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

These signs indicate fluid volume overload, requiring immediate reduction or cessation of the IV infusion and provider notification for diuretic orders.

Question 2

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

Accepted Answer

Hyperkalemia from infusion rate exceeding renal excretion

Answer

Hyperkalemia from excessive IV potassium infusion can cause fatal cardiac arrhythmias, making infusion rate monitoring critical.

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

Isotonic crystalloids have the same osmolality as plasma, expanding intravascular volume without causing osmotic fluid shifts between compartments.

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

Sodium correction should not exceed 8-12 mEq/L in 24 hours to prevent osmotic demyelination syndrome, a devastating neurological complication.

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

Third-spacing causes fluid to shift from the intravascular space into interstitial tissues, resulting in edema, intravascular depletion (hypotension), and decreased urine output.

CRNI Exam Practice Test

CRNI Exam Practice Test

CRNI Fluid and Electrolyte Balance 3