,NR 226 Exam 3 Study Guide | Fundamentals – Patient
Care | Chamberlain | Latest 2026/2027 Update (PDF)
1. A nurse is preparing a client for surgery. The client asks who is responsible for explaining the
surgical procedure, including risks and benefits. Which member of the healthcare team should the
nurse identify?
A) The circulating nurse
B) The surgeon
C) The anesthesiologist
D) The scrub nurse
Correct Answer: The surgeon
Rationale: The surgeon is responsible for explaining the procedure, risks, benefits, and alternatives to
obtain informed consent. The circulating nurse, anesthesiologist, and scrub nurse have other roles in
the surgical process but do not obtain informed consent. The nurse's role is to witness the consent
and ensure the client understands.
2. A client with a potassium level of 2.8 mEq/L is being monitored. Which electrocardiogram (ECG)
finding should the nurse expect?
A) Peaked T waves
B) Presence of a U wave
C) Shortened QT interval
D) Widened QRS complex
Correct Answer: Presence of a U wave
Rationale: Hypokalemia (low potassium) is characterized by the presence of U waves, flattened T
waves, and ST-segment depression. Peaked T waves and widened QRS complexes are associated with
hyperkalemia, not hypokalemia.
,3. A nurse is caring for a client who is receiving a blood transfusion. The client becomes anxiously
fidgety, afebrile, and dyspneic. The nurse auscultates crackles in both lung bases and observes jugular
vein distention. Which transfusion complication should the nurse suspect?
A) Fluid volume overload
B) Hemolytic reaction
C) Anaphylactic shock
D) Septicemia
Correct Answer: Fluid volume overload
Rationale: Crackles in the lung bases, jugular vein distention, and dyspnea are classic signs of fluid
volume overload (transfusion-associated circulatory overload). Hemolytic reactions present with
fever, chills, and hypotension. Anaphylactic shock presents with urticaria and bronchospasm.
4. A nurse is preparing to start a blood transfusion. Which type of tubing should the nurse obtain?
A) Two-way valves to allow the patient's blood to mix and warm the blood transfusing
B) An injection port to mix additional electrolytes into the blood
C) A filter to ensure that clots do not enter the patient
D) An air vent to let bubbles into the blood
Correct Answer: A filter to ensure that clots do not enter the patient
Rationale: Blood transfusion tubing must include a filter to prevent clots and debris from entering the
client's bloodstream. Two-way valves, injection ports for electrolytes, and air vents are not standard
for blood administration.
5. A client with a calcium level of 4 mg/dL is being assessed. Which finding should the nurse expect?
A) Weak quadriceps muscles
B) Decreased deep tendon reflexes
C) Light-headedness when standing up
D) Tingling of extremities with possible tetany
, Correct Answer: Tingling of extremities with possible tetany
Rationale: A calcium level of 4 mg/dL indicates severe hypocalcemia. Tingling of the extremities and
tetany are classic signs of hypocalcemia due to increased neuromuscular excitability. Weak muscles,
decreased reflexes, and light-headedness are not characteristic of hypocalcemia.
6. A nurse is evaluating the effectiveness of intravenous fluid therapy in a client with hypernatremia.
Which finding indicates goal achievement?
A) Urine output increases to 150 mL/hr
B) Systolic and diastolic blood pressure decreases
C) Serum sodium concentration returns to normal
D) Large amounts of emesis and diarrhea decrease
Correct Answer: Serum sodium concentration returns to normal
Rationale: The goal of therapy for hypernatremia is to restore serum sodium to normal levels (135-145
mEq/L). Increased urine output, decreased blood pressure, and decreased emesis/diarrhea may be
secondary effects but do not directly indicate correction of the sodium imbalance.
7. A nurse has just received a bag of packed red blood cells for a client. What is the longest time the
nurse can let the blood infuse?
A) 30 minutes
B) 2 hours
C) 4 hours
D) 6 hours
Correct Answer: 4 hours
Rationale: Blood products must be infused within 4 hours of initiation to reduce the risk of bacterial
proliferation and transfusion reactions. Infusing blood over a longer period increases the risk of
contamination.
Care | Chamberlain | Latest 2026/2027 Update (PDF)
1. A nurse is preparing a client for surgery. The client asks who is responsible for explaining the
surgical procedure, including risks and benefits. Which member of the healthcare team should the
nurse identify?
A) The circulating nurse
B) The surgeon
C) The anesthesiologist
D) The scrub nurse
Correct Answer: The surgeon
Rationale: The surgeon is responsible for explaining the procedure, risks, benefits, and alternatives to
obtain informed consent. The circulating nurse, anesthesiologist, and scrub nurse have other roles in
the surgical process but do not obtain informed consent. The nurse's role is to witness the consent
and ensure the client understands.
2. A client with a potassium level of 2.8 mEq/L is being monitored. Which electrocardiogram (ECG)
finding should the nurse expect?
A) Peaked T waves
B) Presence of a U wave
C) Shortened QT interval
D) Widened QRS complex
Correct Answer: Presence of a U wave
Rationale: Hypokalemia (low potassium) is characterized by the presence of U waves, flattened T
waves, and ST-segment depression. Peaked T waves and widened QRS complexes are associated with
hyperkalemia, not hypokalemia.
,3. A nurse is caring for a client who is receiving a blood transfusion. The client becomes anxiously
fidgety, afebrile, and dyspneic. The nurse auscultates crackles in both lung bases and observes jugular
vein distention. Which transfusion complication should the nurse suspect?
A) Fluid volume overload
B) Hemolytic reaction
C) Anaphylactic shock
D) Septicemia
Correct Answer: Fluid volume overload
Rationale: Crackles in the lung bases, jugular vein distention, and dyspnea are classic signs of fluid
volume overload (transfusion-associated circulatory overload). Hemolytic reactions present with
fever, chills, and hypotension. Anaphylactic shock presents with urticaria and bronchospasm.
4. A nurse is preparing to start a blood transfusion. Which type of tubing should the nurse obtain?
A) Two-way valves to allow the patient's blood to mix and warm the blood transfusing
B) An injection port to mix additional electrolytes into the blood
C) A filter to ensure that clots do not enter the patient
D) An air vent to let bubbles into the blood
Correct Answer: A filter to ensure that clots do not enter the patient
Rationale: Blood transfusion tubing must include a filter to prevent clots and debris from entering the
client's bloodstream. Two-way valves, injection ports for electrolytes, and air vents are not standard
for blood administration.
5. A client with a calcium level of 4 mg/dL is being assessed. Which finding should the nurse expect?
A) Weak quadriceps muscles
B) Decreased deep tendon reflexes
C) Light-headedness when standing up
D) Tingling of extremities with possible tetany
, Correct Answer: Tingling of extremities with possible tetany
Rationale: A calcium level of 4 mg/dL indicates severe hypocalcemia. Tingling of the extremities and
tetany are classic signs of hypocalcemia due to increased neuromuscular excitability. Weak muscles,
decreased reflexes, and light-headedness are not characteristic of hypocalcemia.
6. A nurse is evaluating the effectiveness of intravenous fluid therapy in a client with hypernatremia.
Which finding indicates goal achievement?
A) Urine output increases to 150 mL/hr
B) Systolic and diastolic blood pressure decreases
C) Serum sodium concentration returns to normal
D) Large amounts of emesis and diarrhea decrease
Correct Answer: Serum sodium concentration returns to normal
Rationale: The goal of therapy for hypernatremia is to restore serum sodium to normal levels (135-145
mEq/L). Increased urine output, decreased blood pressure, and decreased emesis/diarrhea may be
secondary effects but do not directly indicate correction of the sodium imbalance.
7. A nurse has just received a bag of packed red blood cells for a client. What is the longest time the
nurse can let the blood infuse?
A) 30 minutes
B) 2 hours
C) 4 hours
D) 6 hours
Correct Answer: 4 hours
Rationale: Blood products must be infused within 4 hours of initiation to reduce the risk of bacterial
proliferation and transfusion reactions. Infusing blood over a longer period increases the risk of
contamination.
