FCCS FCCS Fluid and Electrolyte Management 2

Question 1

A patient with hyperkalemia (K+ = 6.8 mEq/L) shows peaked T-waves and widened QRS on ECG. What is the FIRST intervention?

Accepted Answer

Calcium gluconate IV

Answer

Sodium polystyrene sulfonate (Kayexalate)

Answer

Furosemide IV

Answer

Insulin and dextrose

Question 2

A critically ill patient develops carpopedal spasm and a positive Chvostek's sign. Which electrolyte abnormality is most likely?

Accepted Answer

Hypocalcemia

Answer

Hyponatremia

Answer

Hyperkalemia

Answer

Hypophosphatemia

Question 3

Which electrolyte deficiency must be corrected before refractory hypokalemia can be successfully treated?

Accepted Answer

Magnesium

Answer

Sodium

Answer

Calcium

Answer

Phosphate

Question 4

What is the maximum recommended rate of sodium correction in chronic hyponatremia to prevent osmotic demyelination syndrome?

Accepted Answer

8–10 mEq/L per 24 hours

Answer

1–2 mEq/L per hour

Answer

15–20 mEq/L per 24 hours

Answer

25 mEq/L per 24 hours

Question 5

In diabetic ketoacidosis (DKA), why may serum potassium appear normal or elevated despite total body potassium depletion?

Accepted Answer

Acidosis shifts potassium from intracellular to extracellular fluid

Answer

Insulin resistance causes potassium retention in cells

Answer

Hyperglycemia increases gastrointestinal potassium absorption

Answer

Osmotic diuresis selectively preserves potassium

Question 6

Which ECG change is most characteristic of hypokalemia?

Accepted Answer

U-waves and flattened T-waves

Answer

Peaked T-waves

Answer

Prolonged PR interval

Answer

Wide QRS complex

Question 7

What is the most common cause of hyperphosphatemia in critically ill patients?

Accepted Answer

Renal failure

Answer

Excessive dietary phosphate intake

Answer

Malnutrition and refeeding syndrome

Answer

Hyperparathyroidism