MSNCB Fluid & Electrolyte Balance 3

Question 1

A patient develops confusion, muscle twitching, and seizures after receiving multiple blood transfusions. Which electrolyte imbalance is most likely responsible?

Accepted Answer

Hypocalcemia

Answer

Hyponatremia

Answer

Hyperkalemia

Answer

Hyperphosphatemia

Question 2

Which set of findings would most clearly differentiate diabetes insipidus (DI) from SIADH?

Accepted Answer

Elevated serum sodium and dilute urine in DI

Answer

Low serum sodium and concentrated urine in DI

Answer

Normal urine output in both conditions

Answer

Hyponatremia in both conditions

Question 3

A post-operative patient who underwent bowel resection develops third-spacing with hypotension and decreased urine output. Which IV fluid replacement is most appropriate?

Accepted Answer

Isotonic crystalloid such as 0.9% NaCl or lactated Ringer's

Answer

D5W to replace free water

Answer

3% NaCl to expand plasma volume

Answer

25% albumin exclusively

Question 4

A patient with chronic kidney disease has a serum potassium of 5.8 mEq/L. Which dietary instruction is the most important priority?

Accepted Answer

Avoid high-potassium foods such as bananas, oranges, and potatoes

Answer

Increase intake of bananas and oranges

Answer

Increase sodium intake to balance potassium levels

Answer

Restrict protein intake only

Question 5

Which arterial blood gas result indicates respiratory alkalosis?

Accepted Answer

pH 7.50, PaCO2 28, HCO3 22

Answer

pH 7.30, PaCO2 55, HCO3 24

Answer

pH 7.32, PaCO2 40, HCO3 18

Answer

pH 7.48, PaCO2 40, HCO3 30

Question 6

A post-operative patient receiving 0.45% NaCl IV develops sudden confusion and seizures. Which complication has most likely occurred?

Accepted Answer

Dilutional hyponatremia

Answer

Hypernatremia

Answer

Hyperkalemia

Answer

Hypercalcemia

Question 7

A patient presents with severe hyponatremia (sodium 118 mEq/L) and altered mental status. Which nursing intervention is the highest priority?

Accepted Answer

Restrict free water and notify the physician for possible hypertonic saline administration

Answer

Administer oral sodium supplements

Answer

Increase the IV infusion rate of 0.9% NaCl

Answer

Encourage increased dietary sodium intake