Neonatal Nurse Practitioner Practice Exam

Which group of neonates is at increased risk for hypochloremia?

1. Asphyxiated at birth

2. Had prolonged diarrhea

3. Have been over-treated with diuretics

4. Born with congenital anomalies

The correct answer is: Have been over-treated with diuretics

Hypochloremia, or low serum chloride levels, can occur due to several physiological conditions and interventions. In the context of neonates who have been over-treated with diuretics, this group is particularly at risk for hypochloremia because diuretics enhance the excretion of various electrolytes, including chloride, through urine. When fluid balance is altered, particularly in newborns whose renal function may not yet be fully developed, this can lead to significant imbalances in electrolytes. Over-treatment can particularly exacerbate these losses, leading directly to hypochloremia. While other groups, such as those with congenital anomalies, asphyxia at birth, or experiencing prolonged diarrhea, may face various metabolic or fluid imbalances, the direct link to hypochloremia is most pronounced in the case of over-treatment with diuretics. In such instances, the risk is a direct consequence of the medications, making this the most relevant choice in this scenario.