NU 136 EXAM 3 - FLUIDS,
ELECTROLYTES, ACID-BASE, AND
PERIOPERATIVE CARE QUESTIONS
AND ANSWERS 100% VERIFIED
(2026/2027) GALEN COLLEGE OF
NURSING
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 25
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with a
serum potassium level of 6.5 mEq/L?
A. Peaked T-waves on the EKG
,B. Increased bowel sounds and diarrhea
C. Muscle weakness in the lower extremities
D. Hypotension and bradycardia
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) can cause life-threatening cardiac
dysrhythmias; peaked T-waves are an early sign of cardiac toxicity and require immediate
intervention.
3. The nurse is caring for a patient post-thyroidectomy who reports numbness and tingling
around the mouth. Which action should the nurse take first?
A. Notify the rapid response team
B. Check the patient’s serum magnesium level
C. Administer a prescribed oral calcium supplement
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Paresthesia around the mouth is a sign of hypocalcemia, often
caused by accidental parathyroid damage during thyroid surgery. Assessing for Chvostek’s
sign (facial twitching) confirms neuromuscular irritability.
, 4. A patient is receiving 0.45% normal saline at 125 mL/hr. For which complication should the
nurse monitor most closely?
A. Circulatory overload
B. Cerebral edema
C. Cellular dehydration
D. Hypernatremia
Answer: B
Conceptual Explanation: 0.45% NS is a hypotonic solution, which causes fluid to shift
from the intravascular space into the cells. Rapid shifts into brain cells can lead to cerebral
edema and increased intracranial pressure.
5. Which assessment finding is most indicative of fluid volume deficit in an older adult?
A. Skin tenting on the back of the hand
B. Dry mucous membranes
C. Decreased blood pressure when standing
D. Distended neck veins
Answer: C
Conceptual Explanation: Orthostatic hypotension is a reliable indicator of fluid volume
deficit. Skin turgor is less reliable in older adults due to loss of elasticity, but dry mucous
membranes are also helpful, orthostasis is a priority physiological change.
ELECTROLYTES, ACID-BASE, AND
PERIOPERATIVE CARE QUESTIONS
AND ANSWERS 100% VERIFIED
(2026/2027) GALEN COLLEGE OF
NURSING
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 25
mEq/L. Which acid-base imbalance does the nurse identify?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: The pH is low (acidosis) and the PaCO2 is high (respiratory
cause), while the HCO3 is within normal range, indicating uncompensated respiratory
acidosis.
2. Which clinical manifestation should the nurse prioritize when assessing a patient with a
serum potassium level of 6.5 mEq/L?
A. Peaked T-waves on the EKG
,B. Increased bowel sounds and diarrhea
C. Muscle weakness in the lower extremities
D. Hypotension and bradycardia
Answer: A
Conceptual Explanation: Hyperkalemia (K+ > 5.0) can cause life-threatening cardiac
dysrhythmias; peaked T-waves are an early sign of cardiac toxicity and require immediate
intervention.
3. The nurse is caring for a patient post-thyroidectomy who reports numbness and tingling
around the mouth. Which action should the nurse take first?
A. Notify the rapid response team
B. Check the patient’s serum magnesium level
C. Administer a prescribed oral calcium supplement
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Paresthesia around the mouth is a sign of hypocalcemia, often
caused by accidental parathyroid damage during thyroid surgery. Assessing for Chvostek’s
sign (facial twitching) confirms neuromuscular irritability.
, 4. A patient is receiving 0.45% normal saline at 125 mL/hr. For which complication should the
nurse monitor most closely?
A. Circulatory overload
B. Cerebral edema
C. Cellular dehydration
D. Hypernatremia
Answer: B
Conceptual Explanation: 0.45% NS is a hypotonic solution, which causes fluid to shift
from the intravascular space into the cells. Rapid shifts into brain cells can lead to cerebral
edema and increased intracranial pressure.
5. Which assessment finding is most indicative of fluid volume deficit in an older adult?
A. Skin tenting on the back of the hand
B. Dry mucous membranes
C. Decreased blood pressure when standing
D. Distended neck veins
Answer: C
Conceptual Explanation: Orthostatic hypotension is a reliable indicator of fluid volume
deficit. Skin turgor is less reliable in older adults due to loss of elasticity, but dry mucous
membranes are also helpful, orthostasis is a priority physiological change.
