Nursing 2520 Test 2 Questions With
Complete Solutions
NURSING 2520 — TEST 2
Comprehensive NCLEX-Style Practice Examination
200 Questions With Complete Solutions
SECTION I — FLUIDS, ELECTROLYTES & ACID–BASE
BALANCE
Questions 1–25
1. A client with prolonged vomiting is at greatest risk for which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyperphosphatemia
Answer: B. Hypokalemia
Rationale: Prolonged vomiting causes loss of gastric fluid and potassium, increasing the risk for
hypokalemia. Severe hypokalemia can produce muscle weakness and dysrhythmias.
2. Which assessment finding is most concerning in a client with severe hypokalemia?
A. Increased bowel sounds
B. Muscle weakness
C. Bounding pulses
D. Facial flushing
Answer: B. Muscle weakness
Rationale: Potassium is essential for neuromuscular function. Significant potassium depletion
can cause weakness, paralysis, and potentially life-threatening cardiac dysrhythmias.
,3. A client has a serum sodium of 124 mEq/L. Which assessment is the priority?
A. Bowel sounds
B. Neurological status
C. Skin turgor
D. Peripheral pulses
Answer: B. Neurological status
Rationale: Significant hyponatremia can cause cerebral edema, confusion, seizures, and
decreased level of consciousness. Neurological assessment is therefore the priority.
4. Which finding is most consistent with hypernatremia?
A. Confusion and intense thirst
B. Hyporeflexia and diarrhea
C. Tetany and positive Chvostek sign
D. Bradycardia and hypothermia
Answer: A. Confusion and intense thirst
Rationale: Hypernatremia causes cellular dehydration, particularly affecting the brain. Thirst,
restlessness, confusion, and neurological changes may occur.
5. The nurse is caring for a client receiving IV potassium chloride. Which action is appropriate?
A. Administer it IV push if potassium is very low
B. Infuse it using an electronic pump
C. Mix it with blood products
D. Administer it undiluted
Answer: B. Infuse it using an electronic pump
Rationale: IV potassium must be diluted and administered carefully using a controlled infusion
device. IV potassium should never be administered by IV push.
6. Which finding suggests fluid volume overload?
,A. Flat neck veins
B. Orthostatic hypotension
C. Crackles in the lungs
D. Poor skin turgor
Answer: C. Crackles in the lungs
Rationale: Excess intravascular fluid can cause pulmonary congestion, producing crackles,
dyspnea, edema, and weight gain.
7. Which assessment finding is most consistent with fluid volume deficit?
A. Peripheral edema
B. Jugular venous distention
C. Tachycardia and hypotension
D. Bounding pulse
Answer: C. Tachycardia and hypotension
Rationale: Reduced circulating volume causes compensatory tachycardia and can result in
hypotension.
8. Which client is at greatest risk for fluid volume deficit?
A. Client with heart failure
B. Client with severe diarrhea
C. Client receiving corticosteroids
D. Client with chronic hypertension
Answer: B. Client with severe diarrhea
Rationale: Significant gastrointestinal losses can rapidly cause dehydration and electrolyte
abnormalities.
9. Which laboratory value should the nurse report immediately?
A. Sodium 139 mEq/L
B. Potassium 6.4 mEq/L
C. Calcium 9.3 mg/dL
D. Chloride 101 mEq/L
, Answer: B. Potassium 6.4 mEq/L
Rationale: Severe hyperkalemia can cause fatal cardiac dysrhythmias and requires prompt
intervention.
10. A client with hyperkalemia is placed on a cardiac monitor. What is the primary reason?
A. Hyperkalemia causes hypertension
B. Potassium abnormalities affect cardiac conduction
C. Monitoring prevents fluid overload
D. Potassium causes respiratory depression
Answer: B. Potassium abnormalities affect cardiac conduction
Rationale: Both severe hyperkalemia and hypokalemia can produce dangerous cardiac
conduction abnormalities.
11. Which foods should the nurse recommend limiting for a client with hyperkalemia? Select all
that apply.
A. Bananas
B. Oranges
C. White rice
D. Potatoes
E. Avocados
Answers: A, B, D, E
Rationale: Bananas, oranges, potatoes, and avocados contain substantial potassium. White rice
is comparatively low in potassium.
12. A client has a calcium level of 7.0 mg/dL. Which finding should the nurse anticipate?
A. Muscle twitching
B. Decreased deep tendon reflexes
C. Constipation
D. Bradycardia
Answer: A. Muscle twitching
Complete Solutions
NURSING 2520 — TEST 2
Comprehensive NCLEX-Style Practice Examination
200 Questions With Complete Solutions
SECTION I — FLUIDS, ELECTROLYTES & ACID–BASE
BALANCE
Questions 1–25
1. A client with prolonged vomiting is at greatest risk for which electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hyperphosphatemia
Answer: B. Hypokalemia
Rationale: Prolonged vomiting causes loss of gastric fluid and potassium, increasing the risk for
hypokalemia. Severe hypokalemia can produce muscle weakness and dysrhythmias.
2. Which assessment finding is most concerning in a client with severe hypokalemia?
A. Increased bowel sounds
B. Muscle weakness
C. Bounding pulses
D. Facial flushing
Answer: B. Muscle weakness
Rationale: Potassium is essential for neuromuscular function. Significant potassium depletion
can cause weakness, paralysis, and potentially life-threatening cardiac dysrhythmias.
,3. A client has a serum sodium of 124 mEq/L. Which assessment is the priority?
A. Bowel sounds
B. Neurological status
C. Skin turgor
D. Peripheral pulses
Answer: B. Neurological status
Rationale: Significant hyponatremia can cause cerebral edema, confusion, seizures, and
decreased level of consciousness. Neurological assessment is therefore the priority.
4. Which finding is most consistent with hypernatremia?
A. Confusion and intense thirst
B. Hyporeflexia and diarrhea
C. Tetany and positive Chvostek sign
D. Bradycardia and hypothermia
Answer: A. Confusion and intense thirst
Rationale: Hypernatremia causes cellular dehydration, particularly affecting the brain. Thirst,
restlessness, confusion, and neurological changes may occur.
5. The nurse is caring for a client receiving IV potassium chloride. Which action is appropriate?
A. Administer it IV push if potassium is very low
B. Infuse it using an electronic pump
C. Mix it with blood products
D. Administer it undiluted
Answer: B. Infuse it using an electronic pump
Rationale: IV potassium must be diluted and administered carefully using a controlled infusion
device. IV potassium should never be administered by IV push.
6. Which finding suggests fluid volume overload?
,A. Flat neck veins
B. Orthostatic hypotension
C. Crackles in the lungs
D. Poor skin turgor
Answer: C. Crackles in the lungs
Rationale: Excess intravascular fluid can cause pulmonary congestion, producing crackles,
dyspnea, edema, and weight gain.
7. Which assessment finding is most consistent with fluid volume deficit?
A. Peripheral edema
B. Jugular venous distention
C. Tachycardia and hypotension
D. Bounding pulse
Answer: C. Tachycardia and hypotension
Rationale: Reduced circulating volume causes compensatory tachycardia and can result in
hypotension.
8. Which client is at greatest risk for fluid volume deficit?
A. Client with heart failure
B. Client with severe diarrhea
C. Client receiving corticosteroids
D. Client with chronic hypertension
Answer: B. Client with severe diarrhea
Rationale: Significant gastrointestinal losses can rapidly cause dehydration and electrolyte
abnormalities.
9. Which laboratory value should the nurse report immediately?
A. Sodium 139 mEq/L
B. Potassium 6.4 mEq/L
C. Calcium 9.3 mg/dL
D. Chloride 101 mEq/L
, Answer: B. Potassium 6.4 mEq/L
Rationale: Severe hyperkalemia can cause fatal cardiac dysrhythmias and requires prompt
intervention.
10. A client with hyperkalemia is placed on a cardiac monitor. What is the primary reason?
A. Hyperkalemia causes hypertension
B. Potassium abnormalities affect cardiac conduction
C. Monitoring prevents fluid overload
D. Potassium causes respiratory depression
Answer: B. Potassium abnormalities affect cardiac conduction
Rationale: Both severe hyperkalemia and hypokalemia can produce dangerous cardiac
conduction abnormalities.
11. Which foods should the nurse recommend limiting for a client with hyperkalemia? Select all
that apply.
A. Bananas
B. Oranges
C. White rice
D. Potatoes
E. Avocados
Answers: A, B, D, E
Rationale: Bananas, oranges, potatoes, and avocados contain substantial potassium. White rice
is comparatively low in potassium.
12. A client has a calcium level of 7.0 mg/dL. Which finding should the nurse anticipate?
A. Muscle twitching
B. Decreased deep tendon reflexes
C. Constipation
D. Bradycardia
Answer: A. Muscle twitching
