenous fluids. Rationale 2: The administration of intravenous fluids would be indicated in fluid
3. Provide Kayexalate. volume deficit & hypernatremia.
4. Administer intravenous normal saline with furosemide. Rationale 3: Kayexalate is used in pts with hyperkalemia.
Rationale 4: The administration of normal saline with furosemide is used to
increase calcium secretion.
When caring for a pt diagnosed with hypocalcemia, Answer: 1
which of the following should the nurse additionally Rationale 1: The pt diagnosed with hypocalcemia may also have high phosphorus
assess in the pt? or decreased magnesium levels.
1. other electrolyte disturbances Rationale 2: The pt with hypocalcemia may exhibit hypotension, & not
2. hypertension hypertension.
3. visual disturbances Rationale 3: Visual disturbances do not occur with hypocalcemia.
4. drug toxicity Rationale 4: Hypercalcemia is more commonly caused by drug toxicities.
A pt with a history of stomach ulcers is diagnosed with Answer: 1
hypophosphatemia. Which of the following interventions Rationale 1: Treatment of hypophosphatemia includes treating the underlying
should the nurse include in this pt's plan of care? cause & promoting a high phosphate diet, especially milk, if it is tolerated. Other
1. Request a dietitian consult for selecting foods high in foods high in phosphate are dried beans & peas, eggs, fish, organ meats, Brazil
phosphorous. nuts & peanuts, poultry, seeds & whole grains.
2. Provide aluminum hydroxide antacids as prescribed. Rationale 2: Phosphate-binding antacids, such as aluminum hydroxide, should be
3. Instruct pt to avoid poultry, peanuts, & seeds. avoided.
4. Instruct to avoid the intake of sodium phosphate. Rationale 3: Poultry, peanuts, & seeds are part of a high phosphate diet.
Rationale 4: Mild hypophosphatemia may be corrected by oral supplements, such
as sodium phosphate.
