,NR 324 Adult Health I Exam 1 | Chamberlain
College of Nursing | Latest 2026/2027 Update
(PDF)
1. A nurse is assessing a client with fluid volume deficit. Which cardiovascular manifestation should
the nurse expect to find?
A) Bounding pulse and hypertension
B) Tachycardia and weak, thready pulse
C) Bradycardia and hypotension
D) Distended neck veins and crackles
Correct Answer: Tachycardia and weak, thready pulse
Rationale: In fluid volume deficit, the body compensates for decreased circulating volume by
increasing heart rate (tachycardia) to maintain cardiac output. The pulse becomes weak and thready
due to decreased stroke volume. Bounding pulse, hypertension, distended neck veins, and crackles
are manifestations of fluid volume excess, not deficit.
2. A nurse is reviewing the laboratory results of a client with hyperkalemia. Which electrocardiogram
(ECG) change should the nurse expect to observe?
A) Flattened T-waves
B) Tall, peaked T-waves
C) Prolonged QT interval
D) ST-segment depression
Correct Answer: Tall, peaked T-waves
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by tall, peaked T-waves on
the ECG. Flattened T-waves, prolonged QT interval, and ST-segment depression are associated with
hypokalemia. Hyperkalemia can progress to widened QRS complexes and ventricular fibrillation if left
untreated.
,3. A nurse is caring for a client with a nasogastric tube attached to low intermittent suction. The nurse
should monitor the client for which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the stomach, leading to a loss of
hydrogen ions. This results in an increase in serum bicarbonate (HCO3⁻) and a subsequent metabolic
alkalosis. The loss of gastric acid causes an excess of base, not acidosis.
4. A nurse is assessing a client with a sodium level of 128 mEq/L. Which manifestation should the
nurse expect?
A) Thirst and dry mucous membranes
B) Muscle cramps and hyperreflexia
C) Confusion and headache
D) Tachycardia and hypotension
Correct Answer: Confusion and headache
Rationale: Hyponatremia (serum sodium < 135 mEq/L) causes cerebral edema, leading to confusion,
headache, nausea, and seizures. Thirst and dry mucous membranes are signs of hypernatremia
(dehydration). Muscle cramps and hyperreflexia are associated with hypocalcemia. Tachycardia and
hypotension are signs of hypovolemia, not specifically hyponatremia.
5. A client is receiving intravenous fluids of 0.9% Normal Saline at 125 mL/hr. The client's serum
sodium is 148 mEq/L. Which action should the nurse take?
A) Decrease the IV fluid rate
B) Switch the IV fluid to 0.45% Normal Saline
C) Continue the IV fluid as prescribed
, D) Add potassium chloride to the IV fluids
Correct Answer: Switch the IV fluid to 0.45% Normal Saline
Rationale: The client is hypernatremic (serum sodium > 145 mEq/L). 0.9% Normal Saline is an isotonic
fluid that will not correct hypernatremia. The nurse should anticipate a prescription to switch to a
hypotonic solution such as 0.45% Normal Saline, which will help dilute serum sodium. Decreasing the
rate or continuing the current fluid would not address the imbalance.
6. A nurse is caring for a client with a serum potassium level of 6.8 mEq/L. Which action should the
nurse take first?
A) Administer sodium polystyrene sulfonate as prescribed
B) Prepare for emergency dialysis
C) Obtain a 12-lead ECG
D) Administer IV calcium gluconate as prescribed
Correct Answer: Obtain a 12-lead ECG
Rationale: A serum potassium of 6.8 mEq/L is significantly elevated and can cause life-threatening
cardiac dysrhythmias. The nurse should first obtain a 12-lead ECG to assess for cardiac changes such as
tall peaked T-waves, widened QRS, or ventricular arrhythmias. This assessment guides immediate
intervention. Administering medications may be appropriate but assessment comes first.
7. A nurse is assessing a client with fluid volume excess. Which finding should the nurse expect?
A) Decreased central venous pressure
B) Flat neck veins
C) Crackles in the lungs
D) Decreased urine output
Correct Answer: Crackles in the lungs
College of Nursing | Latest 2026/2027 Update
(PDF)
1. A nurse is assessing a client with fluid volume deficit. Which cardiovascular manifestation should
the nurse expect to find?
A) Bounding pulse and hypertension
B) Tachycardia and weak, thready pulse
C) Bradycardia and hypotension
D) Distended neck veins and crackles
Correct Answer: Tachycardia and weak, thready pulse
Rationale: In fluid volume deficit, the body compensates for decreased circulating volume by
increasing heart rate (tachycardia) to maintain cardiac output. The pulse becomes weak and thready
due to decreased stroke volume. Bounding pulse, hypertension, distended neck veins, and crackles
are manifestations of fluid volume excess, not deficit.
2. A nurse is reviewing the laboratory results of a client with hyperkalemia. Which electrocardiogram
(ECG) change should the nurse expect to observe?
A) Flattened T-waves
B) Tall, peaked T-waves
C) Prolonged QT interval
D) ST-segment depression
Correct Answer: Tall, peaked T-waves
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by tall, peaked T-waves on
the ECG. Flattened T-waves, prolonged QT interval, and ST-segment depression are associated with
hypokalemia. Hyperkalemia can progress to widened QRS complexes and ventricular fibrillation if left
untreated.
,3. A nurse is caring for a client with a nasogastric tube attached to low intermittent suction. The nurse
should monitor the client for which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the stomach, leading to a loss of
hydrogen ions. This results in an increase in serum bicarbonate (HCO3⁻) and a subsequent metabolic
alkalosis. The loss of gastric acid causes an excess of base, not acidosis.
4. A nurse is assessing a client with a sodium level of 128 mEq/L. Which manifestation should the
nurse expect?
A) Thirst and dry mucous membranes
B) Muscle cramps and hyperreflexia
C) Confusion and headache
D) Tachycardia and hypotension
Correct Answer: Confusion and headache
Rationale: Hyponatremia (serum sodium < 135 mEq/L) causes cerebral edema, leading to confusion,
headache, nausea, and seizures. Thirst and dry mucous membranes are signs of hypernatremia
(dehydration). Muscle cramps and hyperreflexia are associated with hypocalcemia. Tachycardia and
hypotension are signs of hypovolemia, not specifically hyponatremia.
5. A client is receiving intravenous fluids of 0.9% Normal Saline at 125 mL/hr. The client's serum
sodium is 148 mEq/L. Which action should the nurse take?
A) Decrease the IV fluid rate
B) Switch the IV fluid to 0.45% Normal Saline
C) Continue the IV fluid as prescribed
, D) Add potassium chloride to the IV fluids
Correct Answer: Switch the IV fluid to 0.45% Normal Saline
Rationale: The client is hypernatremic (serum sodium > 145 mEq/L). 0.9% Normal Saline is an isotonic
fluid that will not correct hypernatremia. The nurse should anticipate a prescription to switch to a
hypotonic solution such as 0.45% Normal Saline, which will help dilute serum sodium. Decreasing the
rate or continuing the current fluid would not address the imbalance.
6. A nurse is caring for a client with a serum potassium level of 6.8 mEq/L. Which action should the
nurse take first?
A) Administer sodium polystyrene sulfonate as prescribed
B) Prepare for emergency dialysis
C) Obtain a 12-lead ECG
D) Administer IV calcium gluconate as prescribed
Correct Answer: Obtain a 12-lead ECG
Rationale: A serum potassium of 6.8 mEq/L is significantly elevated and can cause life-threatening
cardiac dysrhythmias. The nurse should first obtain a 12-lead ECG to assess for cardiac changes such as
tall peaked T-waves, widened QRS, or ventricular arrhythmias. This assessment guides immediate
intervention. Administering medications may be appropriate but assessment comes first.
7. A nurse is assessing a client with fluid volume excess. Which finding should the nurse expect?
A) Decreased central venous pressure
B) Flat neck veins
C) Crackles in the lungs
D) Decreased urine output
Correct Answer: Crackles in the lungs
