BSN 246 Exam 3 — Exam Questions with
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
Question 1
A client has a serum potassium level of 6.2 mEq/L. Which
assessment finding requires the nurse's priority attention?
A. Hyperactive bowel sounds
B. Muscle weakness
C. Increased thirst
D. Cardiac dysrhythmia on the ECG
Correct answer: D. Cardiac dysrhythmia on the ECG
Rationale: Hyperkalemia can significantly alter cardiac
conduction and may produce life-threatening dysrhythmias,
ventricular fibrillation, or cardiac arrest. Although muscle
weakness and gastrointestinal manifestations can occur with
elevated potassium, cardiac monitoring takes priority because
dysrhythmias can deteriorate rapidly. A potassium level of 6.2
mEq/L is sufficiently elevated to warrant prompt assessment
and intervention.
,Question 2
Which clinical manifestation is most characteristic of
hypocalcemia?
A. Decreased neuromuscular excitability
B. Flaccid muscles
C. Positive Trousseau's sign
D. Bradycardia
Correct answer: C. Positive Trousseau's sign
Rationale: Hypocalcemia increases neuromuscular excitability
and can cause paresthesias, muscle cramps, tetany, and positive
Chvostek's or Trousseau's signs. Trousseau's sign is elicited when
carpal spasm occurs after inflation of a blood-pressure cuff.
These findings are important because severe hypocalcemia can
progress to seizures, laryngospasm, or cardiac abnormalities.
Question 3
Which assessment finding is most consistent with fluid volume
deficit?
A. Bounding peripheral pulses
B. Distended neck veins
C. Crackles in the lungs
D. Decreased urine output
,Correct answer: D. Decreased urine output
Rationale: Fluid volume deficit reduces circulating blood volume
and renal perfusion. The kidneys respond by conserving water,
resulting in decreased urine output and concentrated urine.
Other expected findings include hypotension, tachycardia, dry
mucous membranes, poor skin turgor, and weight loss.
Distended neck veins and pulmonary crackles are more
consistent with fluid volume excess.
Question 4
A client's arterial blood gas results are pH 7.30, PaCO₂ 50
mmHg, and HCO₃⁻ 24 mEq/L. How should the nurse interpret
these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Correct answer: D. Respiratory acidosis
Rationale: The pH of 7.30 indicates acidemia. The PaCO₂ is
elevated above the expected range, while the bicarbonate level
remains within the normal range. This pattern indicates that the
primary disturbance is respiratory acidosis. Hypoventilation,
, airway obstruction, respiratory depression, and impaired gas
exchange are common causes.
Question 5
Which intravenous solution is isotonic and commonly used for
extracellular fluid volume replacement?
A. 0.45% sodium chloride
B. 3% sodium chloride
C. 0.9% sodium chloride
D. 0.225% sodium chloride
Correct answer: C. 0.9% sodium chloride
Rationale: Normal saline, or 0.9% sodium chloride, is an isotonic
crystalloid that expands the extracellular fluid compartment and
is commonly used for fluid resuscitation and volume
replacement. Hypotonic solutions such as 0.45% sodium
chloride move water into cells, whereas hypertonic solutions
such as 3% sodium chloride pull water into the intravascular
space and require careful monitoring.
Question 6
A client is hyperventilating because of severe anxiety. Which
acid–base imbalance is the client most likely to develop?
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
Question 1
A client has a serum potassium level of 6.2 mEq/L. Which
assessment finding requires the nurse's priority attention?
A. Hyperactive bowel sounds
B. Muscle weakness
C. Increased thirst
D. Cardiac dysrhythmia on the ECG
Correct answer: D. Cardiac dysrhythmia on the ECG
Rationale: Hyperkalemia can significantly alter cardiac
conduction and may produce life-threatening dysrhythmias,
ventricular fibrillation, or cardiac arrest. Although muscle
weakness and gastrointestinal manifestations can occur with
elevated potassium, cardiac monitoring takes priority because
dysrhythmias can deteriorate rapidly. A potassium level of 6.2
mEq/L is sufficiently elevated to warrant prompt assessment
and intervention.
,Question 2
Which clinical manifestation is most characteristic of
hypocalcemia?
A. Decreased neuromuscular excitability
B. Flaccid muscles
C. Positive Trousseau's sign
D. Bradycardia
Correct answer: C. Positive Trousseau's sign
Rationale: Hypocalcemia increases neuromuscular excitability
and can cause paresthesias, muscle cramps, tetany, and positive
Chvostek's or Trousseau's signs. Trousseau's sign is elicited when
carpal spasm occurs after inflation of a blood-pressure cuff.
These findings are important because severe hypocalcemia can
progress to seizures, laryngospasm, or cardiac abnormalities.
Question 3
Which assessment finding is most consistent with fluid volume
deficit?
A. Bounding peripheral pulses
B. Distended neck veins
C. Crackles in the lungs
D. Decreased urine output
,Correct answer: D. Decreased urine output
Rationale: Fluid volume deficit reduces circulating blood volume
and renal perfusion. The kidneys respond by conserving water,
resulting in decreased urine output and concentrated urine.
Other expected findings include hypotension, tachycardia, dry
mucous membranes, poor skin turgor, and weight loss.
Distended neck veins and pulmonary crackles are more
consistent with fluid volume excess.
Question 4
A client's arterial blood gas results are pH 7.30, PaCO₂ 50
mmHg, and HCO₃⁻ 24 mEq/L. How should the nurse interpret
these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Correct answer: D. Respiratory acidosis
Rationale: The pH of 7.30 indicates acidemia. The PaCO₂ is
elevated above the expected range, while the bicarbonate level
remains within the normal range. This pattern indicates that the
primary disturbance is respiratory acidosis. Hypoventilation,
, airway obstruction, respiratory depression, and impaired gas
exchange are common causes.
Question 5
Which intravenous solution is isotonic and commonly used for
extracellular fluid volume replacement?
A. 0.45% sodium chloride
B. 3% sodium chloride
C. 0.9% sodium chloride
D. 0.225% sodium chloride
Correct answer: C. 0.9% sodium chloride
Rationale: Normal saline, or 0.9% sodium chloride, is an isotonic
crystalloid that expands the extracellular fluid compartment and
is commonly used for fluid resuscitation and volume
replacement. Hypotonic solutions such as 0.45% sodium
chloride move water into cells, whereas hypertonic solutions
such as 3% sodium chloride pull water into the intravascular
space and require careful monitoring.
Question 6
A client is hyperventilating because of severe anxiety. Which
acid–base imbalance is the client most likely to develop?
