ATI Fluid and Electrolytes Module Exam
Review (2026/2027 Edition) – Elsevier ATI
Content Mastery Series® | NGN-
Integrated Practice Questions with
Correct Answers and Rationales
Question 1: A nurse is reviewing the laboratory results of a client who takes
furosemide. Which of the following results should the nurse identify as the priority
finding?
• A) Phosphorus 4.5 mEq/L
• B) Sodium 145 mEq/L
• C) Potassium 2.9 mEq/L
• D) Calcium 8.2 mg/dL
Correct Answer: C
Rationale: Furosemide is a loop diuretic that can cause potassium loss.
Hypokalemia (a potassium level below 3.5 mEq/L) can be life-threatening due to
its effects on cardiac and neuromuscular function.
Question 2: A client has a sodium level of 125 mEq/L. Which assessment finding
should the nurse expect?
• A) Thirst and dry mucous membranes
• B) Lethargy and confusion
• C) Muscle twitching and tetany
, • D) Hypertension and tachycardia
Correct Answer: B
Rationale: A sodium level of 125 mEq/L indicates hyponatremia. This condition
leads to cerebral edema, causing neurological symptoms such as lethargy,
confusion, headache, and nausea.
Question 3: A nurse on a Medical Surgical unit is caring for a group of clients.
Which client should the nurse identify as being at risk for hypovolemia?
• A) A client who has chronic constipation
• B) A client who has syndrome of inappropriate antidiuretic hormone
(SIADH)
• C) A client who has nasogastric suctioning
• D) A client who took an overdose of sodium bicarbonate antacids
Correct Answer: C
Rationale: Nasogastric suctioning removes gastric contents, leading to a direct
loss of fluid and electrolytes, placing the client at significant risk for hypovolemia
(fluid volume deficit).
Question 4: A nurse is caring for a client who requires nasogastric suctioning.
Which set of laboratory results indicates that the client has metabolic alkalosis?
• A) pH 7.31, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 23 mEq/L
• B) pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 26 mEq/L
• C) pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L
• D) pH 7.51, PaO2 94 mmHg, PaCO2 36 mmHg, HCO3- 31 mEq/L
,Correct Answer: D
Rationale: In metabolic alkalosis, the pH is elevated (above 7.45), and the HCO3-
(bicarbonate) level is high (above 26 mEq/L). In this case, the elevated pH and
HCO3- with a normal PaCO2 confirm metabolic alkalosis.
Question 5: A nurse is assessing a client who is dehydrated. Which of the
following findings should the nurse expect? (Select all that apply)
• A) Moist skin
• B) Distended neck veins
• C) Tachycardia
• D) Syncope
• E) Decreased skin turgor
Correct Answer: C, D, E
Rationale: Fluid volume deficit leads to tachycardia (compensatory mechanism),
syncope (due to decreased cerebral perfusion), and poor skin turgor. Distended
neck veins and moist skin are signs of fluid volume excess.
Question 6: A nurse is preparing an IV fluid for a client who has a prescription for
a blood transfusion. Which IV solution should the nurse use to prime the tubing?
• A) 0.45% sodium chloride (½ normal saline)
• B) 0.9% sodium chloride (normal saline)
• C) Dextrose 5% in water (D5W)
• D) Lactated Ringer’s (LR)
, Correct Answer: B
Rationale: 0.9% sodium chloride (normal saline) is the only isotonic solution
compatible with blood products. It prevents hemolysis and red blood cell damage.
Hypotonic solutions can cause hemolysis, while dextrose solutions can cause
clumping.
Question 7: A client is admitted with a potassium level of 5.8 mEq/L. Which of
the following medications should the nurse anticipate administering to lower this
client's potassium level?
• A) Furosemide
• B) Spironolactone
• C) Potassium chloride
• D) Calcium gluconate
Correct Answer: A
Rationale: Furosemide is a loop diuretic that promotes potassium excretion by the
kidneys, making it effective for reducing an elevated potassium level.
Spironolactone is a potassium-sparing diuretic and would worsen hyperkalemia.
Question 8: A nurse is caring for a client 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
Review (2026/2027 Edition) – Elsevier ATI
Content Mastery Series® | NGN-
Integrated Practice Questions with
Correct Answers and Rationales
Question 1: A nurse is reviewing the laboratory results of a client who takes
furosemide. Which of the following results should the nurse identify as the priority
finding?
• A) Phosphorus 4.5 mEq/L
• B) Sodium 145 mEq/L
• C) Potassium 2.9 mEq/L
• D) Calcium 8.2 mg/dL
Correct Answer: C
Rationale: Furosemide is a loop diuretic that can cause potassium loss.
Hypokalemia (a potassium level below 3.5 mEq/L) can be life-threatening due to
its effects on cardiac and neuromuscular function.
Question 2: A client has a sodium level of 125 mEq/L. Which assessment finding
should the nurse expect?
• A) Thirst and dry mucous membranes
• B) Lethargy and confusion
• C) Muscle twitching and tetany
, • D) Hypertension and tachycardia
Correct Answer: B
Rationale: A sodium level of 125 mEq/L indicates hyponatremia. This condition
leads to cerebral edema, causing neurological symptoms such as lethargy,
confusion, headache, and nausea.
Question 3: A nurse on a Medical Surgical unit is caring for a group of clients.
Which client should the nurse identify as being at risk for hypovolemia?
• A) A client who has chronic constipation
• B) A client who has syndrome of inappropriate antidiuretic hormone
(SIADH)
• C) A client who has nasogastric suctioning
• D) A client who took an overdose of sodium bicarbonate antacids
Correct Answer: C
Rationale: Nasogastric suctioning removes gastric contents, leading to a direct
loss of fluid and electrolytes, placing the client at significant risk for hypovolemia
(fluid volume deficit).
Question 4: A nurse is caring for a client who requires nasogastric suctioning.
Which set of laboratory results indicates that the client has metabolic alkalosis?
• A) pH 7.31, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 23 mEq/L
• B) pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 26 mEq/L
• C) pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L
• D) pH 7.51, PaO2 94 mmHg, PaCO2 36 mmHg, HCO3- 31 mEq/L
,Correct Answer: D
Rationale: In metabolic alkalosis, the pH is elevated (above 7.45), and the HCO3-
(bicarbonate) level is high (above 26 mEq/L). In this case, the elevated pH and
HCO3- with a normal PaCO2 confirm metabolic alkalosis.
Question 5: A nurse is assessing a client who is dehydrated. Which of the
following findings should the nurse expect? (Select all that apply)
• A) Moist skin
• B) Distended neck veins
• C) Tachycardia
• D) Syncope
• E) Decreased skin turgor
Correct Answer: C, D, E
Rationale: Fluid volume deficit leads to tachycardia (compensatory mechanism),
syncope (due to decreased cerebral perfusion), and poor skin turgor. Distended
neck veins and moist skin are signs of fluid volume excess.
Question 6: A nurse is preparing an IV fluid for a client who has a prescription for
a blood transfusion. Which IV solution should the nurse use to prime the tubing?
• A) 0.45% sodium chloride (½ normal saline)
• B) 0.9% sodium chloride (normal saline)
• C) Dextrose 5% in water (D5W)
• D) Lactated Ringer’s (LR)
, Correct Answer: B
Rationale: 0.9% sodium chloride (normal saline) is the only isotonic solution
compatible with blood products. It prevents hemolysis and red blood cell damage.
Hypotonic solutions can cause hemolysis, while dextrose solutions can cause
clumping.
Question 7: A client is admitted with a potassium level of 5.8 mEq/L. Which of
the following medications should the nurse anticipate administering to lower this
client's potassium level?
• A) Furosemide
• B) Spironolactone
• C) Potassium chloride
• D) Calcium gluconate
Correct Answer: A
Rationale: Furosemide is a loop diuretic that promotes potassium excretion by the
kidneys, making it effective for reducing an elevated potassium level.
Spironolactone is a potassium-sparing diuretic and would worsen hyperkalemia.
Question 8: A nurse is caring for a client 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
