Nutrition, Hydration and Electrolytes Practice Questions
20 free Nutrition, Hydration and Electrolytes practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
A 72-year-old post-operative patient with poor oral intake and hypokalemia should have nutrition support that focuses on:
- A Restrict dietary protein to reduce the renal workload
- B Start enteral feeds with adequate calories and potassium-rich foods
- C Delay all nutrition until full oral feeding resumes
- D Provide only intravenous fluids without any added electrolytes
Correct answer: Start enteral feeds with adequate calories and potassium-rich foods
Poor intake and hypokalemia indicate the need for nutrition support with adequate calories and potassium-rich foods to address electrolyte imbalance.
Why is oral rehydration solution with glucose and sodium recommended for a severely dehydrated patient with vomiting and diarrhea?
- A Plain water alone corrects electrolyte imbalance most effectively
- B Glucose-sodium co-transport boosts intestinal sodium and water uptake
- C Only intravenous fluids can be effective in this clinical scenario
- D High-sugar soft drinks are always adequate for full rehydration
Correct answer: Glucose-sodium co-transport boosts intestinal sodium and water uptake
Oral rehydration solutions with glucose and sodium enhance intestinal absorption of sodium and water to restore hydration and electrolyte balance.
What is the most appropriate strategy for managing hydration status in a critically ill patient with fluid overload?
- A Give liberal fluid boluses to keep urine output high
- B Use concentrated feeds with restricted free water and monitoring
- C Provide isotonic saline as the only route of hydration
- D Ignore fluid input because only electrolyte levels truly matter
Correct answer: Use concentrated feeds with restricted free water and monitoring
In fluid-overloaded patients, concentrated feeds with restricted free water and monitoring total fluid balance and electrolytes are crucial.
Why should a patient with malnutrition starting re-feeding after being NPO be closely monitored for worsening hypophosphatemia?
- A Hypophosphatemia worsening, characteristic of refeeding syndrome
- B Isolated hypermagnesemia without other electrolyte changes
- C Weight gain alone occurring without any electrolyte shifts
- D Hypernatremia developing as the sole metabolic disturbance
Correct answer: Hypophosphatemia worsening, characteristic of refeeding syndrome
Re-feeding syndrome can cause rapid shifts in electrolytes, especially phosphate, necessitating close monitoring during nutrition initiation.
What is the most appropriate hydration strategy for a patient with hyponatremia and mild fluid overload?
- A Allow unlimited oral water intake as desired
- B Restrict free water, watch sodium, and limit fluid in feeds
- C Give hypertonic saline to raise the sodium level quickly
- D Offer only plain water with no electrolyte supplementation
Correct answer: Restrict free water, watch sodium, and limit fluid in feeds
For a patient with hyponatremia and fluid overload, restricting free water, monitoring sodium intake, and providing nutrition with appropriate fluid content are essential.
In chronic kidney disease with elevated serum potassium, which high-potassium food example might need restriction for electrolyte management?
- A Apples
- B Bananas
- C White bread
- D Rice
Correct answer: Bananas
In CKD with hyperkalemia, high-potassium foods like bananas need limitation to manage potassium levels effectively.
What is a key consideration for hydration needs associated with total parenteral nutrition (TPN) in a critically ill patient?
- A No separate fluid allowance is needed beyond the nutrients
- B Infuse TPN alone without tracking overall fluid volume
- C Monitor intake/output and adjust IV fluids for hydration
- D Always give unrestricted free water along with the TPN
Correct answer: Monitor intake/output and adjust IV fluids for hydration
TPN may not meet all hydration needs; thus, monitoring fluid balance and adjusting additional fluids are crucial for adequate hydration and electrolyte balance.
What electrolyte is expected to be lost in high amounts in a patient with severe dehydration from heat injury and profuse sweating?
- A Magnesium only
- B Sodium and chloride
- C Calcium only
- D Phosphate only
Correct answer: Sodium and chloride
Profuse sweating leads to significant loss of sodium and chloride that must be addressed in hydration support for proper fluid and electrolyte balance.
For a patient on loop diuretics, which key electrolyte requires monitoring and supplementation when necessary?
- A Sodium only
- B Potassium and magnesium
- C Calcium exclusively
- D Phosphate exclusively
Correct answer: Potassium and magnesium
Loop diuretics cause renal loss of potassium and magnesium, highlighting the need for monitoring and possible supplementation of these electrolytes.
Why is checking electrolytes twice daily included in the nursing plan for a patient receiving enteral nutrition?
- A Electrolyte levels are influenced only by IV fluid therapy
- B Nutrition support drives electrolyte shifts, hydration, and organ function
- C Electrolyte values essentially never change with nutrition
- D Checking electrolytes once per week is fully sufficient
Correct answer: Nutrition support drives electrolyte shifts, hydration, and organ function
Both nutrition and fluids influence electrolyte shifts, making frequent monitoring essential, especially in patients on enteral or parenteral nutrition.
Why should a patient with malabsorption and chronic diarrhea be given a hydration solution containing electrolytes?
- A Plain water alone is sufficient for adequate hydration
- B Electrolyte fluids replace GI losses and support cell function
- C Only the sugar content of the fluid actually matters here
- D Electrolytes are needed only when intravenous fluids are used
Correct answer: Electrolyte fluids replace GI losses and support cell function
GI losses in malabsorption and chronic diarrhea include electrolytes, making electrolyte-containing solutions vital for restoring balance.
Which nutritional approach is suitable for a patient with hypomagnesemia and poor oral intake?
- A Provide high-magnesium foods and hydration to aid absorption
- B Place the patient on a strict low-magnesium diet
- C Focus nutrition planning solely on vitamin C intake
- D Exclude magnesium because it is not a nutrition-related concern
Correct answer: Provide high-magnesium foods and hydration to aid absorption
Nutrition support for hypomagnesemia involves providing high-magnesium foods and optimizing hydration to aid magnesium absorption.
What should be included in the nutrition/hydration plan for a sedated patient on mechanical ventilation with rising blood urea nitrogen and creatinine?
- A Restrict the patient's fluid intake even further
- B Increase enteral/IV fluids and monitor electrolytes and perfusion
- C Eliminate routine electrolyte checks from the plan
- D Increase protein while leaving fluid and electrolyte strategy unchanged
Correct answer: Increase enteral/IV fluids and monitor electrolytes and perfusion
Poor hydration and renal function require a plan that includes adequate fluids, electrolyte monitoring, and support for hydration and renal perfusion.
For a patient with severe burns, what should nursing nutrition and hydration support include?
- A Provide a standard diet without any modifications
- B Increase calories, protein, fluid, and replace electrolyte losses
- C Restrict fluids strictly to avoid any risk of overload
- D Disregard electrolyte losses during the healing phase
Correct answer: Increase calories, protein, fluid, and replace electrolyte losses
Severe burns necessitate increased calories, protein, fluid, and electrolyte replacement for healing support and managing fluid losses.
Why is hydration and electrolyte support important for a patient preparing for a colonoscopy on clear liquids?
- A Clear liquids always supply sufficient electrolytes on their own
- B Fasting and bowel prep cause fluid/electrolyte loss needing support
- C Electrolyte levels remain entirely unaffected by bowel preparation
- D No special attention is needed since the procedure is brief
Correct answer: Fasting and bowel prep cause fluid/electrolyte loss needing support
Bowel prep and fasting can cause fluid and electrolyte losses, necessitating hydration and electrolyte support even on clear liquids.
What should be included in nutritional and hydration support for a patient with low chloride levels from severe vomiting?
- A Only plain water by mouth to dilute the stomach contents
- B Sodium chloride fluids (oral or IV) to replace chloride and maintain acid-base balance
- C Only potassium replacement, since chloride corrects on its own
- D Strict avoidance of all dietary salt to prevent fluid overload
Correct answer: Sodium chloride fluids (oral or IV) to replace chloride and maintain acid-base balance
Fluids with sodium chloride help replace chloride losses and maintain acid-base balance in patients with low chloride levels due to vomiting.
What must hydration and electrolyte support include for a patient with hyperglycemia and hypernatremia during enteral nutrition initiation?
- A Simply reduce the enteral feed rate until sodium normalizes
- B Match fluid administration to feed content and assess the formula's sodium load
- C Ignore the hypernatremia, since it is expected to self-correct over time
- D Adjust insulin dosing only and leave fluids unchanged
Correct answer: Match fluid administration to feed content and assess the formula's sodium load
Fluid content and sodium load in nutrition must be considered to address hyperglycemia, hypernatremia, and maintain electrolyte balance.
Why should early nutrition and hydration support be provided to a patient with marked fluid and electrolyte losses from cholera?
- A Nutritional support can safely wait until rehydration is fully completed
- B Early support lowers mortality and aids electrolyte recovery
- C Only hydration matters; electrolytes and nutrition are not priorities here
- D Nutrition should be withheld for at least 48 hours after presentation
Correct answer: Early support lowers mortality and aids electrolyte recovery
Early nutrition and hydration support help reduce mortality, restore electrolyte balance, and promote recovery in patients with severe fluid and electrolyte losses.
What is the dietary adjustment recommended for a patient on loop diuretics to prevent potassium depletion?
- A Encourage high-potassium foods and adequate hydration to offset diuretic losses
- B Avoid all dietary potassium to prevent the risk of overload
- C Rely on potassium supplements alone with no change to the diet
- D Disregard hydration status as it does not affect potassium
Correct answer: Encourage high-potassium foods and adequate hydration to offset diuretic losses
Loop diuretics cause potassium loss, so eating high-potassium foods and staying hydrated helps prevent depletion associated with diuretics.
What is the primary target of nutrition/hydration support for a critically ill patient with low albumin and edema?
- A Restrict fluids tightly to reduce the visible edema
- B Increase protein to raise albumin, manage fluids, and support electrolytes
- C Give diuretics alone with no adjustment to nutrition
- D Focus solely on calories and disregard protein intake entirely
Correct answer: Increase protein to raise albumin, manage fluids, and support electrolytes
Low albumin and edema require increased protein intake, fluid management, and electrolyte support for reducing edema and promoting healing.