NR 283 Pathophysiology Exam 3: (Latest 2026/2027 Update) Fluid &
Electrolytes, Acid-Base, GI, Renal, Neuro, Cardiac Disorders | Q&A | Grade A |
100% Correct (Verified Answers)
COMPREHENSIVE PATHOPHYSIOLOGY REVIEW
SUBJECT SOURCE FORMAT
Pathophysiology / Fluid & NR 283 Patho Exam 3 2026/2027 Q&A Guide with Clinical Rationale
Electrolytes / Acid-Base / GI / Renal
/ Neuro / Cardiac
Q1
Which assessment finding most strongly suggests hypovolemia?
CORRECT ANSWER Decreased urine output
CLINICAL RATIONALE
● Hypovolemia triggers ADH and aldosterone release, causing the kidneys to conserve water → decreased urine
output.
● Other signs include tachycardia, hypotension, dry mucous membranes, and poor skin turgor.
Q2
A client with diarrhea for 3 days presents with dizziness and tachycardia. Which hormone is most
likely increased?
CORRECT ANSWER Aldosterone
CLINICAL RATIONALE
● Aldosterone is released in response to low blood volume to promote sodium and water retention.
● Dizziness and tachycardia are compensatory responses to hypovolemia.
Q3
Which clinical manifestation requires the nurse's immediate intervention in a client with
hypervolemia?
CORRECT ANSWER Crackles and shortness of breath
CLINICAL RATIONALE
● Crackles and dyspnea indicate pulmonary edema, a life-threatening complication of fluid overload.
● ABC priority: breathing is the first concern.
,Q4
A client receiving large volumes of IV fluids suddenly develops hypertension and jugular vein
distention. Which complication is the nurse most concerned about?
CORRECT ANSWER Pulmonary edema
CLINICAL RATIONALE
● JVD and hypertension indicate fluid overload that can lead to fluid leaking into the lungs (pulmonary edema).
● This is a medical emergency requiring immediate intervention.
Q5
Which finding differentiates hypervolemia from hypovolemia?
CORRECT ANSWER Edema
CLINICAL RATIONALE
● Edema occurs only in hypervolemia (fluid overload). Hypovolemia does not cause edema.
● Both conditions may cause tachycardia, but edema is specific to hypervolemia.
Q6
Which situation places a client at highest risk for hyponatremia?
CORRECT ANSWER Excessive water intake during a marathon
CLINICAL RATIONALE
● Drinking excessive water without replacing sodium dilutes serum sodium (dilutional hyponatremia).
● This is common in endurance athletes who drink only water.
Q7
The nurse suspects hypernatremia in which client?
CORRECT ANSWER Dry tongue and intense thirst
CLINICAL RATIONALE
● Hypernatremia causes intracellular dehydration → dry mucous membranes and intense thirst.
● Neurologic changes (confusion, seizures) occur with severe hypernatremia.
Q8
A client with hypernatremia is most likely experiencing which problem?
CORRECT ANSWER Dehydration
CLINICAL RATIONALE
● Hypernatremia (high sodium) typically indicates a deficit of water relative to sodium.
● The primary problem is water loss, not sodium excess.
, Q9
A client has a potassium level of 2.9 mEq/L. Which assessment finding does the nurse expect?
CORRECT ANSWER Muscle weakness
CLINICAL RATIONALE
● Hypokalemia causes muscle weakness, fatigue, and decreased reflexes.
● ECG changes include flat T waves and U waves.
Q10
Which client is at greatest risk for hyperkalemia?
CORRECT ANSWER Client with kidney failure
CLINICAL RATIONALE
● Kidneys excrete 90% of potassium. Kidney failure impairs potassium elimination → hyperkalemia.
● Hyperkalemia can cause life-threatening cardiac arrhythmias.
Q11
A client suddenly develops seizures. Which electrolyte imbalance is MOST likely?
CORRECT ANSWER Hyponatremia
CLINICAL RATIONALE
● Hyponatremia causes cerebral edema due to water shift into brain cells → seizures.
● Seizures are a late sign of severe hyponatremia.
Q12
A client is at greatest risk for lethal dysrhythmias with which condition?
CORRECT ANSWER Hyperkalemia
CLINICAL RATIONALE
● Hyperkalemia (high potassium) is the most dangerous electrolyte for cardiac conduction.
● ECG changes include peaked T waves, widened QRS, and ventricular fibrillation.
Q13
The nurse taps the client's cheek and observes facial twitching. This finding indicates which
condition?
CORRECT ANSWER Hypocalcemia
CLINICAL RATIONALE
● Chvostek's sign (facial twitching when tapping facial nerve) is classic for hypocalcemia.
● Also seen in hypomagnesemia.
Electrolytes, Acid-Base, GI, Renal, Neuro, Cardiac Disorders | Q&A | Grade A |
100% Correct (Verified Answers)
COMPREHENSIVE PATHOPHYSIOLOGY REVIEW
SUBJECT SOURCE FORMAT
Pathophysiology / Fluid & NR 283 Patho Exam 3 2026/2027 Q&A Guide with Clinical Rationale
Electrolytes / Acid-Base / GI / Renal
/ Neuro / Cardiac
Q1
Which assessment finding most strongly suggests hypovolemia?
CORRECT ANSWER Decreased urine output
CLINICAL RATIONALE
● Hypovolemia triggers ADH and aldosterone release, causing the kidneys to conserve water → decreased urine
output.
● Other signs include tachycardia, hypotension, dry mucous membranes, and poor skin turgor.
Q2
A client with diarrhea for 3 days presents with dizziness and tachycardia. Which hormone is most
likely increased?
CORRECT ANSWER Aldosterone
CLINICAL RATIONALE
● Aldosterone is released in response to low blood volume to promote sodium and water retention.
● Dizziness and tachycardia are compensatory responses to hypovolemia.
Q3
Which clinical manifestation requires the nurse's immediate intervention in a client with
hypervolemia?
CORRECT ANSWER Crackles and shortness of breath
CLINICAL RATIONALE
● Crackles and dyspnea indicate pulmonary edema, a life-threatening complication of fluid overload.
● ABC priority: breathing is the first concern.
,Q4
A client receiving large volumes of IV fluids suddenly develops hypertension and jugular vein
distention. Which complication is the nurse most concerned about?
CORRECT ANSWER Pulmonary edema
CLINICAL RATIONALE
● JVD and hypertension indicate fluid overload that can lead to fluid leaking into the lungs (pulmonary edema).
● This is a medical emergency requiring immediate intervention.
Q5
Which finding differentiates hypervolemia from hypovolemia?
CORRECT ANSWER Edema
CLINICAL RATIONALE
● Edema occurs only in hypervolemia (fluid overload). Hypovolemia does not cause edema.
● Both conditions may cause tachycardia, but edema is specific to hypervolemia.
Q6
Which situation places a client at highest risk for hyponatremia?
CORRECT ANSWER Excessive water intake during a marathon
CLINICAL RATIONALE
● Drinking excessive water without replacing sodium dilutes serum sodium (dilutional hyponatremia).
● This is common in endurance athletes who drink only water.
Q7
The nurse suspects hypernatremia in which client?
CORRECT ANSWER Dry tongue and intense thirst
CLINICAL RATIONALE
● Hypernatremia causes intracellular dehydration → dry mucous membranes and intense thirst.
● Neurologic changes (confusion, seizures) occur with severe hypernatremia.
Q8
A client with hypernatremia is most likely experiencing which problem?
CORRECT ANSWER Dehydration
CLINICAL RATIONALE
● Hypernatremia (high sodium) typically indicates a deficit of water relative to sodium.
● The primary problem is water loss, not sodium excess.
, Q9
A client has a potassium level of 2.9 mEq/L. Which assessment finding does the nurse expect?
CORRECT ANSWER Muscle weakness
CLINICAL RATIONALE
● Hypokalemia causes muscle weakness, fatigue, and decreased reflexes.
● ECG changes include flat T waves and U waves.
Q10
Which client is at greatest risk for hyperkalemia?
CORRECT ANSWER Client with kidney failure
CLINICAL RATIONALE
● Kidneys excrete 90% of potassium. Kidney failure impairs potassium elimination → hyperkalemia.
● Hyperkalemia can cause life-threatening cardiac arrhythmias.
Q11
A client suddenly develops seizures. Which electrolyte imbalance is MOST likely?
CORRECT ANSWER Hyponatremia
CLINICAL RATIONALE
● Hyponatremia causes cerebral edema due to water shift into brain cells → seizures.
● Seizures are a late sign of severe hyponatremia.
Q12
A client is at greatest risk for lethal dysrhythmias with which condition?
CORRECT ANSWER Hyperkalemia
CLINICAL RATIONALE
● Hyperkalemia (high potassium) is the most dangerous electrolyte for cardiac conduction.
● ECG changes include peaked T waves, widened QRS, and ventricular fibrillation.
Q13
The nurse taps the client's cheek and observes facial twitching. This finding indicates which
condition?
CORRECT ANSWER Hypocalcemia
CLINICAL RATIONALE
● Chvostek's sign (facial twitching when tapping facial nerve) is classic for hypocalcemia.
● Also seen in hypomagnesemia.
