NCLEX QUESTIONS and ANSWERS
FLUID AND ELECTROLYTES
1. The nurse is caring for a client with heart failure. On assessment, the nurse notes
that the client is dyspneic and crackles are audible on auscultation. What additional
signs would the nurse expect to note in this client if excess fluid volume is present?
1. Weight loss
2. Flat neck and hand veins
3. An increase in blood pressure
4. Decreased central venous pressure (CVP)
3. An increase in blood pressure
2. The nurse is preparing to care for a client with a potassium deficit. The nurse
reviews the client's record and determines that the client was at risk for developing
the potassium deficit because of which situation?
1. Sustained tissue damage
2. Requires nasogastric suction
3. Has a history of Addison's disease
4. Is taking a potassium-retaining diuretic
2. Requires nasogastric suction
3. The nurse reviews a client's electrolyte laboratory report and notes that the
potassium level is 2.5 mEq/L. Which pattern would the nurse note on the
electrocardiogram as a result of the laboratory value?
1. U waves
2. Absent P waves
3. Elevated T waves
4. Elevated ST segment
1. U waves
4. The nurse provides instructions to a client with a low potassium level about the
foods that are high in potassium and tells the client to consume which foods? Select
all that apply.
1. Peas
2. Raisins
3. Potatoes
4. Cantaloupe
5. Cauliflower
6. Strawberries
o 2. Raisins
, o 3. Potatoes
o 4. Cantaloupe
o 6. Strawberries
5. The nurse is reviewing laboratory results and notes that a client's serum sodium
level is 150 mEq/L. The nurse reports the serum sodium level to the health care
provider (HCP) and the HCP prescribes dietary instructions based on the sodium
level. Which food item does the nurse instruct the client to avoid?
1. Peas
2. Nuts
3. Cauliflower
4. Processed oat cereals
4. Processed oat cereals
6. The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which
clinical manifestation would the nurse expect to note in the client?
1. Twitching
2. Hypoactive bowel sounds
3. Negative Trousseau's sign
4. Hypoactive deep tendon reflexes
1. Twitching
7. The nurse caring for a client with hypocalcemia would expect to note which change
on the electrocardiogram (ECG)?
1. Widened T wave
2. Prominent U wave
3. Prolonged QT interval
4. Shortened ST segment
3. Prolonged QT interval
8. The nurse reviews the electrolyte results of an assigned client and notes that the
potassium level is 5.7 mEq/L. Which finding would the nurse expect to note on the
electrocardiogram as a result of the laboratory value?
1. ST depression
2. Inverted T wave
3. Prominent U wave
4. Tall peaked T waves
4. Tall peaked T waves
, 9. The nurse caring for a group of clients reviews the electrolyte laboratory results and
notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse
understands that which client is at highest risk for the development of a sodium
value at this level?
1. The client who is taking diuretics
2. The client with hyperaldosteronism
3. The client with Cushing's syndrome
4. The client who is taking corticosteroids
1. The client who is taking diuretics
10. The nurse is caring for a client with heart failure who is receiving high doses of a
diuretic. On assessment, the nurse notes that the client has flat neck veins,
generalized muscle weakness, and diminished deep tendon reflexes. The nurse
suspects hyponatremia. What additional signs would the nurse expect to note in a
client with hyponatremia?
1. Muscle twitches
2. Decreased urinary output
3. Hyperactive bowel sounds
4. Increased specific gravity of the urine
3. Hyperactive bowel sounds
11. The nurse reviews a client's laboratory report and notes that the client's serum
phosphorus level is 2 mg/dL. Which condition most likely caused this serum
phosphorus level?
1. Alcoholism
2. Renal insufficiency
3. Hypoparathyroidism
4. Tumor lysis syndrome
1. Alcoholism
12. The nurse is reading a health care provider's (HCP) progress notes in the client's
record and reads that the HCP has documented "insensible fluid loss of
approximately 800 mL daily." The nurse interprets that this type of fluid loss can
occur through which route?
1. The skin
2. Urinary output
3. Wound drainage
4. The gastrointestinal tract
1. The skin
13. The nurse is assigned to care for a group of clients. On review of the clients' medical
records, the nurse determines that which client is most likely at risk for a fluid
FLUID AND ELECTROLYTES
1. The nurse is caring for a client with heart failure. On assessment, the nurse notes
that the client is dyspneic and crackles are audible on auscultation. What additional
signs would the nurse expect to note in this client if excess fluid volume is present?
1. Weight loss
2. Flat neck and hand veins
3. An increase in blood pressure
4. Decreased central venous pressure (CVP)
3. An increase in blood pressure
2. The nurse is preparing to care for a client with a potassium deficit. The nurse
reviews the client's record and determines that the client was at risk for developing
the potassium deficit because of which situation?
1. Sustained tissue damage
2. Requires nasogastric suction
3. Has a history of Addison's disease
4. Is taking a potassium-retaining diuretic
2. Requires nasogastric suction
3. The nurse reviews a client's electrolyte laboratory report and notes that the
potassium level is 2.5 mEq/L. Which pattern would the nurse note on the
electrocardiogram as a result of the laboratory value?
1. U waves
2. Absent P waves
3. Elevated T waves
4. Elevated ST segment
1. U waves
4. The nurse provides instructions to a client with a low potassium level about the
foods that are high in potassium and tells the client to consume which foods? Select
all that apply.
1. Peas
2. Raisins
3. Potatoes
4. Cantaloupe
5. Cauliflower
6. Strawberries
o 2. Raisins
, o 3. Potatoes
o 4. Cantaloupe
o 6. Strawberries
5. The nurse is reviewing laboratory results and notes that a client's serum sodium
level is 150 mEq/L. The nurse reports the serum sodium level to the health care
provider (HCP) and the HCP prescribes dietary instructions based on the sodium
level. Which food item does the nurse instruct the client to avoid?
1. Peas
2. Nuts
3. Cauliflower
4. Processed oat cereals
4. Processed oat cereals
6. The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which
clinical manifestation would the nurse expect to note in the client?
1. Twitching
2. Hypoactive bowel sounds
3. Negative Trousseau's sign
4. Hypoactive deep tendon reflexes
1. Twitching
7. The nurse caring for a client with hypocalcemia would expect to note which change
on the electrocardiogram (ECG)?
1. Widened T wave
2. Prominent U wave
3. Prolonged QT interval
4. Shortened ST segment
3. Prolonged QT interval
8. The nurse reviews the electrolyte results of an assigned client and notes that the
potassium level is 5.7 mEq/L. Which finding would the nurse expect to note on the
electrocardiogram as a result of the laboratory value?
1. ST depression
2. Inverted T wave
3. Prominent U wave
4. Tall peaked T waves
4. Tall peaked T waves
, 9. The nurse caring for a group of clients reviews the electrolyte laboratory results and
notes a sodium level of 130 mEq/L on one client's laboratory report. The nurse
understands that which client is at highest risk for the development of a sodium
value at this level?
1. The client who is taking diuretics
2. The client with hyperaldosteronism
3. The client with Cushing's syndrome
4. The client who is taking corticosteroids
1. The client who is taking diuretics
10. The nurse is caring for a client with heart failure who is receiving high doses of a
diuretic. On assessment, the nurse notes that the client has flat neck veins,
generalized muscle weakness, and diminished deep tendon reflexes. The nurse
suspects hyponatremia. What additional signs would the nurse expect to note in a
client with hyponatremia?
1. Muscle twitches
2. Decreased urinary output
3. Hyperactive bowel sounds
4. Increased specific gravity of the urine
3. Hyperactive bowel sounds
11. The nurse reviews a client's laboratory report and notes that the client's serum
phosphorus level is 2 mg/dL. Which condition most likely caused this serum
phosphorus level?
1. Alcoholism
2. Renal insufficiency
3. Hypoparathyroidism
4. Tumor lysis syndrome
1. Alcoholism
12. The nurse is reading a health care provider's (HCP) progress notes in the client's
record and reads that the HCP has documented "insensible fluid loss of
approximately 800 mL daily." The nurse interprets that this type of fluid loss can
occur through which route?
1. The skin
2. Urinary output
3. Wound drainage
4. The gastrointestinal tract
1. The skin
13. The nurse is assigned to care for a group of clients. On review of the clients' medical
records, the nurse determines that which client is most likely at risk for a fluid
