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NU 155 EXAM 3 2026 | Medical-Surgical Nursing I |
Galen College of Nursing | Verified Questions &
Answers | Pass Guaranteed - A+ Graded
Section 1: Fluid, Electrolyte & Acid-Base Imbalances (Q1-12)
Q1. A 78-year-old client is admitted with dehydration after 3 days of vomiting. Which
assessment finding requires the most immediate intervention? A. Dry mucous
membranes B. Decreased skin turgor C. Orthostatic hypotension D. Dark amber urine
C. Orthostatic hypotension [CORRECT]
Rationale: Orthostatic hypotension reflects significant intravascular volume depletion
and increases risk for syncope and hypovolemic shock; dry mucous membranes, poor
turgor, and concentrated urine are expected findings but do not indicate immediate
hemodynamic compromise.
Correct Answer: C
Q2. A client with syndrome of inappropriate antidiuretic hormone (SIADH) develops a
headache and confusion. Lab results show sodium 118 mEq/L. Which intervention is
the priority? A. Restrict free water intake to 800 mL/day B. Administer 3% saline IV
rapidly C. Initiate seizure precautions D. Insert Foley catheter for strict I&O
C. Initiate seizure precautions [CORRECT]
Rationale: A sodium level of 118 mEq/L with neurologic symptoms indicates severe
hyponatremia with cerebral edema; seizure precautions are the priority safety
measure, while water restriction and hypertonic saline are treatments but do not
address the immediate risk of seizure.
Correct Answer: C
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Q3. A client with diabetes insipidus has a serum sodium of 156 mEq/L. Which clinical
manifestation is most consistent with this finding? A. Bounding pulse and
hypertension B. Restlessness and intense thirst C. Muscle cramps and weakness D.
Bradycardia and hypotension
B. Restlessness and intense thirst [CORRECT]
Rationale: Hypernatremia leads to intracellular dehydration, causing neurologic
symptoms such as restlessness and intense thirst; bounding pulse and hypertension
are not typical, while muscle cramps and bradycardia are more associated with other
electrolyte imbalances.
Correct Answer: B
Q4. A client on loop diuretic therapy has ECG changes showing flattened T waves
and prominent U waves. Which electrolyte imbalance is most likely? A.
Hypernatremia B. Hypokalemia C. Hyperkalemia D. Hyponatremia
B. Hypokalemia [CORRECT]
Rationale: Hypokalemia characteristically produces ECG changes including flattened T
waves, prominent U waves, and ST depression; hyperkalemia produces peaked T
waves and widened QRS complexes.
Correct Answer: B
Q5. A client with renal failure has a potassium of 6.8 mEq/L and ECG showing peaked
T waves. Which action should the nurse take first? A. Prepare for emergent dialysis B.
Administer calcium gluconate IV C. Give sodium polystyrene sulfonate (Kayexalate)
orally D. Hold all potassium-containing medications
B. Administer calcium gluconate IV [CORRECT]
, 3
Rationale: With a potassium of 6.8 mEq/L and ECG changes, calcium gluconate is the
priority to stabilize cardiac cell membranes and prevent fatal dysrhythmias; while
holding potassium and administering Kayexalate are appropriate, they do not
provide immediate cardiac protection.
Correct Answer: B
Q6. A client with COPD has the following ABG: pH 7.32, PaCO2 58 mmHg, HCO3- 30
mEq/L, PaO2 62 mmHg. Which interpretation is correct? A. Respiratory acidosis,
uncompensated B. Respiratory acidosis, partially compensated C. Metabolic alkalosis,
compensated D. Respiratory acidosis, fully compensated
B. Respiratory acidosis, partially compensated [CORRECT]
Rationale: The pH is low (acidosis) with an elevated PaCO2 (respiratory cause) and
elevated HCO3- (metabolic compensation); because the pH remains outside normal
range, compensation is partial rather than full.
Correct Answer: B
Q7. A client with prolonged vomiting has ABG: pH 7.48, PaCO2 42 mmHg, HCO3- 32
mEq/L, PaO2 88 mmHg. Which interpretation is correct? A. Metabolic alkalosis,
uncompensated B. Respiratory alkalosis, uncompensated C. Metabolic alkalosis,
partially compensated D. Respiratory acidosis, compensated
A. Metabolic alkalosis, uncompensated [CORRECT]
Rationale: The elevated pH and elevated HCO3- indicate metabolic alkalosis; the
PaCO2 is within normal range, indicating no respiratory compensation has occurred.
Correct Answer: A
NU 155 EXAM 3 2026 | Medical-Surgical Nursing I |
Galen College of Nursing | Verified Questions &
Answers | Pass Guaranteed - A+ Graded
Section 1: Fluid, Electrolyte & Acid-Base Imbalances (Q1-12)
Q1. A 78-year-old client is admitted with dehydration after 3 days of vomiting. Which
assessment finding requires the most immediate intervention? A. Dry mucous
membranes B. Decreased skin turgor C. Orthostatic hypotension D. Dark amber urine
C. Orthostatic hypotension [CORRECT]
Rationale: Orthostatic hypotension reflects significant intravascular volume depletion
and increases risk for syncope and hypovolemic shock; dry mucous membranes, poor
turgor, and concentrated urine are expected findings but do not indicate immediate
hemodynamic compromise.
Correct Answer: C
Q2. A client with syndrome of inappropriate antidiuretic hormone (SIADH) develops a
headache and confusion. Lab results show sodium 118 mEq/L. Which intervention is
the priority? A. Restrict free water intake to 800 mL/day B. Administer 3% saline IV
rapidly C. Initiate seizure precautions D. Insert Foley catheter for strict I&O
C. Initiate seizure precautions [CORRECT]
Rationale: A sodium level of 118 mEq/L with neurologic symptoms indicates severe
hyponatremia with cerebral edema; seizure precautions are the priority safety
measure, while water restriction and hypertonic saline are treatments but do not
address the immediate risk of seizure.
Correct Answer: C
,2
Q3. A client with diabetes insipidus has a serum sodium of 156 mEq/L. Which clinical
manifestation is most consistent with this finding? A. Bounding pulse and
hypertension B. Restlessness and intense thirst C. Muscle cramps and weakness D.
Bradycardia and hypotension
B. Restlessness and intense thirst [CORRECT]
Rationale: Hypernatremia leads to intracellular dehydration, causing neurologic
symptoms such as restlessness and intense thirst; bounding pulse and hypertension
are not typical, while muscle cramps and bradycardia are more associated with other
electrolyte imbalances.
Correct Answer: B
Q4. A client on loop diuretic therapy has ECG changes showing flattened T waves
and prominent U waves. Which electrolyte imbalance is most likely? A.
Hypernatremia B. Hypokalemia C. Hyperkalemia D. Hyponatremia
B. Hypokalemia [CORRECT]
Rationale: Hypokalemia characteristically produces ECG changes including flattened T
waves, prominent U waves, and ST depression; hyperkalemia produces peaked T
waves and widened QRS complexes.
Correct Answer: B
Q5. A client with renal failure has a potassium of 6.8 mEq/L and ECG showing peaked
T waves. Which action should the nurse take first? A. Prepare for emergent dialysis B.
Administer calcium gluconate IV C. Give sodium polystyrene sulfonate (Kayexalate)
orally D. Hold all potassium-containing medications
B. Administer calcium gluconate IV [CORRECT]
, 3
Rationale: With a potassium of 6.8 mEq/L and ECG changes, calcium gluconate is the
priority to stabilize cardiac cell membranes and prevent fatal dysrhythmias; while
holding potassium and administering Kayexalate are appropriate, they do not
provide immediate cardiac protection.
Correct Answer: B
Q6. A client with COPD has the following ABG: pH 7.32, PaCO2 58 mmHg, HCO3- 30
mEq/L, PaO2 62 mmHg. Which interpretation is correct? A. Respiratory acidosis,
uncompensated B. Respiratory acidosis, partially compensated C. Metabolic alkalosis,
compensated D. Respiratory acidosis, fully compensated
B. Respiratory acidosis, partially compensated [CORRECT]
Rationale: The pH is low (acidosis) with an elevated PaCO2 (respiratory cause) and
elevated HCO3- (metabolic compensation); because the pH remains outside normal
range, compensation is partial rather than full.
Correct Answer: B
Q7. A client with prolonged vomiting has ABG: pH 7.48, PaCO2 42 mmHg, HCO3- 32
mEq/L, PaO2 88 mmHg. Which interpretation is correct? A. Metabolic alkalosis,
uncompensated B. Respiratory alkalosis, uncompensated C. Metabolic alkalosis,
partially compensated D. Respiratory acidosis, compensated
A. Metabolic alkalosis, uncompensated [CORRECT]
Rationale: The elevated pH and elevated HCO3- indicate metabolic alkalosis; the
PaCO2 is within normal range, indicating no respiratory compensation has occurred.
Correct Answer: A
