NUR Exam 1 – Fundamental Concepts of Practical
Nursing II – Hondros College of Nursing – 2026/2027 |
Updated exam questions with verified Answers!!
NUR Exam 1 – Fundamental Concepts of Practical Nursing II
Hondros College of Nursing – 2026/2027
Total Questions: 125
Format: Multiple Choice, Select All That Apply, Ordered Response
Section 1: Fluid & Electrolyte Balance (Questions 1-20)
1. A nurse is reviewing a client's lab results. The serum sodium level is 128 mEq/L. Which
clinical finding should the nurse expect?
• A) Hyperreflexia and muscle twitching
o Rationale: Hyperreflexia is seen in HYPERnatremia or HYPOcalcemia, not
hyponatremia.
• B) Thirst and dry mucous membranes
o Rationale: Thirst is a sign of hypernatremia (high sodium).
• C) Nausea, headache, and confusion
o Rationale: ✅ Correct. Hyponatremia (Na <135) causes cerebral edema,
leading to nausea, headache, confusion, and potentially seizures.
• D) Positive Chvostek’s sign
o Rationale: Chvostek’s sign is seen in hypocalcemia, not hyponatremia.
2. A client has a potassium level of 2.9 mEq/L. Which intervention has the highest priority?
• A) Administer oral potassium supplements with meals
o Rationale: Oral potassium is safe but slow. IV is faster for severe hypokalemia.
• B) Place the client on a cardiac monitor
, o Rationale: ✅ Correct. Hypokalemia (<3.5) causes U waves, flat T waves, and
risk of ventricular dysrhythmias. Cardiac monitoring is priority.
• C) Encourage high-potassium foods like bananas
o Rationale: Dietary changes are long-term, not acute priority.
• D) Restrict fluid intake to 1 L/day
o Rationale: Fluid restriction is not indicated for hypokalemia.
3. A client with heart failure has edema and crackles in lung bases. Serum sodium is 130
mEq/L. Which IV fluid order should the nurse question?
• A) 0.9% Normal Saline at 75 mL/hr
o Rationale: Normal saline is isotonic but contains sodium—will worsen
hypervolemia and hyponatremia.
• B) 0.45% Normal Saline at 50 mL/hr
o Rationale: Hypotonic fluid would further dilute sodium, worsening
hyponatremia.
• C) 3% Normal Saline at 30 mL/hr
o Rationale: Hypertonic saline is used for severe symptomatic hyponatremia,
but with heart failure, it increases volume overload.
• D) Lactated Ringer’s at 100 mL/hr
o Rationale: ✅ Correct answer for “question” – LR is isotonic but contains
sodium and potassium; in fluid overload, the nurse should question any IV
fluid unless hypertonic saline is specifically ordered for cerebral symptoms.
*(Note: The BEST answer is to question any fluid without a specific hypertonic saline
indication. For exam purposes, 0.45% NS is most dangerous in hyponatremia + overload.)*
4. Which client is at highest risk for hyperkalemia?
• A) A client with nasogastric suctioning
o Rationale: NG suction removes GI fluids, causing hypokalemia, not
hyperkalemia.
• B) A client taking furosemide (Lasix) daily
o Rationale: Loop diuretics cause potassium LOSS (hypokalemia).
• C) A client with chronic kidney disease stage 4
Nursing II – Hondros College of Nursing – 2026/2027 |
Updated exam questions with verified Answers!!
NUR Exam 1 – Fundamental Concepts of Practical Nursing II
Hondros College of Nursing – 2026/2027
Total Questions: 125
Format: Multiple Choice, Select All That Apply, Ordered Response
Section 1: Fluid & Electrolyte Balance (Questions 1-20)
1. A nurse is reviewing a client's lab results. The serum sodium level is 128 mEq/L. Which
clinical finding should the nurse expect?
• A) Hyperreflexia and muscle twitching
o Rationale: Hyperreflexia is seen in HYPERnatremia or HYPOcalcemia, not
hyponatremia.
• B) Thirst and dry mucous membranes
o Rationale: Thirst is a sign of hypernatremia (high sodium).
• C) Nausea, headache, and confusion
o Rationale: ✅ Correct. Hyponatremia (Na <135) causes cerebral edema,
leading to nausea, headache, confusion, and potentially seizures.
• D) Positive Chvostek’s sign
o Rationale: Chvostek’s sign is seen in hypocalcemia, not hyponatremia.
2. A client has a potassium level of 2.9 mEq/L. Which intervention has the highest priority?
• A) Administer oral potassium supplements with meals
o Rationale: Oral potassium is safe but slow. IV is faster for severe hypokalemia.
• B) Place the client on a cardiac monitor
, o Rationale: ✅ Correct. Hypokalemia (<3.5) causes U waves, flat T waves, and
risk of ventricular dysrhythmias. Cardiac monitoring is priority.
• C) Encourage high-potassium foods like bananas
o Rationale: Dietary changes are long-term, not acute priority.
• D) Restrict fluid intake to 1 L/day
o Rationale: Fluid restriction is not indicated for hypokalemia.
3. A client with heart failure has edema and crackles in lung bases. Serum sodium is 130
mEq/L. Which IV fluid order should the nurse question?
• A) 0.9% Normal Saline at 75 mL/hr
o Rationale: Normal saline is isotonic but contains sodium—will worsen
hypervolemia and hyponatremia.
• B) 0.45% Normal Saline at 50 mL/hr
o Rationale: Hypotonic fluid would further dilute sodium, worsening
hyponatremia.
• C) 3% Normal Saline at 30 mL/hr
o Rationale: Hypertonic saline is used for severe symptomatic hyponatremia,
but with heart failure, it increases volume overload.
• D) Lactated Ringer’s at 100 mL/hr
o Rationale: ✅ Correct answer for “question” – LR is isotonic but contains
sodium and potassium; in fluid overload, the nurse should question any IV
fluid unless hypertonic saline is specifically ordered for cerebral symptoms.
*(Note: The BEST answer is to question any fluid without a specific hypertonic saline
indication. For exam purposes, 0.45% NS is most dangerous in hyponatremia + overload.)*
4. Which client is at highest risk for hyperkalemia?
• A) A client with nasogastric suctioning
o Rationale: NG suction removes GI fluids, causing hypokalemia, not
hyperkalemia.
• B) A client taking furosemide (Lasix) daily
o Rationale: Loop diuretics cause potassium LOSS (hypokalemia).
• C) A client with chronic kidney disease stage 4
