Virtual RN Medical-Surgical and Mental Health Proctored Exam – Includes Both
Actual and Retake Assessments....
Virtual RN Medical-Surgical and Mental Health Proctored Exam Practice Questions
180 Multiple-Choice Questions with Answers and Rationales
MEDICAL-SURGICAL SECTION (Questions 1-90)
Fluid, Electrolyte, and Acid-Base Balance
1. A nurse is caring for a client with fluid volume deficit. Which of the following
findings should the nurse expect?
A) Bounding pulse and hypertension
B) Distended neck veins and crackles
C) Dizziness, orthostatic hypotension, and flat neck veins
D) Peripheral edema and weight gain
Answer: C
Rationale: In fluid volume deficit, decreased vascular volume reduces venous
return and cardiac output, leading to dizziness, orthostatic hypotension, and flat
,neck veins. Heart rate increases and blood pressure falls. Options A, B, and D are
findings associated with fluid volume excess .
2. A client's arterial blood gas results show pH 7.30, PaCO2 50 mmHg, and HCO3-
24 mEq/L. Which acid-base imbalance does this indicate?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: C
Rationale: The pH is below 7.35 (acidosis), PaCO2 is elevated above 45 mmHg
(respiratory cause), and HCO3- is normal. This indicates respiratory acidosis from
inadequate alveolar ventilation and CO2 retention .
,3. A nurse is assessing a client with hypokalemia. Which finding requires
immediate intervention?
A) Muscle weakness
B) ECG changes with cardiac dysrhythmias
C) Nausea and vomiting
D) Fatigue and lethargy
Answer: B
Rationale: Hypokalemia affects cardiac impulse transmission and can cause life-
threatening atrial or ventricular dysrhythmias. While muscle weakness, nausea,
and fatigue are also manifestations, cardiac changes require the most immediate
intervention .
4. A client with hypernatremia is receiving treatment. Which nursing intervention
is a priority?
, A) Restrict fluid intake to 1 L per day
B) Administer hypertonic saline
C) Monitor neurological status frequently
D) Encourage high-sodium foods
Answer: C
Rationale: Hypernatremia draws water out of brain cells, causing them to shrink.
This places tension on cerebral vessels and can cause tearing and bleeding.
Frequent neurological checks are essential to monitor for changes in mental
status and orientation .
5. Which clinical manifestation is associated with hypomagnesemia?
A) Positive Chvostek's sign
B) Decreased deep tendon reflexes
Actual and Retake Assessments....
Virtual RN Medical-Surgical and Mental Health Proctored Exam Practice Questions
180 Multiple-Choice Questions with Answers and Rationales
MEDICAL-SURGICAL SECTION (Questions 1-90)
Fluid, Electrolyte, and Acid-Base Balance
1. A nurse is caring for a client with fluid volume deficit. Which of the following
findings should the nurse expect?
A) Bounding pulse and hypertension
B) Distended neck veins and crackles
C) Dizziness, orthostatic hypotension, and flat neck veins
D) Peripheral edema and weight gain
Answer: C
Rationale: In fluid volume deficit, decreased vascular volume reduces venous
return and cardiac output, leading to dizziness, orthostatic hypotension, and flat
,neck veins. Heart rate increases and blood pressure falls. Options A, B, and D are
findings associated with fluid volume excess .
2. A client's arterial blood gas results show pH 7.30, PaCO2 50 mmHg, and HCO3-
24 mEq/L. Which acid-base imbalance does this indicate?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Answer: C
Rationale: The pH is below 7.35 (acidosis), PaCO2 is elevated above 45 mmHg
(respiratory cause), and HCO3- is normal. This indicates respiratory acidosis from
inadequate alveolar ventilation and CO2 retention .
,3. A nurse is assessing a client with hypokalemia. Which finding requires
immediate intervention?
A) Muscle weakness
B) ECG changes with cardiac dysrhythmias
C) Nausea and vomiting
D) Fatigue and lethargy
Answer: B
Rationale: Hypokalemia affects cardiac impulse transmission and can cause life-
threatening atrial or ventricular dysrhythmias. While muscle weakness, nausea,
and fatigue are also manifestations, cardiac changes require the most immediate
intervention .
4. A client with hypernatremia is receiving treatment. Which nursing intervention
is a priority?
, A) Restrict fluid intake to 1 L per day
B) Administer hypertonic saline
C) Monitor neurological status frequently
D) Encourage high-sodium foods
Answer: C
Rationale: Hypernatremia draws water out of brain cells, causing them to shrink.
This places tension on cerebral vessels and can cause tearing and bleeding.
Frequent neurological checks are essential to monitor for changes in mental
status and orientation .
5. Which clinical manifestation is associated with hypomagnesemia?
A) Positive Chvostek's sign
B) Decreased deep tendon reflexes
