Comprehensive NSG 3250 Adult Health I Exam 1 Review 2026/2027 | Practice Questions, Verified Answers, and Rationales (Galen College of Nursing)

Comprehensive NSG 3250 Adult Health I
Exam 1 Review 2026/2027 | Practice
Questions, Verified Answers, and Rationales
(Galen College of Nursing)

1. A client is admitted with fluid volume deficit. Which finding is most consistent with this
condition?
A) Bounding pulse
B) Urine specific gravity 1.035
C) Peripheral edema
D) Jugular vein distention
Answer: B
Rationale: Fluid volume deficit causes concentrated urine with high specific gravity (>1.030). Bounding
pulse and edema indicate excess.




2. A client with heart failure has fluid volume excess. Which assessment finding supports this?
A) Flat neck veins
B) Crackles in lung bases
C) Decreased urine output
D) Dry mucous membranes
Answer: B
Rationale: Fluid overload leads to pulmonary congestion and crackles. Decreased urine output and dry
mucous membranes indicate deficit.

,3. A client’s serum sodium is 128 mEq/L. Which manifestation is most likely?
A) Thirst and dry mouth
B) Confusion and headache
C) Hypertension and tachycardia
D) Muscle twitching and seizures
Answer: B
Rationale: Hyponatremia causes cerebral edema, leading to confusion, headache, and seizures. Thirst is
seen in hypernatremia.




4. A client with hypernatremia is at risk for which complication?
A) Cerebral edema
B) Seizures from dehydration of brain cells
C) Bradycardia
D) Hypotension
Answer: B
Rationale: Hypernatremia pulls water out of brain cells, causing shrinkage and seizures. Hypotension is
not typical.




5. A client has a potassium level of 2.9 mEq/L. Which intervention is priority?
A) Administer Kayexalate
B) Initiate cardiac monitoring
C) Restrict potassium intake
D) Administer insulin
Answer: B
Rationale: Hypokalemia can cause life-threatening arrhythmias; cardiac monitoring is essential.
Kayexalate and insulin treat hyperkalemia.

,6. A client with hyperkalemia has a potassium of 6.8 mEq/L. Which medication should the nurse
anticipate giving first?
A) Insulin and glucose
B) Calcium gluconate IV
C) Sodium polystyrene sulfonate
D) Furosemide
Answer: B
Rationale: Calcium gluconate stabilizes the myocardium immediately. Insulin/glucose and Kayexalate
lower potassium but take longer.




7. A client with hypocalcemia is likely to exhibit which sign?
A) Decreased deep tendon reflexes
B) Positive Trousseau sign
C) Bradycardia
D) Hypertension
Answer: B
Rationale: Hypocalcemia causes neuromuscular irritability (Trousseau, Chvostek). Decreased reflexes
occur in hypercalcemia.




8. A client with hypercalcemia should be monitored for which complication?
A) Tetany
B) Renal calculi
C) Diarrhea
D) Hyporeflexia
Answer: B
Rationale: Hypercalcemia leads to kidney stones due to increased calcium excretion. Tetany is seen in
hypocalcemia.

, 9. A client has a magnesium level of 1.2 mEq/L. Which finding is most concerning?
A) Constipation
B) Cardiac arrhythmias
C) Hypertension
D) Hyperreflexia
Answer: B
Rationale: Hypomagnesemia can cause arrhythmias, especially torsades de pointes. Hyperreflexia is also
seen but arrhythmias are life-threatening.




10. A client with hypermagnesemia is at risk for which condition?
A) Seizures
B) Respiratory depression
C) Hyperreflexia
D) Tachycardia
Answer: B
Rationale: Hypermagnesemia depresses the central nervous system, leading to respiratory depression
and loss of deep tendon reflexes.




11. A client’s ABG shows pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L. Which acid-base imbalance is
present?
A) Metabolic acidosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Answer: B
Rationale: pH <7.35 and PaCO2 >45 indicate respiratory acidosis (hypoventilation). HCO3 is normal, so
uncompensated.