NACE Fluid and Electrolyte Balance 2

Question 1

A nurse taps a patient's facial nerve anterior to the ear and observes facial muscle twitching. This positive Chvostek's sign indicates which electrolyte imbalance?

Accepted Answer

Hypocalcemia

Answer

Hyperkalemia

Answer

Hypomagnesemia

Answer

Hyponatremia

Question 2

A patient receiving total parenteral nutrition (TPN) develops tetany and muscle spasms. Which laboratory finding would confirm hypomagnesemia?

Accepted Answer

Serum magnesium 0.8 mEq/L

Answer

Serum magnesium 1.8 mEq/L

Answer

Serum magnesium 2.5 mEq/L

Answer

Serum magnesium 3.0 mEq/L

Question 3

A patient's ABG results show: pH 7.30, PaCO2 38 mmHg, HCO3- 18 mEq/L. How should the nurse interpret these results?

Accepted Answer

Metabolic acidosis

Answer

Respiratory acidosis with compensation

Answer

Respiratory alkalosis

Answer

Metabolic alkalosis

Question 4

A nurse is administering a hypotonic IV solution. Which physiologic effect should be anticipated?

Accepted Answer

Fluid shifts from the vascular space into cells

Answer

Fluid shifts from cells into the vascular space

Answer

No change in cellular fluid volume

Answer

Increased serum osmolality

Question 5

Which clinical presentation is most consistent with third-spacing of fluid?

Accepted Answer

Decreased urine output with low intravascular volume despite visible fluid accumulation

Answer

Increased urine output with elevated blood pressure

Answer

Peripheral edema with hypertension and bounding pulse

Answer

Jugular vein distension with crackles and weight gain

Question 6

A postoperative patient develops respiratory acidosis. Which compensatory change would the nurse expect to see in the metabolic component?

Accepted Answer

Increased serum bicarbonate (HCO3-)

Answer

Decreased serum bicarbonate (HCO3-)

Answer

Decreased pH below 7.20

Answer

Decreased PaCO2 below 35 mmHg

Question 7

A patient develops hypophosphatemia after several days NPO without phosphate supplementation. Which complication is the nurse most concerned about?

Accepted Answer

Muscle weakness and respiratory failure

Answer

Renal calculi formation

Answer

Peaked T waves and cardiac arrhythmias

Answer

Pathological bone fractures from calcification