NRSG 2350 LATEST 2026 EXAM QUESTIONS AND
SOLUTIONS GRADED A+
✔✔Signs of Hypovolemia - ✔✔Rapid heartbeat
Quick, shallow breathing
Feeling weak
Being tired
Confusion or wooziness
Having little or no pee
Low blood pressure
Cool, clammy skin
✔✔Types of IV fluids (3) - ✔✔isotonic, hypertonic, hypotonic
✔✔Isotonic IV fluids - ✔✔Most IV fluids are _______meaning they_have the same
concentration of solutes as blood plasma. When infused, ___ solutions expand both the
intracellular fluid and extracellular fluid spaces, equally.
Such fluids do not alter the osmolality of the vascular compartment.
These IV fluids have a total osmolality close to that of the ECF and do not cause red
blood cells to shrink or swell
✔✔Hypertonic IV fluids - ✔✔These IV solutions have a greater concentration of solutes
(375 mEq/L and greater) than plasma and cause fluids to move out of the cells and into
the ECF in order to normalize the concentration of particles between two compartments.
This effect causes cells to shrink and may disrupt their function.
They are also known as volume expanders as they draw water out of the intracellular
space, increasing extracellular fluid volume.
✔✔Hypotonic IV fluids - ✔✔These IV solutions have a lower osmolality and contain
fewer solutes than plasma.
They cause fluid shifts from the ECF into the ICF to achieve homeostasis, therefore,
causing cells to swell and may even rupture.
These IV fluids are usually used to provide free water for excretion of body wastes, treat
cellular dehydration, and replace the cellular fluid.
✔✔IV fluid types (3) Image - ✔✔
✔✔Sodium (electrolyte) - ✔✔Regulates osmolality - ICF: 14 mmol/L & ECF: 135 -145
mmol/L • Helps maintain blood pressure by balancing the volume of water in the body •
Works with other electrolytes to promote nerves, muscles and other body tissues to
work properly.
✔✔Normal Sodium level Range - ✔✔135-145
,✔✔Potassium (electrolyte) - ✔✔essential for normal cell function. Among its many
functions are regulation of the heartbeat and the function of the muscles
✔✔Normal Potassium level Range - ✔✔3.5-5.0
✔✔Calcium (electrolyte) - ✔✔Helps maintain muscle tone • Contributes to regulation of
blood pressure by maintaining cardiac contractility • Necessary for nerve transmission
and contraction of skeletal and cardiac muscle
✔✔Normal Calcium level Range - ✔✔8.5-10.5 mg/dL (9-11)
✔✔BUN test (blood urea nitrogen) - ✔✔This test is done to see how well your kidneys
are working. If your kidneys are not able to remove urea from the blood normally, your
BUN level rises. Heart failure, dehydration, or a diet high in protein can also make your
BUN level higher.
✔✔Hypernatremia - ✔✔A high concentration of sodium in the blood.
✔✔Hypernatremia causes - ✔✔excess water loss, excess sodium administration,
diabetes insipidus, heat stroke, hypertonic IV solutions
✔✔Hypernatremia S/S - ✔✔You are 'fried' or S.A.L.T.
F - Fever (low grade), flushed skin
R - Restless (irritable)
I - Increased fluid retention and increased BP
E - Edema (peripheral and pitting)
D - Decreased urinary output, dry mouth
S = Skin flushed
A = Agitation
L = Low-grade fever
T = Thirst
✔✔Hyponatremia - ✔✔deficient sodium in the blood
✔✔Hyponatremia causes - ✔✔*Inadequate sodium intake* (nothing by mouth)
Gastrointestinal suction
*Excessive intake of water*
*Irrigation of gastrointestinal tubes with plain water*
*Potent* diuretics
*Increased* perspiration
*Draining skin lesions*
Burns
*Nausea* and vomiting
, Diabetic ketoacidosis (metabolic acidosis)
Syndrome of *inappropriate antidiuretic hormone secretion*
Retention of fluid, such as with kidney or heart failure
✔✔Hyponatremia S/S - ✔✔Whole body: dizziness, fatigue, lethargy, malaise, or thirst,
hypotension
Also common: headache, insufficient urine production, mental confusion, or nausea
✔✔Hyperkalemia - ✔✔excessive potassium in the blood
✔✔Hyperkalemia causes - ✔✔M.A.C.H.I.N.E.
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory
C - Cellular destruction - Burns, traumatic injury
H - Hypoaldosteronism, hemolysis
I - Intake - Excesssive
N - Nephrons, renal failure
E - Excretion - Impaired
✔✔Hyperkalemia S/S - ✔✔M.U.R.D.E.R.
M - Muscle weakness
U - Urine, oliguria, anuria
R- Respiratory distress
D - Decreased cardiac contractility
E - ECG changes
R - Reflexes, hyperreflexia, or areflexia (flaccid)
✔✔Hypocalcemia - ✔✔an abnormally low level of calcium in the blood
✔✔Hypocalcemia causes - ✔✔*Inadequate dietary intake of calcium*
*Inhibited absorption of calcium from the intestinal tract*
*Inadequate vitamin D consumption*
Diarrhea
Long-term immobilization and *bone demineralization*
Excessive gastrointestinal losses from diarrhea or wound draining
*End-stage* renal disease
*Calcium-excreting medications* such as diuretics, caffeine, anticonvulsants, heparin,
laxatives, and nicotine
*Decrease secretion of parathyroid hormone*
Acute pancreatitis
Crohn's disease
*Excessive administration of blood*
✔✔Hypocalcemia S/S - ✔✔C.A.T.S.
C - Convulsions
SOLUTIONS GRADED A+
✔✔Signs of Hypovolemia - ✔✔Rapid heartbeat
Quick, shallow breathing
Feeling weak
Being tired
Confusion or wooziness
Having little or no pee
Low blood pressure
Cool, clammy skin
✔✔Types of IV fluids (3) - ✔✔isotonic, hypertonic, hypotonic
✔✔Isotonic IV fluids - ✔✔Most IV fluids are _______meaning they_have the same
concentration of solutes as blood plasma. When infused, ___ solutions expand both the
intracellular fluid and extracellular fluid spaces, equally.
Such fluids do not alter the osmolality of the vascular compartment.
These IV fluids have a total osmolality close to that of the ECF and do not cause red
blood cells to shrink or swell
✔✔Hypertonic IV fluids - ✔✔These IV solutions have a greater concentration of solutes
(375 mEq/L and greater) than plasma and cause fluids to move out of the cells and into
the ECF in order to normalize the concentration of particles between two compartments.
This effect causes cells to shrink and may disrupt their function.
They are also known as volume expanders as they draw water out of the intracellular
space, increasing extracellular fluid volume.
✔✔Hypotonic IV fluids - ✔✔These IV solutions have a lower osmolality and contain
fewer solutes than plasma.
They cause fluid shifts from the ECF into the ICF to achieve homeostasis, therefore,
causing cells to swell and may even rupture.
These IV fluids are usually used to provide free water for excretion of body wastes, treat
cellular dehydration, and replace the cellular fluid.
✔✔IV fluid types (3) Image - ✔✔
✔✔Sodium (electrolyte) - ✔✔Regulates osmolality - ICF: 14 mmol/L & ECF: 135 -145
mmol/L • Helps maintain blood pressure by balancing the volume of water in the body •
Works with other electrolytes to promote nerves, muscles and other body tissues to
work properly.
✔✔Normal Sodium level Range - ✔✔135-145
,✔✔Potassium (electrolyte) - ✔✔essential for normal cell function. Among its many
functions are regulation of the heartbeat and the function of the muscles
✔✔Normal Potassium level Range - ✔✔3.5-5.0
✔✔Calcium (electrolyte) - ✔✔Helps maintain muscle tone • Contributes to regulation of
blood pressure by maintaining cardiac contractility • Necessary for nerve transmission
and contraction of skeletal and cardiac muscle
✔✔Normal Calcium level Range - ✔✔8.5-10.5 mg/dL (9-11)
✔✔BUN test (blood urea nitrogen) - ✔✔This test is done to see how well your kidneys
are working. If your kidneys are not able to remove urea from the blood normally, your
BUN level rises. Heart failure, dehydration, or a diet high in protein can also make your
BUN level higher.
✔✔Hypernatremia - ✔✔A high concentration of sodium in the blood.
✔✔Hypernatremia causes - ✔✔excess water loss, excess sodium administration,
diabetes insipidus, heat stroke, hypertonic IV solutions
✔✔Hypernatremia S/S - ✔✔You are 'fried' or S.A.L.T.
F - Fever (low grade), flushed skin
R - Restless (irritable)
I - Increased fluid retention and increased BP
E - Edema (peripheral and pitting)
D - Decreased urinary output, dry mouth
S = Skin flushed
A = Agitation
L = Low-grade fever
T = Thirst
✔✔Hyponatremia - ✔✔deficient sodium in the blood
✔✔Hyponatremia causes - ✔✔*Inadequate sodium intake* (nothing by mouth)
Gastrointestinal suction
*Excessive intake of water*
*Irrigation of gastrointestinal tubes with plain water*
*Potent* diuretics
*Increased* perspiration
*Draining skin lesions*
Burns
*Nausea* and vomiting
, Diabetic ketoacidosis (metabolic acidosis)
Syndrome of *inappropriate antidiuretic hormone secretion*
Retention of fluid, such as with kidney or heart failure
✔✔Hyponatremia S/S - ✔✔Whole body: dizziness, fatigue, lethargy, malaise, or thirst,
hypotension
Also common: headache, insufficient urine production, mental confusion, or nausea
✔✔Hyperkalemia - ✔✔excessive potassium in the blood
✔✔Hyperkalemia causes - ✔✔M.A.C.H.I.N.E.
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory
C - Cellular destruction - Burns, traumatic injury
H - Hypoaldosteronism, hemolysis
I - Intake - Excesssive
N - Nephrons, renal failure
E - Excretion - Impaired
✔✔Hyperkalemia S/S - ✔✔M.U.R.D.E.R.
M - Muscle weakness
U - Urine, oliguria, anuria
R- Respiratory distress
D - Decreased cardiac contractility
E - ECG changes
R - Reflexes, hyperreflexia, or areflexia (flaccid)
✔✔Hypocalcemia - ✔✔an abnormally low level of calcium in the blood
✔✔Hypocalcemia causes - ✔✔*Inadequate dietary intake of calcium*
*Inhibited absorption of calcium from the intestinal tract*
*Inadequate vitamin D consumption*
Diarrhea
Long-term immobilization and *bone demineralization*
Excessive gastrointestinal losses from diarrhea or wound draining
*End-stage* renal disease
*Calcium-excreting medications* such as diuretics, caffeine, anticonvulsants, heparin,
laxatives, and nicotine
*Decrease secretion of parathyroid hormone*
Acute pancreatitis
Crohn's disease
*Excessive administration of blood*
✔✔Hypocalcemia S/S - ✔✔C.A.T.S.
C - Convulsions
