1.

You are caring to a 23 years old patient named Melvin is diagnosed with severe
dehydration. As a nurse, which nursing intervention is appropriate for maintaining
function?
a. Assess the dietary intake
b. Advice to increase fluid intake
c. Provide limited physical activity
d. Start IV fluid administration

2. A patient is hemorrhaging from multiple trauma site. The nurse expects that
compensatory mechanism associated with hypovolemia would cause all of the
following symptoms except?
a. Hypertension
b. Oliguria
c. Tachycardia
d. Tachypnea

3. It comprises fluid surrounding the cell and it is known to be non – functional space
a. Intracellular space
b. Intravascular space
c. Interstitial space
d. Transcellular space

4. You are caring for a patient with dry mucous membranes, tented skin turgor and
decreased urinary output. Which of the following nursing intervention should be
included in your plan of care?
a. Monitoring of serum urine osmolality and albumin level
b. Administering intravenous fluid
c. Assess sputum appearance, consistency and odor
d. Provide diet high In fiber and calories

5. Which of the following patient is at more risk in developing fluid and electrolytes
imbalance?
a. A 79-year-old retired teacher with right sided heart failure
b. A 2-year-old female patient with a body temperature of 104.5’F and vomiting
c. A 69-year-old male patient post – ORIF with nausea and vomiting
d. A 1-year-old baby respiratory distress syndrome

6. Osmotic pressure is created through the process of?

a. Diffusion
b. Ultrafiltration
c. Osmosis
d. Filtration
7. Which of the following statements about administration of hypotonic solution in
patient with fluid volume deficit is correct?
a. It provides free water to help kidneys eliminate the solute
b. It supplies an excess of sodium and chloride ions
c. Excessive volumes are recommended in the early postoperative periods
d. It is used to treat hyponatremia

8. The nurse assesses the client with chronic renal failure and notes the following:
crackles in the lung bases, elevated blood pressure, and weight gain of 2 lb in 1 day.
Based on these data, which of the following nursing diagnoses is appropriate?
a. Excess fluid volume related to the kidney’s inability to maintain fluid balance.
b. Ineffective breathing pattern related to fluid in the lungs.
c. Ineffective tissue perfusion related to interrupted arterial blood flow.
d. Ineffective therapeutic regimen management related to lack of knowledge about therapy

9. The smallest compartment of the extracellular fluid space is called

a. Interstitial space
b. Intracellular space
c. Transcellular space
d. Intravascular space

10. Which of the following nursing intervention is appropriate in maintaining normal

bowel function in a patient diagnosed with constipation?
a. Encourage decrease fluid intake
b. Assessing dietary intake
c. Instruct deep breathing and coughing
d. Provide stationary activity

11. Which of the following conditions is an equal decrease of extracellular fluid (ECF)
solute and water volume?
a. Isotonic Fluid Volume Deficit
b. Hypertonic Fluid Volume Deficit
c. Hypotonic Fluid Volume Deficit
d. Fluid volume deficit

12. Which client is at risk of developing a sodium level at 130 mEq/L (130 mmol/L)?
a. The client who is taking diuretics
b. The client with hyperaldosteronism
c. The client with Cushing’s syndrome
d. The client who is taking corticosteroids

13. The average daily urinary output in an adult is?

a. 0.5 L
b. 1.0L
c. 1.5 L
d. 2.5 L

14. Lasix was prescribed by the attending physician to a client with hypervolemia. All
except of the following interventions regarding the drug regimen are correct. Select all
that applies (1. Observe sign and symptoms of hypokalemia, 2. Notify the physician if
urine output does not increase, 3. Administer rapidly the IV medication, 4. Be alert for
marked increase in blood pressure, 5. Teach patient to take oral form of the
medication early in the day to prevent nocturia)
a. 1, 4, and 5
b. 2 and 3
c. 3 and 4
d. 1, 2, and 5

15. The nurse must understand both the normal and abnormal characteristics of urine.
After obtaining the laboratory result of client’s urinalysis, which of the following should
be reported to the physician
a. Faintly aromatic
b. pH of 6
Option 3
c. Specific gravity of 1.030
d. Slightly turbid and transparent

16. A patient experiencing multisystem fluid volume deficit, has the symptoms of
tachycardia, pale, cool skin, & decreased urine output. The nurse realizes these
findings are most likely a direct result of which of the following?
a. The body’s natural compensatory mechanisms
b. Pharmacological effects of a diuretic
c. Effects of rapidly infused intravenous fluids
d. Cardiac failure

17. A febrile patient’s fluid output is in excess of normal because of diaphoresis. The
nurse should plan fluid replacement based on the knowledge that insensible losses in
an afebrile person are normally not greater than?
a. 300 ml / 24 hours
b. 600 ml / 24 hours
c. 900 ml / 24 hours
d. 1200 ml / 24 hours

18. The function of the kidneys includes all of the following, except
a. Regulation of acid – base balance
b. Control blood pressure
c. Excretion of ammonia
d. Regulation of RBC production
19. It is the space where plasma is contained is called:
a. Intracellular space
b. Intravascular space
c. Interstitial space
d. Transcellular space

20. Chloe is admitted in the hospital due to severe vomiting and body weakness. A
lower-than-normal serum potassium is noted in her serum electrolytes test. As a nurse
in charged in caring for her, which of the following food you will advice to the client to
increase?
a. Avocados, Bananas and Apricots
b. Walnuts, Cabbage and orange fruits
c. Pork, canned beans and mangoes
d. Milk, cheese and leafy vegetables

21. Nurse Ordonez is totaling the 24 hours intake and output of patient Lapuz, a
patient diagnosed with chronic renal failure who is on clear liquid diet. The patient
received a double dose of 100 cc of PNSS incorporated with 20 mEq potassium
chloride (stock dose 40 mEq/20ml) that runs for 6 hours continuously; total IV
medications administered of 90ml, an intravenous fluid of PNSS at 20cc/hour and 5 oz
of apple juice. How many milliliters should the nurse document as the client’s intake.
a. 1230
b. 850
c. 940
d. 1430

22. A client with very dry mouth, skin and mucous membranes is diagnosed of having
dehydration. Which intervention should the nurse perform when caring for a client
diagnosed with fluid volume deficit? Select all that applies (1. Regulate the
intravenous therapy at the keep – vein open rate, 2. Weigh the patient daily at the
same time with different clothing is acceptable, 3. Strict checking of serum potassium
and urine specific gravity, 4. Monitoring of intake and output, 5. Monitoring of the
arterial blood gas, 6. Assessing patient’s neurological status)
a. 2, 3, 4 and 5
b. All except 1, 3 and 4
c. 3, 4, and 6
d. 1, 2, 4 is the priority

23. A patient with fever losses fluid through insensible fluid loss. This includes:
a. Bleeding in the gum
b. Gastric drainage
c. Perspiration
d. Urine and feces

24. When assessing patient’s total body fluid percentage, the nurse is aware that all
except one are factors that influence fluid loss
a. Fat tissue
b. Gender
c. Muscle mass
d. Age

25. A patient’s serum sodium concentration is within the normal range. The nurse
estimates that the serum osmolality should be?
a. Less than 136 mOsm / kg
b. 275 to 300 mOsm / kg
c. Greater than 408 mOsm / kg
d. 350 to 544 mOsm / kg

26. What signs and symptoms will the nurse look when caring for an infant with severe
dehydration? Select all that applies (1. Dark yellow urine, 2. Lethargic, 3. Bulging
fontanels, 4. Tachycardia, and 5. Decreased urine output)
a. 3, 4 and 5
b. 1, 2, 4 and 5
c. 1, 2, 3 and 5
d. 2, 3, 4 and 5

27. Manifestation of extracellular FVD includes all of the following except:

a. Collapsed neck veins
b. Decreased serum albumin
c. Elevated hematocrit
d. Weight loss

28. Which of the following intravenous solutions would be appropriate for a patient
with severe extracellular fluid deficit?
a. Hypotonic solution
b. Hypertonic solution
c. Isotonic solution
d. Normotonic solution

29. A manifestation of extracellular volume excess is:

a. Altered serum osmolality
b. Elevated CVP
c. Increase hematocrit when volume excess develops quickly
d. Rapid weight gain

30. The nurse expects that a decrease in serum osmolality would occur with
a. Diabetes insipidus
b. Hyperglycemia
c. Renal Failure
d. Uremia

31. Nurse Allyza is recording the 12 hours intake and output of patient Ira, a client
diagnosed with severe dehydration and Dengue fever with warning sign. The patient
intakes 10 oz of pineapple juice, 900 ml of cold water, 3 cups fresh cow’s milk, a blood
transfusion of Platelet concentrates amounting 250cc, and IV fluid of PLRS at 80
ml/hour with 1,500 ml of urine during the shift. How many liters should the nurse
document as the patient’s intake?
a. 2.89 L
b. 3.16 L
c. 2.75 L
d. 3.85 L

32. Which of the following conditions is an equal decrease of extracellular fluid solute
and water volume?
a. Isotonic FVE
b. Hypotonic FVD
c. Hypertonic FVE
d. Isotonic FVD

33. The nurse reviews laboratory results and notes that a client’s serum sodium level
is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the health
care provider (HCP) and the HCP prescribes dietary instructions based on the sodium
level. Which acceptable food items does the nurse instruct the client to consume?
Select all that apply. (1. Peas, 2. Nuts, 3. Cheese, 4. Cauliflower, 5. Processed oat
cereals)
a. 1, 3, 5
b. 2, 4, 5
c. 1, 2, 4
d. 1, 3, 4

34. The nurse is caring for a client with heart failure who receives high doses of a
diuretic. On assessment, the nurse notes that the client has flat neck veins,
generalized muscle weakness, and diminished deep tendon reflexes. The nurse
suspects hyponatremia. What additional signs would the nurse expect to note in a
client with hyponatremia
a. Muscle twitches
b. Decreased urinary output
c. Hyperactive bowel sounds
d. Increased specific gravity of the urine
35. When monitoring the daily weight of a patient with fluid volume deficit (FVD), the
nurse is aware that fluid loss may be considered when weight loss begins to exceed
a. 2.2 pounds
b. ¼ kg
c. 1 pound
d. ½ kg

36. It is the process in which fluids are pushes through biologic membrane by unequal
process from higher to lower pressure
a. Osmosis
b. Diffusion
c. Filtration
d. Osmotic pressure

37. Patient Rodel is scheduled to received hypertonic solution severe diarrhea and
vomiting; which of the following solution should the nurse administer? ISOTONIC
a. 5% dextrose in 0.9% saline
b. 5 % dextrose water
c. 5% dextrose in ringer’s lactate solution
d. 5% dextrose in 0.45% saline

38. Nurse Morry is aware that the following nursing interventions is needed in
preventing fluid and electrolytes disturbances is / are? Select all that applies (1.
Instructing fluid and sodium intake rstriction, 2. Understanding about the anatomy of
fluid imbalance in elderly patient, 3. Administration of antipyretic and antimicrobial
medication to correct the cause as prescribe, 4. Administration of hypotonic solution in
patient with hypotonic dehydration, 5. Monitoring for any cardiac dysrhythmias, 6.
Initiating safety and seizure precautions, 7. Checking for any skeletal muscle
weakness)
a. All except 3 and 6
b. 1, 2, 4, 5, and 7
c. 1, 4, 5 and 7 is incorrect
d. 1, 3, 5, 6 and 7 only

39. The nurse is caring for a client with heart failure. On assessment, the nurse notes
that the client is dyspneic, and crackles are audible on auscultation. What additional
manifestations would the nurse expect to note in this client if excess fluid volume is
present?
a. Weight loss and dry skin
b. Flat neck and hand veins and decreased urinary output
c. An increase in blood pressure and increased respirations
d. Weakness and decreased central venous pressure (CVP
40. If the patient’s serum sodium level is 140 mEq/L, a nurse can estimate that the
serum osmolality is?
a. 70 mOsm / kg
b. 140 mOsm / kg
c. 210 mOsm / kg
d. 280 mOsm / kg

41. During the bedside endorsement, you the in – coming shift nurse notice that your
patient named Yahnah who has severe burns started to develop a fluid accumulation
in her abdominal tissue. You note that there were no changes in her weight and her
intake and output is equal. You should suspect for?
a. Intravascular compartment syndrome
b. It is a normal and expected finding after burn
c. There is a third - space fluid shift
d. There is an extracellular space fluid transport

42. Hypernatremia is associated with a

a. Serum osmolality of 245 mOsm / kg
b. Serum sodium concentration of 150 mEq / L
c. Urine specific gravity lower than 1.003
d. Combination of all of the above

43. One of the best indicators or renal functions is?

a. Blood urea nitrogen (BUN)
b. Serum creatinine
c. Specific Gravity
d. Urine osmolality

44. Clinical manifestation not found in hypovolemia is:

a. Muscle weakness
b. Oliguria
c. Postural hypotension
d. Bradycardia

45. Laboratory findings consistent with hypovolemia in a female would include all of
the following except?
a. Hematocrit greater than 47%
b. BUN – serum creatinine ratio greater than 12:1
c. Urine specific gravity of 1.027
d. Urine osmolality greater than 450 mOsm / kg

46. Comprises about 60% of body fluid is refer as:

a. Interstitial space
b. Intracellular space
c. Transcellular space
d. Intravascular space

47. A patient is admitted to the Emergency department with the following findings:
severe body weakness, heart rate of 119 (thready upon palpation), with episodes of
dyspnea, blood pressure of 90/50, urinary output of 20cc/hour, and serum sodium
level of 157.4 mEq/l. What interventions do you expect the ER resident to order?
a. Administration of kalium durule and hypotonic intravenous fluid such as 5% dextrose in ¼ NSS
b. Restriction of fluid intake and daily weight checking
c. Administer hypertonic solution of 5% Dextrose 0.45% NSS
d. Strict monitoring of urine output and administration of 0.9% NSS

48. Nursing intervention for a patient with a diagnosis of hyponatremia includes all of
the following except:
a. Assessing for symptoms of nausea and malaise
b. Encourage the intake green tea
c. Monitoring neurologic status
d. Restricting tap water intake

49. The nurse in the intensive care unit is caring for a patient receiving hypertonic
solution. He is aware that one of the dangers of treating hypernatremia is:
a. Red blood cell crenation
b. Red blood cell hydrolysis
c. Cerebral edema
d. Renal shot down

50. The nurse is reading a health care provider’s (HCP’s) progress notes in the client’s
record and reads that the HCP has documented “insensible fluid loss of approximately
800 mL daily.” The nurse makes a notation that insensible fluid loss occurs through
which type of excretion?
a. Urinary output
b. Wound drainage
c. Integumentary output
a. The gastrointestinal tract

51. A nurse is directed to administer a hypotonic intravenous solution. Looking at the

following labeled solutions, she should choose:
a. 0.45% sodium chloride
b. 5% dextrose in normal saline
c. 0.90% sodium chloride
d. 5% dextrose in water

52. An isotonic solution that contains electrolytes similar to the concentration of

electrolytes used in plasma is:
a. 5% dextrose in water
b. Lactated ringer’s solution
c. 3% NaCl solution
d. 5% NaCl solution

53. Comprises the intravascular, interstitial and transcellular fluid is called

a. Intracellular fluid compartment
b. Intravascular fluid compartment
c. Extracellular fluid compartment
d. Extravascular fluid compartment

54. It is the most abundant electrolytes in the extracellular fluid and is primarily
responsible for maintaining fluid
a. Potassium
b. Calcium
c. Sodium
d. Phosphate

55. Signs of lethargy, increasing intracranial pressure, and seizure may occur when
the serum sodium level reaches
a. 115 mEq/L
b. 135 mEq/L
c. 145 mEq/L
d. 160 mEq/L

56. In a patient with excess fluid volume, hyponatremia is treated by restricting IV fluid
to how many milliliters in 24 hours?
a. 400 ml
b. 600 ml
c. 800 ml
d. 1200 ml

57. To return a patient with hyponatremia to normal sodium levels, it is safer to restrict
fluid intake than to administer sodium:
a. In patient who are unconscious
b. To prevent fluid overload
c. To prevent dehydration
d. In patient who show neurologic symptoms

58. The nurse is aware that the organs most important in maintaining the fluid and
electrolyte balance are the:
a. Brain stem and heart
b. Lungs and kidneys
c. Pituitary gland and liver
d. Liver and kidney
59. The major indicator of extracellular FVD can be identified by assessing for
a. A full and bounding pulse
b. A drop in postural blood pressure
c. An elevated temperature
d. Pitting edema of the lower extremities

60. A nursing plan of care for patient Dianne who has a diagnosis of extracellular FVD
includes all of the following except
a. Monitoring urinary output to assess kidney perfusion
b. Placing the patient in Trendelenburg position to maximize cerebral blood flow
c. Positioning the patient flat in bed with leg elevated to maintain adequate circulating volume
d. Teaching leg exercise to promote venous return and prevent postural hypotension when the
patient stand

61. Urine output is the best indicator of cardiac output; hence, it should be monitored
accurately. To assess the urinary function of a patient, the nurse collects a urine
sample. Which of the following urine characteristics is considered abnormal?
a. Straw colored
b. pH of 5.7
c. RBC of 1 hpf
d. Specific gravity of 1.020

62. When evaluating a client’s response to fluid replacement therapy, the observation
that indicates adequate tissue perfusion to the vital organs is:
a. Urinary output of 40 ml in an hour
b. Central venous pressure reading of 2cm H20
c. Pulse rate of 120 and 130 in 15-minute period
d. Blood pressure reading of 60/30 and 70/40 mmhg at 30 minutes interval

63. The nurse is reviewing laboratory results and notes that a client’s serum sodium
level is 150 mEq/L (150 mmol/L). The nurse reports the serum sodium level to the
health care provider (HCP) and the HCP prescribes dietary instructions based on the
sodium level. Which acceptable food items does the nurse instruct the client to
consume? Select all that apply. (1. Peas 2. Nuts 3. Cheese 4. Cauliflower 5.
Processed oat cereal 6. Banana 7. Beef tenderloin)
a. 3, 5. 7
b. 1,2, 4
c. 2, 3, 6
d. 4, 5, 6

64. The nurse is assigned to care for a group of clients. On reviewing the clients’
medical records, the nurse determines which client is most likely at risk for a fluid
volume deficit?
a. A client with an ileostomy
b. A client with heart failure
c. A client on long-term corticosteroid therapy
d. A client receiving frequent wound irrigations

65. All of the following are considered as isotonic intravenous fluid, except
a. 0.9% NaCl
b. D5W
c. D5LR
d. PLRS

66. Which of the following laboratory data is the most accurate blood test for
determining kidney function and dehydration:
a. Specific gravity
b. Serum creatinine
c. BUN
d. Creatinine clearance

67. A child diagnosed with hyponatremia suddenly develop seizure. As a nurse caring
for this patient, what will be you immediate nursing intervention?
a. Insert a padded tongue blade if having second seizure attack
b. Protect from injury from the environment
c. Hold the child down to prevent further injury
d. Administer oxygen via venturi mask at 80% fi02

68. Nurse Faiza is caring for a patient named Mohammed with heart failure. On
assessment, the nurse Faiza notes that the client is dyspneic, and crackles are
audible on auscultation. What additional manifestations would the nurse expect to
note in this client if excess fluid volume is present?
a. Weight loss and dry skin
b. Flat neck and hand veins and decreased urinary output
c. An increase in blood pressure and increased respirations
d. Weakness and decreased central venous pressure (CVP)

69. The nurse assesses a client and notes puffy eyelids, swollen ankles, and crackles
at both lung bases. The nurse understands that these clinical findings are most
specifically associated with fluid excess in which of the following compartments?
a. Interstitial compartment.
b. Intravascular compartment.
c. Extracellular compartment.
d. Intracellular compartment
70. The nurse caring for a client who has been receiving intravenous (IV) diuretics
suspects that the client is experiencing a fluid volume deficit. Which assessment
finding would the nurse note in a client with this condition?
a. Weight loss and poor skin turgor
b. Lung congestion and increased heart rate
c. Decreased hematocrit and increased urine output
d. Increased respiration and increased blood pressure