NR 341: Complex Fluid Balance Alterations and Adult Health 2026
Chamberlain College
1. A patient’s laboratory results reveal a serum potassium level of 6.5 mEq/L.
Which ECG change is the nurse most likely to observe?
A. Prominent U waves
B. Inverted T waves
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T waves. U waves
and ST depression are associated with hypokalemia.
2. The nurse is caring for a patient with syndrome of inappropriate antidiuretic
hormone (SIADH). Which sodium level would the nurse expect to see?
A. 155 mEq/L
B. 138 mEq/L
C. 148 mEq/L
D. 128 mEq/L
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia
(Sodium < 135 mEq/L).
,3. A patient has a positive Chvostek’s sign. The nurse should prepare to
administer which medication?
A. Potassium chloride
B. Magnesium sulfate
C. Sodium bicarbonate
D. Calcium gluconate
Answer: D
Rationale: A positive Chvostek’s sign (facial twitching) indicates hypocalcemia, which is
treated with calcium replacement.
4. Which arterial blood gas (ABG) result is consistent with a patient experiencing
a severe panic attack?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.50, PaCO2 40, HCO3 32
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 23
Answer: D
Rationale: Hyperventilation during a panic attack blows off CO2, leading to respiratory
alkalosis (high pH, low PaCO2).
5. A nurse is reviewing the labs of a patient with chronic alcoholism. Which
electrolyte imbalance is most commonly associated with this condition?
A. Hypermagnesemia
B. Hypercalcemia
C. Hypomagnesemia
D. Hypernatremia
Answer: C
Rationale: Chronic alcoholism often leads to hypomagnesemia due to poor dietary intake
and increased urinary excretion.
, 6. A patient with a bowel obstruction has had nasogastric (NG) suctioning for
three days. The nurse monitors for which acid-base imbalance?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: A
Rationale: NG suctioning removes gastric acid (HCl), leading to an excess of bicarbonate in
the body and metabolic alkalosis.
7. Which intravenous fluid is considered hypotonic?
A. 0.9% Normal Saline
B. Lactated Ringer’s
C. 0.45% Normal Saline
D. 5% Dextrose in 0.9% Normal Saline
Answer: C
Rationale: 0.45% NS is hypotonic. 0.9% NS and LR are isotonic, while D5NS is hypertonic.
8. A patient is diagnosed with Diabetes Insipidus (DI). What is the primary fluid-
related concern for this patient?
A. Fluid volume excess
B. Hyperkalemia
C. Fluid volume deficit
D. Hyponatremia
Answer: C
Rationale: DI involves a deficiency of ADH, leading to massive polyuria and severe
dehydration (fluid volume deficit).
Chamberlain College
1. A patient’s laboratory results reveal a serum potassium level of 6.5 mEq/L.
Which ECG change is the nurse most likely to observe?
A. Prominent U waves
B. Inverted T waves
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (K+ > 5.0) causes characteristic tall, peaked T waves. U waves
and ST depression are associated with hypokalemia.
2. The nurse is caring for a patient with syndrome of inappropriate antidiuretic
hormone (SIADH). Which sodium level would the nurse expect to see?
A. 155 mEq/L
B. 138 mEq/L
C. 148 mEq/L
D. 128 mEq/L
Answer: D
Rationale: SIADH causes excessive water retention, leading to dilutional hyponatremia
(Sodium < 135 mEq/L).
,3. A patient has a positive Chvostek’s sign. The nurse should prepare to
administer which medication?
A. Potassium chloride
B. Magnesium sulfate
C. Sodium bicarbonate
D. Calcium gluconate
Answer: D
Rationale: A positive Chvostek’s sign (facial twitching) indicates hypocalcemia, which is
treated with calcium replacement.
4. Which arterial blood gas (ABG) result is consistent with a patient experiencing
a severe panic attack?
A. pH 7.32, PaCO2 50, HCO3 24
B. pH 7.50, PaCO2 40, HCO3 32
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.48, PaCO2 30, HCO3 23
Answer: D
Rationale: Hyperventilation during a panic attack blows off CO2, leading to respiratory
alkalosis (high pH, low PaCO2).
5. A nurse is reviewing the labs of a patient with chronic alcoholism. Which
electrolyte imbalance is most commonly associated with this condition?
A. Hypermagnesemia
B. Hypercalcemia
C. Hypomagnesemia
D. Hypernatremia
Answer: C
Rationale: Chronic alcoholism often leads to hypomagnesemia due to poor dietary intake
and increased urinary excretion.
, 6. A patient with a bowel obstruction has had nasogastric (NG) suctioning for
three days. The nurse monitors for which acid-base imbalance?
A. Metabolic alkalosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Respiratory acidosis
Answer: A
Rationale: NG suctioning removes gastric acid (HCl), leading to an excess of bicarbonate in
the body and metabolic alkalosis.
7. Which intravenous fluid is considered hypotonic?
A. 0.9% Normal Saline
B. Lactated Ringer’s
C. 0.45% Normal Saline
D. 5% Dextrose in 0.9% Normal Saline
Answer: C
Rationale: 0.45% NS is hypotonic. 0.9% NS and LR are isotonic, while D5NS is hypertonic.
8. A patient is diagnosed with Diabetes Insipidus (DI). What is the primary fluid-
related concern for this patient?
A. Fluid volume excess
B. Hyperkalemia
C. Fluid volume deficit
D. Hyponatremia
Answer: C
Rationale: DI involves a deficiency of ADH, leading to massive polyuria and severe
dehydration (fluid volume deficit).
