NUR 330 ACTUAL EXAM PAPER 2026
QUESTIONS AND SOLUTIONS GRADED A+
◉ hyponatremia and causes
Answer: •Serum sodium less than 136 mEq/L
•Actual sodium deficits can occur (sodium loss):
•GI fluid loss
•Excessive diaphoresis
•Diuretics
•Burns
•Hyperglycemia
•Relative sodium deficit (water gain):
•Excessive ingestion of water
•Kidney failure
•Heart failure
•Hypotonic solution
◉ hyponatremia- s/s
Answer: •Cerebral changes: Caused by cerebral edema
•Decreased LOC
•Seizures
,•Coma
•Weakness
•Intestinal changes
•Nausea, vomiting, diarrhea
•Cardiovascular changes
•Due to hypovolemia-fluid loss)- weak thready pulse, hypotension
Water gain (hypervolemia)- bounding pulse, normal to high BP
◉ hyponatremia- treat and assess
Answer: •Treat underlying condition
•Due to sodium loss: Sodium replacement
•Depending on severity: May require hypertonic saline
•Due to water gain: Water restriction
•Diuretics
•Nutritional therapy
•Priority: monitor for response to therapy and prevent
HYPERnatremia
•Assessment: I&O, daily weight, lab values, CNS changes
•Safety
◉ hypernatremia - causes
Answer: •Serum sodium greater than 145 mEq/L
,•Actual sodium excess (gain):
•Hyperaldosteronism
•Kidney failure
•Corticosteroids
•Cushing syndrome or disease
•Excessive intake or IVF with sodium
•Relative sodium excess (water loss):
•Dehydration
•Fever
•Hyperventilation
•Infection
•Excessive diaphoresis
•Diarrhea
◉ hypernatremia- s/s
Answer: •Vary with severity
•Thirst
•Nervous system:
•Change in LOC
•Agitation or confusion
•Lethargic to comatose
•Skeletal muscle:
, •Twitching or abnormal contractions
•Cardiovascular:
•Decrease cardiac contractility
•BP and pulse monitoring
◉ hypernatremia- treat
Answer: •Gradual lowering of serum sodium levels
•When caused by fluid loss:
•IV fluids (NS or D5% 0.45% NS)
•If not caused by fluid loss:
•D5W
•Diuretics
•Nutritional therapy
•Continue to assess for:
•abnormal loss of water and low water intake
•over-the-counter sources of sodium
•CNS changes
◉ hypokalemia- causes
Answer: •Below-normal serum potassium <3.5 mEq/L
•Actual potassium deficits:
•Medications
QUESTIONS AND SOLUTIONS GRADED A+
◉ hyponatremia and causes
Answer: •Serum sodium less than 136 mEq/L
•Actual sodium deficits can occur (sodium loss):
•GI fluid loss
•Excessive diaphoresis
•Diuretics
•Burns
•Hyperglycemia
•Relative sodium deficit (water gain):
•Excessive ingestion of water
•Kidney failure
•Heart failure
•Hypotonic solution
◉ hyponatremia- s/s
Answer: •Cerebral changes: Caused by cerebral edema
•Decreased LOC
•Seizures
,•Coma
•Weakness
•Intestinal changes
•Nausea, vomiting, diarrhea
•Cardiovascular changes
•Due to hypovolemia-fluid loss)- weak thready pulse, hypotension
Water gain (hypervolemia)- bounding pulse, normal to high BP
◉ hyponatremia- treat and assess
Answer: •Treat underlying condition
•Due to sodium loss: Sodium replacement
•Depending on severity: May require hypertonic saline
•Due to water gain: Water restriction
•Diuretics
•Nutritional therapy
•Priority: monitor for response to therapy and prevent
HYPERnatremia
•Assessment: I&O, daily weight, lab values, CNS changes
•Safety
◉ hypernatremia - causes
Answer: •Serum sodium greater than 145 mEq/L
,•Actual sodium excess (gain):
•Hyperaldosteronism
•Kidney failure
•Corticosteroids
•Cushing syndrome or disease
•Excessive intake or IVF with sodium
•Relative sodium excess (water loss):
•Dehydration
•Fever
•Hyperventilation
•Infection
•Excessive diaphoresis
•Diarrhea
◉ hypernatremia- s/s
Answer: •Vary with severity
•Thirst
•Nervous system:
•Change in LOC
•Agitation or confusion
•Lethargic to comatose
•Skeletal muscle:
, •Twitching or abnormal contractions
•Cardiovascular:
•Decrease cardiac contractility
•BP and pulse monitoring
◉ hypernatremia- treat
Answer: •Gradual lowering of serum sodium levels
•When caused by fluid loss:
•IV fluids (NS or D5% 0.45% NS)
•If not caused by fluid loss:
•D5W
•Diuretics
•Nutritional therapy
•Continue to assess for:
•abnormal loss of water and low water intake
•over-the-counter sources of sodium
•CNS changes
◉ hypokalemia- causes
Answer: •Below-normal serum potassium <3.5 mEq/L
•Actual potassium deficits:
•Medications
