Nursing Fundamentals Exam 3
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
D all of the above
Rationale_Na+ decreases with FVE, confusion may result from cerebral swelling as well as
headache for the same reason.
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."
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
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline
A Normal Saline
Rationale NS is an isotonic fluid and is appropriate for fluid (blood) loss
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 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain
A a 3L fluid gain
Rationale_1 kg equals 1 liter
5. You are working in the ER of a local hospital. A patient comes in "feeling ill". The doctor
orders electrolytes on the patient and finds that the Na+ is 135, the K+ is 2.7, chloride is 95 and
C02 is 26. You would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
, c. Na+ supplements PO
d. Chloride PO
B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When able, K+ orally 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
B Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration, fluid loss has less elasticity of the
skin. Edema is not present in fluid loss but 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
D Increased breathing and perspiration
Rationale_Fluid losses increase through increased respirations and increased perspiration from
heavy physical activity.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would
expect his lab values to reveal:
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
D all of the above
Rationale_Na+ decreases with FVE, confusion may result from cerebral swelling as well as
headache for the same reason.
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."
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
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline
A Normal Saline
Rationale NS is an isotonic fluid and is appropriate for fluid (blood) loss
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 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain
A a 3L fluid gain
Rationale_1 kg equals 1 liter
5. You are working in the ER of a local hospital. A patient comes in "feeling ill". The doctor
orders electrolytes on the patient and finds that the Na+ is 135, the K+ is 2.7, chloride is 95 and
C02 is 26. You would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
, c. Na+ supplements PO
d. Chloride PO
B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When able, K+ orally 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
B Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration, fluid loss has less elasticity of the
skin. Edema is not present in fluid loss but 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
D Increased breathing and perspiration
Rationale_Fluid losses increase through increased respirations and increased perspiration from
heavy physical activity.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would
expect his lab values to reveal:
