PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
When monitoring a client with prolonged vomiting for fluid volume deficit, what does the nurse
recognize about fluid shifts that occur as a result of vomiting?
A.Fluid moves from the cells into the interstitial space and the blood vessels.
B.Fluid moves from the vascular system, causing cellular swelling and rupture.
C.An overload of extracellular fluid occurs with a significant increase in intracellular fluid volume.
D.Excretion of large amounts of interstitial fluid occurs with depletion of extracellular fluids. - (answer)A
Prolonged vomiting can lead to a 2nd space shift
A client is taking hydrochlorothiazide for treatment of hypertension. What symptoms should the nurse
teach the client to report?
A.Anxiety and muscle twitching
B.Abdominal cramping and diarrhea
C.Fatigue and muscle weakness
D.Confusion and personality changes - (answer)C - HYPOKALEMIA
A - hypocalcemia
B - hypERkalemia
D - hypomagnesemia
A client who has required prolonged mechanical ventilation has the following arterial blood gas results:
pH 7.48, PO2 85 mm Hg, PCO2 32 mm Hg, and HCO3- 25 mmol/L. How would the nurse interpret these
results?
A.Metabolic acidosis
B.Metabolic alkalosis
C.Respiratory acidosis
,PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
D.Respiratory alkalosis - (answer)D
pH is HIGH = alkaline
PCO2 is altered = RESP
When PCO2 is low, pH will be higher (alkaline), and when PCO2 is high, pH will be low (acidic)
The physician has written an order for a client to receive 0.9% NaCl @ 125mL/hr.
-What other information is needed to run the rate manually?
-Where can this information be found?
-What is the gtts/min? - (answer)Drop factor!
You can find this on the package for IV tubing.
125ml/60min = 2.08
2.08ml/minx10gtts/ml = 21gtts/min
You are administering Cefoxitin 250 mg IV in 50 mL NS over 20 minutes. At what rate per hour will you
program the secondary IV line to infuse? - (answer)50ml/20min = 150ml/hr
A patient with acute blood loss requires a transfusion with packed red blood cells. Which task is
appropriate for the nurse to delegate to nursing assistive personnel (NAP)?
A.Monitor the patient for shortness of breath and back pain.
B.Confirm the IV solution is 0.9% saline.
C.Obtain and record the vital signs before the transfusion is initiated.
D.Double-check the patient identity, and verify the blood product. - (answer)C
,PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
The RN may delegate tasks such as taking vital signs to NAP. Assessments (e.g., monitoring for signs of a
blood transfusion reaction [shortness of breath and back pain]) are within the scope of practice of the
RN and may not be delegated to UAP. The RN must also assume responsibility for ensuring the correct IV
fluid is used with blood products. A licensed nurse must complete verification of the patient's identity
and the blood product data.
Characteristics of a deep partial-thickness burn include all of the following except:
a.Weeping surface
b.Absence of edema
c.Broken epidermis
d.Mottled, red base - (answer)B
Partial-thickness burns often have blisters that fill with edematous fluids
A patient is burned in a house fire. The burns cover the face and the left forearm. What percentage of
burn does the patient have?
A.10%
B.25%
C.9%
D.18% - (answer)C - 4.5%+4.5% = 9%
When monitoring initial fluid replacement for the patient with 40% TBSA deep partial-thickness and full-
thickness burns, which of the following findings is of most concern to the nurse?
A.Urine output of 35 mL/hr
B.Serum K+ of 4.5 mmol/L
C.Decreased bowel sounds
D.Blood pressure of 86/72 mm Hg - (answer)D
, PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
During the emergent phase of burn injury, the nurse assesses for the presence of hypovolemia. In burn
patients, hypovolemia occurs primarily as a result of:
A.Blood loss from injured tissue.
B.Third spacing of fluid into fluid-filled vesicles.
C.Evaporation of fluid from denuded body surfaces.
D.Capillary permeability with fluid shift to the interstitium. - (answer)D
Hypovolemic shock is caused by a massive shift of fluids out of the blood vessels as a result of increased
capillary permeability. Water, sodium, and plasma proteins move into interstitial spaces and other
surrounding tissue.
The nurse is admitting a client who has abdominal pain, nausea, and vomiting. A bowel obstruction is
suspected. The nurse assesses this client for which of the following anticipated primary acid-base
imbalances if the obstruction is high in the intestine?
a)Metabolic acidosis
b)Metabolic alkalosis
c)Respiratory acidosis
d)Respiratory alkalosis - (answer)B
Because gastric secretions are rich in hydrochloric acid, the client who is vomiting will lose a significant
amount of gastric acid and be at an increased risk for metabolic alkalosis.
Which of the following serum potassium results best supports the rationale for administering a stat dose
of potassium chloride 20 mmol in 250 mL of NSS over 2 hours?
a)3.1 mmol/L
b)3.9 mmol/L
SOLUTIONS.
When monitoring a client with prolonged vomiting for fluid volume deficit, what does the nurse
recognize about fluid shifts that occur as a result of vomiting?
A.Fluid moves from the cells into the interstitial space and the blood vessels.
B.Fluid moves from the vascular system, causing cellular swelling and rupture.
C.An overload of extracellular fluid occurs with a significant increase in intracellular fluid volume.
D.Excretion of large amounts of interstitial fluid occurs with depletion of extracellular fluids. - (answer)A
Prolonged vomiting can lead to a 2nd space shift
A client is taking hydrochlorothiazide for treatment of hypertension. What symptoms should the nurse
teach the client to report?
A.Anxiety and muscle twitching
B.Abdominal cramping and diarrhea
C.Fatigue and muscle weakness
D.Confusion and personality changes - (answer)C - HYPOKALEMIA
A - hypocalcemia
B - hypERkalemia
D - hypomagnesemia
A client who has required prolonged mechanical ventilation has the following arterial blood gas results:
pH 7.48, PO2 85 mm Hg, PCO2 32 mm Hg, and HCO3- 25 mmol/L. How would the nurse interpret these
results?
A.Metabolic acidosis
B.Metabolic alkalosis
C.Respiratory acidosis
,PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
D.Respiratory alkalosis - (answer)D
pH is HIGH = alkaline
PCO2 is altered = RESP
When PCO2 is low, pH will be higher (alkaline), and when PCO2 is high, pH will be low (acidic)
The physician has written an order for a client to receive 0.9% NaCl @ 125mL/hr.
-What other information is needed to run the rate manually?
-Where can this information be found?
-What is the gtts/min? - (answer)Drop factor!
You can find this on the package for IV tubing.
125ml/60min = 2.08
2.08ml/minx10gtts/ml = 21gtts/min
You are administering Cefoxitin 250 mg IV in 50 mL NS over 20 minutes. At what rate per hour will you
program the secondary IV line to infuse? - (answer)50ml/20min = 150ml/hr
A patient with acute blood loss requires a transfusion with packed red blood cells. Which task is
appropriate for the nurse to delegate to nursing assistive personnel (NAP)?
A.Monitor the patient for shortness of breath and back pain.
B.Confirm the IV solution is 0.9% saline.
C.Obtain and record the vital signs before the transfusion is initiated.
D.Double-check the patient identity, and verify the blood product. - (answer)C
,PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
The RN may delegate tasks such as taking vital signs to NAP. Assessments (e.g., monitoring for signs of a
blood transfusion reaction [shortness of breath and back pain]) are within the scope of practice of the
RN and may not be delegated to UAP. The RN must also assume responsibility for ensuring the correct IV
fluid is used with blood products. A licensed nurse must complete verification of the patient's identity
and the blood product data.
Characteristics of a deep partial-thickness burn include all of the following except:
a.Weeping surface
b.Absence of edema
c.Broken epidermis
d.Mottled, red base - (answer)B
Partial-thickness burns often have blisters that fill with edematous fluids
A patient is burned in a house fire. The burns cover the face and the left forearm. What percentage of
burn does the patient have?
A.10%
B.25%
C.9%
D.18% - (answer)C - 4.5%+4.5% = 9%
When monitoring initial fluid replacement for the patient with 40% TBSA deep partial-thickness and full-
thickness burns, which of the following findings is of most concern to the nurse?
A.Urine output of 35 mL/hr
B.Serum K+ of 4.5 mmol/L
C.Decreased bowel sounds
D.Blood pressure of 86/72 mm Hg - (answer)D
, PNR 408 TEST #1 | QUESTIONS AND ANSWERS | 2026 UPDATE | WITH COMPLETE
SOLUTIONS.
During the emergent phase of burn injury, the nurse assesses for the presence of hypovolemia. In burn
patients, hypovolemia occurs primarily as a result of:
A.Blood loss from injured tissue.
B.Third spacing of fluid into fluid-filled vesicles.
C.Evaporation of fluid from denuded body surfaces.
D.Capillary permeability with fluid shift to the interstitium. - (answer)D
Hypovolemic shock is caused by a massive shift of fluids out of the blood vessels as a result of increased
capillary permeability. Water, sodium, and plasma proteins move into interstitial spaces and other
surrounding tissue.
The nurse is admitting a client who has abdominal pain, nausea, and vomiting. A bowel obstruction is
suspected. The nurse assesses this client for which of the following anticipated primary acid-base
imbalances if the obstruction is high in the intestine?
a)Metabolic acidosis
b)Metabolic alkalosis
c)Respiratory acidosis
d)Respiratory alkalosis - (answer)B
Because gastric secretions are rich in hydrochloric acid, the client who is vomiting will lose a significant
amount of gastric acid and be at an increased risk for metabolic alkalosis.
Which of the following serum potassium results best supports the rationale for administering a stat dose
of potassium chloride 20 mmol in 250 mL of NSS over 2 hours?
a)3.1 mmol/L
b)3.9 mmol/L
