CRNI Fluid and Electrolyte Balance 3

Question 1

A patient receiving IV normal saline at 150 mL/hr develops crackles, jugular vein distension, and dyspnea. What is the priority nursing intervention?

Accepted Answer

Slow or stop the infusion and notify the provider

Answer

Increase the head of bed elevation and continue monitoring

Answer

Switch to a hypotonic solution

Answer

Administer a fluid bolus to improve cardiac output

Question 2

Which electrolyte imbalance is MOST dangerous when administering potassium chloride IV?

Accepted Answer

Hyperkalemia from infusion rate exceeding renal excretion

Answer

Hypokalemia from too-rapid correction

Answer

Hyponatremia from dilutional effect

Answer

Hypocalcemia from potassium-calcium antagonism

Question 3

What is the primary purpose of using an isotonic crystalloid solution for IV fluid replacement?

Accepted Answer

To expand the intravascular volume without shifting fluid between compartments

Answer

To shift fluid from the intracellular to the intravascular space

Answer

To provide nutrition and caloric support

Answer

To promote cellular hydration through osmosis

Question 4

A patient's serum sodium is 118 mEq/L. What is the maximum safe correction rate to prevent neurological complications?

Accepted Answer

8-12 mEq/L per 24 hours

Answer

4-6 mEq/L per 24 hours

Answer

15-20 mEq/L per 24 hours

Answer

Correct to normal as fast as possible

Question 5

Which assessment finding indicates the patient is experiencing third-spacing of fluid?

Accepted Answer

Peripheral edema with low urine output and hypotension

Answer

Hypertension with bounding pulses

Answer

Polyuria with increased specific gravity

Answer

Weight loss with dry mucous membranes

Question 6

What is the nursing implication of infusing hypertonic saline (3% NaCl)?

Accepted Answer

It requires central venous access and continuous cardiac monitoring

Answer

It can be safely administered through a peripheral IV

Answer

It should be infused as a rapid bolus for maximum effect

Answer

It requires co-infusion with potassium replacement