PSA PSA Fluid and Electrolyte Prescribing 1

Question 1

A patient is admitted with hypovolemic shock following gastrointestinal bleeding. Which intravenous fluid is most appropriate for initial resuscitation?

Accepted Answer

0.9% Normal saline (isotonic saline)

Answer

Isotonic saline (0.9% NaCl) is the standard initial fluid for hypovolemic shock because it expands intravascular volume effectively.

Question 2

Which of the following is the most appropriate fluid for replacing isolated free water deficit in a patient with hypernatremia?

Accepted Answer

5% Dextrose in water (D5W)

Answer

D5W is effectively free water after glucose is metabolized and is the preferred fluid for correcting hypernatremia due to free water deficit.

Question 3

A post-operative patient develops oliguria. What is the first step in assessing fluid status before prescribing additional IV fluids?

Accepted Answer

Assess clinical signs of hypovolemia and review fluid balance

Answer

Clinical assessment of volume status (skin turgor, BP, HR, fluid balance) is essential before prescribing additional fluids to avoid fluid overload.

Question 4

What complication can result from rapid correction of chronic hyponatremia?

Accepted Answer

Osmotic demyelination syndrome

Answer

Correcting chronic hyponatremia too rapidly risks osmotic demyelination syndrome (previously called central pontine myelinolysis).

Question 5

Which IV fluid is most appropriate for a patient with diabetic ketoacidosis (DKA) after initial stabilization?

Accepted Answer

0.9% Normal saline followed by 0.45% saline with dextrose when glucose falls

Answer

In DKA, isotonic saline is used initially; as serum glucose approaches 200 mg/dL, dextrose-containing fluid is added to prevent hypoglycemia while continuing insulin.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA PSA Fluid and Electrolyte Prescribing 1