NUR 2356 MDC 1 FINAL EXAM VERSION A &
B TEST BANK (Q&A WITH RATIONALES)
LATEST UPDATE
, Question 1
A nurse is assessing a patient with a history of severe vomiting and
diarrhea. The patient's serum potassium level is reported as 2.9 mE/L.
Which clinical manifestation should the nurse prioritize for immediate
intervention?
A) Hyperactive bowel sounds
B) Flat or inverted T waves on the ECG
C) Prominent U waves and a prolonged PR interval
D) Peak T waves and widened QRS complex
VERIFIED ANSWER: C) Prominent U waves and a prolonged PR
interval
EXPLANATION: Hypokalemia (potassium level below 3.5 mEq/L)
changes myocardial conduction. Electrocardiogram (ECG) changes
include flat or inverted T waves, ST-segment depression, and
prominent U waves. In contrast, peaked T waves and widened QRS
complexes indicate hyperkalemia.
Question 2
A patient with an acute exacerbation of chronic obstructive pulmonary
disease (COPD) has the following arterial blood gas (ABG) values: pH
7.31, PaCO2 58 mmHg, HCO3 26 mEq/L. How should the nurse
interpret these findings?
A) Uncompensated respiratory acidosis
B) Fully compensated metabolic acidosis
C) Partially compensated respiratory alkalosis
D) Uncompensated respiratory alkalosis
VERIFIED ANSWER: A) Uncompensated respiratory acidosis
, EXPLANATION: A pH less than 7.35 indicates acidosis. The PaCO2
is greater than 45 mmHg, pointing to a respiratory cause. Because
the HCO3 remains within the normal range (22-26 mEq/L), the
kidneys have not yet compensated for the respiratory imbalance.
Question 3
The nurse is caring for a patient experiencing severe anxiety who is
hyperventilating. The nurse expects the patient’s arterial blood gas
(ABG) analysis to reveal which condition?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
VERIFIED ANSWER: D) Respiratory alkalosis
EXPLANATION: Hyperventilation leads to the excessive elimination
of carbon dioxide (CO2), dropping PaCO2 below 35 mmHg. This
reduction in carbonic acid elevates blood pH above 7.45, resulting
in respiratory alkalosis.
Question 4
A nurse is reviewing lab results for an older adult patient admitted with
severe dehydration. Which lab value is most consistent with this
diagnosis?
A) Serum sodium of 132 mEq/L
B) Hematocrit of 54%
C) Urine specific gravity of 1.005
D) Blood urea nitrogen (BUN) of 8 mg/dL
VERIFIED ANSWER: B) Hematocrit of 54%
, EXPLANATION: Dehydration causes hemoconcentration, elevating
hematocrit and BUN values. A hematocrit above 50% in females or
52% in males strongly indicates fluid volume deficit. Urine specific
gravity would be elevated (above 1.030) as kidneys conserve water.
Question 5
Which action should the nurse take first when administering intravenous
potassium chloride (KCl) to a patient with a confirmed serum potassium
level of 3.1 mEq/L?
A) Administer the medication via rapid IV push
B) Ensure the infusion rate does not exceed 10 mEq/hour via an infusion
pump
C) Assess the injection site for bruising every 8 hours
D) Restrict oral fluid intake during the entire infusion period
VERIFIED ANSWER: B) Ensure the infusion rate does not exceed 10
mEq/hour via an infusion pump
EXPLANATION: Potassium chloride must never be administered via
IV push because it causes immediate cardiac arrest. It should
always be diluted and infused using an electronic control device at
a rate not exceeding 10 to 20 mEq/hour to prevent fatal
dysrhythmias.
Question 6
A patient is admitted with syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should anticipate which fluid and
electrolyte alteration?
A) Hypernatremia and fluid deficit
B) Hyponatremia and fluid volume excess
C) Hypokalemia and fluid deficit
D) Hypercalcemia and fluid volume excess
B TEST BANK (Q&A WITH RATIONALES)
LATEST UPDATE
, Question 1
A nurse is assessing a patient with a history of severe vomiting and
diarrhea. The patient's serum potassium level is reported as 2.9 mE/L.
Which clinical manifestation should the nurse prioritize for immediate
intervention?
A) Hyperactive bowel sounds
B) Flat or inverted T waves on the ECG
C) Prominent U waves and a prolonged PR interval
D) Peak T waves and widened QRS complex
VERIFIED ANSWER: C) Prominent U waves and a prolonged PR
interval
EXPLANATION: Hypokalemia (potassium level below 3.5 mEq/L)
changes myocardial conduction. Electrocardiogram (ECG) changes
include flat or inverted T waves, ST-segment depression, and
prominent U waves. In contrast, peaked T waves and widened QRS
complexes indicate hyperkalemia.
Question 2
A patient with an acute exacerbation of chronic obstructive pulmonary
disease (COPD) has the following arterial blood gas (ABG) values: pH
7.31, PaCO2 58 mmHg, HCO3 26 mEq/L. How should the nurse
interpret these findings?
A) Uncompensated respiratory acidosis
B) Fully compensated metabolic acidosis
C) Partially compensated respiratory alkalosis
D) Uncompensated respiratory alkalosis
VERIFIED ANSWER: A) Uncompensated respiratory acidosis
, EXPLANATION: A pH less than 7.35 indicates acidosis. The PaCO2
is greater than 45 mmHg, pointing to a respiratory cause. Because
the HCO3 remains within the normal range (22-26 mEq/L), the
kidneys have not yet compensated for the respiratory imbalance.
Question 3
The nurse is caring for a patient experiencing severe anxiety who is
hyperventilating. The nurse expects the patient’s arterial blood gas
(ABG) analysis to reveal which condition?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
VERIFIED ANSWER: D) Respiratory alkalosis
EXPLANATION: Hyperventilation leads to the excessive elimination
of carbon dioxide (CO2), dropping PaCO2 below 35 mmHg. This
reduction in carbonic acid elevates blood pH above 7.45, resulting
in respiratory alkalosis.
Question 4
A nurse is reviewing lab results for an older adult patient admitted with
severe dehydration. Which lab value is most consistent with this
diagnosis?
A) Serum sodium of 132 mEq/L
B) Hematocrit of 54%
C) Urine specific gravity of 1.005
D) Blood urea nitrogen (BUN) of 8 mg/dL
VERIFIED ANSWER: B) Hematocrit of 54%
, EXPLANATION: Dehydration causes hemoconcentration, elevating
hematocrit and BUN values. A hematocrit above 50% in females or
52% in males strongly indicates fluid volume deficit. Urine specific
gravity would be elevated (above 1.030) as kidneys conserve water.
Question 5
Which action should the nurse take first when administering intravenous
potassium chloride (KCl) to a patient with a confirmed serum potassium
level of 3.1 mEq/L?
A) Administer the medication via rapid IV push
B) Ensure the infusion rate does not exceed 10 mEq/hour via an infusion
pump
C) Assess the injection site for bruising every 8 hours
D) Restrict oral fluid intake during the entire infusion period
VERIFIED ANSWER: B) Ensure the infusion rate does not exceed 10
mEq/hour via an infusion pump
EXPLANATION: Potassium chloride must never be administered via
IV push because it causes immediate cardiac arrest. It should
always be diluted and infused using an electronic control device at
a rate not exceeding 10 to 20 mEq/hour to prevent fatal
dysrhythmias.
Question 6
A patient is admitted with syndrome of inappropriate antidiuretic
hormone (SIADH). The nurse should anticipate which fluid and
electrolyte alteration?
A) Hypernatremia and fluid deficit
B) Hyponatremia and fluid volume excess
C) Hypokalemia and fluid deficit
D) Hypercalcemia and fluid volume excess
