College of Nursing
4 MAXE SDNUF
★ ★
N Department of Health Sciences
SCIENTIA · CURA · COMPASSIO
EST. 1908
Fundamentals of Nursing — Examination 4
F LU I D & E L E C T R O LYT E S · A C I D - B A S E B A L A N C E · R E S P I R ATO R Y · OX YG E N T H E R A P Y
INSTITUTION College of Nursing COURSE CODE NURS 1101
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Fundamentals of Nursing Exam 4 TOTAL QUESTIONS 120+ Questions
COURSE TITLE Nursing Fundamentals FORMAT Comprehensive Study Guide — Short
Answer & Concept Review
EXAMINATION INSTRUCTIONS
▸ This comprehensive study guide covers fluid and electrolyte balance, acid-base interpretation, respiratory anatomy and
physiology, and oxygen delivery devices.
▸ Each item includes the correct answer/definition and a clinical rationale for NCLEX preparation.
▸ Normal lab value ranges follow current clinical laboratory standards.
▸ Master these concepts for safe nursing practice and examination success.
SECTION I — FLUID BALANCE, HORMONES & BODY FLUID Questions 1 –
COMPARTMENTS 35
1. What is vasopressin?
CORRECT ANSWER Antidiuretic hormone (ADH) — released by the pituitary gland; stimulates the kidneys to excrete less
urine (conserves water).
RATIONALE ADH/vasopressin is the primary hormone regulating water balance. It increases water reabsorption in the
collecting ducts of the nephron, concentrating urine and conserving body water. Released in response to
increased plasma osmolality or decreased blood volume.
2. What are the functions of water in the body?
CORRECT ANSWER Transport nutrients to cells and wastes from cells; transport hormones, enzymes, blood platelets,
and RBCs/WBCs; facilitate cellular metabolism and proper cellular chemical functioning; act as
solvent for electrolytes/non-electrolytes; help maintain body temperature; facilitate digestion and
promote elimination; tissue lubricant.
RATIONALE Water is the most abundant substance in the body (60% of adult weight). It serves as the universal solvent,
transport medium, temperature regulator, and lubricant. Every physiological process depends on adequate
hydration.
,3. Where is fluid stored in the body?
CORRECT ANSWER Intracellular fluid (ICF): ~70% (2/3) of total body fluid — inside cells. Extracellular fluid (ECF): ~30%
(1/3) — includes interstitial fluid (75% of ECF) and intravascular fluid (25% of ECF).
RATIONALE The two main compartments are ICF (within cells, rich in K+) and ECF (outside cells, rich in Na+). The ECF is
further divided into interstitial (between cells) and intravascular (plasma within blood vessels).
4. What is the intracellular space?
CORRECT ANSWER The space inside cells — holds 2/3 of all body fluid. Optimal amount required to ensure cells don't
swell and burst or become dehydrated.
RATIONALE ICF volume is regulated by osmotic gradients. If ECF becomes hypotonic, water shifts into cells causing
swelling/lysis. If ECF becomes hypertonic, water leaves cells causing crenation.
5. What is the intravascular space?
CORRECT ANSWER The space found in blood vessels. Optimal amount required to ensure adequate preload, cardiac
output, blood pressure, and perfusion.
RATIONALE Intravascular volume directly affects hemodynamics. Low intravascular volume → decreased preload →
decreased stroke volume → decreased cardiac output → hypotension and poor tissue perfusion.
6. What is the interstitial space?
CORRECT ANSWER Between the intravascular and intracellular space. Can become a nonfunctional "third space" where
fluid is trapped and not available for physiological function.
RATIONALE Third spacing occurs when fluid shifts from the vascular space into interstitial spaces that normally have
little or no fluid (e.g., peritoneal cavity, pleural space). This fluid is physiologically "lost" — it doesn't
contribute to circulating volume.
7. How do infants differ in body fluid composition?
CORRECT ANSWER Infants have considerably more body fluid and ECF; more prone to volume deficits.
RATIONALE Infants are ~75–80% water by weight (vs. 60% in adults). Their higher metabolic rate, immature kidneys, and
larger body surface area-to-weight ratio make them more susceptible to dehydration.
8. How do women and obese individuals differ in body water?
CORRECT ANSWER Women and obese individuals have less body water (proportionally).
RATIONALE Adipose tissue contains very little water compared to muscle tissue. Women generally have higher body fat
percentage and less muscle mass than men, resulting in lower total body water percentage. Obesity further
reduces the proportion.
9. What is a solvent? What are solutes?
CORRECT ANSWER Solvent: liquid that holds a substance in solution (water is the universal solvent). Solutes: substances
dissolved in solution (electrolytes, glucose, proteins).
RATIONALE In body fluids, water is the solvent and electrolytes (Na+, K+, Cl-, etc.) are the primary solutes. The
concentration of solutes determines osmolality and drives water movement between compartments.
, 10. What are the routes of fluid loss from the body?
CORRECT ANSWER Kidneys: urine. Intestinal tract: feces. Skin: perspiration (sweat). Lungs: insensible water loss
(respiration).
RATIONALE The kidneys are the primary regulators of fluid output (~1,500 mL/day). GI losses (~100–200 mL/day), skin
(sensible sweat + insensible evaporation), and lungs (exhaled water vapor) account for the remainder.
11. What is the difference between sensible and insensible water loss?
CORRECT ANSWER Sensible: urine, stool, sweat (measurable/observable). Insensible: lungs (respiration), skin
evaporation (not easily measured).
RATIONALE Insensible losses occur continuously without awareness — approximately 600–900 mL/day through skin and
lungs. These losses increase with fever, tachypnea, and dry environments. Sensible losses can be quantified
and documented.
12. What is diffusion?
CORRECT ANSWER Solutes move from HIGH concentration to LOW concentration; results in equal distribution.
RATIONALE Diffusion is passive transport requiring no energy. It is driven by the concentration gradient. In the body, O₂
and CO₂ exchange in alveoli occurs by diffusion.
13. What is osmosis?
CORRECT ANSWER Passive movement of fluid across a membrane from an area of LOW solute concentration to HIGH
solute concentration; stops when both sides have equal distribution.
RATIONALE Osmosis is the movement of water (not solutes) across a semipermeable membrane. Water follows solutes.
This is the mechanism by which IV fluid tonicity affects fluid shifts between compartments.
14. What is active transport?
CORRECT ANSWER Use of ATP to move solutes from low to high concentration; the sodium-potassium pump is the
classic example.
RATIONALE The Na+/K+ ATPase pump actively transports 3 Na+ out of the cell and 2 K+ into the cell against their
concentration gradients. This maintains the resting membrane potential essential for nerve and muscle
function.
15. What is filtration?
CORRECT ANSWER Fluid moves across capillary wall from hydrostatic pressure.
RATIONALE Filtration is driven by hydrostatic pressure pushing fluid out of capillaries. It is opposed by oncotic pressure
(from plasma proteins, primarily albumin) that pulls fluid back in. This balance (Starling forces) determines
net fluid movement.
16. What are electrolytes?
CORRECT ANSWER Minerals in the body that conduct electricity; found in urine, blood, tissues, and body fluids;
naturally occurring but also found in food, drink, and supplements. Include potassium, sodium,
calcium, magnesium.
RATIONALE Electrolytes dissociate into charged ions in solution, enabling electrical conduction essential for nerve
impulses, muscle contraction, and acid-base balance. Cations (Na+, K+, Ca2+, Mg2+) and anions (Cl-, HCO3-,
PO4-) must be balanced.
4 MAXE SDNUF
★ ★
N Department of Health Sciences
SCIENTIA · CURA · COMPASSIO
EST. 1908
Fundamentals of Nursing — Examination 4
F LU I D & E L E C T R O LYT E S · A C I D - B A S E B A L A N C E · R E S P I R ATO R Y · OX YG E N T H E R A P Y
INSTITUTION College of Nursing COURSE CODE NURS 1101
PROGRAM Bachelor of Science in Nursing (BSN) ACADEMIC YEAR
EXAM TITLE Fundamentals of Nursing Exam 4 TOTAL QUESTIONS 120+ Questions
COURSE TITLE Nursing Fundamentals FORMAT Comprehensive Study Guide — Short
Answer & Concept Review
EXAMINATION INSTRUCTIONS
▸ This comprehensive study guide covers fluid and electrolyte balance, acid-base interpretation, respiratory anatomy and
physiology, and oxygen delivery devices.
▸ Each item includes the correct answer/definition and a clinical rationale for NCLEX preparation.
▸ Normal lab value ranges follow current clinical laboratory standards.
▸ Master these concepts for safe nursing practice and examination success.
SECTION I — FLUID BALANCE, HORMONES & BODY FLUID Questions 1 –
COMPARTMENTS 35
1. What is vasopressin?
CORRECT ANSWER Antidiuretic hormone (ADH) — released by the pituitary gland; stimulates the kidneys to excrete less
urine (conserves water).
RATIONALE ADH/vasopressin is the primary hormone regulating water balance. It increases water reabsorption in the
collecting ducts of the nephron, concentrating urine and conserving body water. Released in response to
increased plasma osmolality or decreased blood volume.
2. What are the functions of water in the body?
CORRECT ANSWER Transport nutrients to cells and wastes from cells; transport hormones, enzymes, blood platelets,
and RBCs/WBCs; facilitate cellular metabolism and proper cellular chemical functioning; act as
solvent for electrolytes/non-electrolytes; help maintain body temperature; facilitate digestion and
promote elimination; tissue lubricant.
RATIONALE Water is the most abundant substance in the body (60% of adult weight). It serves as the universal solvent,
transport medium, temperature regulator, and lubricant. Every physiological process depends on adequate
hydration.
,3. Where is fluid stored in the body?
CORRECT ANSWER Intracellular fluid (ICF): ~70% (2/3) of total body fluid — inside cells. Extracellular fluid (ECF): ~30%
(1/3) — includes interstitial fluid (75% of ECF) and intravascular fluid (25% of ECF).
RATIONALE The two main compartments are ICF (within cells, rich in K+) and ECF (outside cells, rich in Na+). The ECF is
further divided into interstitial (between cells) and intravascular (plasma within blood vessels).
4. What is the intracellular space?
CORRECT ANSWER The space inside cells — holds 2/3 of all body fluid. Optimal amount required to ensure cells don't
swell and burst or become dehydrated.
RATIONALE ICF volume is regulated by osmotic gradients. If ECF becomes hypotonic, water shifts into cells causing
swelling/lysis. If ECF becomes hypertonic, water leaves cells causing crenation.
5. What is the intravascular space?
CORRECT ANSWER The space found in blood vessels. Optimal amount required to ensure adequate preload, cardiac
output, blood pressure, and perfusion.
RATIONALE Intravascular volume directly affects hemodynamics. Low intravascular volume → decreased preload →
decreased stroke volume → decreased cardiac output → hypotension and poor tissue perfusion.
6. What is the interstitial space?
CORRECT ANSWER Between the intravascular and intracellular space. Can become a nonfunctional "third space" where
fluid is trapped and not available for physiological function.
RATIONALE Third spacing occurs when fluid shifts from the vascular space into interstitial spaces that normally have
little or no fluid (e.g., peritoneal cavity, pleural space). This fluid is physiologically "lost" — it doesn't
contribute to circulating volume.
7. How do infants differ in body fluid composition?
CORRECT ANSWER Infants have considerably more body fluid and ECF; more prone to volume deficits.
RATIONALE Infants are ~75–80% water by weight (vs. 60% in adults). Their higher metabolic rate, immature kidneys, and
larger body surface area-to-weight ratio make them more susceptible to dehydration.
8. How do women and obese individuals differ in body water?
CORRECT ANSWER Women and obese individuals have less body water (proportionally).
RATIONALE Adipose tissue contains very little water compared to muscle tissue. Women generally have higher body fat
percentage and less muscle mass than men, resulting in lower total body water percentage. Obesity further
reduces the proportion.
9. What is a solvent? What are solutes?
CORRECT ANSWER Solvent: liquid that holds a substance in solution (water is the universal solvent). Solutes: substances
dissolved in solution (electrolytes, glucose, proteins).
RATIONALE In body fluids, water is the solvent and electrolytes (Na+, K+, Cl-, etc.) are the primary solutes. The
concentration of solutes determines osmolality and drives water movement between compartments.
, 10. What are the routes of fluid loss from the body?
CORRECT ANSWER Kidneys: urine. Intestinal tract: feces. Skin: perspiration (sweat). Lungs: insensible water loss
(respiration).
RATIONALE The kidneys are the primary regulators of fluid output (~1,500 mL/day). GI losses (~100–200 mL/day), skin
(sensible sweat + insensible evaporation), and lungs (exhaled water vapor) account for the remainder.
11. What is the difference between sensible and insensible water loss?
CORRECT ANSWER Sensible: urine, stool, sweat (measurable/observable). Insensible: lungs (respiration), skin
evaporation (not easily measured).
RATIONALE Insensible losses occur continuously without awareness — approximately 600–900 mL/day through skin and
lungs. These losses increase with fever, tachypnea, and dry environments. Sensible losses can be quantified
and documented.
12. What is diffusion?
CORRECT ANSWER Solutes move from HIGH concentration to LOW concentration; results in equal distribution.
RATIONALE Diffusion is passive transport requiring no energy. It is driven by the concentration gradient. In the body, O₂
and CO₂ exchange in alveoli occurs by diffusion.
13. What is osmosis?
CORRECT ANSWER Passive movement of fluid across a membrane from an area of LOW solute concentration to HIGH
solute concentration; stops when both sides have equal distribution.
RATIONALE Osmosis is the movement of water (not solutes) across a semipermeable membrane. Water follows solutes.
This is the mechanism by which IV fluid tonicity affects fluid shifts between compartments.
14. What is active transport?
CORRECT ANSWER Use of ATP to move solutes from low to high concentration; the sodium-potassium pump is the
classic example.
RATIONALE The Na+/K+ ATPase pump actively transports 3 Na+ out of the cell and 2 K+ into the cell against their
concentration gradients. This maintains the resting membrane potential essential for nerve and muscle
function.
15. What is filtration?
CORRECT ANSWER Fluid moves across capillary wall from hydrostatic pressure.
RATIONALE Filtration is driven by hydrostatic pressure pushing fluid out of capillaries. It is opposed by oncotic pressure
(from plasma proteins, primarily albumin) that pulls fluid back in. This balance (Starling forces) determines
net fluid movement.
16. What are electrolytes?
CORRECT ANSWER Minerals in the body that conduct electricity; found in urine, blood, tissues, and body fluids;
naturally occurring but also found in food, drink, and supplements. Include potassium, sodium,
calcium, magnesium.
RATIONALE Electrolytes dissociate into charged ions in solution, enabling electrical conduction essential for nerve
impulses, muscle contraction, and acid-base balance. Cations (Na+, K+, Ca2+, Mg2+) and anions (Cl-, HCO3-,
PO4-) must be balanced.
