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Free NCLEX-RN Fluid & Electrolytes Practice Questions

Fluid and electrolyte balance underpins much of Physiological Adaptation on the NCLEX-RN. These free questions cover common imbalances and their nursing priorities.

Q1

A client has a serum potassium of 6.8 mEq/L. Which finding is the nurse's greatest concern?

AMuscle weakness
Peaked T waves on the ECG
CNausea
DHyperactive bowel sounds

RATIONALE

Severe hyperkalemia is life-threatening because of its cardiac effects. Peaked T waves progressing to widened QRS and dysrhythmias are the priority concern and require immediate intervention.

Q2

Which client is at highest risk for hyponatremia?

AA client with diabetes insipidus
A client with SIADH
CA client taking a loop diuretic with adequate intake
DA client with excessive sweating replaced with saline

RATIONALE

SIADH (syndrome of inappropriate antidiuretic hormone) causes water retention and dilutional hyponatremia. Diabetes insipidus tends toward hypernatremia from water loss.

Q3

A client with hypocalcemia may exhibit which sign?

Positive Trousseau's sign
BConstipation
CDecreased deep tendon reflexes
DKidney stones

RATIONALE

Hypocalcemia increases neuromuscular excitability, producing a positive Trousseau's (carpal spasm) and Chvostek's sign, tetany, and hyperactive reflexes. Constipation and kidney stones are associated with hypercalcemia.

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