IV Fluid & Electrolyte Balance 3 — Questions and Answers
Question 1: Lactated Ringer's solution most closely resembles which body fluid?
- Intracellular fluid
- Plasma (Correct answer)
- Cerebrospinal fluid
- Urine
Correct answer: Plasma
Lactated Ringer's electrolyte composition (Na, K, Ca, Cl, lactate) approximates that of plasma.
Question 2: A patient is receiving hypotonic IV fluids. Where will fluid shift?
- From intracellular to extracellular space
- From extracellular to intracellular space (Correct answer)
- From intravascular to interstitial space
- No fluid shift occurs
Correct answer: From extracellular to intracellular space
Hypotonic solutions have lower osmolality than cells, causing osmosis to pull fluid into the intracellular space.
Question 3: Which sign indicates hypocalcemia in a patient receiving a large blood transfusion?
- Chvostek's sign
- Trousseau's sign is absent
- Hyperreflexia only
- Chvostek's and Trousseau's signs (Correct answer)
Correct answer: Chvostek's and Trousseau's signs
Both Chvostek's (facial twitching) and Trousseau's (carpal spasm) signs indicate hypocalcemia, which can occur when citrate in stored blood chelates calcium.
Question 4: The nurse is calculating a patient's fluid balance. Insensible fluid losses include:
- Urine output
- Wound drainage
- Perspiration and respiration (Correct answer)
- Nasogastric tube output
Correct answer: Perspiration and respiration
Insensible losses are those not easily measured and include perspiration and water lost through respiration.
Question 5: A patient's urine specific gravity is 1.030. What does this suggest?
- Overhydration
- Diabetes insipidus
- Concentrated urine indicating dehydration (Correct answer)
- Normal hydration status
Correct answer: Concentrated urine indicating dehydration
A specific gravity of 1.030 is above the normal range (1.003–1.030) and indicates highly concentrated urine, a sign of dehydration.
Question 6: Which IV fluid is contraindicated in patients with traumatic brain injury (TBI)?
- 0.9% Normal Saline
- Lactated Ringer's
- Hypertonic Saline 3%
- D5W (5% Dextrose in Water) (Correct answer)
Correct answer: D5W (5% Dextrose in Water)
D5W is hypotonic once dextrose is metabolized and can worsen cerebral edema in TBI patients.
Question 7: A patient has a serum phosphate of 1.5 mg/dL. Which condition is most likely contributing?
- Renal failure
- Hypoparathyroidism
- Prolonged malnutrition or refeeding syndrome (Correct answer)
- Vitamin D toxicity
Correct answer: Prolonged malnutrition or refeeding syndrome
Hypophosphatemia commonly results from refeeding syndrome or prolonged malnutrition, as insulin release drives phosphate into cells.
IV Fluid & Electrolyte Balance 3
Lactated Ringer's solution most closely resembles which body fluid?