NSG 3100
Exam 4 | Galen College of Nursing | 2026 Practice
Questions, Answers & Detailed Rationales
Resource Features
➢ NSG 3100 Exam 4 practice questions
➢ 2026-focused review
➢ Detailed answers
➢ Comprehensive rationales
➢ Nursing clinical scenarios
➢ Prioritization questions
, NSG 3100 Exam 4 | Galen College of Nursing |
2026 Practice Questions, Answers & Detailed
Rationales
1. Which client is at greatest risk for dehydration?
A. The younger adult client with immobility
B. The older adult client receiving hypotonic IV fluid
C. The younger adult client receiving hypertonic IV fluid
D. The older adult client with cognitive impairment
Answer: D
Rationale: Older adults with cognitive impairment are at greatest risk for
dehydration because they may forget to drink, be unable to communicate
thirst, or refuse fluids. Age-related changes include decreased thirst
sensation and reduced total body water. Younger adults generally have
better physiological reserves and compensatory mechanisms. Hypotonic IV
fluids would treat dehydration rather than cause it, and hypertonic IV fluids
could lead to hypertonic dehydration but are administered in controlled
settings.
2. What are the fluid compartment consequences of isotonic
dehydration?
A. ECF compartment volume contracts, ICF volume contracts
B. ECF compartment volume contracts, ICF volume remains the same
,C. ECF compartment volume expands, ICF volume contracts
D. ECF compartment volume expands, ICF volume remains the same
Answer: B
Rationale: In isotonic dehydration, there is an equal loss of water and
sodium from the extracellular fluid (ECF) compartment. Because osmolarity
remains normal, there is no osmotic gradient to cause fluid shifts between
ECF and intracellular fluid (ICF) compartments. Therefore, the ECF volume
contracts while the ICF volume remains unchanged. This is the most
common type of dehydration and typically results from fluid losses such as
vomiting, diarrhea, or hemorrhage.
3. What are the fluid compartment consequences of hypertonic
dehydration?
A. ECF compartment volume contracts, ICF volume contracts
B. ECF compartment volume contracts, ICF volume remains the same
C. ECF compartment volume expands, ICF volume contracts
D. ECF compartment volume expands, ICF volume remains the same
Answer: C
Rationale: In hypertonic dehydration, water loss exceeds sodium loss,
resulting in increased ECF osmolarity. The hyperosmolar ECF draws water
out of the ICF compartment into the ECF compartment. This causes the ECF
volume to initially expand (from the fluid shift) while the ICF volume
contracts. This condition is often seen in clients with diabetes insipidus,
excessive sweating, or inadequate water intake.
, 4. The client has been diagnosed with hypotonic dehydration. Which
assessment finding should the nurse expect?
A. Flattened hand veins when the hand is positioned above the heart
B. Increased urine output, decreased urine specific gravity
C. Nonpitting dependent edema
D. Poor handgrip strength
Answer: D
Rationale: Hypotonic dehydration (also called hyponatremic dehydration)
involves greater sodium loss than water loss, leading to decreased ECF
osmolarity. Water moves into cells, causing cellular swelling, which can
impair muscle function including handgrip strength. Flattened hand veins
may occur in any type of dehydration but are not specific to hypotonic
dehydration. Increased urine output with decreased specific gravity is not
typical of dehydration. Nonpitting edema is associated with conditions like
lymphedema or myxedema, not dehydration.
5. Which is the most important question the nurse should ask the
client who has been diagnosed with isotonic dehydration to identify a
possible cause of the fluid imbalance?
A. "Do you take diuretics or 'water pills'?"
B. "What and how much do you normally eat over a day's time?"
C. "How many bowel movements do you usually have each day?"
D. "Have you or any member of your family been diagnosed with diabetes
mellitus?"
Exam 4 | Galen College of Nursing | 2026 Practice
Questions, Answers & Detailed Rationales
Resource Features
➢ NSG 3100 Exam 4 practice questions
➢ 2026-focused review
➢ Detailed answers
➢ Comprehensive rationales
➢ Nursing clinical scenarios
➢ Prioritization questions
, NSG 3100 Exam 4 | Galen College of Nursing |
2026 Practice Questions, Answers & Detailed
Rationales
1. Which client is at greatest risk for dehydration?
A. The younger adult client with immobility
B. The older adult client receiving hypotonic IV fluid
C. The younger adult client receiving hypertonic IV fluid
D. The older adult client with cognitive impairment
Answer: D
Rationale: Older adults with cognitive impairment are at greatest risk for
dehydration because they may forget to drink, be unable to communicate
thirst, or refuse fluids. Age-related changes include decreased thirst
sensation and reduced total body water. Younger adults generally have
better physiological reserves and compensatory mechanisms. Hypotonic IV
fluids would treat dehydration rather than cause it, and hypertonic IV fluids
could lead to hypertonic dehydration but are administered in controlled
settings.
2. What are the fluid compartment consequences of isotonic
dehydration?
A. ECF compartment volume contracts, ICF volume contracts
B. ECF compartment volume contracts, ICF volume remains the same
,C. ECF compartment volume expands, ICF volume contracts
D. ECF compartment volume expands, ICF volume remains the same
Answer: B
Rationale: In isotonic dehydration, there is an equal loss of water and
sodium from the extracellular fluid (ECF) compartment. Because osmolarity
remains normal, there is no osmotic gradient to cause fluid shifts between
ECF and intracellular fluid (ICF) compartments. Therefore, the ECF volume
contracts while the ICF volume remains unchanged. This is the most
common type of dehydration and typically results from fluid losses such as
vomiting, diarrhea, or hemorrhage.
3. What are the fluid compartment consequences of hypertonic
dehydration?
A. ECF compartment volume contracts, ICF volume contracts
B. ECF compartment volume contracts, ICF volume remains the same
C. ECF compartment volume expands, ICF volume contracts
D. ECF compartment volume expands, ICF volume remains the same
Answer: C
Rationale: In hypertonic dehydration, water loss exceeds sodium loss,
resulting in increased ECF osmolarity. The hyperosmolar ECF draws water
out of the ICF compartment into the ECF compartment. This causes the ECF
volume to initially expand (from the fluid shift) while the ICF volume
contracts. This condition is often seen in clients with diabetes insipidus,
excessive sweating, or inadequate water intake.
, 4. The client has been diagnosed with hypotonic dehydration. Which
assessment finding should the nurse expect?
A. Flattened hand veins when the hand is positioned above the heart
B. Increased urine output, decreased urine specific gravity
C. Nonpitting dependent edema
D. Poor handgrip strength
Answer: D
Rationale: Hypotonic dehydration (also called hyponatremic dehydration)
involves greater sodium loss than water loss, leading to decreased ECF
osmolarity. Water moves into cells, causing cellular swelling, which can
impair muscle function including handgrip strength. Flattened hand veins
may occur in any type of dehydration but are not specific to hypotonic
dehydration. Increased urine output with decreased specific gravity is not
typical of dehydration. Nonpitting edema is associated with conditions like
lymphedema or myxedema, not dehydration.
5. Which is the most important question the nurse should ask the
client who has been diagnosed with isotonic dehydration to identify a
possible cause of the fluid imbalance?
A. "Do you take diuretics or 'water pills'?"
B. "What and how much do you normally eat over a day's time?"
C. "How many bowel movements do you usually have each day?"
D. "Have you or any member of your family been diagnosed with diabetes
mellitus?"
