Adult Critical Care Specialty (ACCS) Practice Exam

In assessing a patient’s fluid balance, what would a net fluid balance of +8 L indicate?

1. Dehydration

2. Positive fluid retention

3. Normal fluid status

4. Fluid overload

The correct answer is: Fluid overload

A net fluid balance of +8 L indicates fluid overload in a patient. This value reflects an accumulation of excess fluid in the body, surpassing the normal physiological levels. In clinical practice, monitoring fluid balance is essential for managing patients who may be at risk for fluid overload, such as those with heart failure, kidney dysfunction, or receiving intravenous fluids. When a patient has a positive fluid balance, it typically suggests that they have taken in more fluid than they have excreted. A value this high (+8 L) indicates a significant excess, which can lead to complications, including edema, pulmonary congestion, or even heart failure. Recognizing this condition is critical, as it requires prompt evaluation and management to prevent further deterioration of the patient's health status. In contrast, dehydration would present with a negative fluid balance, while a normal fluid status would indicate that fluid intake and output are balanced, and positive fluid retention generally suggests mild fluid overload rather than the significant excess indicated by +8 L. Thus, fluid overload is the most appropriate interpretation of this net fluid balance.