Basic Nursing Skills Nutrition & Fluid Balance 1 — Questions and Answers
Question 1: A patient has a serum sodium level of 128 mEq/L. The nurse recognizes this as:
- Hypernatremia
- Hyponatremia (Correct answer)
- Hyperkalemia
- Hypokalemia
Correct answer: Hyponatremia
Normal serum sodium is 135–145 mEq/L; a level of 128 mEq/L is below normal, indicating hyponatremia.
Question 2: Signs and symptoms of dehydration include all of the following EXCEPT:
- Decreased urine output
- Dry mucous membranes
- Bounding pulse (Correct answer)
- Increased skin turgor loss
Correct answer: Bounding pulse
Dehydration causes a weak, thready pulse due to reduced circulating volume — a bounding pulse is associated with fluid overload, not dehydration.
Question 3: Which IV fluid is isotonic and used for fluid replacement and maintenance?
- 0.45% NaCl (half normal saline)
- 0.9% NaCl (normal saline) (Correct answer)
- D5W (5% dextrose in water)
- 3% NaCl (hypertonic saline)
Correct answer: 0.9% NaCl (normal saline)
0.9% NaCl (normal saline) is isotonic, matching the osmolarity of blood plasma, making it the most common fluid for replacement and maintenance.
Question 4: The nurse is assessing a patient for fluid overload. Which finding supports this assessment?
- Decreased blood pressure
- Sunken eyes and dry mouth
- Peripheral edema and crackles in the lungs (Correct answer)
- Poor skin turgor and dark urine
Correct answer: Peripheral edema and crackles in the lungs
Peripheral edema and pulmonary crackles (from fluid accumulation in lung interstitium) are hallmark signs of fluid overload (hypervolemia).
Question 5: A diet high in which mineral is the most important dietary modification for a patient with hypertension?
- Potassium restriction
- Sodium restriction (Correct answer)
- Calcium restriction
- Iron restriction
Correct answer: Sodium restriction
Sodium restriction (typically <2,300 mg/day) is the primary dietary modification for hypertension because sodium causes fluid retention and increases blood pressure.
Question 6: Which lab value best reflects a patient's long-term nutritional status and protein synthesis?
- Serum albumin (Correct answer)
- Hemoglobin
- Blood glucose
- Serum creatinine
Correct answer: Serum albumin
Serum albumin reflects long-term protein status (half-life ~20 days); levels below 3.5 g/dL indicate malnutrition or poor protein synthesis.
Basic Nursing Skills Nutrition & Fluid Balance 1
A patient has a serum sodium level of 128 mEq/L.
The nurse recognizes this as: