Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
SAUNDERS NCLEX RN EXAM FLUID/ELECTROLYTES ACID/BASE
NEWEST 2025/2026 COMPLETE ALL 150 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which
clinical manifestation would the nurse expect to note in the client?
a. Twitching
b. Hypoactive bowel sounds
c. Negative Trousseau's sign
d. Hypoactive deep tendon reflexes
a. Twitching
Rationale:
Signs of hypocalcemia include paresthesias followed by numbness, hyperactive
deep tendon reflexes, and a positive Trousseau's or Chvostek's sign. Additional
signs of hypocalcemia include increased neuromuscular excitability, muscle
cramps, twitching, tetany, seizures, irritability, and anxiety. Gastrointestinal
symptoms include increased gastric motility, hyperactive bowel sounds,
abdominal cramping, and diarrhea.
The nurse caring for a client with hypocalcemia would expect to note which
change on the electrocardiogram (ECG)?
a. Widened T wave
b. Prominent U wave
c. Prolonged QT interval
d. Shortened ST segment
c. Prolonged QT interval
Rationale:
Electrocardiographic changes that occur in a client with hypocalcemia include a
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, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
prolonged ST or QT interval. A shortened ST segment and a widened T wave occur
with hypercalcemia. Prominent U waves occur with hypokalemia.
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?
a. ST depression
b. Inverted T wave
c. Prominent U wave
d. Tall peaked T waves
d. Tall peaked T waves
Rationale:
Electrocardiographic changes associated with hyperkalemia include flat P waves,
prolonged PR intervals, widened QRS complexes, and tall peaked T waves.
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?
a. The client who is taking diuretics
b. The client with hyperaldosteronism
c. The client with Cushing's syndrome
d. The client who is taking corticosteroids
a. The client who is taking diuretics
Rationale:
Hyponatremia can occur in the client taking diuretics. The client taking
corticosteroids and the client with hyperaldosteronism or Cushing's syndrome are
at risk for hypernatremia.
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
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, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
client with hyponatremia?
a. Muscle twitches
b. Decreased urinary output
c. Hyperactive bowel sounds
d. Increased specific gravity of the urine
c. Hyperactive bowel sounds
Rationale:
Hyperactive bowel sounds indicate hyponatremia. The remaining options are signs
of hypernatremia. In hyponatremia, muscle weakness, increased urinary output,
and decreased specific gravity of the urine would be noted.
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?
a. Alcoholism
b. Renal insufficiency
c. Hypoparathyroidism
d. Tumor lysis syndrome
a. Alcoholism
Rationale:
Causative factors relate to malnutrition or starvation and the use of aluminum
hydroxide-based or magnesium-based antacids. Malnutrition is associated with
alcoholism. Renal insufficiency, hypoparathyroidism, and tumor lysis syndrome are
causative factors of hyperphosphatemia.
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?
a. The skin
b. Urinary output
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, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
c. Wound drainage
d. The gastrointestinal tract
a. The skin
Rationale:
Insensible losses occur daily through the skin and the lungs. Sensible losses are
those of which the person is aware, such as through urination, wound drainage,
and gastrointestinal tract losses.
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 volume deficit?
a. A client with an ileostomy
b. A client with heart failure
c. A client on long-term corticosteroid therapy
d. A client receiving frequent wound irrigations
a. A client with an ileostomy
Rationale:
Causes of a fluid volume deficit include vomiting, diarrhea, conditions that cause
increased respirations or increased urinary output, insufficient intravenous fluid
replacement, draining fistulas, and the presence of an ileostomy or colostomy. A
client with heart failure or on long-term corticosteroid therapy, or a client
receiving frequent wound irrigations, are most at risk for fluid volume excess.
The nurse caring for a client who has been receiving intravenous (IV) diuretics
suspects that the client is experiencing a fluid volume deficit. Which assessment
finding would the nurse note in a client with this condition?
a. Lung congestion
b. Decreased hematocrit
c. Increased blood pressure
d. Decreased central venous pressure (CVP)
d. Decreased central venous pressure (CVP)
Rationale:
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SAUNDERS NCLEX RN EXAM FLUID/ELECTROLYTES ACID/BASE
NEWEST 2025/2026 COMPLETE ALL 150 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY
GRADED A+||BRAND NEW VERSION!!
The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which
clinical manifestation would the nurse expect to note in the client?
a. Twitching
b. Hypoactive bowel sounds
c. Negative Trousseau's sign
d. Hypoactive deep tendon reflexes
a. Twitching
Rationale:
Signs of hypocalcemia include paresthesias followed by numbness, hyperactive
deep tendon reflexes, and a positive Trousseau's or Chvostek's sign. Additional
signs of hypocalcemia include increased neuromuscular excitability, muscle
cramps, twitching, tetany, seizures, irritability, and anxiety. Gastrointestinal
symptoms include increased gastric motility, hyperactive bowel sounds,
abdominal cramping, and diarrhea.
The nurse caring for a client with hypocalcemia would expect to note which
change on the electrocardiogram (ECG)?
a. Widened T wave
b. Prominent U wave
c. Prolonged QT interval
d. Shortened ST segment
c. Prolonged QT interval
Rationale:
Electrocardiographic changes that occur in a client with hypocalcemia include a
1|Page
, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
prolonged ST or QT interval. A shortened ST segment and a widened T wave occur
with hypercalcemia. Prominent U waves occur with hypokalemia.
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?
a. ST depression
b. Inverted T wave
c. Prominent U wave
d. Tall peaked T waves
d. Tall peaked T waves
Rationale:
Electrocardiographic changes associated with hyperkalemia include flat P waves,
prolonged PR intervals, widened QRS complexes, and tall peaked T waves.
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?
a. The client who is taking diuretics
b. The client with hyperaldosteronism
c. The client with Cushing's syndrome
d. The client who is taking corticosteroids
a. The client who is taking diuretics
Rationale:
Hyponatremia can occur in the client taking diuretics. The client taking
corticosteroids and the client with hyperaldosteronism or Cushing's syndrome are
at risk for hypernatremia.
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
2|Page
, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
client with hyponatremia?
a. Muscle twitches
b. Decreased urinary output
c. Hyperactive bowel sounds
d. Increased specific gravity of the urine
c. Hyperactive bowel sounds
Rationale:
Hyperactive bowel sounds indicate hyponatremia. The remaining options are signs
of hypernatremia. In hyponatremia, muscle weakness, increased urinary output,
and decreased specific gravity of the urine would be noted.
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?
a. Alcoholism
b. Renal insufficiency
c. Hypoparathyroidism
d. Tumor lysis syndrome
a. Alcoholism
Rationale:
Causative factors relate to malnutrition or starvation and the use of aluminum
hydroxide-based or magnesium-based antacids. Malnutrition is associated with
alcoholism. Renal insufficiency, hypoparathyroidism, and tumor lysis syndrome are
causative factors of hyperphosphatemia.
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?
a. The skin
b. Urinary output
3|Page
, Saunders NCLEX RN exam Fluid/electrolytes Acid/Base
c. Wound drainage
d. The gastrointestinal tract
a. The skin
Rationale:
Insensible losses occur daily through the skin and the lungs. Sensible losses are
those of which the person is aware, such as through urination, wound drainage,
and gastrointestinal tract losses.
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 volume deficit?
a. A client with an ileostomy
b. A client with heart failure
c. A client on long-term corticosteroid therapy
d. A client receiving frequent wound irrigations
a. A client with an ileostomy
Rationale:
Causes of a fluid volume deficit include vomiting, diarrhea, conditions that cause
increased respirations or increased urinary output, insufficient intravenous fluid
replacement, draining fistulas, and the presence of an ileostomy or colostomy. A
client with heart failure or on long-term corticosteroid therapy, or a client
receiving frequent wound irrigations, are most at risk for fluid volume excess.
The nurse caring for a client who has been receiving intravenous (IV) diuretics
suspects that the client is experiencing a fluid volume deficit. Which assessment
finding would the nurse note in a client with this condition?
a. Lung congestion
b. Decreased hematocrit
c. Increased blood pressure
d. Decreased central venous pressure (CVP)
d. Decreased central venous pressure (CVP)
Rationale:
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