,Galen NSG 3800 Exam 1 | Nursing Practice –
Adult Health II (2026) Actual Q&A PDF
1. For a client with a serum sodium of 155 mEq/L, the nurse should first assess
for which clinical manifestation?
A) Confusion and muscle twitching
B) Jugular vein distention
C) Tachycardia and hypotension
D) Periorbital edema
Correct Answer: Confusion and muscle twitching
Rationale: Hypernatremia (sodium >145 mEq/L) causes intracellular
dehydration, primarily affecting the central nervous system. Early signs include
confusion, restlessness, and muscle twitching. Jugular vein distention and
edema indicate hypervolemia, not hypernatremia.
2. The nurse identifies 0.45% sodium chloride as which type of intravenous
solution?
A) Isotonic
B) Hypotonic
C) Hypertonic
D) Colloid
Correct Answer: Hypotonic
,Rationale: 0.45% NaCl is a hypotonic solution, with an osmolality lower than
plasma. It shifts water into cells and is used for hypernatremia. Isotonic
solutions (0.9% NaCl, LR) expand intravascular volume. Hypertonic solutions
draw fluid from cells.
3. In caring for a client with SIADH, the nurse monitors specific gravity every 4
hours to assess:
A) Nutritional status
B) Potassium balance
C) Fluid volume status
D) Calcium balance
Correct Answer: Fluid volume status
Rationale: SIADH causes water retention, diluting body fluids and decreasing
specific gravity. Tracking specific gravity helps detect fluid volume excess or
deficit. It does not directly measure nutrition, potassium, or calcium.
4. The #1 sign of fluid volume deficit is:
A) Hypotension
B) Decreased urine output
C) Dry mucous membranes
D) Tachycardia
Correct Answer: Tachycardia
, Rationale: Tachycardia is the earliest compensatory mechanism for
hypovolemia, as the heart rate increases to maintain cardiac output. Blood
pressure drops later. Dry membranes and oliguria are also present but not the
number one sign.
5. When caring for a client with a potassium level of 5.2 mEq/L, the nurse should
monitor for which priority complication?
A) Cardiac dysrhythmias
B) Polyuria
C) Hypotension
D) Tetany
Correct Answer: Cardiac dysrhythmias
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves,
widened QRS, and potentially fatal arrhythmias. While muscle weakness may
occur, cardiac monitoring is the priority.
6. The nurse is caring for a client experiencing hyperventilation from anxiety.
This is most likely to cause which acid-base imbalance?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory alkalosis
Adult Health II (2026) Actual Q&A PDF
1. For a client with a serum sodium of 155 mEq/L, the nurse should first assess
for which clinical manifestation?
A) Confusion and muscle twitching
B) Jugular vein distention
C) Tachycardia and hypotension
D) Periorbital edema
Correct Answer: Confusion and muscle twitching
Rationale: Hypernatremia (sodium >145 mEq/L) causes intracellular
dehydration, primarily affecting the central nervous system. Early signs include
confusion, restlessness, and muscle twitching. Jugular vein distention and
edema indicate hypervolemia, not hypernatremia.
2. The nurse identifies 0.45% sodium chloride as which type of intravenous
solution?
A) Isotonic
B) Hypotonic
C) Hypertonic
D) Colloid
Correct Answer: Hypotonic
,Rationale: 0.45% NaCl is a hypotonic solution, with an osmolality lower than
plasma. It shifts water into cells and is used for hypernatremia. Isotonic
solutions (0.9% NaCl, LR) expand intravascular volume. Hypertonic solutions
draw fluid from cells.
3. In caring for a client with SIADH, the nurse monitors specific gravity every 4
hours to assess:
A) Nutritional status
B) Potassium balance
C) Fluid volume status
D) Calcium balance
Correct Answer: Fluid volume status
Rationale: SIADH causes water retention, diluting body fluids and decreasing
specific gravity. Tracking specific gravity helps detect fluid volume excess or
deficit. It does not directly measure nutrition, potassium, or calcium.
4. The #1 sign of fluid volume deficit is:
A) Hypotension
B) Decreased urine output
C) Dry mucous membranes
D) Tachycardia
Correct Answer: Tachycardia
, Rationale: Tachycardia is the earliest compensatory mechanism for
hypovolemia, as the heart rate increases to maintain cardiac output. Blood
pressure drops later. Dry membranes and oliguria are also present but not the
number one sign.
5. When caring for a client with a potassium level of 5.2 mEq/L, the nurse should
monitor for which priority complication?
A) Cardiac dysrhythmias
B) Polyuria
C) Hypotension
D) Tetany
Correct Answer: Cardiac dysrhythmias
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves,
widened QRS, and potentially fatal arrhythmias. While muscle weakness may
occur, cardiac monitoring is the priority.
6. The nurse is caring for a client experiencing hyperventilation from anxiety.
This is most likely to cause which acid-base imbalance?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory alkalosis
