NR 226 Adult Health I - Week 2 Study Guide (Fluid, Electrolytes, Acid-
Base, and Perioperative) 2026 |Chamberlain College
1. A nurse is caring for a patient with a potassium level of 2.8 mEq/L. Which of
the following assessment findings is most consistent with this lab value?
A. Peaked T waves on ECG
B. Increased deep tendon reflexes
C. Hyperactive bowel sounds
D. Muscle weakness and leg cramps
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically causes muscle weakness,
fatigue, leg cramps, and flattened T waves on an ECG.
2. Which electrolyte imbalance is a patient at risk for if they are receiving
prolonged nasogastric (NG) suctioning?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: A
Rationale: Gastric secretions are rich in potassium; therefore, prolonged suctioning can
lead to significant potassium loss and hypokalemia.
,3. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: The pH is low (< 7.35) indicating acidosis, and the PaCO2 is high (> 45 mmHg),
which points to a respiratory cause.
4. When assessing a patient for Trousseau’s sign, which action should the nurse
perform?
A. Tap the facial nerve in front of the ear
B. Observe for hyperreflexia in the lower extremities
C. Inflate a blood pressure cuff on the upper arm
D. Palpate the calf for tenderness with dorsiflexion
Answer: C
Rationale: Trousseau’s sign is assessed by inflating a BP cuff above systolic pressure for
several minutes; a positive sign is carpal spasm, indicating hypocalcemia.
5. Which of the following is the primary responsibility of the nurse regarding
informed consent for surgery?
A. Obtaining the patient’s signature and witnessing it
B. Explaining the risks and benefits of the procedure
C. Describing alternative treatments to the patient
D. Answering specific questions about the surgical technique
Answer: A
Rationale: The surgeon is responsible for explaining the procedure. The nurse witnesses
the signature and ensures the patient is competent to sign.
, 6. A patient with a sodium level of 150 mEq/L is most likely to exhibit which
clinical manifestation?
A. Abdominal cramping
B. Muscle tremors
C. Confusion and agitation
D. Bradycardia
Answer: C
Rationale: Hypernatremia causes cellular dehydration, which primarily affects the central
nervous system, leading to confusion, agitation, or lethargy.
7. Which IV fluid is considered hypotonic and is used to treat cellular
dehydration?
A. 0.45% Normal Saline
B. Lactated Ringer’s
C. 0.9% Normal Saline
D. 5% Dextrose in 0.9% Normal Saline
Answer: A
Rationale: 0.45% Sodium Chloride (Half Normal Saline) is a hypotonic solution that moves
water into the cells.
8. The nurse is monitoring a patient receiving magnesium sulfate IV. Which
assessment finding requires immediate intervention?
A. Magnesium level of 2.2 mEq/L
B. Flushing and warmth
C. Urine output of 50 mL/hour
D. Absent deep tendon reflexes
Answer: D
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can
lead to respiratory depression and cardiac arrest.
Base, and Perioperative) 2026 |Chamberlain College
1. A nurse is caring for a patient with a potassium level of 2.8 mEq/L. Which of
the following assessment findings is most consistent with this lab value?
A. Peaked T waves on ECG
B. Increased deep tendon reflexes
C. Hyperactive bowel sounds
D. Muscle weakness and leg cramps
Answer: D
Rationale: Hypokalemia (potassium < 3.5 mEq/L) typically causes muscle weakness,
fatigue, leg cramps, and flattened T waves on an ECG.
2. Which electrolyte imbalance is a patient at risk for if they are receiving
prolonged nasogastric (NG) suctioning?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: A
Rationale: Gastric secretions are rich in potassium; therefore, prolonged suctioning can
lead to significant potassium loss and hypokalemia.
,3. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C
Rationale: The pH is low (< 7.35) indicating acidosis, and the PaCO2 is high (> 45 mmHg),
which points to a respiratory cause.
4. When assessing a patient for Trousseau’s sign, which action should the nurse
perform?
A. Tap the facial nerve in front of the ear
B. Observe for hyperreflexia in the lower extremities
C. Inflate a blood pressure cuff on the upper arm
D. Palpate the calf for tenderness with dorsiflexion
Answer: C
Rationale: Trousseau’s sign is assessed by inflating a BP cuff above systolic pressure for
several minutes; a positive sign is carpal spasm, indicating hypocalcemia.
5. Which of the following is the primary responsibility of the nurse regarding
informed consent for surgery?
A. Obtaining the patient’s signature and witnessing it
B. Explaining the risks and benefits of the procedure
C. Describing alternative treatments to the patient
D. Answering specific questions about the surgical technique
Answer: A
Rationale: The surgeon is responsible for explaining the procedure. The nurse witnesses
the signature and ensures the patient is competent to sign.
, 6. A patient with a sodium level of 150 mEq/L is most likely to exhibit which
clinical manifestation?
A. Abdominal cramping
B. Muscle tremors
C. Confusion and agitation
D. Bradycardia
Answer: C
Rationale: Hypernatremia causes cellular dehydration, which primarily affects the central
nervous system, leading to confusion, agitation, or lethargy.
7. Which IV fluid is considered hypotonic and is used to treat cellular
dehydration?
A. 0.45% Normal Saline
B. Lactated Ringer’s
C. 0.9% Normal Saline
D. 5% Dextrose in 0.9% Normal Saline
Answer: A
Rationale: 0.45% Sodium Chloride (Half Normal Saline) is a hypotonic solution that moves
water into the cells.
8. The nurse is monitoring a patient receiving magnesium sulfate IV. Which
assessment finding requires immediate intervention?
A. Magnesium level of 2.2 mEq/L
B. Flushing and warmth
C. Urine output of 50 mL/hour
D. Absent deep tendon reflexes
Answer: D
Rationale: Loss of deep tendon reflexes is an early sign of magnesium toxicity, which can
lead to respiratory depression and cardiac arrest.
