NACE Fluid and Electrolyte Balance

Question 1

A patient's serum sodium is 128 mEq/L. Which symptom would the nurse most likely assess?

Accepted Answer

Muscle cramps and irritability

Answer

Hyponatremia (sodium <135 mEq/L) causes neurological symptoms including confusion, headache, muscle cramps, and irritability due to osmotic fluid shifts into brain cells.

Question 2

Which IV solution is classified as isotonic?

Accepted Answer

0.9% sodium chloride

Answer

0.9% sodium chloride (normal saline) is isotonic with an osmolality of approximately 308 mOsm/L, close to plasma osmolality, so it does not cause fluid shifts into or out of cells.

Question 3

A patient with chronic renal failure has a serum potassium of 6.2 mEq/L. Which ECG change would the nurse anticipate first?

Accepted Answer

Peaked T waves

Answer

Hyperkalemia initially produces tall, narrow (peaked) T waves on ECG due to altered cardiac repolarization; this may progress to widened QRS complexes and ventricular fibrillation.

Question 4

A postoperative patient receiving 3 L of IV fluids daily develops a new respiratory finding. Which assessment finding indicates fluid overload?

Accepted Answer

Bilateral crackles at the lung bases

Answer

Bilateral crackles at the lung bases indicate pulmonary edema from fluid overload, as excess fluid accumulates in the alveoli and interstitial lung tissue.

Question 5

Which clinical finding is most consistent with severe dehydration in an adult patient?

Accepted Answer

Poor skin turgor and concentrated urine

Answer

Poor skin turgor (tenting) and dark, concentrated urine (high specific gravity) are classic signs of severe dehydration reflecting significant fluid deficit.

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