RN Targeted Medical Surgical Fluid, Electrolyte, and Acid-Base Online Practice 2019

1. A nurse is planning care for a client who has experienced excessive fluid loss.
Which of the following interventions should the nurse include in the plan of care?
(Select all that apply.)
o Administer IV fluids to the client evenly over 24 hr.
o Provide the client with a salt substitute.
o Assess the client for pitting edema.
o Encourage the client to rise slowly when standing up.
o Weigh the client every 8 hr.

2. A nurse is caring for a client who has a sodium level of 155 mEq/L. Which of the
following IV fluids should the nurse anticipate the provider to prescribe?
o Dextrose 5% in 0.9% sodium chloride
o Dextrose 5% in lactated Ringer's
o 3% sodium chloride
o 0.45% sodium chloride

3. A nurse is admitting a client who has status asthmaticus. The client's ABG results
are pH 7.32, PaO2 74 mm Hg, PaCO2 56 mm Hg, and HCO3- 26 mEq/L. The nurse
should interpret these laboratory values as which of the following imbalances?
o Respiratory acidosis
o Respiratory alkalosis
o Metabolic acidosis
o Metabolic alkalosis
4. A nurse is reviewing the laboratory report of a client who has fluid volume excess.
Which of the following laboratory values should the nurse expect?
o Hgb 20 g/dL
o Hct 34%
o BUN 25 mg/dL
o Urine specific gravity 1.050
5. A nurse is teaching nutritional strategies to a client who has a low calcium level
and an allergy to milk. Which of the following statements by the client indicates
an understanding of the teaching?
o "I will eat more cheese because I can't drink milk."
o "I need to avoid foods with vitamin D because I am allergic to milk."
o "I will stop taking my calcium supplements if they irritate my stomach."
o "I will add broccoli and kale to my diet."
6. A nurse is caring for a client who is receiving furosemide daily. During the
morning assessment, the client tells the nurse that he is "feeling weak in the
legs." Which of the following actions should the nurse take first?
o Monitor the client's bowel sounds.
o Review the client's daily laboratory results.
o Auscultate the client's lungs.
o Palpate the client's peripheral pulses.
7. A nurse is caring for a client who reports difficulty breathing and tingling in both
hands. His respiratory rate is 36/min and he appears very restless. Which of the
following values should the nurse anticipate to be outside the expected reference
range if the client is experiencing respiratory alkalosis?
o PaO2
o PaCO2
o Sodium
o Bicarbonate
8. A nurse is assessing a client who has a calcium level of 8.1 mg/dL. Which of the
following findings is the priority for the nurse to assess?
o Deep-tendon reflexes
o Cardiac rhythm
o Peripheral sensation
o Bowel sounds
9. While reviewing a client's laboratory results, a nurse notes a serum calcium level
of 8.0 mg/dL. Which of the following actions should the nurse take?
o Implement seizure precautions.
o Administer phosphate.
o Initiate diuretic therapy.
o Prepare the client for hemodialysis.
10. A nurse is providing teaching to a client who is at risk for developing respiratory
acidosis following surgery. Which of the following statements by the client
indicates an understanding of the teaching?
o "I should conserve energy by limiting my physical activity."
o "I will wait until my pain is at least 6 out of 10 before I use the PCA."
o "I will limit my daily fluid intake to two to three glasses."
o "I will use the incentive spirometer every hour."
11. A nurse is assessing a client who has a phosphorus level of 2.4 mg/dL. Which of the
following findings should the nurse expect?
o Hepatic failure
o Abdominal pain
o Slow peripheral pulses
o Increase in cardiac output
12. A nurse is caring for a client who requires continuous cardiac monitoring. The
nurse identifies a prolonged PR interval and a widened QRS complex. Which of the
following laboratory values supports this finding?
o Sodium 152 mEq/L
o Chloride 102 mEq/L
o Magnesium 1.8 mEq/L
o Potassium 6.1 mEq/L
13. A nurse is assessing a client who has dehydration. Which of the following
assessments is the priority?
o Skin turgor
o Urine output
o Weight
o Mental status
14. A nurse is assessing a client who is receiving hydrochlorothiazide and notes that
the client is confused and lethargic. Which of the following laboratory values
should the nurse report to the provider?
o Sodium 128 mEq/L
o Potassium 4.8 mEq/L
o Calcium 9.1 mg/dL
o Magnesium 2.0 mEq/L
15. A nurse is evaluating a client who is receiving IV fluids to treat dehydration. Which
of the following laboratory findings indicates that the fluid therapy has been
effective?
o BUN 26 mg/dL
o Sodium 142 mEq/L
o Hct 56%
o Urine specific gravity 1.035
16. A nurse is assessing a client who has respiratory acidosis. Which of the following
findings should the nurse expect?
o Confusion
o Peripheral edema
o Facial flushing and warmth
o Hyperreflexia
17. A nurse is caring for a client who is experiencing respiratory distress as a result of
pulmonary edema. Which of the following actions should the nurse take first?
o Assist with intubation.
o Initiate high-flow oxygen therapy.
o Administer a rapid-acting diuretic.
o Provide cardiac monitoring.
18. A nurse is preparing to administer oral potassium to a client who has a potassium
level of 5.5 mEq/L. Which of the following actions should the nurse take first?
o Administer a hypertonic solution.
o Repeat the potassium level.
o Withhold the medication.
o Monitor for paresthesia.
19. A nurse is assessing a client who has hyperkalemia. Which of the following
findings should the nurse expect?
o Decreased muscle strength
o Decreased gastric motility
o Increased heart rate
o Increased blood pressure
20. A nurse is admitting a client who takes 40 mg furosemide daily for heart failure
and has experienced 3 days of vomiting. The nurse suspects hypokalemia. Which
of the following medications should the nurse prepare to administer?
o Sodium polystyrene sulfonate 30 g/day
o 0.9% sodium chloride with 10 mEq/L of potassium chloride at 100 mL/hr
o Bumetanide 8 mg/day
o 100 mL of dextrose 10% in water with 10 units of insulin
21. A nurse is assessing a client who has hypomagnesemia. Which of the following
findings should the nurse expect?
o Hyperactive deep-tendon reflexes
o Increased bowel sounds
o Drowsiness
o Decreased blood pressure
22. A nurse is caring for a client who requires nasogastric suctioning. Which of the
following sets of laboratory results indicates that the client has metabolic
alkalosis?
o pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3- 31 mEq/L
o pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 26 mEq/L
o pH 7.31, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 23 mEq/L
o pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L
23. A nurse is assessing a client who is using PCA following a thoracotomy. The client
is short of breath, appears restless, and has a respiratory rate of 28/min. The
client's ABG results are pH 7.52, PaO2 89 mm Hg, PaCO2 28 mm Hg, and HCO3- 24
mEq/L. Which of the following actions should the nurse take?
o Instruct the client to cough forcefully.
o Assist the client with ambulation.
o Provide calming interventions.
o Discontinue the PCA.
24. A nurse is reviewing the ABG results for four clients. Which of the following
findings should the nurse identify as metabolic acidosis?
o pH 7.51, PaO2 94 mm Hg, PaCO2 38 mm Hg, HCO3- 29 mEq/L
o pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 24 mEq/L
o pH 7.36, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 26 mEq/L
o pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L
25. A nurse is providing dietary teaching to a client who has heart failure and is
receiving furosemide. Which of the following foods should the nurse recommend
as containing the greatest amount of potassium?
o 1/2 cup chopped celery
o 1 cup plain yogurt
o One slice whole grain bread
o 1/2 cup cooked tofu
26. A nurse is providing dietary teaching to a client who has kidney disease. Which of
the following food choices should the nurse include in the teaching as containing
the lowest amount of magnesium?
o One large hard-boiled egg
o 1 cup bran cereal
o 1/2 cup almonds
o 1 cup cooked spinach
27. A nurse is planning care for a client who has a potassium level of 3.0 mEq/L. The
nurse should plan to monitor the client for which of the following findings?
o Hyperactive deep-tendon reflexes
o Orthostatic hypotension
o Rapid, deep respirations
o Strong, bounding pulse
28. A nurse is providing teaching to a client who has venous insufficiency of the lower
extremities. Which of the following statements by the client indicates an
understanding of the teaching?
o "If my stockings feel tight, I'll just roll them down for a while."
o "I'll put on my elastic stockings at the first sign of swelling."
o "When I sit down to watch television, I'll be sure to put my feet up."
o "It's okay to cross my legs as long as it's for less than an hour."
29. A nurse is caring for a client who has dehydration and is receiving IV fluids. When
assessing for complications, the nurse should recognize which of the following
manifestations as a sign of fluid overload?
o Increased urine specific gravity
o Hypoactive bowel sounds
o Bounding peripheral pulses
o Decreased respiratory rate
30. A nurse is reviewing the medical record of a client who has diabetes mellitus and
is receiving regular insulin by continuous IV infusion to treat diabetic
ketoacidosis. Which of the following findings should the nurse report to the
provider?
o Urine output 30 mL/hr
o Blood glucose 180 mg/dL
o Serum potassium 3.0 mEq/L
o BUN 18 mg/dL