Benchmark Clinical Judgment Exam (CJE) Practice Exam

When an ileostomy produces a very large output, the most immediate danger is fluid and electrolyte loss leading to dehydration and reduced organ perfusion. The first priority is to restore and maintain circulating volume by providing fluids. This helps prevent hypovolemia, hypotension, and renal compromise, which can occur rapidly with high ostomy output.

Electrolyte losses accompany large fluid losses, so later steps will include assessing electrolytes and replacing potassium or sodium as needed based on labs and clinical status. But you don’t wait to replace fluids while the patient becomes more volume depleted; fluids come first to stabilize the patient.

Why not other options? Doing nothing ignores the acute risk of dehydration. Giving potassium or sodium without addressing the volume deficit may not prevent hypovolemia and could be insufficient or inappropriate if the patient remains fluid depleted. Fluids directly tackle the immediate hemodynamic threat.