NACE Fluid and Electrolyte Balance 3

Question 1

A patient is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which primary intervention should the nurse implement?

Accepted Answer

Restrict fluid intake per physician orders

Answer

SIADH causes excess water retention from inappropriate ADH release, leading to dilutional hyponatremia; fluid restriction is the primary intervention to reduce water excess and raise serum sodium.

Question 2

A patient with diabetes insipidus has a urine specific gravity of 1.001 and urinary output of 8 L/day. Which medication does the nurse anticipate administering?

Accepted Answer

Desmopressin (DDAVP)

Answer

Diabetes insipidus results from ADH deficiency or insensitivity, producing large volumes of very dilute urine; desmopressin (synthetic ADH) is administered to reduce excessive water loss.

Question 3

A patient's serum calcium is 12.5 mg/dL. Which priority intervention should the nurse implement for hypercalcemia?

Accepted Answer

Encourage oral fluid intake and ambulation

Answer

Increasing fluid intake promotes renal calcium excretion, and weight-bearing ambulation reduces bone resorption, making these the first-line interventions for mild-to-moderate hypercalcemia.

Question 4

Which patient is most at risk for developing hypokalemia?

Accepted Answer

A patient taking hydrochlorothiazide for hypertension

Answer

Thiazide diuretics such as hydrochlorothiazide promote renal potassium wasting through enhanced sodium-potassium exchange in the distal tubule, significantly increasing hypokalemia risk.

Question 5

A nurse is caring for a patient with hypernatremia (serum Na+ 158 mEq/L). Which IV fluid would the nurse anticipate administering to correct this imbalance?

Accepted Answer

0.45% sodium chloride (half-normal saline)

Answer

0.45% sodium chloride (hypotonic saline) provides free water to dilute the elevated serum sodium and restore normal plasma osmolality, correcting hypernatremia gradually.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

NACE Fluid and Electrolyte Balance 3