2026 UPDATED QUESTIONS DOWNLOAD
NUR 325 Exam 2 Comprehensive 400-Question Study
Guide 2026
This guide provides a massive bank of 400 practice questions covering high-yield
nursing concepts for Health and Illness II. It focuses on critical topics like advanced
respiratory care, cardiac dysrhythmias, neurological emergencies, and renal-hepatic
failure. Every question includes a bolded answer and an italicized rationale to help
you master the "why" behind the nursing interventions.
1. A nurse is caring for a client with a sodium level of 128 mEq/L. Which of the following
interventions should the nurse implement first?
A. Administer a hypotonic IV solution.
B. Initiate seizure precautions.
C. Encourage increased oral water intake.
D. Administer a diuretic.
Rationale: Hyponatremia (sodium < 135) puts the client at high risk for cerebral edema and
seizures. Safety is the priority.
2. A nurse is assessing a client with hypocalcemia. Which of the following findings
should the nurse expect?
A. Hyporeflexia
B. Positive Chvostek's sign
C. Constipation
D. Polyuria
Rationale: Hypocalcemia increases neuromuscular excitability. A positive Chvostek's sign
(facial twitching when the facial nerve is tapped) is a classic indicator.
3. A nurse is reviewing ABG results: pH 7.30, PaCO2 52, HCO3 26. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Rationale: A pH below 7.35 indicates acidosis. A high PaCO2 (>45) indicates the cause is
respiratory.
4. A nurse is caring for a client 2 hours postoperative. Which of the following is the
priority assessment?
, 2026 UPDATED QUESTIONS DOWNLOAD
A. Pain level
B. Airway patency
C. Urine output
D. Wound drainage
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, ensuring the airway is
clear is always the first priority post-anesthesia.
5. A nurse is providing discharge teaching to a client with Heart Failure. Which
instruction is most important?
A. "Weigh yourself daily at the same time."
B. "Increase your intake of leafy greens."
C. "Limit your protein intake."
D. "Restrict your carbohydrate intake."
Rationale: Daily weights are the most sensitive indicator of fluid retention in heart failure
patients.
6. A client has a potassium level of 6.2 mEq/L. Which of the following medications
should the nurse prepare to administer?
A. Potassium chloride
B. Sodium polystyrene sulfonate (Kayexalate)
C. Furosemide
D. Spironolactone
Rationale: Kayexalate is used to treat hyperkalemia by exchanging sodium ions for potassium
ions in the intestine.
7. A nurse is assessing a client for fluid volume deficit. Which finding should the nurse
expect?
A. Jugular venous distension
B. Orthostatic hypotension
C. Bradycardia
D. Crackles in the lungs
Rationale: Dehydration or fluid loss leads to decreased circulating volume, causing a drop in
blood pressure when standing.
8. A nurse is caring for a client with Type 1 Diabetes who is "shaky" and "sweaty." What
is the first action?
A. Administer insulin.
B. Call the provider.
C. Check the blood glucose level.
D. Give 15g of simple carbohydrates.
Rationale: Assessment is the first step. The nurse must confirm hypoglycemia before treating it.
, 2026 UPDATED QUESTIONS DOWNLOAD
9. A client is in the "Oliguric Phase" of Acute Kidney Injury (AKI). The nurse should
monitor for which complication?
A. Hypovolemia
B. Hyperkalemia
C. Hypokalemia
D. Hypotension
Rationale: During the oliguric phase, the kidneys cannot excrete potassium, leading to
dangerous elevations (hyperkalemia).
10. A nurse is caring for a client with an incentive spirometer. What is the goal of this
device?
A. To measure oxygen saturation.
B. To prevent atelectasis.
C. To reduce surgical pain.
D. To deliver bronchodilators.
Rationale: Incentive spirometry encourages deep breathing to keep alveoli open and prevent
pneumonia post-surgery.
11. A nurse is assessing a client with Cushing's Syndrome. Which finding is expected?
A. Weight loss
B. Moon face and buffalo hump
C. Hypotension
D. Low blood glucose
Rationale: Excessive cortisol production leads to fat redistribution, resulting in a rounded face
and a fatty hump on the back.
12. A nurse is caring for a client with a DVT (Deep Vein Thrombosis). Which action is
contraindicated?
A. Elevating the affected extremity.
B. Massaging the affected leg.
C. Applying warm compresses.
D. Administering anticoagulants.
Rationale: Massaging the leg can dislodge the clot, leading to a pulmonary embolism (PE).
13. A client is diagnosed with Metabolic Alkalosis. Which of the following could be the
cause?
A. Severe diarrhea
B. Excessive vomiting
C. Overdose of aspirin
D. Hyperventilation
Rationale: Vomiting causes a loss of gastric acid, which shifts the body's pH toward alkalosis.
, 2026 UPDATED QUESTIONS DOWNLOAD
14. A nurse is monitoring a client for "Third Spacing." Which of the following indicates
this is occurring?
A. Rapid weight loss
B. Increased abdominal girth (Ascites)
C. High blood pressure
D. Increased urine output
Rationale: Third spacing is fluid moving from the intravascular space to areas like the peritoneal
cavity (ascites).
15. A nurse is teaching a client about a clear liquid diet. Which is allowed?
A. Milk
B. Apple juice
C. Orange juice with pulp
D. Vanilla shake
Rationale: Clear liquids must be transparent and liquid at room temperature.
16. A nurse is caring for a client with COPD. Which oxygen flow rate is typically
appropriate to prevent respiratory depression?
A. 10 L/min via non-rebreather
B. 1-2 L/min via nasal cannula
C. 6 L/min via simple mask
D. 15 L/min via bag-valve mask
Rationale: Many COPD patients rely on a hypoxic drive to breathe; too much oxygen can
suppress their urge to breathe.
17. A nurse is assessing a client for a "Trousseau's Sign." What does a positive result
indicate?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Rationale: Trousseau's sign (carpal spasm with BP cuff inflation) is a sign of low calcium.
18. A nurse is caring for a client with Peripheral Arterial Disease (PAD). What is a
common symptom?
A. Intermittent claudication
B. Pitting edema
C. Warm, flushed skin
D. Bounding pulses
Rationale: Pain in the legs during exercise that is relieved by rest is the hallmark sign of arterial
insufficiency.
NUR 325 Exam 2 Comprehensive 400-Question Study
Guide 2026
This guide provides a massive bank of 400 practice questions covering high-yield
nursing concepts for Health and Illness II. It focuses on critical topics like advanced
respiratory care, cardiac dysrhythmias, neurological emergencies, and renal-hepatic
failure. Every question includes a bolded answer and an italicized rationale to help
you master the "why" behind the nursing interventions.
1. A nurse is caring for a client with a sodium level of 128 mEq/L. Which of the following
interventions should the nurse implement first?
A. Administer a hypotonic IV solution.
B. Initiate seizure precautions.
C. Encourage increased oral water intake.
D. Administer a diuretic.
Rationale: Hyponatremia (sodium < 135) puts the client at high risk for cerebral edema and
seizures. Safety is the priority.
2. A nurse is assessing a client with hypocalcemia. Which of the following findings
should the nurse expect?
A. Hyporeflexia
B. Positive Chvostek's sign
C. Constipation
D. Polyuria
Rationale: Hypocalcemia increases neuromuscular excitability. A positive Chvostek's sign
(facial twitching when the facial nerve is tapped) is a classic indicator.
3. A nurse is reviewing ABG results: pH 7.30, PaCO2 52, HCO3 26. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Rationale: A pH below 7.35 indicates acidosis. A high PaCO2 (>45) indicates the cause is
respiratory.
4. A nurse is caring for a client 2 hours postoperative. Which of the following is the
priority assessment?
, 2026 UPDATED QUESTIONS DOWNLOAD
A. Pain level
B. Airway patency
C. Urine output
D. Wound drainage
Rationale: Using the ABC (Airway, Breathing, Circulation) framework, ensuring the airway is
clear is always the first priority post-anesthesia.
5. A nurse is providing discharge teaching to a client with Heart Failure. Which
instruction is most important?
A. "Weigh yourself daily at the same time."
B. "Increase your intake of leafy greens."
C. "Limit your protein intake."
D. "Restrict your carbohydrate intake."
Rationale: Daily weights are the most sensitive indicator of fluid retention in heart failure
patients.
6. A client has a potassium level of 6.2 mEq/L. Which of the following medications
should the nurse prepare to administer?
A. Potassium chloride
B. Sodium polystyrene sulfonate (Kayexalate)
C. Furosemide
D. Spironolactone
Rationale: Kayexalate is used to treat hyperkalemia by exchanging sodium ions for potassium
ions in the intestine.
7. A nurse is assessing a client for fluid volume deficit. Which finding should the nurse
expect?
A. Jugular venous distension
B. Orthostatic hypotension
C. Bradycardia
D. Crackles in the lungs
Rationale: Dehydration or fluid loss leads to decreased circulating volume, causing a drop in
blood pressure when standing.
8. A nurse is caring for a client with Type 1 Diabetes who is "shaky" and "sweaty." What
is the first action?
A. Administer insulin.
B. Call the provider.
C. Check the blood glucose level.
D. Give 15g of simple carbohydrates.
Rationale: Assessment is the first step. The nurse must confirm hypoglycemia before treating it.
, 2026 UPDATED QUESTIONS DOWNLOAD
9. A client is in the "Oliguric Phase" of Acute Kidney Injury (AKI). The nurse should
monitor for which complication?
A. Hypovolemia
B. Hyperkalemia
C. Hypokalemia
D. Hypotension
Rationale: During the oliguric phase, the kidneys cannot excrete potassium, leading to
dangerous elevations (hyperkalemia).
10. A nurse is caring for a client with an incentive spirometer. What is the goal of this
device?
A. To measure oxygen saturation.
B. To prevent atelectasis.
C. To reduce surgical pain.
D. To deliver bronchodilators.
Rationale: Incentive spirometry encourages deep breathing to keep alveoli open and prevent
pneumonia post-surgery.
11. A nurse is assessing a client with Cushing's Syndrome. Which finding is expected?
A. Weight loss
B. Moon face and buffalo hump
C. Hypotension
D. Low blood glucose
Rationale: Excessive cortisol production leads to fat redistribution, resulting in a rounded face
and a fatty hump on the back.
12. A nurse is caring for a client with a DVT (Deep Vein Thrombosis). Which action is
contraindicated?
A. Elevating the affected extremity.
B. Massaging the affected leg.
C. Applying warm compresses.
D. Administering anticoagulants.
Rationale: Massaging the leg can dislodge the clot, leading to a pulmonary embolism (PE).
13. A client is diagnosed with Metabolic Alkalosis. Which of the following could be the
cause?
A. Severe diarrhea
B. Excessive vomiting
C. Overdose of aspirin
D. Hyperventilation
Rationale: Vomiting causes a loss of gastric acid, which shifts the body's pH toward alkalosis.
, 2026 UPDATED QUESTIONS DOWNLOAD
14. A nurse is monitoring a client for "Third Spacing." Which of the following indicates
this is occurring?
A. Rapid weight loss
B. Increased abdominal girth (Ascites)
C. High blood pressure
D. Increased urine output
Rationale: Third spacing is fluid moving from the intravascular space to areas like the peritoneal
cavity (ascites).
15. A nurse is teaching a client about a clear liquid diet. Which is allowed?
A. Milk
B. Apple juice
C. Orange juice with pulp
D. Vanilla shake
Rationale: Clear liquids must be transparent and liquid at room temperature.
16. A nurse is caring for a client with COPD. Which oxygen flow rate is typically
appropriate to prevent respiratory depression?
A. 10 L/min via non-rebreather
B. 1-2 L/min via nasal cannula
C. 6 L/min via simple mask
D. 15 L/min via bag-valve mask
Rationale: Many COPD patients rely on a hypoxic drive to breathe; too much oxygen can
suppress their urge to breathe.
17. A nurse is assessing a client for a "Trousseau's Sign." What does a positive result
indicate?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hypokalemia
Rationale: Trousseau's sign (carpal spasm with BP cuff inflation) is a sign of low calcium.
18. A nurse is caring for a client with Peripheral Arterial Disease (PAD). What is a
common symptom?
A. Intermittent claudication
B. Pitting edema
C. Warm, flushed skin
D. Bounding pulses
Rationale: Pain in the legs during exercise that is relieved by rest is the hallmark sign of arterial
insufficiency.
