NACE Fluid and Electrolyte Balance 5

Question 1

A client taking furosemide reports muscle cramps and weakness. The nurse checks the lab results and finds a serum potassium of 3.1 mEq/L. Which action is the priority?

Accepted Answer

Hold the furosemide and notify the provider

Answer

Hypokalemia (K+ < 3.5 mEq/L) with symptoms requires holding a potassium-wasting diuretic and notifying the provider to prevent life-threatening dysrhythmias.

Question 2

Which arterial blood gas result indicates metabolic alkalosis with respiratory compensation?

Accepted Answer

pH 7.50, PaCO2 48, HCO3 36

Answer

pH 7.50 (alkalotic), elevated HCO3 36 (metabolic cause), and elevated PaCO2 48 (respiratory compensation by retaining CO2) indicate compensated metabolic alkalosis.

Question 3

A client presents with confusion, muscle twitching, and a serum sodium of 122 mEq/L. What is the most likely cause of these neurological symptoms?

Accepted Answer

Cerebral edema from hypotonic fluid shifting into brain cells

Answer

Severe hyponatremia causes water to shift into brain cells, leading to cerebral edema and neurological symptoms such as confusion and seizures.

Question 4

Which client is at greatest risk for developing hypermagnesemia?

Accepted Answer

A 70-year-old with chronic kidney disease taking magnesium-containing antacids

Answer

Impaired renal excretion combined with magnesium intake from antacids places clients with chronic kidney disease at highest risk for hypermagnesemia.

Question 5

The nurse assesses a client and notes weak, irregular pulse, flat T waves on ECG, and abdominal distension. Which electrolyte imbalance is most likely?

Accepted Answer

Hypokalemia

Answer

Flat or inverted T waves, U waves, weak pulse, and decreased GI motility (distension) are classic ECG and clinical signs of hypokalemia.

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 5