NSG 3100 Exam 4 Practice Exam
NSG 3100 Exam 4 Exam
Combined Practice Bank — 450 Questions (Fluids, Electrolytes, ABGs & Nutrition, mixed)
Galen College of Nursing | Fundamentals of Nursing I
1. A patient with metabolic alkalosis is hypoventilating. What effect does this have on acid-base balance?
A. It decreases CO2 and raises pH further.
B. It removes bicarbonate through the lungs.
C. It retains CO2 and helps lower pH toward normal.
D. It causes immediate renal hydrogen loss.
2. A patient has pH 7.48, PaCO2 31 mm Hg, HCO3- 24 mEq/L. Which patient history best fits this ABG?
A. Prolonged diarrhea
B. Prolonged NG suction
C. Panic-related hyperventilation
D. Renal failure
3. A client with fluid volume excess would be expected to have which urine specific gravity finding?
A. Increased
B. Unaffected
C. Absent
D. Decreased, indicating dilute urine
4. Which teaching points are appropriate for a client on a potassium-sparing diuretic? (Select all that apply.)
A. Avoid excessive potassium supplements
B. Monitor for signs of hyperkalemia
C. Increase intake of potassium-rich foods aggressively
D. Report muscle weakness or irregular heartbeat
E. Salt substitutes may contain potassium and should be used cautiously
5. Select all that apply: Which findings support fluid volume deficit?
A. Weak, thready pulse
B. Bounding pulse
C. Dry, sticky mucous membranes
D. Increased urine specific gravity
E. Rapid weight gain
F. Orthostatic hypotension
6. A nurse begins lunch assistance for a patient who had a stroke and has dysphagia. Which observation requires the
nurse to stop feeding and reassess immediately?
A. The patient asks for smaller bites
B. The patient takes 15 seconds between bites
C. The patient coughs and becomes dyspneic after swallowing
D. The patient eats only half of the meal
7. A client with a serum magnesium of 1.0 mEq/L reports difficulty swallowing. What is the priority nursing action?
A. Administer the next dose of oral medication as scheduled
B. Encourage a regular diet
C. Document and continue the plan of care
D. Hold oral intake and notify the provider due to aspiration risk
8. A client at high altitude experiences hyperventilation due to lower oxygen levels. This places the client at risk for:
A. Metabolic acidosis
B. Metabolic alkalosis
Galen College of Nursing – Fundamentals of Nursing I Page 1 of 83
,NSG 3100 Exam 4 Practice Exam
C. Respiratory alkalosis
D. Respiratory acidosis
9. A patient with hypercalcemia is at risk for which complication?
A. Hyperactive reflexes
B. Positive Trousseau sign
C. Seizures from tetany
D. Pathologic fractures
10. A patient taking a thiazide diuretic reports weakness and muscle cramping. Which electrolyte imbalance should the
nurse suspect first?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hyperphosphatemia
11. A patient with hypophosphatemia is prescribed a phosphorus supplement. Which additional teaching is appropriate?
A. Avoid phosphorus-binding antacids
B. Avoid foods containing phosphate
C. Use phosphorus-binding antacids daily
D. Restrict fluid intake
12. A client receiving a continuous enteral tube feeding develops diarrhea. Which factors could be contributing? (Select
all that apply.)
A. Feeding administered too rapidly
B. Contaminated feeding equipment
C. Hypertonic formula
D. Adequate fiber content in the formula
E. Medication sorbitol content
13. A nurse delegates vital sign monitoring to a UAP for a client with severe hyperkalemia. Which instruction is most
important?
A. "No need to report findings unless asked."
B. "Only check vital signs at end of shift."
C. "Heart rate changes are not relevant here."
D. "Report any irregular pulse or significant vital sign changes immediately."
14. A client with Crohn's disease and chronic diarrhea reports muscle twitching and hyperactive reflexes. Which
electrolyte imbalance is most likely?
A. Hypermagnesemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypomagnesemia
15. A patient has had profuse diarrhea for 24 hours. The nurse determines that water and sodium have been lost in
approximately equal amounts. Which fluid imbalance is most consistent with this situation?
A. Isotonic fluid volume excess
B. Hypertonic fluid volume deficit
C. Hypotonic fluid volume excess
D. Isotonic fluid volume deficit
16. A nurse receives ECG results showing peaked T waves in a client with renal failure. Priority action is:
A. Notify the provider immediately; suspect hyperkalemia
B. Document and reassess in 4 hours
C. Encourage potassium-rich foods
D. Restrict IV fluids
Galen College of Nursing – Fundamentals of Nursing I Page 2 of 83
,NSG 3100 Exam 4 Practice Exam
17. What is the primary trigger for renin release from the kidneys?
A. Decreased blood pressure/renal perfusion
B. Increased blood pressure
C. Increased serum sodium
D. Increased ADH levels
18. The nurse is prioritizing care for four clients. Which requires the most immediate intervention?
A. A client with a central line who develops sudden dyspnea and chest pain during a rapid infusion
B. A client with mild dependent edema
C. A client tolerating a fluid restriction well
D. A client with a normal urine specific gravity
19. A nurse is reviewing orders for a patient with severe dehydration and hypernatremia. Which IV solution type would
move water into the cells?
A. Hypotonic
B. Isotonic
C. Colloid
D. Hypertonic
20. A patient with hypermagnesemia becomes increasingly lethargic. Which nursing intervention is most appropriate?
A. Administer magnesium supplements
B. Restrict all fluids
C. Encourage increased fluids as ordered and monitor respiratory status
D. Encourage bed rest only
21. Which nursing intervention is most appropriate to promote adequate nutrition in a homebound older adult with
limited income?
A. Recommend a high-protein supplement instead of meals
B. Instruct the client to eat only raw fruits and vegetables
C. Refer the client to a meal delivery program
D. Encourage the client to skip meals to save money
22. Which patient should the nurse see first?
A. A patient with PaO2 44 mm Hg and restlessness
B. A patient with O2 saturation 96% and pH 7.32
C. A patient with PaO2 76 mm Hg who is alert
D. A patient with PaCO2 46 mm Hg and no symptoms
23. A client with excess aldosterone secretion should be assessed for:
A. Hyperkalemia and hyponatremia
B. Hypokalemia and hypernatremia (fluid retention)
C. Hyperkalemia and dehydration
D. Hypocalcemia
24. Select all that apply: Which values are within the normal ABG ranges listed in the study guide?
A. pH 7.40
B. PaCO2 40 mm Hg
C. HCO3- 24 mEq/L
D. PaO2 92 mm Hg
E. O2 saturation 97%
F. PaCO2 52 mm Hg
25. A client experiencing a panic attack presents with numbness, tingling in the fingers, and lightheadedness. The nurse
understands these symptoms are most likely related to:
A. Metabolic acidosis
Galen College of Nursing – Fundamentals of Nursing I Page 3 of 83
, NSG 3100 Exam 4 Practice Exam
B. Hyperkalemia
C. Respiratory acidosis
D. Respiratory alkalosis from hyperventilation
26. A nurse is teaching a patient about healthy carbohydrate intake. Which points should the nurse include? Select all that
apply.
A. Carbohydrates are a major energy source.
B. Adequate carbohydrate intake helps spare protein for tissue building.
C. Very low carbohydrate intake can contribute to ketosis.
D. Glycogen is a stored form of carbohydrate.
E. Carbohydrates provide 9 kcal per gram.
27. A client asks about licorice supplements. The nurse should explain licorice can cause:
A. Hyperkalemia
B. Hypocalcemia
C. Hypermagnesemia
D. Sodium retention and hypokalemia
28. A patient with hypernatremia has increasing confusion and hallucinations. Which nursing assessment is most
important to continue?
A. Skin pigmentation
B. Level of consciousness
C. Bowel sounds only
D. Visual acuity
29. Which measurement, when combined with BMI, provides additional information about a client's cardiovascular and
metabolic risk?
A. Waist circumference
B. Height alone
C. Skinfold thickness of the triceps alone
D. Shoe size
30. A patient is hyperventilating from severe anxiety. ABG results show pH 7.49, PaCO2 30 mm Hg, HCO3- 24 mEq/L.
Which imbalance is present?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
31. A patient with severe hypermagnesemia develops respiratory depression. Which intervention should the nurse
anticipate first?
A. Encourage magnesium-rich foods
B. Respiratory support with oxygen or mechanical ventilation as needed
C. Administer magnesium supplements
D. Restrict oral and IV fluids
32. A client with chronic renal failure is at greatest risk for which acid-base imbalance due to impaired hydrogen ion
excretion?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
33. A client on a mechanical ventilator with a set respiratory rate that is too high for the client's needs is at risk for:
A. Metabolic acidosis
B. Metabolic alkalosis
Galen College of Nursing – Fundamentals of Nursing I Page 4 of 83
NSG 3100 Exam 4 Exam
Combined Practice Bank — 450 Questions (Fluids, Electrolytes, ABGs & Nutrition, mixed)
Galen College of Nursing | Fundamentals of Nursing I
1. A patient with metabolic alkalosis is hypoventilating. What effect does this have on acid-base balance?
A. It decreases CO2 and raises pH further.
B. It removes bicarbonate through the lungs.
C. It retains CO2 and helps lower pH toward normal.
D. It causes immediate renal hydrogen loss.
2. A patient has pH 7.48, PaCO2 31 mm Hg, HCO3- 24 mEq/L. Which patient history best fits this ABG?
A. Prolonged diarrhea
B. Prolonged NG suction
C. Panic-related hyperventilation
D. Renal failure
3. A client with fluid volume excess would be expected to have which urine specific gravity finding?
A. Increased
B. Unaffected
C. Absent
D. Decreased, indicating dilute urine
4. Which teaching points are appropriate for a client on a potassium-sparing diuretic? (Select all that apply.)
A. Avoid excessive potassium supplements
B. Monitor for signs of hyperkalemia
C. Increase intake of potassium-rich foods aggressively
D. Report muscle weakness or irregular heartbeat
E. Salt substitutes may contain potassium and should be used cautiously
5. Select all that apply: Which findings support fluid volume deficit?
A. Weak, thready pulse
B. Bounding pulse
C. Dry, sticky mucous membranes
D. Increased urine specific gravity
E. Rapid weight gain
F. Orthostatic hypotension
6. A nurse begins lunch assistance for a patient who had a stroke and has dysphagia. Which observation requires the
nurse to stop feeding and reassess immediately?
A. The patient asks for smaller bites
B. The patient takes 15 seconds between bites
C. The patient coughs and becomes dyspneic after swallowing
D. The patient eats only half of the meal
7. A client with a serum magnesium of 1.0 mEq/L reports difficulty swallowing. What is the priority nursing action?
A. Administer the next dose of oral medication as scheduled
B. Encourage a regular diet
C. Document and continue the plan of care
D. Hold oral intake and notify the provider due to aspiration risk
8. A client at high altitude experiences hyperventilation due to lower oxygen levels. This places the client at risk for:
A. Metabolic acidosis
B. Metabolic alkalosis
Galen College of Nursing – Fundamentals of Nursing I Page 1 of 83
,NSG 3100 Exam 4 Practice Exam
C. Respiratory alkalosis
D. Respiratory acidosis
9. A patient with hypercalcemia is at risk for which complication?
A. Hyperactive reflexes
B. Positive Trousseau sign
C. Seizures from tetany
D. Pathologic fractures
10. A patient taking a thiazide diuretic reports weakness and muscle cramping. Which electrolyte imbalance should the
nurse suspect first?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hyperphosphatemia
11. A patient with hypophosphatemia is prescribed a phosphorus supplement. Which additional teaching is appropriate?
A. Avoid phosphorus-binding antacids
B. Avoid foods containing phosphate
C. Use phosphorus-binding antacids daily
D. Restrict fluid intake
12. A client receiving a continuous enteral tube feeding develops diarrhea. Which factors could be contributing? (Select
all that apply.)
A. Feeding administered too rapidly
B. Contaminated feeding equipment
C. Hypertonic formula
D. Adequate fiber content in the formula
E. Medication sorbitol content
13. A nurse delegates vital sign monitoring to a UAP for a client with severe hyperkalemia. Which instruction is most
important?
A. "No need to report findings unless asked."
B. "Only check vital signs at end of shift."
C. "Heart rate changes are not relevant here."
D. "Report any irregular pulse or significant vital sign changes immediately."
14. A client with Crohn's disease and chronic diarrhea reports muscle twitching and hyperactive reflexes. Which
electrolyte imbalance is most likely?
A. Hypermagnesemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypomagnesemia
15. A patient has had profuse diarrhea for 24 hours. The nurse determines that water and sodium have been lost in
approximately equal amounts. Which fluid imbalance is most consistent with this situation?
A. Isotonic fluid volume excess
B. Hypertonic fluid volume deficit
C. Hypotonic fluid volume excess
D. Isotonic fluid volume deficit
16. A nurse receives ECG results showing peaked T waves in a client with renal failure. Priority action is:
A. Notify the provider immediately; suspect hyperkalemia
B. Document and reassess in 4 hours
C. Encourage potassium-rich foods
D. Restrict IV fluids
Galen College of Nursing – Fundamentals of Nursing I Page 2 of 83
,NSG 3100 Exam 4 Practice Exam
17. What is the primary trigger for renin release from the kidneys?
A. Decreased blood pressure/renal perfusion
B. Increased blood pressure
C. Increased serum sodium
D. Increased ADH levels
18. The nurse is prioritizing care for four clients. Which requires the most immediate intervention?
A. A client with a central line who develops sudden dyspnea and chest pain during a rapid infusion
B. A client with mild dependent edema
C. A client tolerating a fluid restriction well
D. A client with a normal urine specific gravity
19. A nurse is reviewing orders for a patient with severe dehydration and hypernatremia. Which IV solution type would
move water into the cells?
A. Hypotonic
B. Isotonic
C. Colloid
D. Hypertonic
20. A patient with hypermagnesemia becomes increasingly lethargic. Which nursing intervention is most appropriate?
A. Administer magnesium supplements
B. Restrict all fluids
C. Encourage increased fluids as ordered and monitor respiratory status
D. Encourage bed rest only
21. Which nursing intervention is most appropriate to promote adequate nutrition in a homebound older adult with
limited income?
A. Recommend a high-protein supplement instead of meals
B. Instruct the client to eat only raw fruits and vegetables
C. Refer the client to a meal delivery program
D. Encourage the client to skip meals to save money
22. Which patient should the nurse see first?
A. A patient with PaO2 44 mm Hg and restlessness
B. A patient with O2 saturation 96% and pH 7.32
C. A patient with PaO2 76 mm Hg who is alert
D. A patient with PaCO2 46 mm Hg and no symptoms
23. A client with excess aldosterone secretion should be assessed for:
A. Hyperkalemia and hyponatremia
B. Hypokalemia and hypernatremia (fluid retention)
C. Hyperkalemia and dehydration
D. Hypocalcemia
24. Select all that apply: Which values are within the normal ABG ranges listed in the study guide?
A. pH 7.40
B. PaCO2 40 mm Hg
C. HCO3- 24 mEq/L
D. PaO2 92 mm Hg
E. O2 saturation 97%
F. PaCO2 52 mm Hg
25. A client experiencing a panic attack presents with numbness, tingling in the fingers, and lightheadedness. The nurse
understands these symptoms are most likely related to:
A. Metabolic acidosis
Galen College of Nursing – Fundamentals of Nursing I Page 3 of 83
, NSG 3100 Exam 4 Practice Exam
B. Hyperkalemia
C. Respiratory acidosis
D. Respiratory alkalosis from hyperventilation
26. A nurse is teaching a patient about healthy carbohydrate intake. Which points should the nurse include? Select all that
apply.
A. Carbohydrates are a major energy source.
B. Adequate carbohydrate intake helps spare protein for tissue building.
C. Very low carbohydrate intake can contribute to ketosis.
D. Glycogen is a stored form of carbohydrate.
E. Carbohydrates provide 9 kcal per gram.
27. A client asks about licorice supplements. The nurse should explain licorice can cause:
A. Hyperkalemia
B. Hypocalcemia
C. Hypermagnesemia
D. Sodium retention and hypokalemia
28. A patient with hypernatremia has increasing confusion and hallucinations. Which nursing assessment is most
important to continue?
A. Skin pigmentation
B. Level of consciousness
C. Bowel sounds only
D. Visual acuity
29. Which measurement, when combined with BMI, provides additional information about a client's cardiovascular and
metabolic risk?
A. Waist circumference
B. Height alone
C. Skinfold thickness of the triceps alone
D. Shoe size
30. A patient is hyperventilating from severe anxiety. ABG results show pH 7.49, PaCO2 30 mm Hg, HCO3- 24 mEq/L.
Which imbalance is present?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
31. A patient with severe hypermagnesemia develops respiratory depression. Which intervention should the nurse
anticipate first?
A. Encourage magnesium-rich foods
B. Respiratory support with oxygen or mechanical ventilation as needed
C. Administer magnesium supplements
D. Restrict oral and IV fluids
32. A client with chronic renal failure is at greatest risk for which acid-base imbalance due to impaired hydrogen ion
excretion?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
33. A client on a mechanical ventilator with a set respiratory rate that is too high for the client's needs is at risk for:
A. Metabolic acidosis
B. Metabolic alkalosis
Galen College of Nursing – Fundamentals of Nursing I Page 4 of 83
