CRNI Fluid and Electrolyte Balance 4

Question 1

A patient receiving TPN develops confusion, muscle weakness, and a serum phosphate of 1.2 mg/dL. Which condition is most likely?

Accepted Answer

Refeeding syndrome

Answer

Refeeding syndrome causes severe hypophosphatemia as glucose infusion shifts phosphate intracellularly.

Question 2

Which IV fluid is most appropriate for initial resuscitation of a patient with severe burns?

Accepted Answer

Lactated Ringer's

Answer

Lactated Ringer's is the preferred fluid for burn resuscitation per the Parkland formula due to its isotonic composition.

Question 3

A patient with chronic kidney disease has a serum potassium of 6.2 mEq/L and peaked T-waves on ECG. What is the priority intervention?

Accepted Answer

Give IV calcium gluconate

Answer

IV calcium gluconate is the priority to stabilize cardiac membranes and prevent life-threatening dysrhythmias.

Question 4

Which finding best indicates adequate fluid resuscitation in a critically ill patient?

Accepted Answer

MAP > 65 mmHg and urine output 0.5 mL/kg/hr

Answer

A MAP > 65 mmHg with urine output ≥ 0.5 mL/kg/hr reflects adequate organ perfusion and resuscitation.

Question 5

A patient's serum sodium is 118 mEq/L and they are asymptomatic. What is the safest correction rate?

Accepted Answer

No more than 8-12 mEq/L in 24 hours

Answer

Correcting hyponatremia faster than 8-12 mEq/L per 24 hours risks osmotic demyelination syndrome.

CRNI Exam Practice Test