______________________________________
NSG 3100 EXAM 4
PRACTICE
FUNDAMENTAL CONCEPTS & SKILLS
FOR NURSING PRACTICE I
GALEN COLLEGE OF NURSING
EXAM- QUESTIONS & (UPDATED)
ANSWERS
EXAM COVER SHEET
PROGRAM: NSG (Nursing Program)
COURSE NUMBER: NSG 3100 Exam 4 Practice
COURSE NAME: Fundamental Concepts & Skills for Nursing
Practice I
EXAM NAME: Exam 4 Practice
,1. Risk Factors for Potassium Imbalance in Clients Receiving Treatment
Question:
The nurse is providing teaching to clients regarding intake of dietary potassium
and is reviewing factors that may increase the risk of developing potassium
electrolyte imbalances. The nurse is caring for four clients and needs to identify
which client is at the greatest risk for developing an alteration in potassium levels.
Which client should the nurse recognize as being at increased risk for potassium
imbalance?
A. The client who has fatty stools after taking an over-the-counter (OTC) weight
loss medication.
B. The client who experiences anorexia and has a decreased appetite for several
weeks.
C. The client who has chronic heart failure (HF) that is being treated with diuretic
medications.
D. The client who takes very large doses of vitamin D as a chemotherapy
supplement.
Correct Answer: C. The client who has chronic heart failure (HF) that is
being treated with diuretic medications.
Rationale:
Clients with chronic heart failure who receive diuretic therapy, especially loop
diuretics such as furosemide, are at increased risk for hypokalemia because these
medications increase potassium loss through the kidneys. Low potassium levels
can interfere with normal muscle function and cardiac conduction, increasing the
risk for weakness, fatigue, and dangerous cardiac dysrhythmias. The nurse should
monitor serum potassium levels regularly and encourage appropriate dietary
potassium intake if prescribed. Clients taking medications that promote potassium
loss require close assessment for signs of electrolyte imbalance.
The client with fatty stools from an OTC weight loss product may have problems
absorbing fat-soluble vitamins but is not at the highest risk for potassium
imbalance. Anorexia may contribute to nutritional deficiencies, but potassium
imbalance is more commonly associated with conditions causing excessive
potassium loss, such as vomiting, diarrhea, or diuretic use. High doses of vitamin
D primarily affect calcium and phosphate levels rather than directly causing
potassium imbalance.
,2. Signs and Symptoms of Hypokalemia After Prolonged Diarrhea
Question:
The nurse is caring for a client who has experienced diarrhea for 48 hours and is
now reporting increased fatigue and muscle weakness. During assessment, the
nurse notes that the client has an irregular pulse and suspects that an electrolyte
imbalance may be affecting cardiac function. Which laboratory result should the
nurse correlate with the client’s current signs and symptoms?
A. Serum phosphate level of 4 mEq/L.
B. Serum magnesium level of 2 mEq/L.
C. Serum calcium level of 9.5 mEq/L.
D. Serum potassium level of 2.8 mEq/L.
Correct Answer: D. Serum potassium level of 2.8 mEq/L.
Rationale:
A serum potassium level of 2.8 mEq/L indicates hypokalemia, which is a low
potassium level that can occur after prolonged diarrhea due to potassium loss from
the gastrointestinal tract. Hypokalemia commonly causes symptoms such as
fatigue, generalized muscle weakness, decreased muscle function, and cardiac
dysrhythmias because potassium plays an important role in nerve and heart
conduction. The irregular pulse noted in the client is a significant finding that
supports a potassium imbalance. The nurse should anticipate interventions to
correct potassium levels and continue cardiac monitoring if needed.
A serum phosphate level of 4 mEq/L is within the expected range and does not
explain the client’s symptoms. A magnesium level of 2 mEq/L is also within
normal limits and is not associated with these findings. A calcium level of 9.5
mEq/L is within the normal range and would not be the likely cause of fatigue,
weakness, and irregular heart rhythm.
3. Assessment Findings Associated With Hypovolemia
Question:
The nurse is caring for a client who has multiple draining wounds and has been
admitted with a diagnosis of hypovolemia related to fluid loss. During the
, assessment, the nurse evaluates the client for signs of decreased circulating fluid
volume. Which assessment finding should the nurse expect to observe in a client
experiencing hypovolemia?
A. Increased urine output.
B. Decreased skin turgor.
C. Hypertension with elevated blood pressure readings.
D. Bounding peripheral pulses.
Correct Answer: B. Decreased skin turgor.
Rationale:
Decreased skin turgor is a common assessment finding in clients experiencing
hypovolemia because reduced fluid volume causes decreased hydration of body
tissues. When the skin is pinched, it returns slowly to its normal position due to
reduced interstitial fluid. Clients with fluid volume loss may also experience dry
mucous membranes, decreased urine output, low blood pressure, and weak
peripheral pulses. Monitoring fluid status is essential to prevent complications such
as inadequate tissue perfusion and shock.
Increased urine output is not expected with hypovolemia because the kidneys
attempt to conserve water by reducing urine production. Hypertension is generally
associated with fluid overload rather than fluid loss, while hypovolemia commonly
causes hypotension. Bounding pulses are typically associated with increased
circulating volume and are not expected in a client with decreased fluid volume.
4. Priority Assessment: Client Requiring Immediate Nursing Attention
Question:
The nurse is caring for several assigned clients who have different electrolyte
abnormalities. The nurse must determine which client requires immediate
assessment and intervention based on the potential severity of the condition. Which
client should the nurse see first?
A. The client whose serum potassium concentration is decreasing and who reports
abdominal distention but denies difficulty breathing.
B. The client whose serum calcium concentration is increasing and who reports
constipation but is alert and denies discomfort.
C. The client whose serum potassium concentration is increasing and who has
NSG 3100 EXAM 4
PRACTICE
FUNDAMENTAL CONCEPTS & SKILLS
FOR NURSING PRACTICE I
GALEN COLLEGE OF NURSING
EXAM- QUESTIONS & (UPDATED)
ANSWERS
EXAM COVER SHEET
PROGRAM: NSG (Nursing Program)
COURSE NUMBER: NSG 3100 Exam 4 Practice
COURSE NAME: Fundamental Concepts & Skills for Nursing
Practice I
EXAM NAME: Exam 4 Practice
,1. Risk Factors for Potassium Imbalance in Clients Receiving Treatment
Question:
The nurse is providing teaching to clients regarding intake of dietary potassium
and is reviewing factors that may increase the risk of developing potassium
electrolyte imbalances. The nurse is caring for four clients and needs to identify
which client is at the greatest risk for developing an alteration in potassium levels.
Which client should the nurse recognize as being at increased risk for potassium
imbalance?
A. The client who has fatty stools after taking an over-the-counter (OTC) weight
loss medication.
B. The client who experiences anorexia and has a decreased appetite for several
weeks.
C. The client who has chronic heart failure (HF) that is being treated with diuretic
medications.
D. The client who takes very large doses of vitamin D as a chemotherapy
supplement.
Correct Answer: C. The client who has chronic heart failure (HF) that is
being treated with diuretic medications.
Rationale:
Clients with chronic heart failure who receive diuretic therapy, especially loop
diuretics such as furosemide, are at increased risk for hypokalemia because these
medications increase potassium loss through the kidneys. Low potassium levels
can interfere with normal muscle function and cardiac conduction, increasing the
risk for weakness, fatigue, and dangerous cardiac dysrhythmias. The nurse should
monitor serum potassium levels regularly and encourage appropriate dietary
potassium intake if prescribed. Clients taking medications that promote potassium
loss require close assessment for signs of electrolyte imbalance.
The client with fatty stools from an OTC weight loss product may have problems
absorbing fat-soluble vitamins but is not at the highest risk for potassium
imbalance. Anorexia may contribute to nutritional deficiencies, but potassium
imbalance is more commonly associated with conditions causing excessive
potassium loss, such as vomiting, diarrhea, or diuretic use. High doses of vitamin
D primarily affect calcium and phosphate levels rather than directly causing
potassium imbalance.
,2. Signs and Symptoms of Hypokalemia After Prolonged Diarrhea
Question:
The nurse is caring for a client who has experienced diarrhea for 48 hours and is
now reporting increased fatigue and muscle weakness. During assessment, the
nurse notes that the client has an irregular pulse and suspects that an electrolyte
imbalance may be affecting cardiac function. Which laboratory result should the
nurse correlate with the client’s current signs and symptoms?
A. Serum phosphate level of 4 mEq/L.
B. Serum magnesium level of 2 mEq/L.
C. Serum calcium level of 9.5 mEq/L.
D. Serum potassium level of 2.8 mEq/L.
Correct Answer: D. Serum potassium level of 2.8 mEq/L.
Rationale:
A serum potassium level of 2.8 mEq/L indicates hypokalemia, which is a low
potassium level that can occur after prolonged diarrhea due to potassium loss from
the gastrointestinal tract. Hypokalemia commonly causes symptoms such as
fatigue, generalized muscle weakness, decreased muscle function, and cardiac
dysrhythmias because potassium plays an important role in nerve and heart
conduction. The irregular pulse noted in the client is a significant finding that
supports a potassium imbalance. The nurse should anticipate interventions to
correct potassium levels and continue cardiac monitoring if needed.
A serum phosphate level of 4 mEq/L is within the expected range and does not
explain the client’s symptoms. A magnesium level of 2 mEq/L is also within
normal limits and is not associated with these findings. A calcium level of 9.5
mEq/L is within the normal range and would not be the likely cause of fatigue,
weakness, and irregular heart rhythm.
3. Assessment Findings Associated With Hypovolemia
Question:
The nurse is caring for a client who has multiple draining wounds and has been
admitted with a diagnosis of hypovolemia related to fluid loss. During the
, assessment, the nurse evaluates the client for signs of decreased circulating fluid
volume. Which assessment finding should the nurse expect to observe in a client
experiencing hypovolemia?
A. Increased urine output.
B. Decreased skin turgor.
C. Hypertension with elevated blood pressure readings.
D. Bounding peripheral pulses.
Correct Answer: B. Decreased skin turgor.
Rationale:
Decreased skin turgor is a common assessment finding in clients experiencing
hypovolemia because reduced fluid volume causes decreased hydration of body
tissues. When the skin is pinched, it returns slowly to its normal position due to
reduced interstitial fluid. Clients with fluid volume loss may also experience dry
mucous membranes, decreased urine output, low blood pressure, and weak
peripheral pulses. Monitoring fluid status is essential to prevent complications such
as inadequate tissue perfusion and shock.
Increased urine output is not expected with hypovolemia because the kidneys
attempt to conserve water by reducing urine production. Hypertension is generally
associated with fluid overload rather than fluid loss, while hypovolemia commonly
causes hypotension. Bounding pulses are typically associated with increased
circulating volume and are not expected in a client with decreased fluid volume.
4. Priority Assessment: Client Requiring Immediate Nursing Attention
Question:
The nurse is caring for several assigned clients who have different electrolyte
abnormalities. The nurse must determine which client requires immediate
assessment and intervention based on the potential severity of the condition. Which
client should the nurse see first?
A. The client whose serum potassium concentration is decreasing and who reports
abdominal distention but denies difficulty breathing.
B. The client whose serum calcium concentration is increasing and who reports
constipation but is alert and denies discomfort.
C. The client whose serum potassium concentration is increasing and who has
