CJE ADULT HEALTH THEORY WITH COMPLETE 200 REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES/ GRADED A+|ADULT HEALTH THEORY
EXAM PREP (BRAND NEW!!)
SECTION 1: FLUID AND ELECTROLYTE BALANCE (Questions 1-25)
1. A nurse is reviewing laboratory results for a client with dehydration.
Which finding is consistent with this condition?
A) Decreased serum osmolality
B) Decreased urine specific gravity
C) Increased serum osmolality
D) Decreased serum sodium
Correct Answer: C – Dehydration leads to hemoconcentration, resulting in
increased serum osmolality. Increased urine specific gravity and increased
serum sodium are also expected.
2. A client has a serum osmolality of 320 mOsm/kg (normal 275-300). The nurse
interprets this finding as:
A) Isotonic state
B) Hypotonic state
C) Hypertonic state
D) Normal finding
Correct Answer: C – Hypertonic states occur with high osmolality
(>300 mOsm/kg), indicating higher particle concentration in the blood,
seen in dehydration, hyperglycemia, or excessive sodium intake.
3. A client with heart failure has gained 3 kg in 48 hours and has crackles in
the lung bases. The nurse recognizes these findings as indicative of:
A) Fluid volume deficit
B) Fluid volume overload
C) Third-spacing
D) Hypertonic dehydration
1
, Correct Answer: B – Rapid weight gain (1 kg = 1 L fluid), crackles, and
dyspnea are classic signs of fluid volume overload (hypervolemia),
commonly exacerbated in heart failure.
4. The nurse anticipates which intervention for a client with severe
hyponatremia (serum sodium 118 mEq/L) who is symptomatic with confusion?
A) Fluid restriction
B) Administration of 3% hypertonic saline
C) Administration of furosemide
D) Administration of oral salt tablets
Correct Answer: B – Severe, symptomatic hyponatremia requires cautious
IV hypertonic saline (3% NaCl) to raise sodium slowly and prevent
osmotic demyelination syndrome.
5. Which electrocardiogram (ECG) change is most characteristic of
hyperkalemia?
A) Prominent U waves
B) Peaked (tall, tented) T waves
C) ST segment depression
D) Prolonged PR interval
Correct Answer: B – Peaked, narrow, tented T waves are the earliest and
most characteristic ECG sign of hyperkalemia. Prominent U waves are seen
in hypokalemia.
6. A client with hypokalemia is receiving IV potassium chloride. Which nursing
action is essential?
A) Administer via IV push for rapid replacement
B) Infuse at a rate not to exceed 10 mEq/hour peripherally
C) Dilute in normal saline and infuse through a peripheral IV
D) Monitor urine output and ensure it is at least 30 mL/hour before
administration
Correct Answer: D – Potassium should NEVER be given IV push. Maximum
peripheral infusion rate is 10 mEq/hour (central line up to 40 mEq/hour).
2
, Adequate urine output (≥30 mL/hr) must be confirmed to prevent
hyperkalemia from renal retention.
7. A client exhibits facial muscle twitching when the nurse taps the facial
nerve just below the temple. This positive sign is known as:
A) Trousseau's sign
B) Chvostek's sign
C) Babinski's sign
D) Kernig's sign
Correct Answer: B – Chvostek's sign (facial twitching upon tapping the
facial nerve) indicates hypocalcemia. Trousseau's sign is carpal spasm
upon inflating a blood pressure cuff.
8. A client with end-stage renal disease has a serum magnesium level of
4.5 mEq/L (normal 1.5-2.5). The nurse should prioritize monitoring for:
A) Hyperreflexia and tetany
B) Hypotension and respiratory depression
C) Tachycardia and hypertension
D) Muscle cramps and paresthesia
Correct Answer: B – Hypermagnesemia causes hypotension, bradycardia,
respiratory depression, and loss of deep tendon reflexes. Severe levels
(>7 mEq/L) can cause cardiac arrest.
9. An arterial blood gas (ABG) result shows: pH 7.28, PaCO2 55 mm Hg,
HCO3- 24 mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C – pH is low (acidosis), PaCO2 is high (respiratory
cause). HCO3- is normal, indicating no metabolic compensation yet
(acute respiratory acidosis).
3
, 10. Which ABG result is consistent with fully compensated metabolic
alkalosis?
A) pH 7.35, PaCO2 48, HCO3- 30
B) pH 7.38, PaCO2 48, HCO3- 32
C) pH 7.45, PaCO2 32, HCO3- 20
D) pH 7.48, PaCO2 50, HCO3- 34
Correct Answer: B – In compensated metabolic alkalosis, pH returns
toward normal (7.35-7.45), HCO3- remains high, and PaCO2 increases as
compensatory hypoventilation.
11. The nurse is caring for a client with diabetic ketoacidosis (DKA).
Which IV fluid should the nurse prepare for initial rehydration?
A) Dextrose 5% in water (D5W)
B) 0.45% normal saline (half-strength)
C) 0.9% normal saline (isotonic)
D) 3% normal saline (hypertonic)
Correct Answer: C – Isotonic 0.9% NS is the initial fluid of choice
for DKA to restore intravascular volume. After initial resuscitation,
hypotonic fluids may follow, and dextrose is added when glucose drops.
12. A client receiving a blood transfusion develops chills, fever, and
lower back pain 30 minutes into the infusion. The nurse's priority
action is:
A) Slow the infusion rate
B) Administer diphenhydramine (Benadryl)
C) Stop the transfusion and hang normal saline
D) Notify the provider after completing the infusion
Correct Answer: C – These are signs of an acute hemolytic transfusion
reaction. The nurse must STOP the transfusion immediately, disconnect
the blood tubing, hang NS with new tubing, and notify the provider
and blood bank.
13. The nurse is preparing to administer total parenteral nutrition (TPN)
4
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES/ GRADED A+|ADULT HEALTH THEORY
EXAM PREP (BRAND NEW!!)
SECTION 1: FLUID AND ELECTROLYTE BALANCE (Questions 1-25)
1. A nurse is reviewing laboratory results for a client with dehydration.
Which finding is consistent with this condition?
A) Decreased serum osmolality
B) Decreased urine specific gravity
C) Increased serum osmolality
D) Decreased serum sodium
Correct Answer: C – Dehydration leads to hemoconcentration, resulting in
increased serum osmolality. Increased urine specific gravity and increased
serum sodium are also expected.
2. A client has a serum osmolality of 320 mOsm/kg (normal 275-300). The nurse
interprets this finding as:
A) Isotonic state
B) Hypotonic state
C) Hypertonic state
D) Normal finding
Correct Answer: C – Hypertonic states occur with high osmolality
(>300 mOsm/kg), indicating higher particle concentration in the blood,
seen in dehydration, hyperglycemia, or excessive sodium intake.
3. A client with heart failure has gained 3 kg in 48 hours and has crackles in
the lung bases. The nurse recognizes these findings as indicative of:
A) Fluid volume deficit
B) Fluid volume overload
C) Third-spacing
D) Hypertonic dehydration
1
, Correct Answer: B – Rapid weight gain (1 kg = 1 L fluid), crackles, and
dyspnea are classic signs of fluid volume overload (hypervolemia),
commonly exacerbated in heart failure.
4. The nurse anticipates which intervention for a client with severe
hyponatremia (serum sodium 118 mEq/L) who is symptomatic with confusion?
A) Fluid restriction
B) Administration of 3% hypertonic saline
C) Administration of furosemide
D) Administration of oral salt tablets
Correct Answer: B – Severe, symptomatic hyponatremia requires cautious
IV hypertonic saline (3% NaCl) to raise sodium slowly and prevent
osmotic demyelination syndrome.
5. Which electrocardiogram (ECG) change is most characteristic of
hyperkalemia?
A) Prominent U waves
B) Peaked (tall, tented) T waves
C) ST segment depression
D) Prolonged PR interval
Correct Answer: B – Peaked, narrow, tented T waves are the earliest and
most characteristic ECG sign of hyperkalemia. Prominent U waves are seen
in hypokalemia.
6. A client with hypokalemia is receiving IV potassium chloride. Which nursing
action is essential?
A) Administer via IV push for rapid replacement
B) Infuse at a rate not to exceed 10 mEq/hour peripherally
C) Dilute in normal saline and infuse through a peripheral IV
D) Monitor urine output and ensure it is at least 30 mL/hour before
administration
Correct Answer: D – Potassium should NEVER be given IV push. Maximum
peripheral infusion rate is 10 mEq/hour (central line up to 40 mEq/hour).
2
, Adequate urine output (≥30 mL/hr) must be confirmed to prevent
hyperkalemia from renal retention.
7. A client exhibits facial muscle twitching when the nurse taps the facial
nerve just below the temple. This positive sign is known as:
A) Trousseau's sign
B) Chvostek's sign
C) Babinski's sign
D) Kernig's sign
Correct Answer: B – Chvostek's sign (facial twitching upon tapping the
facial nerve) indicates hypocalcemia. Trousseau's sign is carpal spasm
upon inflating a blood pressure cuff.
8. A client with end-stage renal disease has a serum magnesium level of
4.5 mEq/L (normal 1.5-2.5). The nurse should prioritize monitoring for:
A) Hyperreflexia and tetany
B) Hypotension and respiratory depression
C) Tachycardia and hypertension
D) Muscle cramps and paresthesia
Correct Answer: B – Hypermagnesemia causes hypotension, bradycardia,
respiratory depression, and loss of deep tendon reflexes. Severe levels
(>7 mEq/L) can cause cardiac arrest.
9. An arterial blood gas (ABG) result shows: pH 7.28, PaCO2 55 mm Hg,
HCO3- 24 mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C – pH is low (acidosis), PaCO2 is high (respiratory
cause). HCO3- is normal, indicating no metabolic compensation yet
(acute respiratory acidosis).
3
, 10. Which ABG result is consistent with fully compensated metabolic
alkalosis?
A) pH 7.35, PaCO2 48, HCO3- 30
B) pH 7.38, PaCO2 48, HCO3- 32
C) pH 7.45, PaCO2 32, HCO3- 20
D) pH 7.48, PaCO2 50, HCO3- 34
Correct Answer: B – In compensated metabolic alkalosis, pH returns
toward normal (7.35-7.45), HCO3- remains high, and PaCO2 increases as
compensatory hypoventilation.
11. The nurse is caring for a client with diabetic ketoacidosis (DKA).
Which IV fluid should the nurse prepare for initial rehydration?
A) Dextrose 5% in water (D5W)
B) 0.45% normal saline (half-strength)
C) 0.9% normal saline (isotonic)
D) 3% normal saline (hypertonic)
Correct Answer: C – Isotonic 0.9% NS is the initial fluid of choice
for DKA to restore intravascular volume. After initial resuscitation,
hypotonic fluids may follow, and dextrose is added when glucose drops.
12. A client receiving a blood transfusion develops chills, fever, and
lower back pain 30 minutes into the infusion. The nurse's priority
action is:
A) Slow the infusion rate
B) Administer diphenhydramine (Benadryl)
C) Stop the transfusion and hang normal saline
D) Notify the provider after completing the infusion
Correct Answer: C – These are signs of an acute hemolytic transfusion
reaction. The nurse must STOP the transfusion immediately, disconnect
the blood tubing, hang NS with new tubing, and notify the provider
and blood bank.
13. The nurse is preparing to administer total parenteral nutrition (TPN)
4
