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NUR2063: Essentials of Pathophysiology Exam 2
100 Practice Questions & Answers with Detailed
Rationales 2026-2027.
Section 1: Fluid & Electrolyte Imbalances (Questions 1–25)
1. A patient is admitted with severe hyponatremia (serum Na⁺ 118
mEq/L). Which assessment finding requires immediate
intervention?
A) Muscle cramps
B) Hyperactive deep tendon reflexes
C) Altered mental status
D) Dry mucous membranes
Answer: C) Altered mental status
Rationale: Severe hyponatremia causes water to shift into brain cells,
leading to cerebral edema. Altered mental status (confusion, seizures,
coma) indicates critical neurological compromise and is the priority.
Muscle cramps may occur but are not immediately life-threatening.
Hyperactive reflexes suggest hypocalcemia. Dry mucous membranes
indicate dehydration, typically seen in hypernatremia.
2. A client with heart failure is receiving furosemide (Lasix). Which
laboratory value requires priority intervention?
A) Potassium: 3.1 mEq/L
B) Sodium: 135 mEq/L
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C) Calcium: 9.0 mg/dL
D) Magnesium: 1.8 mg/dL
Answer: A) Potassium: 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium of 3.1 mEq/L is critically low (hypokalemia), placing the
patient at high risk for ventricular dysrhythmias. Normal potassium
range is 3.5–5.0 mEq/L. The other values are within normal limits.
3. A nurse is assessing a patient with hyperkalemia. Which
electrocardiographic (ECG) change is most characteristic?
A) Flattened T waves
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged PR interval
Answer: C) Tall, peaked T waves
Rationale: Tall, peaked T waves are the earliest and most classic ECG
finding in hyperkalemia. Flattened T waves and prominent U waves are
characteristic of hypokalemia. Prolonged PR interval may occur in
severe hyperkalemia but is not the earliest sign.
4. A patient presents with Chvostek’s sign and Trousseau’s sign.
These findings are hallmark indicators of which electrolyte
imbalance?
A) Hypernatremia
B) Hypomagnesemia
C) Hypocalcemia
D) Hyperkalemia
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Answer: C) Hypocalcemia
Rationale: Chvostek’s sign (facial twitching when tapping the facial
nerve) and Trousseau’s sign (carpal spasm during blood pressure cuff
inflation) are classic signs of neuromuscular irritability caused by
hypocalcemia. These signs may also occur in hypomagnesemia, but
hypocalcemia is the direct cause of the symptoms.
5. Which patient is at the highest risk for developing
hypermagnesemia?
A) A patient with chronic alcoholism
B) A patient with end-stage renal disease taking magnesium-based
antacids
C) A patient with prolonged nasogastric suctioning
D) A patient with diabetic ketoacidosis
Answer: B) A patient with end-stage renal disease taking
magnesium-based antacids
Rationale: Magnesium is primarily excreted by the kidneys. In end-
stage renal disease, excretion is severely impaired. The addition of
magnesium-based antacids leads to toxic accumulation. Alcoholism and
NG suctioning increase risk of hypomagnesemia. DKA may cause initial
hypermagnesemia but is not the highest risk.
6. A patient has a serum calcium level of 12.5 mg/dL. Which
intervention should the nurse anticipate?
A) Administer IV calcium gluconate
B) Encourage increased dietary calcium intake
C) Administer IV normal saline and calcitonin
D) Restrict oral fluids
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Answer: C) Administer IV normal saline and calcitonin
Rationale: Hypercalcemia (normal 8.5–10.5 mg/dL) is managed with
IV normal saline to promote calcium excretion via the kidneys and
calcitonin to lower serum calcium. Calcium gluconate is given for
hypocalcemia. Fluid restriction would worsen hypercalcemia by
decreasing excretion.
7. A patient with chronic kidney disease has a serum phosphorus
level of 6.5 mg/dL. Which assessment finding correlates with this
abnormality?
A) Hyperreflexia
B) Prolonged bleeding time
C) Hypocalcemia with tetany
D) Hypertension
Answer: C) Hypocalcemia with tetany
Rationale: Hyperphosphatemia (normal 2.5–4.5 mg/dL) commonly
occurs with chronic kidney disease. Elevated phosphorus binds with
calcium, leading to hypocalcemia. The hypocalcemia can cause
neuromuscular irritability, including tetany and seizures.
8. A patient is receiving IV fluids postoperatively and develops
crackles in the lung bases, distended neck veins, and edema. This
presentation is most consistent with:
A) Hypovolemia
B) Third-spacing
C) Fluid volume excess (hypervolemia)
D) Dehydration
NUR2063: Essentials of Pathophysiology Exam 2
100 Practice Questions & Answers with Detailed
Rationales 2026-2027.
Section 1: Fluid & Electrolyte Imbalances (Questions 1–25)
1. A patient is admitted with severe hyponatremia (serum Na⁺ 118
mEq/L). Which assessment finding requires immediate
intervention?
A) Muscle cramps
B) Hyperactive deep tendon reflexes
C) Altered mental status
D) Dry mucous membranes
Answer: C) Altered mental status
Rationale: Severe hyponatremia causes water to shift into brain cells,
leading to cerebral edema. Altered mental status (confusion, seizures,
coma) indicates critical neurological compromise and is the priority.
Muscle cramps may occur but are not immediately life-threatening.
Hyperactive reflexes suggest hypocalcemia. Dry mucous membranes
indicate dehydration, typically seen in hypernatremia.
2. A client with heart failure is receiving furosemide (Lasix). Which
laboratory value requires priority intervention?
A) Potassium: 3.1 mEq/L
B) Sodium: 135 mEq/L
,2|Page
C) Calcium: 9.0 mg/dL
D) Magnesium: 1.8 mg/dL
Answer: A) Potassium: 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium of 3.1 mEq/L is critically low (hypokalemia), placing the
patient at high risk for ventricular dysrhythmias. Normal potassium
range is 3.5–5.0 mEq/L. The other values are within normal limits.
3. A nurse is assessing a patient with hyperkalemia. Which
electrocardiographic (ECG) change is most characteristic?
A) Flattened T waves
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged PR interval
Answer: C) Tall, peaked T waves
Rationale: Tall, peaked T waves are the earliest and most classic ECG
finding in hyperkalemia. Flattened T waves and prominent U waves are
characteristic of hypokalemia. Prolonged PR interval may occur in
severe hyperkalemia but is not the earliest sign.
4. A patient presents with Chvostek’s sign and Trousseau’s sign.
These findings are hallmark indicators of which electrolyte
imbalance?
A) Hypernatremia
B) Hypomagnesemia
C) Hypocalcemia
D) Hyperkalemia
,3|Page
Answer: C) Hypocalcemia
Rationale: Chvostek’s sign (facial twitching when tapping the facial
nerve) and Trousseau’s sign (carpal spasm during blood pressure cuff
inflation) are classic signs of neuromuscular irritability caused by
hypocalcemia. These signs may also occur in hypomagnesemia, but
hypocalcemia is the direct cause of the symptoms.
5. Which patient is at the highest risk for developing
hypermagnesemia?
A) A patient with chronic alcoholism
B) A patient with end-stage renal disease taking magnesium-based
antacids
C) A patient with prolonged nasogastric suctioning
D) A patient with diabetic ketoacidosis
Answer: B) A patient with end-stage renal disease taking
magnesium-based antacids
Rationale: Magnesium is primarily excreted by the kidneys. In end-
stage renal disease, excretion is severely impaired. The addition of
magnesium-based antacids leads to toxic accumulation. Alcoholism and
NG suctioning increase risk of hypomagnesemia. DKA may cause initial
hypermagnesemia but is not the highest risk.
6. A patient has a serum calcium level of 12.5 mg/dL. Which
intervention should the nurse anticipate?
A) Administer IV calcium gluconate
B) Encourage increased dietary calcium intake
C) Administer IV normal saline and calcitonin
D) Restrict oral fluids
, 4|Page
Answer: C) Administer IV normal saline and calcitonin
Rationale: Hypercalcemia (normal 8.5–10.5 mg/dL) is managed with
IV normal saline to promote calcium excretion via the kidneys and
calcitonin to lower serum calcium. Calcium gluconate is given for
hypocalcemia. Fluid restriction would worsen hypercalcemia by
decreasing excretion.
7. A patient with chronic kidney disease has a serum phosphorus
level of 6.5 mg/dL. Which assessment finding correlates with this
abnormality?
A) Hyperreflexia
B) Prolonged bleeding time
C) Hypocalcemia with tetany
D) Hypertension
Answer: C) Hypocalcemia with tetany
Rationale: Hyperphosphatemia (normal 2.5–4.5 mg/dL) commonly
occurs with chronic kidney disease. Elevated phosphorus binds with
calcium, leading to hypocalcemia. The hypocalcemia can cause
neuromuscular irritability, including tetany and seizures.
8. A patient is receiving IV fluids postoperatively and develops
crackles in the lung bases, distended neck veins, and edema. This
presentation is most consistent with:
A) Hypovolemia
B) Third-spacing
C) Fluid volume excess (hypervolemia)
D) Dehydration
