NUR 283 COMP 1 EXAM VERIFIED EXAM QUESTIONS AND
ANSWERS - LATEST VERSION 2026 /2027
1. What is the normal serum sodium level? 135–145 mEq/L
2. What is the primary manifestation of hypernatremia? Thirst, dry mucous
membranes, confusion, and decreased LOC
3. What is the normal serum potassium level? 3.5–5.0 mEq/L
4. What are classic ECG changes seen in hyperkalemia? Peaked T waves,
widened QRS, sine wave pattern
5. What is the priority nursing action for a K+ of 6.5 mEq/L? Notify the
provider immediately; prepare for cardiac monitoring and treatment
6. What causes hypokalemia? Diuretics, vomiting, diarrhea, inadequate intake,
corticosteroids
7. Signs of hypokalemia include: Muscle weakness, leg cramps, dysrhythmias,
decreased bowel sounds, flat T waves
8. Normal serum calcium level: 8.5–10.5 mg/dL
9. Chvostek's sign indicates: Hypocalcemia (facial muscle twitch when
tapping facial nerve)
10. Trousseau's sign indicates: Hypocalcemia (carpal spasm with BP cuff
inflation)
11. What is the normal serum magnesium level? 1.5–2.5 mEq/L
12. What medication is used to treat hypermagnesemia emergently?
Calcium gluconate
13. Normal serum phosphorus level: 2.5–4.5 mg/dL
14. Hypophosphatemia is commonly associated with: Malnutrition, refeeding
syndrome, hyperparathyroidism, antacid overuse
,15. Isotonic fluid example: 0.9% NaCl (Normal Saline), Lactated Ringer's,
D5W (in bag)
16. Hypotonic fluid example: 0.45% NaCl (half normal saline)
17. Hypertonic fluid example: 3% NaCl, D10W, D5 0.9% NaCl
18. What does isotonic IV fluid do to cells? No change in cell size; stays in
extracellular space
19. What does hypotonic IV fluid do to cells? Fluid shifts into cells, causing
them to swell
20. What does hypertonic IV fluid do to cells? Fluid shifts out of cells,
causing them to shrink
21. Normal serum osmolality: 275–295 mOsm/kg
22. What is third-spacing? Fluid shift from intravascular to interstitial/body
cavities (not accessible); seen in burns, peritonitis, cirrhosis
23. Signs of fluid volume deficit (FVD): Tachycardia, hypotension, dry
mucous membranes, dark urine, decreased skin turgor, oliguria
24. Signs of fluid volume excess (FVE): Edema, weight gain, crackles in
lungs, bounding pulse, hypertension, JVD
25. Best indicator of fluid balance: Daily weight (1 kg = ~1 L of fluid)
UNIT 2: ACID-BASE BALANCE
26. Normal arterial blood gas (ABG) values: pH 7.35–7.45 | PaCO2 35–45 |
HCO3 22–26 | PaO2 80–100
27. In respiratory acidosis, what happens to CO2 and pH? CO2 increases,
pH decreases
28. Common cause of respiratory acidosis: Hypoventilation, COPD,
pneumonia, drug overdose
29. In respiratory alkalosis, what happens? CO2 decreases, pH increases
(hyperventilation)
, 30. Common cause of respiratory alkalosis: Anxiety, hyperventilation, fever,
hypoxia
31. In metabolic acidosis, what happens to HCO3 and pH? HCO3 decreases,
pH decreases
32. Common causes of metabolic acidosis: DKA, renal failure, diarrhea, lactic
acidosis (MUDPILES mnemonic)
33. In metabolic alkalosis, what happens? HCO3 increases, pH increases
34. Common causes of metabolic alkalosis: Vomiting, nasogastric suction,
excess antacids, diuretics
35. How does the body compensate for metabolic acidosis? Hyperventilation
(blowing off CO2) — Kussmaul respirations
36. How does the body compensate for metabolic alkalosis? Hypoventilation
(retaining CO2)
37. How does the kidney compensate for respiratory acidosis? Retains
HCO3 and excretes H+
38. A patient has pH 7.28, CO2 55, HCO3 24. What is the interpretation?
Respiratory acidosis, uncompensated
39. A patient has pH 7.48, CO2 30, HCO3 22. What is the interpretation?
Respiratory alkalosis, uncompensated
40. A patient has pH 7.32, CO2 38, HCO3 18. What is the interpretation?
Metabolic acidosis, uncompensated
41. A patient has pH 7.50, CO2 48, HCO3 30. What is the interpretation?
Metabolic alkalosis, compensated
42. Steps to interpret ABGs (ROME method): Respiratory Opposite (pH↑
CO2↓ or pH↓ CO2↑); Metabolic Equal (pH↑ HCO3↑ or pH↓ HCO3↓)
43. What lab finding is associated with DKA? Low pH, low HCO3, low CO2
(compensatory), elevated blood glucose, ketones in urine
44. Kussmaul respirations are associated with: Metabolic acidosis (DKA)
45. Tetany and numbness are associated with which acid-base disorder?
Respiratory or metabolic alkalosis (decreased ionized calcium)
ANSWERS - LATEST VERSION 2026 /2027
1. What is the normal serum sodium level? 135–145 mEq/L
2. What is the primary manifestation of hypernatremia? Thirst, dry mucous
membranes, confusion, and decreased LOC
3. What is the normal serum potassium level? 3.5–5.0 mEq/L
4. What are classic ECG changes seen in hyperkalemia? Peaked T waves,
widened QRS, sine wave pattern
5. What is the priority nursing action for a K+ of 6.5 mEq/L? Notify the
provider immediately; prepare for cardiac monitoring and treatment
6. What causes hypokalemia? Diuretics, vomiting, diarrhea, inadequate intake,
corticosteroids
7. Signs of hypokalemia include: Muscle weakness, leg cramps, dysrhythmias,
decreased bowel sounds, flat T waves
8. Normal serum calcium level: 8.5–10.5 mg/dL
9. Chvostek's sign indicates: Hypocalcemia (facial muscle twitch when
tapping facial nerve)
10. Trousseau's sign indicates: Hypocalcemia (carpal spasm with BP cuff
inflation)
11. What is the normal serum magnesium level? 1.5–2.5 mEq/L
12. What medication is used to treat hypermagnesemia emergently?
Calcium gluconate
13. Normal serum phosphorus level: 2.5–4.5 mg/dL
14. Hypophosphatemia is commonly associated with: Malnutrition, refeeding
syndrome, hyperparathyroidism, antacid overuse
,15. Isotonic fluid example: 0.9% NaCl (Normal Saline), Lactated Ringer's,
D5W (in bag)
16. Hypotonic fluid example: 0.45% NaCl (half normal saline)
17. Hypertonic fluid example: 3% NaCl, D10W, D5 0.9% NaCl
18. What does isotonic IV fluid do to cells? No change in cell size; stays in
extracellular space
19. What does hypotonic IV fluid do to cells? Fluid shifts into cells, causing
them to swell
20. What does hypertonic IV fluid do to cells? Fluid shifts out of cells,
causing them to shrink
21. Normal serum osmolality: 275–295 mOsm/kg
22. What is third-spacing? Fluid shift from intravascular to interstitial/body
cavities (not accessible); seen in burns, peritonitis, cirrhosis
23. Signs of fluid volume deficit (FVD): Tachycardia, hypotension, dry
mucous membranes, dark urine, decreased skin turgor, oliguria
24. Signs of fluid volume excess (FVE): Edema, weight gain, crackles in
lungs, bounding pulse, hypertension, JVD
25. Best indicator of fluid balance: Daily weight (1 kg = ~1 L of fluid)
UNIT 2: ACID-BASE BALANCE
26. Normal arterial blood gas (ABG) values: pH 7.35–7.45 | PaCO2 35–45 |
HCO3 22–26 | PaO2 80–100
27. In respiratory acidosis, what happens to CO2 and pH? CO2 increases,
pH decreases
28. Common cause of respiratory acidosis: Hypoventilation, COPD,
pneumonia, drug overdose
29. In respiratory alkalosis, what happens? CO2 decreases, pH increases
(hyperventilation)
, 30. Common cause of respiratory alkalosis: Anxiety, hyperventilation, fever,
hypoxia
31. In metabolic acidosis, what happens to HCO3 and pH? HCO3 decreases,
pH decreases
32. Common causes of metabolic acidosis: DKA, renal failure, diarrhea, lactic
acidosis (MUDPILES mnemonic)
33. In metabolic alkalosis, what happens? HCO3 increases, pH increases
34. Common causes of metabolic alkalosis: Vomiting, nasogastric suction,
excess antacids, diuretics
35. How does the body compensate for metabolic acidosis? Hyperventilation
(blowing off CO2) — Kussmaul respirations
36. How does the body compensate for metabolic alkalosis? Hypoventilation
(retaining CO2)
37. How does the kidney compensate for respiratory acidosis? Retains
HCO3 and excretes H+
38. A patient has pH 7.28, CO2 55, HCO3 24. What is the interpretation?
Respiratory acidosis, uncompensated
39. A patient has pH 7.48, CO2 30, HCO3 22. What is the interpretation?
Respiratory alkalosis, uncompensated
40. A patient has pH 7.32, CO2 38, HCO3 18. What is the interpretation?
Metabolic acidosis, uncompensated
41. A patient has pH 7.50, CO2 48, HCO3 30. What is the interpretation?
Metabolic alkalosis, compensated
42. Steps to interpret ABGs (ROME method): Respiratory Opposite (pH↑
CO2↓ or pH↓ CO2↑); Metabolic Equal (pH↑ HCO3↑ or pH↓ HCO3↓)
43. What lab finding is associated with DKA? Low pH, low HCO3, low CO2
(compensatory), elevated blood glucose, ketones in urine
44. Kussmaul respirations are associated with: Metabolic acidosis (DKA)
45. Tetany and numbness are associated with which acid-base disorder?
Respiratory or metabolic alkalosis (decreased ionized calcium)
