College of Nursing
3 MAXE SDNUF
★ ★
N Department of Health Sciences
SCIENTIA · CURA · COMPASSIO
EST. 1908
Nursing Fundamentals — Examination 3
F LU I D & E L E C T R O LYT E S · I V T H E R A P Y · M E D I C AT I O N S A F E TY
INSTITUTION College of Nursing COURSE CODE NURS 1101
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Nursing Fundamentals Exam 3 TOTAL QUESTIONS 55+ Questions
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless otherwise specified.
▸ For dosage calculation questions, show your work and select the correct answer.
▸ Some questions may have multiple correct answers (Select All That Apply) — read carefully.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ Normal lab value ranges referenced follow current clinical laboratory standards.
SECTION I — FLUID & ELECTROLYTE IMBALANCES Questions 1 – 36
1. When assessing a patient with hypotonic fluid volume excess (FVE), the nurse can expect to find:
A. Hyponatremia
B. Confusion
C. Headache
D. All of the above
CORRECT ANSWER D — All of the above
RATIONALE Na+ decreases with fluid volume excess (hyponatremia), and confusion may result from cerebral swelling, as
well as headache for the same reason. All three findings are expected with hypotonic FVE.
2. The nurse evaluates that discharge teaching has been effective when the patient with hypocalcemia states:
A. "I shouldn't take antacids such as TUMS."
B. "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
C. "I'll need to cut down on my protein in my diet."
D. "I will watch my urine for signs of kidney stones."
CORRECT ANSWER B — "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
RATIONALE Circumoral paresthesia is a sign of impending tetany (intermittent and involuntary muscle spasms caused by
low Ca+) and should alert the patient to contact the physician.
,3. A 28-year-old patient is admitted with severe bleeding from a fractured femur. Which intravenous fluid does the
nurse anticipate would be ordered as the most appropriate to replace that fluid loss?
A. Normal Saline (0.9% NaCl)
B. 3% Saline
C. 5% Dextrose in Water (D5W)
D. 5% Dextrose in 0.225% Saline (D5 ¼ NS)
CORRECT ANSWER A — Normal Saline (0.9% NaCl)
RATIONALE Normal saline is an isotonic fluid and is appropriate for replacing fluid (blood) loss. Isotonic solutions remain
in the intravascular space, making them ideal for volume replacement in hemorrhage.
4. When caring for a patient at risk for fluid overload, the nurse notices that overnight the patient gained 6 pounds.
The nurse interprets this as:
A. A 3 L fluid gain
B. Impending renal failure
C. Excessive diuresis
D. A 6 L fluid gain
CORRECT ANSWER A — A 3 L fluid gain
RATIONALE 1 kg (2.2 lbs) of weight gain equals approximately 1 liter of fluid retention. Therefore, 6 pounds
(approximately 2.7 kg) represents roughly a 3 L fluid gain.
5. You are working in the ER of a local hospital. A patient comes in "feeling ill." The doctor orders electrolytes and
finds: Na+ 135, K+ 2.7, Chloride 95, CO₂ 26. You would expect the doctor to order:
A. Na+ supplements IV
B. K+ supplements PO
C. Na+ supplements PO
D. Chloride PO
CORRECT ANSWER B — K+ supplements PO
RATIONALE K+ is very low (normal 3.5–5.0 mEq/L); the other values are within normal limits. When able, oral potassium
replacement is the best and safest method of replacement.
6. The skin turgor assessment of a patient with hypernatremia as a result of extracellular fluid loss would show:
A. No skin "tenting"
B. Prolonged skin "tenting"
C. Prolonged pitting edema
D. Widespread non-pitting edema
CORRECT ANSWER B — Prolonged skin "tenting"
RATIONALE Poor skin turgor is a measure of tissue hydration. Fluid loss decreases skin elasticity, causing prolonged
tenting. Edema is not present in fluid loss but rather in fluid overload.
, 7. Marathon runners are at risk for fluid volume deficit. Which of the following is a related factor?
A. Decreased diuresis
B. Disease-related processes
C. Decreased breathing and perspiration
D. Increased breathing and perspiration
CORRECT ANSWER D — Increased breathing and perspiration
RATIONALE Fluid losses increase through increased respirations and increased perspiration from heavy physical activity.
Marathon runners lose significant fluid through both routes, placing them at risk for fluid volume deficit.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would expect his lab values to
reveal:
A. Total serum calcium level below 8.5 mg/dL
B. Total serum calcium level above 10.5 mg/dL
C. Normal serum calcium level
D. Total serum calcium level below 3.5 mg/dL
CORRECT ANSWER A — Total serum calcium level below 8.5 mg/dL
RATIONALE Chvostek's sign is associated with hypocalcemia and is a hyperexcitability of the facial nerve when
stimulated in front of the earlobe. Normal calcium is 8.5–10.5 mg/dL.
9. In addition to its responsibility for fluid balance, sodium is also responsible for:
A. Good eyesight and vitamin balance
B. Bone structure
C. Impulse transmission
D. Muscle mass
CORRECT ANSWER C — Impulse transmission
RATIONALE Na+ is essential for nerve impulse transmission and muscle contraction. Sodium influx is the primary driver
of action potential propagation in neurons and muscle cells.
10. An 83-year-old patient with heart failure develops hypokalemia as a result of diuretic therapy. The nurse suggests
that she increase her dietary intake of potassium. Which foods should she consume?
A. Chocolate, mushrooms, and bananas
B. Canned soups, peas, and milk
C. Apples, whole wheat bread, and oatmeal
D. Dairy products and whole grains
CORRECT ANSWER A — Chocolate, mushrooms, and bananas
RATIONALE These items have higher potassium content than the other food choices. Bananas, chocolate, and
mushrooms are all potassium-rich foods appropriate for patients with hypokalemia.
3 MAXE SDNUF
★ ★
N Department of Health Sciences
SCIENTIA · CURA · COMPASSIO
EST. 1908
Nursing Fundamentals — Examination 3
F LU I D & E L E C T R O LYT E S · I V T H E R A P Y · M E D I C AT I O N S A F E TY
INSTITUTION College of Nursing COURSE CODE NURS 1101
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Nursing Fundamentals Exam 3 TOTAL QUESTIONS 55+ Questions
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice — Select the Single Best
Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each multiple-choice question unless otherwise specified.
▸ For dosage calculation questions, show your work and select the correct answer.
▸ Some questions may have multiple correct answers (Select All That Apply) — read carefully.
▸ Correct answers and clinical rationales appear below each question for review purposes.
▸ Normal lab value ranges referenced follow current clinical laboratory standards.
SECTION I — FLUID & ELECTROLYTE IMBALANCES Questions 1 – 36
1. When assessing a patient with hypotonic fluid volume excess (FVE), the nurse can expect to find:
A. Hyponatremia
B. Confusion
C. Headache
D. All of the above
CORRECT ANSWER D — All of the above
RATIONALE Na+ decreases with fluid volume excess (hyponatremia), and confusion may result from cerebral swelling, as
well as headache for the same reason. All three findings are expected with hypotonic FVE.
2. The nurse evaluates that discharge teaching has been effective when the patient with hypocalcemia states:
A. "I shouldn't take antacids such as TUMS."
B. "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
C. "I'll need to cut down on my protein in my diet."
D. "I will watch my urine for signs of kidney stones."
CORRECT ANSWER B — "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
RATIONALE Circumoral paresthesia is a sign of impending tetany (intermittent and involuntary muscle spasms caused by
low Ca+) and should alert the patient to contact the physician.
,3. A 28-year-old patient is admitted with severe bleeding from a fractured femur. Which intravenous fluid does the
nurse anticipate would be ordered as the most appropriate to replace that fluid loss?
A. Normal Saline (0.9% NaCl)
B. 3% Saline
C. 5% Dextrose in Water (D5W)
D. 5% Dextrose in 0.225% Saline (D5 ¼ NS)
CORRECT ANSWER A — Normal Saline (0.9% NaCl)
RATIONALE Normal saline is an isotonic fluid and is appropriate for replacing fluid (blood) loss. Isotonic solutions remain
in the intravascular space, making them ideal for volume replacement in hemorrhage.
4. When caring for a patient at risk for fluid overload, the nurse notices that overnight the patient gained 6 pounds.
The nurse interprets this as:
A. A 3 L fluid gain
B. Impending renal failure
C. Excessive diuresis
D. A 6 L fluid gain
CORRECT ANSWER A — A 3 L fluid gain
RATIONALE 1 kg (2.2 lbs) of weight gain equals approximately 1 liter of fluid retention. Therefore, 6 pounds
(approximately 2.7 kg) represents roughly a 3 L fluid gain.
5. You are working in the ER of a local hospital. A patient comes in "feeling ill." The doctor orders electrolytes and
finds: Na+ 135, K+ 2.7, Chloride 95, CO₂ 26. You would expect the doctor to order:
A. Na+ supplements IV
B. K+ supplements PO
C. Na+ supplements PO
D. Chloride PO
CORRECT ANSWER B — K+ supplements PO
RATIONALE K+ is very low (normal 3.5–5.0 mEq/L); the other values are within normal limits. When able, oral potassium
replacement is the best and safest method of replacement.
6. The skin turgor assessment of a patient with hypernatremia as a result of extracellular fluid loss would show:
A. No skin "tenting"
B. Prolonged skin "tenting"
C. Prolonged pitting edema
D. Widespread non-pitting edema
CORRECT ANSWER B — Prolonged skin "tenting"
RATIONALE Poor skin turgor is a measure of tissue hydration. Fluid loss decreases skin elasticity, causing prolonged
tenting. Edema is not present in fluid loss but rather in fluid overload.
, 7. Marathon runners are at risk for fluid volume deficit. Which of the following is a related factor?
A. Decreased diuresis
B. Disease-related processes
C. Decreased breathing and perspiration
D. Increased breathing and perspiration
CORRECT ANSWER D — Increased breathing and perspiration
RATIONALE Fluid losses increase through increased respirations and increased perspiration from heavy physical activity.
Marathon runners lose significant fluid through both routes, placing them at risk for fluid volume deficit.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would expect his lab values to
reveal:
A. Total serum calcium level below 8.5 mg/dL
B. Total serum calcium level above 10.5 mg/dL
C. Normal serum calcium level
D. Total serum calcium level below 3.5 mg/dL
CORRECT ANSWER A — Total serum calcium level below 8.5 mg/dL
RATIONALE Chvostek's sign is associated with hypocalcemia and is a hyperexcitability of the facial nerve when
stimulated in front of the earlobe. Normal calcium is 8.5–10.5 mg/dL.
9. In addition to its responsibility for fluid balance, sodium is also responsible for:
A. Good eyesight and vitamin balance
B. Bone structure
C. Impulse transmission
D. Muscle mass
CORRECT ANSWER C — Impulse transmission
RATIONALE Na+ is essential for nerve impulse transmission and muscle contraction. Sodium influx is the primary driver
of action potential propagation in neurons and muscle cells.
10. An 83-year-old patient with heart failure develops hypokalemia as a result of diuretic therapy. The nurse suggests
that she increase her dietary intake of potassium. Which foods should she consume?
A. Chocolate, mushrooms, and bananas
B. Canned soups, peas, and milk
C. Apples, whole wheat bread, and oatmeal
D. Dairy products and whole grains
CORRECT ANSWER A — Chocolate, mushrooms, and bananas
RATIONALE These items have higher potassium content than the other food choices. Bananas, chocolate, and
mushrooms are all potassium-rich foods appropriate for patients with hypokalemia.
