NUR 3300 Exam 1 – Nursing Practice II – (2026) Actual Questions & Answers
(WPU).
Fluid & Electrolyte Balance (1–20)
1. A patient has a serum sodium of 118 mEq/L. Which finding requires immediate
intervention?
A. Thirst
B. Seizure activity
C. Muscle cramps
D. Dry mucous membranes
Answer: B – Seizure activity
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death.
2. Which ECG change is characteristic of hyperkalemia?
A. Prominent U wave
B. Peaked T waves
,C. ST elevation
D. Prolonged PR interval
Answer: B – Peaked T waves
Rationale: Hyperkalemia causes tall, tented T waves. Prominent U waves occur in
hypokalemia.
3. A patient with heart failure has a potassium level of 5.9 mEq/L. Which
medication should the nurse prepare to administer?
A. Spironolactone
B. Potassium chloride
C. Sodium polystyrene sulfonate (Kayexalate)
D. Furosemide
Answer: C – Sodium polystyrene sulfonate
Rationale: Kayexalate binds potassium in the gut. Furosemide can help but
Kayexalate is specific for hyperkalemia.
4. A postoperative patient’s serum calcium is 6.5 mg/dL. The nurse expects which
finding?
,A. Positive Chvostek’s sign
B. Diarrhea
C. Hypertension
D. Muscle weakness
Answer: A – Positive Chvostek’s sign
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s (facial
twitching) is an early sign.
5. Which IV fluid is most appropriate for a patient with increased intracranial
pressure?
A. 0.45% NaCl
B. 0.9% NaCl
C. 5% dextrose in water
D. Lactated Ringer’s
Answer: B – 0.9% NaCl
Rationale: Isotonic fluids maintain osmotic pressure and prevent worsening
cerebral edema.
, 6. A patient’s ABG shows: pH 7.31, PaCO2 50 mm Hg, HCO3 24 mEq/L. The nurse
interprets this as:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C – Respiratory acidosis
Rationale: Low pH + elevated PaCO2 = respiratory acidosis. HCO3 is normal, so no
metabolic compensation yet.
7. The nurse assesses a flat jugular vein while the patient is supine. This suggests:
A. Hypervolemia
B. Hypovolemia
C. Heart failure
D. Renal failure
Answer: B – Hypovolemia
Rationale: Flat neck veins indicate decreased blood volume. Distended veins
suggest fluid overload.
(WPU).
Fluid & Electrolyte Balance (1–20)
1. A patient has a serum sodium of 118 mEq/L. Which finding requires immediate
intervention?
A. Thirst
B. Seizure activity
C. Muscle cramps
D. Dry mucous membranes
Answer: B – Seizure activity
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death.
2. Which ECG change is characteristic of hyperkalemia?
A. Prominent U wave
B. Peaked T waves
,C. ST elevation
D. Prolonged PR interval
Answer: B – Peaked T waves
Rationale: Hyperkalemia causes tall, tented T waves. Prominent U waves occur in
hypokalemia.
3. A patient with heart failure has a potassium level of 5.9 mEq/L. Which
medication should the nurse prepare to administer?
A. Spironolactone
B. Potassium chloride
C. Sodium polystyrene sulfonate (Kayexalate)
D. Furosemide
Answer: C – Sodium polystyrene sulfonate
Rationale: Kayexalate binds potassium in the gut. Furosemide can help but
Kayexalate is specific for hyperkalemia.
4. A postoperative patient’s serum calcium is 6.5 mg/dL. The nurse expects which
finding?
,A. Positive Chvostek’s sign
B. Diarrhea
C. Hypertension
D. Muscle weakness
Answer: A – Positive Chvostek’s sign
Rationale: Hypocalcemia causes neuromuscular irritability. Chvostek’s (facial
twitching) is an early sign.
5. Which IV fluid is most appropriate for a patient with increased intracranial
pressure?
A. 0.45% NaCl
B. 0.9% NaCl
C. 5% dextrose in water
D. Lactated Ringer’s
Answer: B – 0.9% NaCl
Rationale: Isotonic fluids maintain osmotic pressure and prevent worsening
cerebral edema.
, 6. A patient’s ABG shows: pH 7.31, PaCO2 50 mm Hg, HCO3 24 mEq/L. The nurse
interprets this as:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
Answer: C – Respiratory acidosis
Rationale: Low pH + elevated PaCO2 = respiratory acidosis. HCO3 is normal, so no
metabolic compensation yet.
7. The nurse assesses a flat jugular vein while the patient is supine. This suggests:
A. Hypervolemia
B. Hypovolemia
C. Heart failure
D. Renal failure
Answer: B – Hypovolemia
Rationale: Flat neck veins indicate decreased blood volume. Distended veins
suggest fluid overload.
