NURS 4450 MED SURGE EXAM :FLUIDS/ELECTROLYTES
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
A nurse assesses clients at a family practice clinic for risk factors that could lead to dehydration.
Which client is at greatest risk for dehydration?
A 76 year old who is cognitively impaired.
A nurse is caring for an older client who exhibits dehydration-induced confusion. Which
intervention by the nurse is best?
Assess client further for fall risk.
After teaching a client who is being treated for dehydration, a nurse assesses the client’s
understanding. Which statement indicates that the client correctly understood the teaching?
“I will weigh myself each morning before I eat or drink.”
A nurse is assessing clients on a medical-surgical unit. Which adult client does the nurse identify
as being at greatest risk for insensible water loss?
Anxious client who has tachypnea.
A nurse is evaluating a client who is being treated for dehydration. Which assessment result does
the nurse correlate with a therapeutic response to the treatment plan?
Decreased orthostatic changes when standing
After teaching a client who is prescribed a restricted sodium diet, a nurse assesses the client’s
understanding. Which food choice for lunch indicates that the client correctly understood the
teaching?
Grilled chicken breast with glazed carrots
A nurse is assessing clients for fluid and electrolyte imbalances. Which client will the nurse
assess first for potential hyponatremia?
A 34 year old who is NPO and receiving rapid intravenous D5W infusions.
A nurse teaches a client who is at risk for hyponatremia. Which statement does the nurse include
in this client’s teaching?
“Call your primary health care provider for diarrhea.”
, NURS 4450 MED SURGE EXAM :FLUIDS/ELECTROLYTES
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
A nurse is caring for a client who has the following laboratory results: potassium 2.4 mEq/L (2.4
mmol/L), magnesium 1.8 mEq/L (0.74 mmol/L), calcium 8.5 mEq/L (2.13 mmol/L), and sodium
144 mEq/L (144 mmol/L). Which assessment does the nurse complete first?
Depth of respirations
A nurse cares for a client who has a serum potassium of 6.5 mEq/L (6.5 mmol/L) and is
exhibiting cardiovascular changes. Which intervention will the nurse implement first?
Prepare to administer dextrose 20% and 10 units of regular insulin IV push.
The nurse is caring for a client who has fluid overload. What action by the nurse takes priority?
Assess the client’s lung sounds every 2 hours.
A nurse is assessing a client with hypokalemia, and notes that the client’s handgrip strength has
diminished since the previous assessment 1 hour ago. What action does the nurse take first?
Assess the client’s respiratory rate, rhythm, and depth.
A new nurse is preparing to administer IV potassium to a client with hypokalemia. What action
indicates the nurse needs to review this procedure?
Sets the IV pump to deliver 30 mEq of potassium an hour.
A nurse is caring for a client with hypocalcemia. Which action by the nurse shows poor
understanding of this condition?
Administers bisphosphonates as prescribed.
A nurse is caring for a client who has a serum calcium level of 14 mg/dL (3.5 mmol/L). Which
primary health care provider order does the nurse implement first?
Connect the client to a cardiac monitor.
A nurse is caring for an older adult client who is admitted with moderate dehydration. Which
intervention will the nurse implement to prevent injury while in the hospital?
Dangle the client on the bedside before ambulating.
, NURS 4450 MED SURGE EXAM :FLUIDS/ELECTROLYTES
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
CH. 14 ACID/BASE
A nurse assesses a client with diabetes mellitus who is admitted with an acid–base imbalance.
The client’s arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3
18 mEq/L (18 mmol/L). Which sign or symptom does the nurse identify as an example of the
client’s compensatory mechanisms?
Increased rate and depth of respirations
A nurse assesses a client who is experiencing an acid–base imbalance. The client’s arterial blood
gas values are pH 7.2, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L (19 mmol/L).
Which assessment would the nurse perform first?
Cardiac rate and rhythm
A nurse assesses a client who is prescribed furosemide for hypertension. For which acid–base
imbalance does the nurse assess to prevent complications of this therapy?
Metabolic alkalosis
A nurse is caring for a client who is experiencing moderate metabolic alkalosis. What action
would the nurse take?
Teach the client fall prevention measures.
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid–base imbalance.
For which manifestation of this acid–base imbalance would the nurse assess?
Kussmaul respirations
A nurse assesses a client who is admitted with an acid–base imbalance. The client’s arterial
blood gas values were pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L (16
mmol/L). The most recent blood gasses show a drop in the pH. What action does the nurse take
next?
Assess client’s rate, rhythm, and depth of respiration.
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm
Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L (22 mmol/L). Which clinical situation does the
nurse correlate with these values?
Bronchial obstruction related to aspiration of a hot dog
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
A nurse assesses clients at a family practice clinic for risk factors that could lead to dehydration.
Which client is at greatest risk for dehydration?
A 76 year old who is cognitively impaired.
A nurse is caring for an older client who exhibits dehydration-induced confusion. Which
intervention by the nurse is best?
Assess client further for fall risk.
After teaching a client who is being treated for dehydration, a nurse assesses the client’s
understanding. Which statement indicates that the client correctly understood the teaching?
“I will weigh myself each morning before I eat or drink.”
A nurse is assessing clients on a medical-surgical unit. Which adult client does the nurse identify
as being at greatest risk for insensible water loss?
Anxious client who has tachypnea.
A nurse is evaluating a client who is being treated for dehydration. Which assessment result does
the nurse correlate with a therapeutic response to the treatment plan?
Decreased orthostatic changes when standing
After teaching a client who is prescribed a restricted sodium diet, a nurse assesses the client’s
understanding. Which food choice for lunch indicates that the client correctly understood the
teaching?
Grilled chicken breast with glazed carrots
A nurse is assessing clients for fluid and electrolyte imbalances. Which client will the nurse
assess first for potential hyponatremia?
A 34 year old who is NPO and receiving rapid intravenous D5W infusions.
A nurse teaches a client who is at risk for hyponatremia. Which statement does the nurse include
in this client’s teaching?
“Call your primary health care provider for diarrhea.”
, NURS 4450 MED SURGE EXAM :FLUIDS/ELECTROLYTES
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
A nurse is caring for a client who has the following laboratory results: potassium 2.4 mEq/L (2.4
mmol/L), magnesium 1.8 mEq/L (0.74 mmol/L), calcium 8.5 mEq/L (2.13 mmol/L), and sodium
144 mEq/L (144 mmol/L). Which assessment does the nurse complete first?
Depth of respirations
A nurse cares for a client who has a serum potassium of 6.5 mEq/L (6.5 mmol/L) and is
exhibiting cardiovascular changes. Which intervention will the nurse implement first?
Prepare to administer dextrose 20% and 10 units of regular insulin IV push.
The nurse is caring for a client who has fluid overload. What action by the nurse takes priority?
Assess the client’s lung sounds every 2 hours.
A nurse is assessing a client with hypokalemia, and notes that the client’s handgrip strength has
diminished since the previous assessment 1 hour ago. What action does the nurse take first?
Assess the client’s respiratory rate, rhythm, and depth.
A new nurse is preparing to administer IV potassium to a client with hypokalemia. What action
indicates the nurse needs to review this procedure?
Sets the IV pump to deliver 30 mEq of potassium an hour.
A nurse is caring for a client with hypocalcemia. Which action by the nurse shows poor
understanding of this condition?
Administers bisphosphonates as prescribed.
A nurse is caring for a client who has a serum calcium level of 14 mg/dL (3.5 mmol/L). Which
primary health care provider order does the nurse implement first?
Connect the client to a cardiac monitor.
A nurse is caring for an older adult client who is admitted with moderate dehydration. Which
intervention will the nurse implement to prevent injury while in the hospital?
Dangle the client on the bedside before ambulating.
, NURS 4450 MED SURGE EXAM :FLUIDS/ELECTROLYTES
QUESTIONS WITH ANSWERS 2023 A+ SUCCESS ASSUARED
CH. 14 ACID/BASE
A nurse assesses a client with diabetes mellitus who is admitted with an acid–base imbalance.
The client’s arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3
18 mEq/L (18 mmol/L). Which sign or symptom does the nurse identify as an example of the
client’s compensatory mechanisms?
Increased rate and depth of respirations
A nurse assesses a client who is experiencing an acid–base imbalance. The client’s arterial blood
gas values are pH 7.2, PaO2 88 mm Hg, PaCO2 38 mm Hg, and HCO3 19 mEq/L (19 mmol/L).
Which assessment would the nurse perform first?
Cardiac rate and rhythm
A nurse assesses a client who is prescribed furosemide for hypertension. For which acid–base
imbalance does the nurse assess to prevent complications of this therapy?
Metabolic alkalosis
A nurse is caring for a client who is experiencing moderate metabolic alkalosis. What action
would the nurse take?
Teach the client fall prevention measures.
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid–base imbalance.
For which manifestation of this acid–base imbalance would the nurse assess?
Kussmaul respirations
A nurse assesses a client who is admitted with an acid–base imbalance. The client’s arterial
blood gas values were pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L (16
mmol/L). The most recent blood gasses show a drop in the pH. What action does the nurse take
next?
Assess client’s rate, rhythm, and depth of respiration.
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm
Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L (22 mmol/L). Which clinical situation does the
nurse correlate with these values?
Bronchial obstruction related to aspiration of a hot dog
