NURS 274 Fluids and Electrolytes
Medsurge 1 UPDATED JUNE 2022
EXAM
1. Intracellular fluids include which of the following?
A. Plasma
B. Intraocular fluid
C. Cerebrospinal fluid
D. All of the above
Answer: B. Intraocular fluid
Rationale: Intracellular fluid (ICF) is the fluid found inside cells,
making up about two-thirds of total body water. Intraocular fluid
(the fluid within the eye) is an example. Plasma, cerebrospinal
fluid, and interstitial fluid are all examples of extracellular fluid
(ECF), which is found outside the cells.
2. The process in which water passes from a solution of lesser
solute concentration to a solution of greater solute
concentration is known as:
A. Diffusion
B. Osmosis
C. Active transport
D. Filtration
Answer: B. Osmosis
Rationale: Osmosis is the passive movement of water across a
,semipermeable membrane from an area of low solute
concentration (more water) to an area of high solute
concentration (less water) to equalize the concentration on both
sides.
3. The primary regulator of fluid and electrolyte balance is
(are) the:
A. Lungs
B. Kidneys
C. Skin
D. Bowel
Answer: B. Kidneys
Rationale: The kidneys are the primary regulators of fluid and
electrolyte balance. They control the excretion and reabsorption
of water and electrolytes to maintain homeostasis. The lungs help
regulate acid-base balance by controlling carbon dioxide, but the
kidneys are the main organs for fluid and electrolyte regulation.
4. The largest volume of body fluid is found in which
compartment?
A. Intracellular compartment
B. Extracellular compartment
C. Interstitial compartment
D. Vascular compartment
Answer: A. Intracellular compartment
Rationale: The intracellular compartment (fluid inside cells)
contains the largest volume of body water, accounting for
approximately two-thirds (about 70%) of total body water. The
extracellular compartment is divided into interstitial fluid and
intravascular fluid (plasma).
,5. What is the approximate normal daily fluid requirement for
a 70 kg adult to maintain homeostasis?
A. 1,000 mL/day
B. 1,500 mL/day
C. 2,500 mL/day
D. 4,000 mL/day
Answer: C. 2,500 mL/day
Rationale: The normal adult daily fluid intake is approximately
2,500 mL, which comes from drinks (1,500 mL), foods (800 mL),
and metabolism (200 mL). Output should be approximately equal:
urine (1,500 mL), breathing/sweat (800 mL), and stools (200 mL).
6. Which client is at greatest risk for dehydration?
A. A 36-year-old prescribed long-term steroid therapy
B. A 55-year-old who recently received intravenous fluids
C. A 76-year-old who is cognitively impaired
D. An 83-year-old with congestive heart failure
Answer: C. A 76-year-old who is cognitively impaired
Rationale: Older adults are at increased risk for dehydration.
Cognitive impairment further increases this risk because the client
may not recognize thirst, may forget to drink, or may be unable to
obtain fluids independently. While the 83-year-old with CHF is
also at risk, the cognitively impaired client is at greatest risk for
inadequate intake.
7. A patient in homeostasis should have approximately the
same fluid:
A. Intake and output
B. Sodium and potassium levels
, C. Intracellular and extracellular volume
D. Blood pressure and heart rate
Answer: A. Intake and output
Rationale: Homeostasis in fluid balance means that fluid intake
approximately equals fluid output. When intake exceeds output,
fluid volume excess occurs; when output exceeds intake, fluid
volume deficit occurs.
8. Which of the following is NOT a risk factor for
dehydration?
A. Vomiting and diarrhea
B. Fever
C. Heart failure with fluid restriction
D. Diabetes insipidus
Answer: C. Heart failure with fluid restriction
Rationale: While heart failure itself can be a risk factor for fluid
imbalances, fluid restriction is a treatment for fluid overload, not a
risk factor for dehydration. Vomiting, diarrhea, fever, and diabetes
insipidus all cause fluid loss and increase the risk of dehydration.
9. Insensible water loss occurs through:
A. Urine and feces
B. Breathing and sweating
C. Vomiting and diarrhea
D. Hemorrhage
Answer: B. Breathing and sweating
Rationale: Insensible water loss refers to fluid loss that cannot be
easily measured, primarily through the skin (sweating) and the
Medsurge 1 UPDATED JUNE 2022
EXAM
1. Intracellular fluids include which of the following?
A. Plasma
B. Intraocular fluid
C. Cerebrospinal fluid
D. All of the above
Answer: B. Intraocular fluid
Rationale: Intracellular fluid (ICF) is the fluid found inside cells,
making up about two-thirds of total body water. Intraocular fluid
(the fluid within the eye) is an example. Plasma, cerebrospinal
fluid, and interstitial fluid are all examples of extracellular fluid
(ECF), which is found outside the cells.
2. The process in which water passes from a solution of lesser
solute concentration to a solution of greater solute
concentration is known as:
A. Diffusion
B. Osmosis
C. Active transport
D. Filtration
Answer: B. Osmosis
Rationale: Osmosis is the passive movement of water across a
,semipermeable membrane from an area of low solute
concentration (more water) to an area of high solute
concentration (less water) to equalize the concentration on both
sides.
3. The primary regulator of fluid and electrolyte balance is
(are) the:
A. Lungs
B. Kidneys
C. Skin
D. Bowel
Answer: B. Kidneys
Rationale: The kidneys are the primary regulators of fluid and
electrolyte balance. They control the excretion and reabsorption
of water and electrolytes to maintain homeostasis. The lungs help
regulate acid-base balance by controlling carbon dioxide, but the
kidneys are the main organs for fluid and electrolyte regulation.
4. The largest volume of body fluid is found in which
compartment?
A. Intracellular compartment
B. Extracellular compartment
C. Interstitial compartment
D. Vascular compartment
Answer: A. Intracellular compartment
Rationale: The intracellular compartment (fluid inside cells)
contains the largest volume of body water, accounting for
approximately two-thirds (about 70%) of total body water. The
extracellular compartment is divided into interstitial fluid and
intravascular fluid (plasma).
,5. What is the approximate normal daily fluid requirement for
a 70 kg adult to maintain homeostasis?
A. 1,000 mL/day
B. 1,500 mL/day
C. 2,500 mL/day
D. 4,000 mL/day
Answer: C. 2,500 mL/day
Rationale: The normal adult daily fluid intake is approximately
2,500 mL, which comes from drinks (1,500 mL), foods (800 mL),
and metabolism (200 mL). Output should be approximately equal:
urine (1,500 mL), breathing/sweat (800 mL), and stools (200 mL).
6. Which client is at greatest risk for dehydration?
A. A 36-year-old prescribed long-term steroid therapy
B. A 55-year-old who recently received intravenous fluids
C. A 76-year-old who is cognitively impaired
D. An 83-year-old with congestive heart failure
Answer: C. A 76-year-old who is cognitively impaired
Rationale: Older adults are at increased risk for dehydration.
Cognitive impairment further increases this risk because the client
may not recognize thirst, may forget to drink, or may be unable to
obtain fluids independently. While the 83-year-old with CHF is
also at risk, the cognitively impaired client is at greatest risk for
inadequate intake.
7. A patient in homeostasis should have approximately the
same fluid:
A. Intake and output
B. Sodium and potassium levels
, C. Intracellular and extracellular volume
D. Blood pressure and heart rate
Answer: A. Intake and output
Rationale: Homeostasis in fluid balance means that fluid intake
approximately equals fluid output. When intake exceeds output,
fluid volume excess occurs; when output exceeds intake, fluid
volume deficit occurs.
8. Which of the following is NOT a risk factor for
dehydration?
A. Vomiting and diarrhea
B. Fever
C. Heart failure with fluid restriction
D. Diabetes insipidus
Answer: C. Heart failure with fluid restriction
Rationale: While heart failure itself can be a risk factor for fluid
imbalances, fluid restriction is a treatment for fluid overload, not a
risk factor for dehydration. Vomiting, diarrhea, fever, and diabetes
insipidus all cause fluid loss and increase the risk of dehydration.
9. Insensible water loss occurs through:
A. Urine and feces
B. Breathing and sweating
C. Vomiting and diarrhea
D. Hemorrhage
Answer: B. Breathing and sweating
Rationale: Insensible water loss refers to fluid loss that cannot be
easily measured, primarily through the skin (sweating) and the
