1
NUR 176 HONDROS - FINAL EXAM 2026/2027 |
CONCEPTS OF ADULT HEALTH NURSING I | 100
VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
EXAM BLUEPRINT OVERVIEW
Topic Approximate Weight
Fluid & Electrolyte / Acid-Base ~12%
Perioperative & Pain Management ~10%
Infection Control / Immunity ~8%
Cardiovascular Disorders ~15%
Respiratory Disorders ~12%
Endocrine Disorders ~12%
Renal & Urinary Disorders ~10%
Gastrointestinal Disorders ~8%
Neurological Disorders ~8%
Musculoskeletal / Hematologic / Integumentary ~5%
Pharmacology, Prioritization, Clinical Judgment ~10%
SECTION 1: FLUID, ELECTROLYTE & ACID-BASE – Questions 1–12
Q1: Third-Spacing – Clinical Example
A client with severe burns develops generalized edema and decreased urine output despite
,2
adequate IV fluid resuscitation. The nurse recognizes this as:
A. Hypervolemia
B. Third-spacing of fluid
C. Dehydration
D. Renal failure
Correct Answer: B
Rationale: Third-spacing occurs when fluid shifts from the intravascular space into interstitial or
body cavity spaces (e.g., burns, ascites). This leads to relative hypovolemia, edema, and decreased
urine output despite adequate intake. [100% CORRECT]
Q2: Sodium Imbalance – Neurological Priority
A client with a serum sodium of 118 mEq/L is at greatest risk for:
A. Cardiac arrhythmias
B. Seizures and coma
C. Muscle tetany
D. Respiratory alkalosis
Correct Answer: B
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema due to osmotic water shift
into brain cells, leading to confusion, seizures, coma, and even death. This is a neurological
emergency. [100% CORRECT]
Q3: Potassium Imbalance – Cardiac Arrest Risk
A client with a serum potassium of 7.2 mEq/L is at risk for which fatal complication?
A. Ventricular fibrillation
B. Pulmonary embolism
C. Stroke
D. Perforated ulcer
Correct Answer: A
Rationale: Severe hyperkalemia (>6.5 mEq/L) causes peaked T waves, widened QRS, and eventually
ventricular fibrillation or asystole. Immediate treatment with calcium gluconate, insulin/glucose, and
kayexalate is required. [100% CORRECT]
Q4: Calcium Imbalance – Surgical Complication
A client who underwent a thyroidectomy develops numbness and tingling around the mouth. Which
electrolyte imbalance is most likely?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperkalemia
Correct Answer: B
Rationale: Thyroidectomy can damage the parathyroid glands, leading to hypocalcemia. Signs
, 3
include paresthesia (circumoral numbness), positive Chvostek's/Trousseau's signs, and muscle
cramps. [100% CORRECT]
Q5: Magnesium Imbalance – Alcohol Withdrawal
A client with chronic alcoholism is admitted with confusion and tremors. Which electrolyte should
the nurse monitor most closely?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium
Correct Answer: C
Rationale: Chronic alcoholism causes hypomagnesemia due to poor intake and increased renal
excretion. Hypomagnesemia can precipitate tremors, confusion, and cardiac arrhythmias. [100%
CORRECT]
Q6: ABG – Respiratory Acidosis with Renal Compensation
Arterial blood gases: pH 7.34, PaCO₂ 58 mmHg, HCO₃⁻ 34 mEq/L. This is best described as:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C
Rationale: pH is at the low end of normal (7.34), PaCO₂ is elevated (respiratory acidosis), and HCO₃⁻
is elevated (metabolic compensation). Since pH is within normal range, it is fully compensated
respiratory acidosis. [100% CORRECT]
Q7: ABG – Metabolic Alkalosis with Respiratory Compensation
Arterial blood gases: pH 7.48, PaCO₂ 48 mmHg, HCO₃⁻ 32 mEq/L. This is consistent with:
A. Uncompensated metabolic alkalosis
B. Partially compensated metabolic alkalosis
C. Fully compensated metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale: pH is elevated (alkalemia), HCO₃⁻ is elevated (metabolic alkalosis). PaCO₂ is elevated
(>45), indicating hypoventilation as respiratory compensation. Since pH is still abnormal, it is
partially compensated metabolic alkalosis. [100% CORRECT]
Q8: ABG – Uncompensated Metabolic Acidosis
A client with severe diarrhea has ABGs: pH 7.25, PaCO₂ 38 mmHg, HCO₃⁻ 16 mEq/L. This is:
A. Uncompensated metabolic acidosis
B. Partially compensated metabolic acidosis
NUR 176 HONDROS - FINAL EXAM 2026/2027 |
CONCEPTS OF ADULT HEALTH NURSING I | 100
VERIFIED Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
EXAM BLUEPRINT OVERVIEW
Topic Approximate Weight
Fluid & Electrolyte / Acid-Base ~12%
Perioperative & Pain Management ~10%
Infection Control / Immunity ~8%
Cardiovascular Disorders ~15%
Respiratory Disorders ~12%
Endocrine Disorders ~12%
Renal & Urinary Disorders ~10%
Gastrointestinal Disorders ~8%
Neurological Disorders ~8%
Musculoskeletal / Hematologic / Integumentary ~5%
Pharmacology, Prioritization, Clinical Judgment ~10%
SECTION 1: FLUID, ELECTROLYTE & ACID-BASE – Questions 1–12
Q1: Third-Spacing – Clinical Example
A client with severe burns develops generalized edema and decreased urine output despite
,2
adequate IV fluid resuscitation. The nurse recognizes this as:
A. Hypervolemia
B. Third-spacing of fluid
C. Dehydration
D. Renal failure
Correct Answer: B
Rationale: Third-spacing occurs when fluid shifts from the intravascular space into interstitial or
body cavity spaces (e.g., burns, ascites). This leads to relative hypovolemia, edema, and decreased
urine output despite adequate intake. [100% CORRECT]
Q2: Sodium Imbalance – Neurological Priority
A client with a serum sodium of 118 mEq/L is at greatest risk for:
A. Cardiac arrhythmias
B. Seizures and coma
C. Muscle tetany
D. Respiratory alkalosis
Correct Answer: B
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema due to osmotic water shift
into brain cells, leading to confusion, seizures, coma, and even death. This is a neurological
emergency. [100% CORRECT]
Q3: Potassium Imbalance – Cardiac Arrest Risk
A client with a serum potassium of 7.2 mEq/L is at risk for which fatal complication?
A. Ventricular fibrillation
B. Pulmonary embolism
C. Stroke
D. Perforated ulcer
Correct Answer: A
Rationale: Severe hyperkalemia (>6.5 mEq/L) causes peaked T waves, widened QRS, and eventually
ventricular fibrillation or asystole. Immediate treatment with calcium gluconate, insulin/glucose, and
kayexalate is required. [100% CORRECT]
Q4: Calcium Imbalance – Surgical Complication
A client who underwent a thyroidectomy develops numbness and tingling around the mouth. Which
electrolyte imbalance is most likely?
A. Hypercalcemia
B. Hypocalcemia
C. Hypermagnesemia
D. Hyperkalemia
Correct Answer: B
Rationale: Thyroidectomy can damage the parathyroid glands, leading to hypocalcemia. Signs
, 3
include paresthesia (circumoral numbness), positive Chvostek's/Trousseau's signs, and muscle
cramps. [100% CORRECT]
Q5: Magnesium Imbalance – Alcohol Withdrawal
A client with chronic alcoholism is admitted with confusion and tremors. Which electrolyte should
the nurse monitor most closely?
A. Sodium
B. Potassium
C. Magnesium
D. Calcium
Correct Answer: C
Rationale: Chronic alcoholism causes hypomagnesemia due to poor intake and increased renal
excretion. Hypomagnesemia can precipitate tremors, confusion, and cardiac arrhythmias. [100%
CORRECT]
Q6: ABG – Respiratory Acidosis with Renal Compensation
Arterial blood gases: pH 7.34, PaCO₂ 58 mmHg, HCO₃⁻ 34 mEq/L. This is best described as:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Fully compensated respiratory acidosis
D. Metabolic alkalosis
Correct Answer: C
Rationale: pH is at the low end of normal (7.34), PaCO₂ is elevated (respiratory acidosis), and HCO₃⁻
is elevated (metabolic compensation). Since pH is within normal range, it is fully compensated
respiratory acidosis. [100% CORRECT]
Q7: ABG – Metabolic Alkalosis with Respiratory Compensation
Arterial blood gases: pH 7.48, PaCO₂ 48 mmHg, HCO₃⁻ 32 mEq/L. This is consistent with:
A. Uncompensated metabolic alkalosis
B. Partially compensated metabolic alkalosis
C. Fully compensated metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale: pH is elevated (alkalemia), HCO₃⁻ is elevated (metabolic alkalosis). PaCO₂ is elevated
(>45), indicating hypoventilation as respiratory compensation. Since pH is still abnormal, it is
partially compensated metabolic alkalosis. [100% CORRECT]
Q8: ABG – Uncompensated Metabolic Acidosis
A client with severe diarrhea has ABGs: pH 7.25, PaCO₂ 38 mmHg, HCO₃⁻ 16 mEq/L. This is:
A. Uncompensated metabolic acidosis
B. Partially compensated metabolic acidosis
