This PNR 408 Review Questions 2026/2027 resource is a focused 13-page nursing exam study guide containing 45+ review questions with answers covering high-yield concepts in fluid and electrolyte balance, acid-base disorders, burns, hematology and blood transfusions, shock, respiratory failure, ARDS, pneumonia and COPD. The questions emphasize clinical application rather than simple recall, requiring students to interpret laboratory values, recognize deteriorating patients, prioritize nursing interventions and connect pathophysiological changes with appropriate bedside care.
The opening section concentrates on fluid and electrolyte imbalances. Students review fluid overload associated with kidney failure, fluid-volume deficit, insensible fluid losses, dehydration and daily fluid requirements. Clinical scenarios address clients receiving nasogastric suction, those with ileostomies and patients receiving long-term diuretic therapy. The document connects these situations with changes in potassium, sodium, urine concentration, blood pressure and respiratory findings. For example, kidney failure accompanied by dyspnea and pulmonary crackles is associated with fluid retention and increased blood pressure, while an ileostomy is identified as a significant risk factor for fluid-volume deficit.
Potassium and sodium disorders receive particularly strong coverage. Students examine hypokalemia and hyperkalemia, including a potassium value around 5.4–5.5 mEq/L and characteristic peaked T-wave changes. Causes discussed include traumatic burns, gastrointestinal losses, nasogastric suction, hyperglycemia and diuretic use. Hyponatremia is reviewed in relation to syndrome of inappropriate antidiuretic hormone secretion (SIADH) and changes in fluid status. These questions help students connect laboratory results with cardiovascular and neurological assessment rather than memorizing electrolyte ranges in isolation.
The guide also provides targeted practice in arterial blood gas interpretation and acid-base balance. Students encounter metabolic alkalosis associated with upper gastrointestinal obstruction and vomiting, normal ABG findings and partially compensated respiratory acidosis in COPD. One clinical scenario presents a pH of 7.33, PaCO2 of 60 mm Hg and HCO3 of 32 mmol/L, requiring recognition of respiratory acidosis with metabolic compensation. This material is particularly useful for learners preparing to interpret pH, PaCO2, bicarbonate and oxygenation values in clinical nursing questions.
Fluid-management questions extend into dehydration, IV therapy and fluid shifts. Students review daily weights, intake and output, adequate oral fluid intake and movement of fluid from interstitial spaces into the vascular compartment during dehydration. A postoperative scenario involving IV fluids infusing substantially faster than prescribed requires the nurse to prioritize respiratory assessment and lung auscultation for possible fluid overload. The guide therefore reinforces the relationship between fluid therapy, cardiovascular status and pulmonary complications.
A dedicated section addresses burn nursing and fluid resuscitation. Students review second- and third-degree burns, superficial partial-thickness injury, electrical burns and nutritional requirements following extensive burns. The Parkland/Baxter formula is incorporated into a resuscitation question emphasizing administration of half of the calculated first-24-hour fluid requirement during the first eight hours after injury. Extensive burns are also linked with increased calorie and protein requirements, while electrical-burn questions emphasize the need for adequate fluid resuscitation.
The hematology and blood-transfusion section covers anemia, packed red blood cells and fresh-frozen plasma. Students review fatigue associated with anemia, increased red-cell destruction in sickle cell disease and essential transfusion-safety procedures. High-yield nursing concepts include verifying the blood product against the patient's identification, using 0.9% sodium chloride with blood products, having another qualified nurse participate in verification as required by the scenario, closely observing the patient during the first 15 minutes and beginning transfusion promptly after the blood product is obtained. Fresh-frozen plasma administration is also addressed.
Another major examination area is shock and multiple organ dysfunction syndrome (MODS). Students distinguish aspects of septic, hypovolemic and cardiogenic shock and identify ineffective tissue perfusion as a major priority in severe blood-loss scenarios. Septic-shock questions emphasize aggressive IV fluid resuscitation and clinical manifestations such as stress-related hyperglycemia, while cardiogenic shock is connected with reduced organ perfusion and elevations in BUN and creatinine. The document further introduces MODS through changes such as decreased respiratory compliance in critically ill mechanically ventilated patients.
The respiratory section covers asthma, respiratory failure, pneumonia, COPD, ARDS and mechanical/noninvasive ventilatory support. A particularly important asthma scenario describes disappearance of inspiratory wheezing in a patient who remains in acute distress, highlighting that a suddenly quiet chest can indicate critically reduced airflow rather than improvement. Hypercapnic respiratory failure is examined through a barbiturate-overdose case involving severe hypoventilation, while secretion management includes augmented or huff coughing for patients with impaired oxygenation and retained pulmonary secretions.
Students also review acute respiratory distress syndrome and oxygenation support. ARDS secondary to sepsis is connected with crystalloid or colloid administration to support cardiac output, while noninvasive positive-pressure ventilation (NIPPV) is considered in selected respiratory-failure scenarios. The guide discusses mini-tracheostomy use for secretion clearance, ineffective airway clearance associated with basilar crackles and respiratory assessment priorities in patients experiencing acute distress.
The final questions emphasize pneumonia, COPD, lung disease and respiratory health promotion. Topics include fever and productive sputum in pneumonia, sputum culture and sensitivity before antimicrobial administration, pneumococcal vaccination, positioning a patient with unilateral malignant lung disease with the “good lung down,” assessment of cor pulmonale and impairment of mucociliary clearance from long-term cigarette smoking. These topics make the resource particularly useful for examination questions that combine respiratory pathophysiology with practical nursing interventions and patient education.
For academic cross-reference, the material aligns closely with standard medical-surgical nursing references such as Harding et al., Lewis's Medical-Surgical Nursing: Assessment and Management of Clinical Problems, particularly its chapters on fluid and electrolyte disorders, acid-base balance, burns, shock, respiratory failure and pulmonary disorders. The transfusion and hematology material can also be cross-referenced with Ignatavicius et al., Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. These established nursing references provide appropriate background for understanding the clinical principles represented in the review questions. Students should nevertheless follow their assigned course text and current institutional protocols for exact laboratory ranges, blood-transfusion procedures, fluid-resuscitation practices and respiratory interventions.
This document is particularly relevant for PNR 408 students, practical nursing students, PN/LPN students, BSN and RN students, medical-surgical nursing students, adult-health nursing students and learners preparing for examinations involving fluids and electrolytes, ABGs, burns, blood administration, shock and respiratory disorders. It is especially useful for students who need scenario-based practice in recognizing priority findings, interpreting laboratory results and selecting safe nursing interventions. The uploaded document does not identify a specific university, so University Not Specified is used rather than attributing it to an unsupported institution.
Keywords: PNR 408 review questions, PNR 408 exam, PNR 408 questions and answers, PNR , nursing review questions, medical surgical nursing exam, fluids and electrolytes nursing, fluid volume deficit, fluid volume excess, dehydration nursing, electrolyte imbalance nursing, hypokalemia nursing, hyperkalemia nursing, peaked T waves hyperkalemia, hyponatremia nursing, SIADH nursing, sodium imbalance, potassium imbalance, ABG interpretation, acid base balance nursing, metabolic alkalosis, respiratory acidosis, COPD ABG interpretation, IV fluid therapy nursing, Parkland formula, burn nursing questions, burn fluid resuscitation, electrical burns nursing, burn nutrition, blood transfusion nursing, packed red blood cells, fresh frozen plasma, blood transfusion safety, anemia nursing, sickle cell anemia, septic shock nursing, hypovolemic shock, cardiogenic shock, multiple organ dysfunction syndrome, MODS nursing, respiratory failure nursing, hypercapnic respiratory failure, asthma nursing, silent chest asthma, ARDS nursing, acute respiratory distress syndrome, NIPPV nursing, pneumonia nursing, COPD nursing, pneumococcal vaccine, ineffective airway clearance, huff coughing, cor pulmonale nursing, lung cancer nursing, mucociliary clearance, respiratory nursing questions, practical nursing exam, PN nursing review
Content preview
PNR 408 Review Questions
2026/2027 Exam All Answers
and Illustrations Given
the nurse who is caring for a client with kidney failure notes that the
client is to dyspneic and crackles are heard when listening to the breath
sounds in the lungs. Which additional signs and symptoms should the
nurse expect to note in this client? - ANSWER ✔✔an increase in
blood pressure
a nurse is reviewing the health records of an assigned client. The nurse
should plan care knowing that which client is a risk for potassium
deficiency? - ANSWER ✔✔the client receiving nasogastric suction
, the nurse reviews a client's electrolyte results and those of potassium
level of 5.5 mEq/L. the nurse understands that potassium values at this
level would be noted with which condition? - ANSWER ✔✔traumatic
burn
the nurse reviews a client's electrolyte results and knows that the
potassium level is 5.4 mEq/L. what should the nurse look for on the
cardiac monitor as a result of this laboratory value? - ANSWER
✔✔narrow, peaked t-waves
the nurse is reading the primary health care providers progress notes in
the clients records and sees that the primary health care provider has
documented insensible fluid loss approximately 800 ml daily. Which
client is at risk for this loss? - ANSWER ✔✔the client with a fast
respiratory rate
the nurse is reviewing the health records of assigned clients. The nurse
should plan care knowing that which client is at risk for fluid volume
deficit? - ANSWER ✔✔the client with an ileostomy
the nurse is caring for a client who has been taking diuretics on a long-
term basis. Which finding should the nurse expect to note as a result of
this long-term use? - ANSWER ✔✔increase Pacific gravity of urine
