FLUID AND ELECTROLYTE BALANCE EXAM QUESTIONS AND ANSWERS (VERIFIED
AND WELL DETAILED ANSWERS) LATEST UPDATE 2025/2026
The nurse is reviewing the laboratory test results for a client and notes that the serum potassium level is
5.5 mEq/L (5.5 mmol/L). The nurse understands that this value would be noted in which condition?
1.Diarrhea
2.Addison's disease
3.Diabetes insipidus
4.Dumping syndrome - CORRECT ANSWER 2. Addison's Disease
The normal serum potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). Many pathological conditions,
including Addison's disease, adrenocortical insufficiency, anemia, burns, and ketoacidosis, result in an
increased potassium level. Hyperkalemia can also cause abdominal cramping and diarrhea. The
conditions in the remaining options would result in a decreased serum potassium level.
A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is
complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings,
the nurse should next assess the results of which serum laboratory study?
1.Sodium
2.Calcium
3.Potassium
4.Magnesium - CORRECT ANSWER 2. Calcium
After surgery on the thyroid gland, the client may experience a temporary calcium imbalance. This is due
to transient malfunction of the parathyroid glands. The nurse also would assess for Chvostek's and
Trousseau's signs. The correct treatment is administration of calcium gluconate or calcium lactate. The
remaining options are unrelated to the client's complaints.
The nurse is reviewing the urinalysis results for a client with glomerulonephritis. Which findings should
the nurse expect to note? Select all that apply.
,1.Proteinuria
2.Hematuria
3.Positive ketones
4.A low specific gravity
5.A dark and smoky appearance of the urine - CORRECT ANSWER 1.Proteinuria
2.Hematuria
5.A dark and smoky appearance of the urine
In the client with glomerulonephritis, characteristic findings in the urinalysis report are gross proteinuria
and hematuria. The specific gravity is elevated, and the urine may appear dark and smoky. Positive
ketones are not associated with this condition but may indicate a secondary problem.
A client with an endocrine disorder has experienced recent weight loss and exhibits tachycardia. Based
on the clinical manifestations, the nurse should suspect dysfunction of which endocrine gland?
1.Thyroid
2.Pituitary
3.Parathyroid
4.Adrenal cortex - CORRECT ANSWER 1. Thyroid
The thyroid gland is responsible for a number of metabolic functions in the body. Among these are
metabolism of nutrients such as fats and carbohydrates. Increased metabolic function places a demand
on the cardiovascular system for a higher cardiac output. A client with increased activity of the thyroid
gland will experience weight loss from the higher metabolic rate and will have an increased pulse rate.
The anterior pituitary gland produces growth hormone, luteinizing hormone, and follicle-stimulating
hormone. Antidiuretic hormone (ADH) and oxytocin are secreted by the posterior pituitary gland. Both
ADH and oxytocin are synthesized by the hypothalamus and stored in the posterior pituitary gland.
These hormones are released as needed into the bloodstream. Parathyroid hormone is responsible for
maintaining serum calcium and phosphorus levels within normal range. The adrenal cortex is responsible
for the production of glucocorticoids and mineralocorticoids.
The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be
receiving peritoneal dialysis treatment. The nurse should plan to implement which measure?
,1.Restrict fluids as prescribed.
2.Care for the arteriovenous fistula.
3.Encourage foods high in potassium.
4.Administer analgesics as prescribed. - CORRECT ANSWER 1.Restrict fluids as prescribed.
Hemolytic-uremic syndrome is thought to be associated with bacterial toxins, chemicals, and viruses that
result in acute kidney injury in children. Clinical manifestations of the disease include acquired hemolytic
anemia, thrombocytopenia, renal injury, and central nervous system symptoms. A child with hemolytic-
uremic syndrome undergoing peritoneal dialysis because of anuria would be on fluid restriction. Pain is
not associated with hemolytic-uremic syndrome, and potassium would be restricted, not encouraged, if
the child is anuric. Peritoneal dialysis does not require an arteriovenous fistula (only hemodialysis).
The nurse teaches the client, who is newly diagnosed with diabetes insipidus, about the prescribed
intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply.
1."This medication will turn my urine orange."
2."I should decrease my oral fluids when I start this medication." 3."The amount of urine I make should
increase if this medicine is working."
4."I need to follow a low-fat diet to avoid pancreatitis when taking this medicine."
5."I should report headache and drowsiness to my health care provider since these symptoms could be
related to my desmopressin." - CORRECT ANSWER 2."I should decrease my oral fluids when I start this
medication."
5."I should report headache and drowsiness to my health care provider since these symptoms could be
related to my desmopressin."
In diabetes insipidus, there is a deficiency in antidiuretic hormone (ADH), resulting in large urinary losses.
Desmopressin is an analog of ADH. Clients with diabetes insipidus drink high volumes of fluid (polydipsia)
as a compensatory mechanism to counteract urinary losses and maintain fluid balance. Once
desmopressin is started, oral fluids should be decreased to prevent water intoxication. Therefore, clients
with diabetes insipidus should decrease their oral fluid intake when they start desmopressin. Headache
and drowsiness are signs of water intoxication in the client taking desmopressin and should be reported
to the health care provider. Desmopressin does not turn urine orange. The amount of urine should
decrease, not increase, when desmopressin is started. Desmopressin does not cause pancreatitis.
, The nurse is monitoring the fluid balance of an assigned client. The nurse determines that the client has
proper fluid balance if which 24-hour intake and output totals are noted?
1.Intake 1500 mL, output 800 mL
2.Intake 3000 mL, output 2000 mL
3.Intake 2400 mL, output 2900 mL
4.Intake 1800 mL, output 1750 mL - CORRECT ANSWER 4.Intake 1800 mL, output 1750 mL
For the client on a normal diet, the normal fluid intake is approximately 1200 to 1800 mL of measurable
fluids per day. The client's output in the same period should be about the same and does not include
insensible losses, which are extra. Insensible losses are offset by the fluid in solid foods, which also is not
measured.
The nurse is reviewing the list of components contained in the peritoneal dialysis solution with the
client. The client asks the nurse about the purpose of the glucose contained in the solution. The nurse
should base the response on knowing that which is the action of the glucose in the solution?
1.Decreases the risk of peritonitis
2.Prevents disequilibrium syndrome
3.Increases osmotic pressure to produce ultrafiltration
4.Prevents excess glucose from being removed from the client - CORRECT ANSWER 3.Increases
osmotic pressure to produce ultrafiltration
Increasing the glucose concentration makes the solution more hypertonic. The more hypertonic the
solution, the higher the osmotic pressure for ultrafiltration and thus the greater the amount of fluid
removed from the client during an exchange. The remaining options do not identify the purpose of the
glucose.
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?
AND WELL DETAILED ANSWERS) LATEST UPDATE 2025/2026
The nurse is reviewing the laboratory test results for a client and notes that the serum potassium level is
5.5 mEq/L (5.5 mmol/L). The nurse understands that this value would be noted in which condition?
1.Diarrhea
2.Addison's disease
3.Diabetes insipidus
4.Dumping syndrome - CORRECT ANSWER 2. Addison's Disease
The normal serum potassium level is 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L). Many pathological conditions,
including Addison's disease, adrenocortical insufficiency, anemia, burns, and ketoacidosis, result in an
increased potassium level. Hyperkalemia can also cause abdominal cramping and diarrhea. The
conditions in the remaining options would result in a decreased serum potassium level.
A client has returned to the nursing unit after a thyroidectomy. The nurse notes that the client is
complaining of tingling sensations around the mouth, fingers, and toes. On the basis of these findings,
the nurse should next assess the results of which serum laboratory study?
1.Sodium
2.Calcium
3.Potassium
4.Magnesium - CORRECT ANSWER 2. Calcium
After surgery on the thyroid gland, the client may experience a temporary calcium imbalance. This is due
to transient malfunction of the parathyroid glands. The nurse also would assess for Chvostek's and
Trousseau's signs. The correct treatment is administration of calcium gluconate or calcium lactate. The
remaining options are unrelated to the client's complaints.
The nurse is reviewing the urinalysis results for a client with glomerulonephritis. Which findings should
the nurse expect to note? Select all that apply.
,1.Proteinuria
2.Hematuria
3.Positive ketones
4.A low specific gravity
5.A dark and smoky appearance of the urine - CORRECT ANSWER 1.Proteinuria
2.Hematuria
5.A dark and smoky appearance of the urine
In the client with glomerulonephritis, characteristic findings in the urinalysis report are gross proteinuria
and hematuria. The specific gravity is elevated, and the urine may appear dark and smoky. Positive
ketones are not associated with this condition but may indicate a secondary problem.
A client with an endocrine disorder has experienced recent weight loss and exhibits tachycardia. Based
on the clinical manifestations, the nurse should suspect dysfunction of which endocrine gland?
1.Thyroid
2.Pituitary
3.Parathyroid
4.Adrenal cortex - CORRECT ANSWER 1. Thyroid
The thyroid gland is responsible for a number of metabolic functions in the body. Among these are
metabolism of nutrients such as fats and carbohydrates. Increased metabolic function places a demand
on the cardiovascular system for a higher cardiac output. A client with increased activity of the thyroid
gland will experience weight loss from the higher metabolic rate and will have an increased pulse rate.
The anterior pituitary gland produces growth hormone, luteinizing hormone, and follicle-stimulating
hormone. Antidiuretic hormone (ADH) and oxytocin are secreted by the posterior pituitary gland. Both
ADH and oxytocin are synthesized by the hypothalamus and stored in the posterior pituitary gland.
These hormones are released as needed into the bloodstream. Parathyroid hormone is responsible for
maintaining serum calcium and phosphorus levels within normal range. The adrenal cortex is responsible
for the production of glucocorticoids and mineralocorticoids.
The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be
receiving peritoneal dialysis treatment. The nurse should plan to implement which measure?
,1.Restrict fluids as prescribed.
2.Care for the arteriovenous fistula.
3.Encourage foods high in potassium.
4.Administer analgesics as prescribed. - CORRECT ANSWER 1.Restrict fluids as prescribed.
Hemolytic-uremic syndrome is thought to be associated with bacterial toxins, chemicals, and viruses that
result in acute kidney injury in children. Clinical manifestations of the disease include acquired hemolytic
anemia, thrombocytopenia, renal injury, and central nervous system symptoms. A child with hemolytic-
uremic syndrome undergoing peritoneal dialysis because of anuria would be on fluid restriction. Pain is
not associated with hemolytic-uremic syndrome, and potassium would be restricted, not encouraged, if
the child is anuric. Peritoneal dialysis does not require an arteriovenous fistula (only hemodialysis).
The nurse teaches the client, who is newly diagnosed with diabetes insipidus, about the prescribed
intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply.
1."This medication will turn my urine orange."
2."I should decrease my oral fluids when I start this medication." 3."The amount of urine I make should
increase if this medicine is working."
4."I need to follow a low-fat diet to avoid pancreatitis when taking this medicine."
5."I should report headache and drowsiness to my health care provider since these symptoms could be
related to my desmopressin." - CORRECT ANSWER 2."I should decrease my oral fluids when I start this
medication."
5."I should report headache and drowsiness to my health care provider since these symptoms could be
related to my desmopressin."
In diabetes insipidus, there is a deficiency in antidiuretic hormone (ADH), resulting in large urinary losses.
Desmopressin is an analog of ADH. Clients with diabetes insipidus drink high volumes of fluid (polydipsia)
as a compensatory mechanism to counteract urinary losses and maintain fluid balance. Once
desmopressin is started, oral fluids should be decreased to prevent water intoxication. Therefore, clients
with diabetes insipidus should decrease their oral fluid intake when they start desmopressin. Headache
and drowsiness are signs of water intoxication in the client taking desmopressin and should be reported
to the health care provider. Desmopressin does not turn urine orange. The amount of urine should
decrease, not increase, when desmopressin is started. Desmopressin does not cause pancreatitis.
, The nurse is monitoring the fluid balance of an assigned client. The nurse determines that the client has
proper fluid balance if which 24-hour intake and output totals are noted?
1.Intake 1500 mL, output 800 mL
2.Intake 3000 mL, output 2000 mL
3.Intake 2400 mL, output 2900 mL
4.Intake 1800 mL, output 1750 mL - CORRECT ANSWER 4.Intake 1800 mL, output 1750 mL
For the client on a normal diet, the normal fluid intake is approximately 1200 to 1800 mL of measurable
fluids per day. The client's output in the same period should be about the same and does not include
insensible losses, which are extra. Insensible losses are offset by the fluid in solid foods, which also is not
measured.
The nurse is reviewing the list of components contained in the peritoneal dialysis solution with the
client. The client asks the nurse about the purpose of the glucose contained in the solution. The nurse
should base the response on knowing that which is the action of the glucose in the solution?
1.Decreases the risk of peritonitis
2.Prevents disequilibrium syndrome
3.Increases osmotic pressure to produce ultrafiltration
4.Prevents excess glucose from being removed from the client - CORRECT ANSWER 3.Increases
osmotic pressure to produce ultrafiltration
Increasing the glucose concentration makes the solution more hypertonic. The more hypertonic the
solution, the higher the osmotic pressure for ultrafiltration and thus the greater the amount of fluid
removed from the client during an exchange. The remaining options do not identify the purpose of the
glucose.
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?
