NGN NCLEX 204 ACTUAL TEST PAPER 2026
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Hyponatremia. Answer: low sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
◉ causes of hyponatremia. Answer: Causes of hyponatremia:
Diuretics-Thiazide Drugs
Dietary Changes,Low Na diet,
Excessive water intake with sweating
Fad diets, Anorexia nervosa.
GI vomiting, diarrhea, GI suctioning,
Tap water enemas,diuretics, kidney disease
◉ Treatments for hyponatremia. Answer: 0.9% NaCl, accurate I&O,
vitals (pulse), watch for signs of water intoxication, monitor blood
gases, watch for respiratory difficulties
◉ Hypernatremia. Answer: high sodium in the blood
Mild: thirst, rough dry tongue, dry sticky mucous membranes,
tachycardia, fever, flushed dry skin
,Severe: disorientation, hallucinations, lethargy, irritability, seizure,
coma
◉ causes of hypernatremia. Answer: Causes:
Dietary Changes-Excessive Salt intake
Excessive IV Saline
Deprivation of water
GI Disorders (Watery Diarrhea)
Decreased Renal Function
Insensible Water Loss
Heat Stroke
Salt water drowning
Head Injury Trauma
◉ treatments for hypernatremia. Answer: restrict sodium intake,
identify drugs that are sodium retaining, monitor Na levels daily,
check for rales, edema in lower extremities, I&O, Urine specific
gravity
◉ urine specific gravity level. Answer: >1.015
◉ normal potassium levels. Answer: 3.5-5.0 mEq/L
,◉ hypokalemia. Answer: low potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias,
hypotension, polyuria, muscle cramps, alkalosis, lethargy
◉ causes of hyponatremia. Answer: Malnutrition; Alcoholism
Potassium wasting diuretics
Renal Failure, Hyperaldosteronism
Steroids
GI Losses;laxative abuse,diarrhea,vomiting,
gastric suctioning
Trauma & injury, excessive sweating
Alkalosis, Insulin
◉ treatments for hypokalemia. Answer: oral supplements or food
replacement, K Cl(20-40) meq, Kay Ciel, Kaochlor, oral potassium is
extremely irritating to the stomach and should be diluted in water
◉ hyperkalemia. Answer: high potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
, Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
◉ causes of hyperkalemia. Answer: Excessive K intake, IV K
Infusions
Decreased renal function
K sparing diuretics -Aldactone,Dyrenium
Metabolic Acidosis,Hypergylcemia
Addisons disease
Hemolysis, Chemotherapy
Tissue damage, crush injuries, burns
Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts,
Beta Blockers
◉ treatments for hyperkalemia. Answer: Potassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Orally given every 4-6 hours and results occur in 1-2 hours
Rectally given has a retention enema every 2-4 hours
Enema removes K in 30-60 minutes
Monitor labs and EKG
QUESTIONS WITH SOLUTIONS GRADED A+
◉ Hyponatremia. Answer: low sodium in the blood
Chronic: Anorexia, Nausea, Emesis, Muscular, Weakness, Irritability
Severe: gait changes, stupor, seizures, coma
◉ causes of hyponatremia. Answer: Causes of hyponatremia:
Diuretics-Thiazide Drugs
Dietary Changes,Low Na diet,
Excessive water intake with sweating
Fad diets, Anorexia nervosa.
GI vomiting, diarrhea, GI suctioning,
Tap water enemas,diuretics, kidney disease
◉ Treatments for hyponatremia. Answer: 0.9% NaCl, accurate I&O,
vitals (pulse), watch for signs of water intoxication, monitor blood
gases, watch for respiratory difficulties
◉ Hypernatremia. Answer: high sodium in the blood
Mild: thirst, rough dry tongue, dry sticky mucous membranes,
tachycardia, fever, flushed dry skin
,Severe: disorientation, hallucinations, lethargy, irritability, seizure,
coma
◉ causes of hypernatremia. Answer: Causes:
Dietary Changes-Excessive Salt intake
Excessive IV Saline
Deprivation of water
GI Disorders (Watery Diarrhea)
Decreased Renal Function
Insensible Water Loss
Heat Stroke
Salt water drowning
Head Injury Trauma
◉ treatments for hypernatremia. Answer: restrict sodium intake,
identify drugs that are sodium retaining, monitor Na levels daily,
check for rales, edema in lower extremities, I&O, Urine specific
gravity
◉ urine specific gravity level. Answer: >1.015
◉ normal potassium levels. Answer: 3.5-5.0 mEq/L
,◉ hypokalemia. Answer: low potassium
nausea, vomiting, diarrhea, vertigo, ventricular arrhythmias,
hypotension, polyuria, muscle cramps, alkalosis, lethargy
◉ causes of hyponatremia. Answer: Malnutrition; Alcoholism
Potassium wasting diuretics
Renal Failure, Hyperaldosteronism
Steroids
GI Losses;laxative abuse,diarrhea,vomiting,
gastric suctioning
Trauma & injury, excessive sweating
Alkalosis, Insulin
◉ treatments for hypokalemia. Answer: oral supplements or food
replacement, K Cl(20-40) meq, Kay Ciel, Kaochlor, oral potassium is
extremely irritating to the stomach and should be diluted in water
◉ hyperkalemia. Answer: high potassium
Abd cramps
Tachycardia
Widened QRS
Ventricular arrhythmia
, Cardiac Arrest
Oliguria
Numbness face, tongue, feet , hands
◉ causes of hyperkalemia. Answer: Excessive K intake, IV K
Infusions
Decreased renal function
K sparing diuretics -Aldactone,Dyrenium
Metabolic Acidosis,Hypergylcemia
Addisons disease
Hemolysis, Chemotherapy
Tissue damage, crush injuries, burns
Drugs: Capotril,Cyclosporin, Heparin, Dig toxicity,Penicillin Salts,
Beta Blockers
◉ treatments for hyperkalemia. Answer: Potassium restriction
IV sodium bicarb
Kayexalate (sodium polystyrene sulfonate)
Orally given every 4-6 hours and results occur in 1-2 hours
Rectally given has a retention enema every 2-4 hours
Enema removes K in 30-60 minutes
Monitor labs and EKG
