NMC CBT Nutrition and Fluid Balance 1 — Questions and Answers
Question 1: A patient is admitted with suspected dehydration. Which clinical sign is MOST consistent with moderate dehydration?
- Bounding pulse and hypertension
- Dry mucous membranes and reduced skin turgor (Correct answer)
- Peripheral oedema and crackles on auscultation
- Bradycardia and increased urine output
Correct answer: Dry mucous membranes and reduced skin turgor
Dry mucous membranes and reduced skin turgor are classic signs of moderate dehydration reflecting intracellular and extracellular fluid loss.
Question 2: When completing a fluid balance chart, which of the following should be recorded as OUTPUT?
- IV infusion rate
- Oral fluid intake
- Nasogastric feed volume
- Wound drainage (Correct answer)
Correct answer: Wound drainage
Wound drainage is a measurable fluid loss from the body and must be recorded as output on the fluid balance chart.
Question 3: The Malnutrition Universal Screening Tool (MUST) includes which three assessment components?
- BMI, recent weight loss, and acute disease effect (Correct answer)
- Age, serum albumin, and dietary intake
- Height, mid-arm circumference, and appetite
- Fluid intake, BMI, and mobility
Correct answer: BMI, recent weight loss, and acute disease effect
MUST assesses BMI, unplanned weight loss over 3–6 months, and the acute disease effect score to calculate overall malnutrition risk.
Question 4: An adult patient weighing 70 kg has a normal daily urine output. Which volume is within the expected range?
- 200–400 mL/day
- 400–600 mL/day
- 800–2000 mL/day (Correct answer)
- 2500–3500 mL/day
Correct answer: 800–2000 mL/day
Normal adult urine output is approximately 0.5–1 mL/kg/hr, equating to roughly 800–2000 mL per day for a 70 kg adult.
Question 5: A patient receiving enteral nutrition via nasogastric tube develops a distended abdomen and vomiting. What is the PRIORITY nursing action?
- Increase the rate of the feed
- Stop the feed and inform the nurse in charge (Correct answer)
- Reposition the patient supine
- Administer an antiemetic and continue the feed
Correct answer: Stop the feed and inform the nurse in charge
A distended abdomen and vomiting suggest feed intolerance or tube misplacement; stopping the feed and escalating is the immediate priority to prevent aspiration.
Question 6: Which serum electrolyte level, if significantly reduced, is MOST likely to cause muscle weakness and cardiac arrhythmias?
- Sodium
- Potassium (Correct answer)
- Calcium
- Magnesium
Correct answer: Potassium
Hypokalaemia (low potassium) impairs cardiac conduction and neuromuscular function, leading to muscle weakness and potentially life-threatening arrhythmias.
Question 7: A nurse uses the BMI formula to assess a patient's nutritional status. Which BMI range indicates underweight in an adult?
- Less than 18.5 kg/m² (Correct answer)
- 18.5–24.9 kg/m²
- 25–29.9 kg/m²
- 30 kg/m² or above
Correct answer: Less than 18.5 kg/m²
A BMI below 18.5 kg/m² is classified as underweight according to standard WHO and NICE guidelines used in clinical nutritional screening.
NMC CBT Nutrition and Fluid Balance 1
A patient is admitted with suspected dehydration.
Which clinical sign is MOST consistent with moderate dehydration?