, NUR 155 Foundations of Nursing | Galen College of Nursing |
Academic Year 2026/2027 | Examination 3 Comprehensive
Examination | 75 Verified Questions and Correct Answer
Rationales | | JUST RELEASED .
Section 1: Fluid, Electrolyte & Acid-Base Balance (Questions 1–15)
Question 1: A nurse is caring for a patient who is receiving 0.9% sodium chloride IV. The nurse
understands that this is which type of IV solution?
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Colloid
CorreCt Answer: B. Isotonic
rAtionAle: 0.9% sodium chloride (normal saline) is an isotonic solution, meaning it has the
same osmolality as body fluids. It expands the extracellular fluid volume without causing fluid
shifts into or out of cells.
Question 2: A patient has a potassium level of 3.1 mEq/L. Which assessment finding should
the nurse expect?
A. Tall, peaked T waves on ECG
B. Muscle weakness and leg cramps
C. Hypertension and bradycardia
D. Increased deep tendon reflexes
CorreCt Answer: B. Muscle weakness and leg cramps
rAtionAle: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness, leg cramps,
fatigue, and dysrhythmias. Tall, peaked T waves are seen in hyperkalemia.
Question 3: A nurse is administering IV potassium to a patient with hypokalemia. Which action
is correct?
A. Administer as a rapid IV push
B. Administer via IV pump at a rate not exceeding 10-20 mEq/hour
C. Administer undiluted through a peripheral IV
D. Administer IM instead of IV
, CorreCt Answer: B. Administer via IV pump at a rate not exceeding 10-20 mEq/hour
rAtionAle: IV potassium must always be diluted and administered via an infusion pump at a
rate not exceeding 10-20 mEq/hour to prevent cardiac arrest. It is never given IV push.
Question 4: A patient presents with dry mucous membranes, poor skin turgor, and a heart rate
of 118 bpm. Which condition should the nurse suspect?
A. Fluid volume excess
B. Fluid volume deficit
C. Hyperkalemia
D. Metabolic alkalosis
CorreCt Answer: B. Fluid volume deficit
rAtionAle: Dry mucous membranes, poor skin turgor, and tachycardia are classic signs of
fluid volume deficit (dehydration).
Question 5: A patient with heart failure has gained 3 kg in 2 days and has crackles in the lung
bases. Which condition should the nurse suspect?
A. Fluid volume deficit
B. Fluid volume excess
C. Hypokalemia
D. Metabolic acidosis
CorreCt Answer: B. Fluid volume excess
rAtionAle: Rapid weight gain, crackles, and edema are signs of fluid volume excess,
common in heart failure due to impaired cardiac pumping.
Question 6: A patient's arterial blood gas (ABG) results are: pH 7.30, PaCO2 50 mmHg, HCO3
24 mEq/L. Which acid-base imbalance is this?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
CorreCt Answer: A. Respiratory acidosis
rAtionAle: A low pH (<7.35) with an elevated PaCO2 (>45 mmHg) and normal HCO3
indicates respiratory acidosis, often due to hypoventilation.
Academic Year 2026/2027 | Examination 3 Comprehensive
Examination | 75 Verified Questions and Correct Answer
Rationales | | JUST RELEASED .
Section 1: Fluid, Electrolyte & Acid-Base Balance (Questions 1–15)
Question 1: A nurse is caring for a patient who is receiving 0.9% sodium chloride IV. The nurse
understands that this is which type of IV solution?
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Colloid
CorreCt Answer: B. Isotonic
rAtionAle: 0.9% sodium chloride (normal saline) is an isotonic solution, meaning it has the
same osmolality as body fluids. It expands the extracellular fluid volume without causing fluid
shifts into or out of cells.
Question 2: A patient has a potassium level of 3.1 mEq/L. Which assessment finding should
the nurse expect?
A. Tall, peaked T waves on ECG
B. Muscle weakness and leg cramps
C. Hypertension and bradycardia
D. Increased deep tendon reflexes
CorreCt Answer: B. Muscle weakness and leg cramps
rAtionAle: Hypokalemia (potassium <3.5 mEq/L) causes muscle weakness, leg cramps,
fatigue, and dysrhythmias. Tall, peaked T waves are seen in hyperkalemia.
Question 3: A nurse is administering IV potassium to a patient with hypokalemia. Which action
is correct?
A. Administer as a rapid IV push
B. Administer via IV pump at a rate not exceeding 10-20 mEq/hour
C. Administer undiluted through a peripheral IV
D. Administer IM instead of IV
, CorreCt Answer: B. Administer via IV pump at a rate not exceeding 10-20 mEq/hour
rAtionAle: IV potassium must always be diluted and administered via an infusion pump at a
rate not exceeding 10-20 mEq/hour to prevent cardiac arrest. It is never given IV push.
Question 4: A patient presents with dry mucous membranes, poor skin turgor, and a heart rate
of 118 bpm. Which condition should the nurse suspect?
A. Fluid volume excess
B. Fluid volume deficit
C. Hyperkalemia
D. Metabolic alkalosis
CorreCt Answer: B. Fluid volume deficit
rAtionAle: Dry mucous membranes, poor skin turgor, and tachycardia are classic signs of
fluid volume deficit (dehydration).
Question 5: A patient with heart failure has gained 3 kg in 2 days and has crackles in the lung
bases. Which condition should the nurse suspect?
A. Fluid volume deficit
B. Fluid volume excess
C. Hypokalemia
D. Metabolic acidosis
CorreCt Answer: B. Fluid volume excess
rAtionAle: Rapid weight gain, crackles, and edema are signs of fluid volume excess,
common in heart failure due to impaired cardiac pumping.
Question 6: A patient's arterial blood gas (ABG) results are: pH 7.30, PaCO2 50 mmHg, HCO3
24 mEq/L. Which acid-base imbalance is this?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
CorreCt Answer: A. Respiratory acidosis
rAtionAle: A low pH (<7.35) with an elevated PaCO2 (>45 mmHg) and normal HCO3
indicates respiratory acidosis, often due to hypoventilation.
