Hypochloremia and hyperchloremia NCLEX questions quiz for nursing students! This review quiz will test your knowledge on the causes, symptoms, and nursing interventions of hypochloremia and hyperchloremia. Before taking this quiz, you might want to review our hypochloremia and hyperchloremia lecture.
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Don’t forget to review the hypochloremia vs. hyperchloremia notes.
This electrolyte imbalance is many times associated with an imbalance of sodium and bicarbonate. In addition, an imbalance of potassium will occur, especially if alkalosis or acidosis is presenting.
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1. Which of the following does Chloride NOT play a role in?
A. Digestion
B. Acid-base balance
C. Fluid balance
D. Bone health
The answer is D: Bone health
2. A patient has a Chloride level of 70 mEq/L. Which condition below can cause this type of level?
A. None, this is a normal Chloride level.
B. Cystic Fibrosis
C. Metabolic acidosis
D. Hypertonic fluids
The answer is B: Cystic Fibrosis
3. A patient is presenting with metabolic alkalosis. Lab results are back and the patient’s bicarb level is 53 mEq/L. What other lab result would correlate with this finding?
A. Chloride 73 mEq/L
B. Chloride 190 mEq/L
C. Potassium 6.5 mEq/L
D. Chloride 100 mEq/L
The answer is A. Hypochloremia (<95 mEq/L) will present with metabolic alkalosis. In this condition, bicarb is elevated which causes chloride to decrease. Remember chloride and bicarb have an opposite relationship on each other due to how these ions are exchanged in the red blood cells. Therefore, hypochloremia can present.
4. You’re assessing a patient’s morning lab work. The patient has a chloride level of 98 mEq/L. The nurse interprets this finding as?
A. Hypochloremia
B. Normal
C. Hyperchloremia
The answer is B. A normal chloride level is 95-105 mEq/L.
5. Which patient below is at risk for developing hyperchloremia?
A. A 25-year-old with cystic fibrosis.
B. A 55-year-old post-op from abdominal surgery that has a nasogastric tube with continuous suctioning.
C. A 62-year-old prescribed IV loop diuretics for the treatment of heart failure.
D. A 53-year-old who received several large fluid boluses of Normal Saline.
The answer is D. The administration of Normal Saline (0.9% of Sodium-Chloride), especially large boluses can lead to hypernatremia and hyperchloremia. When these types of fluids are administered the nurse should monitor for these conditions.
6. True or False: When metabolic acidosis occurs, the bicarb level is decreased and hyperchloremia can develop.
A. True
B. False
The answer is A, TRUE.
7. Lactated Ringer’s can be prescribed to treat?
A. Hypochloremia
B. Hyperchloremia
C. Metabolic alkalosis
D. None, this IV fluid is not typically prescribed for chloride imbalance disorders.
The answer is B. Lactated Ringer’s may be used to help decrease an elevated chloride level (hence hyperchloremia). Why? Once this fluid enters the body it turns the lactate into bicarb, which helps increase the body’s bicarb level and lower chloride levels. Remember the opposite effect bicarb and chloride have on each other.
8. A patient has a Chloride level of 190 mEq/L. Which foods below should the patient avoid? Select all that apply:
A. Carrots
B. Canned beans
C. Table Salt
D. Tomato juice
E. Olives
F. Chicken
The answers are: B, C, D, E. A chloride level of 190 is high. The patient should avoid foods high in chloride. Remember that anything high in salt (sodium chloride) hence that’s salty….is also high in chloride. Therefore, anything processed or canned will be high in chloride along with tomatoes, olives, etc.
9. A patient has a chloride level of 63 mEq/L. The patient is experiencing lethargy, confusion, spasms of muscles, and has a blood pressure of 90/54. What other lab finding below correlates with these findings?
A. Potassium 4 mEq/L
B. Potassium 8 mEq/L
C. Sodium 115 mEq/L
D. Sodium 190 mEq/L
The answer is C. A normal chloride level is 95-105 mEq/L. The patient is experiencing hypochloremia. Remember sodium and chloride mirror each other (when one is low the other is as well and vice versa). The patient is exhibiting signs and symptoms of hyponatremia. Therefore, a sodium level of 115 mEq/L would correlate with these findings.
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10. Which type of IV fluid below can be prescribed to treat a patient with a chloride level of 69 mEq/L?
A. Sodium Bicarbonate
B. Normal Saline
C. Lactated Ringer’s
D. 5% Saline
The answer is B. A chloride level of 69 mEq/L is too low and hypochloremia is presenting. Normal Saline (0.9%) can be used to replace chloride in cases of hypochloremia.
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A chloride blood test measures the levels of chloride in the blood. High levels of chloride cause hyperchloremia. Low levels of chloride cause hypochloremia.
Chloride is an electrolyte that helps balance the amount of fluid inside and outside of cells. It also helps maintain blood volume, blood pressure, and the pH of body fluids.
Most people will not be aware that they have hyperchloremia because the symptoms are almost impossible to identify. Doctors often discover the condition from a chloride blood test, which is part of a routine blood screening to monitor or diagnose electrolyte levels.
A doctor might do these tests if they suspect a person has any of the following:
The doctor will usually do tests for other electrolytes, such as sodium, potassium, and bicarbonate, at the same time.
If a doctor is concerned that a person might have diabetes, they might recommend a urine test as well.
This article explains the chloride blood test and how to interpret the results. High or low levels may have different symptoms and are indicative of a number of different conditions
The test does not require any special preparation. However, always discuss any concerns or questions with a doctor.
The blood test involves taking a blood sample from a vein, usually in the arm or hand.
The test will take less than 10 minutes and should not cause any harm. Some people might experience slight pain or bruising at the site where the doctor inserts the needle.
Once collected, the blood will go to a lab for analysis. The doctor usually receives the results from the lab within a few days.
The normal range for chloride is between 98 and 106 milliequivalents per liter (mEq/L).
Chloride levels above the normal range cause a condition known as hyperchloremia. Hyperchloremia happens when the volume of chloride ions rises, which might be due to a number of factors.
Possible causes include:
Newborn babies often have hyperchloremia because their chloride levels rise in the week after birth. However, this is nothing to worry about, as the levels rise naturally and do not indicate a health problem.
Hyperchloremia is common in critically ill people.
Low levels of chloride cause a condition known as hypochloremia. Hypochloremia happens when the volume of chloride ions decreases.
Possible causes include:
Treatments vary according to the type of electrolyte balance a person has.
Most people can manage hyperchloremia with some lifestyle changes. For example, if dehydration is causing the hyperchloremia, treatment will likely include hydration, which may involve drinking lots of water every day.
People should eat a healthful, balanced diet and avoid caffeine and alcohol as they are diuretics.
However, anyone who experiences any symptoms that might suggest kidney problems should see a doctor as soon as possible.
If someone develops hypochloremia due to a medication they are taking, the doctor may adjust the dosage or prescribe a different drug. If hypochloremia is mild and due to diet irregularities, the doctor may recommend that the person increases their salt intake.
The amount of fluid a person consumes through drinking or loses through excessive sweating, diarrhea, or vomiting can affect chloride levels. Maintaining proper hydration may make chloride levels more stable.
Results of the chloride blood test that are not in the normal range are not usually a cause for concern. However, they can signify an underlying condition that might require treatment.
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