CHAPTER 13 CONCEPTS OF FLUID &
ELECTROLYTE BALANCE NUR240 EXAM
QUESTIONS AND ANSWERS WITH RATIONALES
After reviewing the health records of four assigned patients, which patient would the nurse
determine has a risk for fluid overload?A: 40-year-old woman with Crohn disease
B: 50-year-old man with second-degree burns
C: 60-year-old woman with nausea and vomiting
*** D: 70-year-old man with chronic kidney disease
Which statement explains vascular dehydration?A: Too much fluid loss
B: Too little fluid intake
*** C: Fluid shift from plasma to interstitial space
D: Fluid shift from interstitial space to plasma
Which effect causes edema in a patient's dependent areas?A: Large intercellular spaces
1
,B: Filtration of fluid in the cells
*** C: Changes in normal hydrostatic pressure
D: Equilibrium in solute concentration on each side of the cell
Rationale: Edema develops with changes in normal hydrostatic pressure differences, such as
in patients with right-sided heart failure.
When concerned about a patient's GI fluid losses, which parameter would the nurse assess to
determine fluid loss? Select all that apply. One, some, or all responses may be correct.*** A:
Weight
*** B: Skin turgor
*** C: Urine output
*** D: Blood pressure
*** E: Blood urea nitrogen (BUN)
Rationale: One lb of water weighs about 2.2 lb (1 kg). Therefore the nurse should monitor the
patient's weight. The nurse should assess the patient's skin turgor as loss of elasticity can
occur from dehydration. Diminished urine output could indicate fluid balance changes. The
nurse should also monitor the patient's blood pressure for hypotension from low fluid
2
,volume. The BUN would increase with dehydration, so the nurse should also assess this
laboratory value.
Which patient would the charge nurse assign to a licensed practical nurse/licensed vocational
nurse (LPN/LVN)?A: 44-year-old with congestive heart failure (CHF) who has gained 3 lb
since the previous day
B: 58-year-old with chronic renal failure (CRF) who has a serum potassium level of 6 mEq/L
***C: 76-year-old with poor skin turgor who has a serum osmolarity of 300 mOsm/L
D: 80-year-old with 3+ peripheral edema and crackles throughout the posterior chest
A patient states, "This angiotensin-converting enzyme (ACE) inhibitor medication makes me
urinate all the time. I didn't think it was a water pill." Which response would the nurse
make?A: "You are probably not taking your medication as prescribed."
B: "This medication is a diuretic. I will print literature for you to review."
***C: "This medication causes greater excretion of water and sodium in your urine."
D: "You must not be following your dietary restrictions. How much sodium are you eating?"
Which item will the nurse include when documenting a patient's fluid intake?
Select all that apply. One, some, or all responses may be correct.A: Emesis
3
, *** B: Enemas
*** C: Oral fluids
D: Solid foods
*** E: Irrigation fluids
Which laboratory test would demonstrate effectiveness of diuretic therapy for a patient
admitted with fluid overload from heart failure?A: Serum osmolality
B: Serum creatinine
*** C: Natriuretic peptide
D: Serum magnesium
Which hormone regulates sodium balance? Select all that apply. One, some, or all responses
may be correct.A: Cortisol
*** B: Aldosterone
C: Angiotensin
*** D: Natriuretic peptide (NP)
4
ELECTROLYTE BALANCE NUR240 EXAM
QUESTIONS AND ANSWERS WITH RATIONALES
After reviewing the health records of four assigned patients, which patient would the nurse
determine has a risk for fluid overload?A: 40-year-old woman with Crohn disease
B: 50-year-old man with second-degree burns
C: 60-year-old woman with nausea and vomiting
*** D: 70-year-old man with chronic kidney disease
Which statement explains vascular dehydration?A: Too much fluid loss
B: Too little fluid intake
*** C: Fluid shift from plasma to interstitial space
D: Fluid shift from interstitial space to plasma
Which effect causes edema in a patient's dependent areas?A: Large intercellular spaces
1
,B: Filtration of fluid in the cells
*** C: Changes in normal hydrostatic pressure
D: Equilibrium in solute concentration on each side of the cell
Rationale: Edema develops with changes in normal hydrostatic pressure differences, such as
in patients with right-sided heart failure.
When concerned about a patient's GI fluid losses, which parameter would the nurse assess to
determine fluid loss? Select all that apply. One, some, or all responses may be correct.*** A:
Weight
*** B: Skin turgor
*** C: Urine output
*** D: Blood pressure
*** E: Blood urea nitrogen (BUN)
Rationale: One lb of water weighs about 2.2 lb (1 kg). Therefore the nurse should monitor the
patient's weight. The nurse should assess the patient's skin turgor as loss of elasticity can
occur from dehydration. Diminished urine output could indicate fluid balance changes. The
nurse should also monitor the patient's blood pressure for hypotension from low fluid
2
,volume. The BUN would increase with dehydration, so the nurse should also assess this
laboratory value.
Which patient would the charge nurse assign to a licensed practical nurse/licensed vocational
nurse (LPN/LVN)?A: 44-year-old with congestive heart failure (CHF) who has gained 3 lb
since the previous day
B: 58-year-old with chronic renal failure (CRF) who has a serum potassium level of 6 mEq/L
***C: 76-year-old with poor skin turgor who has a serum osmolarity of 300 mOsm/L
D: 80-year-old with 3+ peripheral edema and crackles throughout the posterior chest
A patient states, "This angiotensin-converting enzyme (ACE) inhibitor medication makes me
urinate all the time. I didn't think it was a water pill." Which response would the nurse
make?A: "You are probably not taking your medication as prescribed."
B: "This medication is a diuretic. I will print literature for you to review."
***C: "This medication causes greater excretion of water and sodium in your urine."
D: "You must not be following your dietary restrictions. How much sodium are you eating?"
Which item will the nurse include when documenting a patient's fluid intake?
Select all that apply. One, some, or all responses may be correct.A: Emesis
3
, *** B: Enemas
*** C: Oral fluids
D: Solid foods
*** E: Irrigation fluids
Which laboratory test would demonstrate effectiveness of diuretic therapy for a patient
admitted with fluid overload from heart failure?A: Serum osmolality
B: Serum creatinine
*** C: Natriuretic peptide
D: Serum magnesium
Which hormone regulates sodium balance? Select all that apply. One, some, or all responses
may be correct.A: Cortisol
*** B: Aldosterone
C: Angiotensin
*** D: Natriuretic peptide (NP)
4
