NURSING 467 NCLEX Presentation Questions 2022 Update
NCLEX question # 01
Which of the following is not a hypertonic fluid? a. 3% saline
• b. D5W
• c. C. 10% Dextrose in Water (D10W)
• d. 5% Dextrose in Lactated Ringer’s
Answer : B
Rationale: Dextrose 5% in water is isotonic fluid.
Isotonic solutions is used to increase extracellular fluid volume due to patient had lost ECF such
as dehydration(fluid loss), blood loss, vomit, diarrhea, low blood sugar (hypoglycemia), insulin
shock, or surgery. Dextrose 5% in water is also given for nutritional support to patients who are
unable to eat because of illness, injury, or other medical condition.
NCLEX question # 02
A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment
data will require the most rapid response by the nurse?
• a. The patient's radial pulse is 105 beats/min.
• b. There are crackles throughout both lung fields.
• c. There is sediment and blood in the patient's urine.
• d. The blood pressure increases from 120/80 to 142/94 mm Hg.
Answer : B
Rationale: Crackles throughout both lungs suggest that the patient may be experiencing
pulmonary edema, a life-threatening adverse effect of hypertonic solutions. The increased pulse
rate and blood pressure and the appearance of the urine should also be reported, but they are not
as dangerous as the presence of fluid in the alveoli.
NCLEX question # 03
fluids remove water from the extracellular space into the intracellular space?
• A. Hypotonic
• B. Hypertonic
• C. Isotonic
• D. Colloids
Answer : A
Rationale: The cell has a low amount of solute extracellularly and it wants to shift inside the cell
to get everything back to normal via osmosis, This will cause cell swelling which can cause the
cell to burst or lyses.
NCLEX question # 04
During administration of a hypertonic IV solution, the mechanism involved in equalizing the
fluid concentration between ECF and the cells is:
• a. Osmosis
,• b. Diffusion
• c. active transport
• d. facilitated diffusion
Answer : A
Rationale: Osmosis is the movement of water between two compartments separated by a
semipermeable membrane. Water moves through the membrane from an area of low solute
concentration to an area of high solute concentration.
NCLEX question # 05
A patient with cerebral edema would MOST likely be order what type of solution?
• A. 3% Saline
• B. 0.9 % Normal Saline C. Lactated Ringer’s
D. 0.225% Normal saline
Answer : A
Rationale: A patient with cerebral edema would be ordered a Hypertonic solution to decrease
brain swelling. The solution would remove water from the brain cells back into the intravascular
system to be excreted. 3% Saline is the only hypertonic option.
NCLEX question # 06
To provide free water and intracellular fluid hydration for a patient with acute gastroenteritis who
is NPO, the nurse would expect administration of which infusion?
• A. Dextrose 5% in water
• B. Dextrose 10% in water
• C. Lactated Ringer’s solution
• D. Dextrose 5% in normal saline (0.9%)
Answer : A
Rationale: Fluids such as 5% dextrose in water (D5W) allow water to move from the ECF to the
ICF. Although D5W is physiologically isotonic, the dextrose is rapidly metabolized, leaving free
water to shift into cells.
NCLEX question # 07
What is an example of an appropriate IV solution to treat an extracellular fluid volume deficit?
• A. D5W
• B. 3% Saline
• C. Lactated Ringer’s solution
• D. D5W in ½ normal saline (0.45%)
Answer : C
, Rationale: An isotonic solution does not change the osmolality of the blood and does not cause
fluid shifts between the ECF and ICF. In the case of ECF loss, an isotonic solution, such as
lactated Ringer’s solution, is ideal because it stays in the extracellular compartment. A hypertonic
solution would pull fluid from the cells into the ECF, resulting in cellular fluid loss and possible
vascular overload.
NCLEX question # 08
D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution
because after the body metabolizes the dextrose the solution acts as a hypotonic solution.
True or False
Answer : True
Rationale: D5W is classified as a isotonic fluid BUT after administration the body metabolizes
the dextrose and the fluid left over is a hypotonic solution
NCLEX question # 09
The dehydrated patient is receiving a hypertonic solution. What assessments must be done to
AVOID risk factors of these solutions (select all that apply)?
• A. Lung sounds
• B. Bowel sounds
• C. Blood pressure
• D. Serum sodium level
• E. Serum potassium level
Answer : A, C, D
Rationale: BP, lung sounds, and serum sodium levels must be monitored frequently because of
the risk for excess intravascular volume with hypertonic solutions.
NCLEX question # 10
Which patient below would not be a candidate for a hypotonic solution?
• a. Patient with increased intracranial pressure
• b. B. Patient with Diabetic ketoacidosis
• c. C. Patient experiencing hyperosmolar Hyperglycemia
• d. All of the options are correct
Answer : A
Rationale: Hypotonic solution: The cell has a low amount of solute extracellularly and it wants to
shift inside the cell to get everything back to normal via osmosis.
This will cause CELL SWELLING which can cause the cell to burst or lyses. Never give
hypotonic solutions to patient who are at risk for increased cranial pressure. It can cause fluid to
shift to brain tissue and deplete their fluid volume.
NCLEX QUESTION #1
NCLEX question # 01
Which of the following is not a hypertonic fluid? a. 3% saline
• b. D5W
• c. C. 10% Dextrose in Water (D10W)
• d. 5% Dextrose in Lactated Ringer’s
Answer : B
Rationale: Dextrose 5% in water is isotonic fluid.
Isotonic solutions is used to increase extracellular fluid volume due to patient had lost ECF such
as dehydration(fluid loss), blood loss, vomit, diarrhea, low blood sugar (hypoglycemia), insulin
shock, or surgery. Dextrose 5% in water is also given for nutritional support to patients who are
unable to eat because of illness, injury, or other medical condition.
NCLEX question # 02
A patient is receiving a 3% saline continuous IV infusion for hyponatremia. Which assessment
data will require the most rapid response by the nurse?
• a. The patient's radial pulse is 105 beats/min.
• b. There are crackles throughout both lung fields.
• c. There is sediment and blood in the patient's urine.
• d. The blood pressure increases from 120/80 to 142/94 mm Hg.
Answer : B
Rationale: Crackles throughout both lungs suggest that the patient may be experiencing
pulmonary edema, a life-threatening adverse effect of hypertonic solutions. The increased pulse
rate and blood pressure and the appearance of the urine should also be reported, but they are not
as dangerous as the presence of fluid in the alveoli.
NCLEX question # 03
fluids remove water from the extracellular space into the intracellular space?
• A. Hypotonic
• B. Hypertonic
• C. Isotonic
• D. Colloids
Answer : A
Rationale: The cell has a low amount of solute extracellularly and it wants to shift inside the cell
to get everything back to normal via osmosis, This will cause cell swelling which can cause the
cell to burst or lyses.
NCLEX question # 04
During administration of a hypertonic IV solution, the mechanism involved in equalizing the
fluid concentration between ECF and the cells is:
• a. Osmosis
,• b. Diffusion
• c. active transport
• d. facilitated diffusion
Answer : A
Rationale: Osmosis is the movement of water between two compartments separated by a
semipermeable membrane. Water moves through the membrane from an area of low solute
concentration to an area of high solute concentration.
NCLEX question # 05
A patient with cerebral edema would MOST likely be order what type of solution?
• A. 3% Saline
• B. 0.9 % Normal Saline C. Lactated Ringer’s
D. 0.225% Normal saline
Answer : A
Rationale: A patient with cerebral edema would be ordered a Hypertonic solution to decrease
brain swelling. The solution would remove water from the brain cells back into the intravascular
system to be excreted. 3% Saline is the only hypertonic option.
NCLEX question # 06
To provide free water and intracellular fluid hydration for a patient with acute gastroenteritis who
is NPO, the nurse would expect administration of which infusion?
• A. Dextrose 5% in water
• B. Dextrose 10% in water
• C. Lactated Ringer’s solution
• D. Dextrose 5% in normal saline (0.9%)
Answer : A
Rationale: Fluids such as 5% dextrose in water (D5W) allow water to move from the ECF to the
ICF. Although D5W is physiologically isotonic, the dextrose is rapidly metabolized, leaving free
water to shift into cells.
NCLEX question # 07
What is an example of an appropriate IV solution to treat an extracellular fluid volume deficit?
• A. D5W
• B. 3% Saline
• C. Lactated Ringer’s solution
• D. D5W in ½ normal saline (0.45%)
Answer : C
, Rationale: An isotonic solution does not change the osmolality of the blood and does not cause
fluid shifts between the ECF and ICF. In the case of ECF loss, an isotonic solution, such as
lactated Ringer’s solution, is ideal because it stays in the extracellular compartment. A hypertonic
solution would pull fluid from the cells into the ECF, resulting in cellular fluid loss and possible
vascular overload.
NCLEX question # 08
D5W solutions are sometimes considered a hypotonic solution as well as an isotonic solution
because after the body metabolizes the dextrose the solution acts as a hypotonic solution.
True or False
Answer : True
Rationale: D5W is classified as a isotonic fluid BUT after administration the body metabolizes
the dextrose and the fluid left over is a hypotonic solution
NCLEX question # 09
The dehydrated patient is receiving a hypertonic solution. What assessments must be done to
AVOID risk factors of these solutions (select all that apply)?
• A. Lung sounds
• B. Bowel sounds
• C. Blood pressure
• D. Serum sodium level
• E. Serum potassium level
Answer : A, C, D
Rationale: BP, lung sounds, and serum sodium levels must be monitored frequently because of
the risk for excess intravascular volume with hypertonic solutions.
NCLEX question # 10
Which patient below would not be a candidate for a hypotonic solution?
• a. Patient with increased intracranial pressure
• b. B. Patient with Diabetic ketoacidosis
• c. C. Patient experiencing hyperosmolar Hyperglycemia
• d. All of the options are correct
Answer : A
Rationale: Hypotonic solution: The cell has a low amount of solute extracellularly and it wants to
shift inside the cell to get everything back to normal via osmosis.
This will cause CELL SWELLING which can cause the cell to burst or lyses. Never give
hypotonic solutions to patient who are at risk for increased cranial pressure. It can cause fluid to
shift to brain tissue and deplete their fluid volume.
NCLEX QUESTION #1
