NUR 242: MEDICAL-SURGICAL NURSING
CONCEPTS EXAM 2
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📋 DOCUMENT OVERVIEW 85 Qs
This document covers fluid overload, congestive heart failure, kidney disease, dehydration, diuretics,
magnesium deficiency, hypomagnesemia, respiratory alkalosis, and related laboratory values and
symptoms. The document provides a comprehensive review of medical-surgical nursing concepts with
85 questions, correct answers, and detailed explanations. It serves as a valuable study resource for
students, allowing them to review and understand complex nursing concepts, identify relationships
between symptoms and laboratory values, and prepare for exams.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
QUESTION 1
A nurse is caring for a client who has been experiencing excessive fluid retention and is showing signs
of fluid overload. Which of the following conditions is most likely to contribute to this situation?
A) Primary pulmonary hypertension
B) Syndrome of inappropriate antidiuretic hormone (SIADH)
C) Chronic kidney disease in its early stages
D) Atrial fibrillation
CORRECT ANSWER
B) Syndrome of inappropriate antidiuretic hormone (SIADH)
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, RATIONALE: The syndrome of inappropriate antidiuretic hormone (SIADH) causes excessive fluid retention, leading to
fluid overload. This occurs when the body produces an excessive amount of antidiuretic hormone (ADH), causing the
kidneys to retain more water than necessary. The other options may be related to fluid balance, but they are not the
primary cause of fluid overload in this scenario.
QUESTION 2
A client arrives at the emergency department with symptoms of fluid overload. Which of the following
signs is most indicative of this condition?
A) Tachypnea and shallow breathing
B) Decreased urine output and dark color
C) Jugular venous distension and weight gain
D) Hypotension and decreased perfusion
CORRECT ANSWER
C) Jugular venous distension and weight gain
RATIONALE: Jugular venous distension (JVD) is a sign of fluid overload due to increased venous pressure. Weight gain
is another indicator of fluid overload. Options A, B, and D are incorrect because tachypnea and shallow breathing can
occur with many respiratory conditions, decreased urine output and dark color can be signs of kidney damage, and
hypotension and decreased perfusion are typically associated with fluid depletion.
QUESTION 3
The nurse is assessing a patient who is admitted with a history of congestive heart failure and kidney
disease. To evaluate fluid overload, the nurse should prioritize assessing which of the following?
A) Monitor the patient's lab values for signs of electrolyte imbalance only.
B) Assess the patient's lung sounds for crackles and weight gain.
C) Evaluate the patient's skin for edema, especially in the sacrum area.
D) Focus on the patient's urine output as the sole indicator of fluid status.
CORRECT ANSWER
C) Evaluate the patient's skin for edema, especially in the sacrum area.
RATIONALE: To assess fluid overload, the nurse should focus on evaluating the patient's skin for edema, particularly in
the sacrum area, as it is a reliable indicator of fluid retention. Options A, B, and D are incomplete and do not address
the comprehensive assessment of fluid overload as required in this scenario.
QUESTION 4
A patient has a prescription for IV fluids due to suspected dehydration. The nurse is monitoring the
patient's laboratory values to determine if the fluid replacement is effective. Which of the following
laboratory results indicates fluid overload?
A) Serum osmolality 320-350 mOsm/kg
B) Serum sodium 145 mEq/L
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, C) Hemoglobin 15 g/dL
D) Urine specific gravity 1.015
CORRECT ANSWER
A) Serum osmolality 320-350 mOsm/kg
RATIONALE: Fluid overload is indicated by decreased serum osmolality, which in this case is less than 275 mOsm/kg.
The correct answer option A reflects this knowledge. The other options are incorrect because serum sodium within the
normal range (B), normal hemoglobin levels (C), and increased urine specific gravity (D) do not indicate fluid overload.
QUESTION 5
The nurse receives report on four clients, including a 35-year-old woman with fluid overload
secondary to heart failure. Which plan of action should the nurse prioritize to address the client's
condition?
A) Administer a diuretic to reduce fluid accumulation and promote elimination.
B) Restrict oral and other fluid intake as prescribed, but not prioritize monitoring I/O.
C) Monitor client's s/s and electrolyte values closely, but not manage underlying cause of fluid
overload.
D) Restrict dietary sodium intake and increase client's physical activity level.
CORRECT ANSWER
A) Administer a diuretic to reduce fluid accumulation and promote elimination.
RATIONALE: The nurse should prioritize administering a diuretic to reduce fluid accumulation and promote elimination
to address the client's fluid overload. The other options, while related to fluid imbalance, do not address the priority
issue of fluid overload in this scenario.
QUESTION 6
A client reports experiencing symptoms of fluid overload, including shortness of breath and swelling
of the legs. What are possible complications of fluid overload in this client?
A) Hypernatremia
B) Hypokalemia
C) Isotonic overhydration
D) Hypocalcemia
CORRECT ANSWER
C) Isotonic overhydration
RATIONALE: Isotonic overhydration is a possible complication of fluid overload, characterized by an excess of isotonic
fluids in the body, leading to HF and pulmonary edema. The other options are not directly related to fluid overload
complications.
QUESTION 7
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, A nurse observes that a client is experiencing fluid overload and requires immediate diuresis. The
client's condition necessitates the administration of medications that will increase urine output.
Which of the following medications would be most appropriate?
A) Metolazone
B) Spironolactone
C) Furosemide
D) Torsemide
CORRECT ANSWER
C) Furosemide
RATIONALE: Furosemide is a potent loop diuretic that increases urine production and reduces fluid overload. It is
commonly used in cases of congestive heart failure and nephrotic syndrome. The other options, while diuretics, are not
as effective as furosemide in promoting diuresis.
QUESTION 8
After reviewing the client's chart, the nurse notes that the patient is experiencing a decrease in
circulating blood volume, which may be related to inadequate fluid intake. The nurse assesses the
patient's signs and symptoms and identifies the following.
A) Tachycardia, diaphoresis, and sunken eyeballs are indicative of dehydration.
B) Hyperthermia, oliguria, and weakness are signs of respiratory distress.
C) Thirst, dry furrowed tongue, and decreased CVP are characteristic of fluid overload.
D) Confusion, syncope, and fatigue are common symptoms of electrolyte imbalance.
CORRECT ANSWER
A) Tachycardia, diaphoresis, and sunken eyeballs are indicative of dehydration.
RATIONALE: The patient's symptoms, including tachycardia, diaphoresis, and sunken eyeballs, are indicative of
dehydration. These signs and symptoms can be associated with a decrease in circulating blood volume, which is often
related to inadequate fluid intake. The other options are incorrect because they are not characteristic of dehydration
and are related to other conditions.
QUESTION 9
The healthcare provider prescribes a medication known to cause fluid loss in a client with a history of
gastrointestinal complications. The nurse recognizes that the primary cause of dehydration in this
client is likely due to:
A) Fever leading to increased metabolic rate
B) Inadequate fluid intake from gastrointestinal symptoms
C) Excessive sweating due to physical activity
D) Insulin resistance causing polyuria
CORRECT ANSWER
B) Inadequate fluid intake from gastrointestinal symptoms
Trusted by thousands of students and professionals worldwide Page 4 of 34
CONCEPTS EXAM 2
85+ (2026 Updated) Solved Exams + 100% Verified Solutions | Complete
Q&A
100% Guarantee Pass
📋 DOCUMENT OVERVIEW 85 Qs
This document covers fluid overload, congestive heart failure, kidney disease, dehydration, diuretics,
magnesium deficiency, hypomagnesemia, respiratory alkalosis, and related laboratory values and
symptoms. The document provides a comprehensive review of medical-surgical nursing concepts with
85 questions, correct answers, and detailed explanations. It serves as a valuable study resource for
students, allowing them to review and understand complex nursing concepts, identify relationships
between symptoms and laboratory values, and prepare for exams.
✓ Verified Answers ✓ Exam Ready ✓ Study Guide
Trusted by thousands of students and professionals worldwide
EXAM QUESTIONS
QUESTION 1
A nurse is caring for a client who has been experiencing excessive fluid retention and is showing signs
of fluid overload. Which of the following conditions is most likely to contribute to this situation?
A) Primary pulmonary hypertension
B) Syndrome of inappropriate antidiuretic hormone (SIADH)
C) Chronic kidney disease in its early stages
D) Atrial fibrillation
CORRECT ANSWER
B) Syndrome of inappropriate antidiuretic hormone (SIADH)
Trusted by thousands of students and professionals worldwide Page 1 of 34
, RATIONALE: The syndrome of inappropriate antidiuretic hormone (SIADH) causes excessive fluid retention, leading to
fluid overload. This occurs when the body produces an excessive amount of antidiuretic hormone (ADH), causing the
kidneys to retain more water than necessary. The other options may be related to fluid balance, but they are not the
primary cause of fluid overload in this scenario.
QUESTION 2
A client arrives at the emergency department with symptoms of fluid overload. Which of the following
signs is most indicative of this condition?
A) Tachypnea and shallow breathing
B) Decreased urine output and dark color
C) Jugular venous distension and weight gain
D) Hypotension and decreased perfusion
CORRECT ANSWER
C) Jugular venous distension and weight gain
RATIONALE: Jugular venous distension (JVD) is a sign of fluid overload due to increased venous pressure. Weight gain
is another indicator of fluid overload. Options A, B, and D are incorrect because tachypnea and shallow breathing can
occur with many respiratory conditions, decreased urine output and dark color can be signs of kidney damage, and
hypotension and decreased perfusion are typically associated with fluid depletion.
QUESTION 3
The nurse is assessing a patient who is admitted with a history of congestive heart failure and kidney
disease. To evaluate fluid overload, the nurse should prioritize assessing which of the following?
A) Monitor the patient's lab values for signs of electrolyte imbalance only.
B) Assess the patient's lung sounds for crackles and weight gain.
C) Evaluate the patient's skin for edema, especially in the sacrum area.
D) Focus on the patient's urine output as the sole indicator of fluid status.
CORRECT ANSWER
C) Evaluate the patient's skin for edema, especially in the sacrum area.
RATIONALE: To assess fluid overload, the nurse should focus on evaluating the patient's skin for edema, particularly in
the sacrum area, as it is a reliable indicator of fluid retention. Options A, B, and D are incomplete and do not address
the comprehensive assessment of fluid overload as required in this scenario.
QUESTION 4
A patient has a prescription for IV fluids due to suspected dehydration. The nurse is monitoring the
patient's laboratory values to determine if the fluid replacement is effective. Which of the following
laboratory results indicates fluid overload?
A) Serum osmolality 320-350 mOsm/kg
B) Serum sodium 145 mEq/L
Trusted by thousands of students and professionals worldwide Page 2 of 34
, C) Hemoglobin 15 g/dL
D) Urine specific gravity 1.015
CORRECT ANSWER
A) Serum osmolality 320-350 mOsm/kg
RATIONALE: Fluid overload is indicated by decreased serum osmolality, which in this case is less than 275 mOsm/kg.
The correct answer option A reflects this knowledge. The other options are incorrect because serum sodium within the
normal range (B), normal hemoglobin levels (C), and increased urine specific gravity (D) do not indicate fluid overload.
QUESTION 5
The nurse receives report on four clients, including a 35-year-old woman with fluid overload
secondary to heart failure. Which plan of action should the nurse prioritize to address the client's
condition?
A) Administer a diuretic to reduce fluid accumulation and promote elimination.
B) Restrict oral and other fluid intake as prescribed, but not prioritize monitoring I/O.
C) Monitor client's s/s and electrolyte values closely, but not manage underlying cause of fluid
overload.
D) Restrict dietary sodium intake and increase client's physical activity level.
CORRECT ANSWER
A) Administer a diuretic to reduce fluid accumulation and promote elimination.
RATIONALE: The nurse should prioritize administering a diuretic to reduce fluid accumulation and promote elimination
to address the client's fluid overload. The other options, while related to fluid imbalance, do not address the priority
issue of fluid overload in this scenario.
QUESTION 6
A client reports experiencing symptoms of fluid overload, including shortness of breath and swelling
of the legs. What are possible complications of fluid overload in this client?
A) Hypernatremia
B) Hypokalemia
C) Isotonic overhydration
D) Hypocalcemia
CORRECT ANSWER
C) Isotonic overhydration
RATIONALE: Isotonic overhydration is a possible complication of fluid overload, characterized by an excess of isotonic
fluids in the body, leading to HF and pulmonary edema. The other options are not directly related to fluid overload
complications.
QUESTION 7
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, A nurse observes that a client is experiencing fluid overload and requires immediate diuresis. The
client's condition necessitates the administration of medications that will increase urine output.
Which of the following medications would be most appropriate?
A) Metolazone
B) Spironolactone
C) Furosemide
D) Torsemide
CORRECT ANSWER
C) Furosemide
RATIONALE: Furosemide is a potent loop diuretic that increases urine production and reduces fluid overload. It is
commonly used in cases of congestive heart failure and nephrotic syndrome. The other options, while diuretics, are not
as effective as furosemide in promoting diuresis.
QUESTION 8
After reviewing the client's chart, the nurse notes that the patient is experiencing a decrease in
circulating blood volume, which may be related to inadequate fluid intake. The nurse assesses the
patient's signs and symptoms and identifies the following.
A) Tachycardia, diaphoresis, and sunken eyeballs are indicative of dehydration.
B) Hyperthermia, oliguria, and weakness are signs of respiratory distress.
C) Thirst, dry furrowed tongue, and decreased CVP are characteristic of fluid overload.
D) Confusion, syncope, and fatigue are common symptoms of electrolyte imbalance.
CORRECT ANSWER
A) Tachycardia, diaphoresis, and sunken eyeballs are indicative of dehydration.
RATIONALE: The patient's symptoms, including tachycardia, diaphoresis, and sunken eyeballs, are indicative of
dehydration. These signs and symptoms can be associated with a decrease in circulating blood volume, which is often
related to inadequate fluid intake. The other options are incorrect because they are not characteristic of dehydration
and are related to other conditions.
QUESTION 9
The healthcare provider prescribes a medication known to cause fluid loss in a client with a history of
gastrointestinal complications. The nurse recognizes that the primary cause of dehydration in this
client is likely due to:
A) Fever leading to increased metabolic rate
B) Inadequate fluid intake from gastrointestinal symptoms
C) Excessive sweating due to physical activity
D) Insulin resistance causing polyuria
CORRECT ANSWER
B) Inadequate fluid intake from gastrointestinal symptoms
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