,NURS 3661 Exam 1 | Nursing of Adults (2026) Q&A
| University of Texas at Arlington
1. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an
electrocardiogram?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypernatremia
Correct Answer: Hyperkalemia
Rationale: Hyperkalemia classically produces tall, peaked T waves, widened QRS
complexes, and can progress to ventricular fibrillation. Hypokalemia produces flattened T
waves and U waves, hypocalcemia prolongs the QT interval, and hypernatremia primarily
causes neurologic and volume-related symptoms rather than peaked T waves.
2. A patient receiving 0.45% sodium chloride intravenously should be monitored for which
potential complication?
A) Cellular dehydration
B) Fluid overload and cellular swelling
C) Hypernatremia
D) Metabolic acidosis
Correct Answer: Fluid overload and cellular swelling
Rationale: 0.45% sodium chloride is hypotonic, so it moves water into cells and can cause
cellular swelling and fluid overload, particularly in patients with compromised renal or
,cardiac function. It does not cause cellular dehydration or hypernatremia; hypertonic fluids
are associated with those risks.
3. What is the primary purpose of administering 0.9% sodium chloride to a patient with
hypovolemia?
A) To expand extracellular fluid volume
B) To pull fluid out of cells
C) To provide free water for cellular hydration
D) To correct hypernatremia rapidly
Correct Answer: To expand extracellular fluid volume
Rationale: 0.9% sodium chloride is isotonic and remains primarily in the extracellular
compartment, making it appropriate for expanding extracellular fluid volume in
hypovolemia. It does not pull fluid out of cells like hypertonic fluids, provide free water like
hypotonic fluids, or rapidly correct hypernatremia.
4. Which assessment finding is most consistent with fluid volume deficit?
A) Bounding pulses and crackles
B) Orthostatic hypotension and decreased urine output
C) Peripheral edema and jugular venous distention
D) Weight gain and hypertension
Correct Answer: Orthostatic hypotension and decreased urine output
Rationale: Fluid volume deficit reduces intravascular volume, leading to orthostatic
hypotension, tachycardia, decreased urine output, and dry mucous membranes. Bounding
pulses, crackles, edema, jugular venous distention, weight gain, and hypertension suggest
fluid volume excess rather than deficit.
, 5. A patient has a serum calcium level of 7.2 mg/dL. Which clinical manifestation should the
nurse anticipate?
A) Muscle weakness and hyporeflexia
B) Tetany and positive Trousseau sign
C) Tall peaked T waves
D) Hypertension and flushing
Correct Answer: Tetany and positive Trousseau sign
Rationale: Hypocalcemia increases neuromuscular excitability, causing tetany,
paresthesias, and a positive Trousseau or Chvostek sign. Muscle weakness and hyporeflexia
suggest hypercalcemia, tall peaked T waves suggest hyperkalemia, and hypertension with
flushing is not characteristic of hypocalcemia.
6. Which patient is at greatest risk for developing hypernatremia?
A) A patient with excessive vomiting
B) A patient with an inability to access water independently
C) A patient receiving excessive free water flushes
D) A patient with syndrome of inappropriate antidiuretic hormone
Correct Answer: A patient with an inability to access water independently
Rationale: Hypernatremia most often results from water loss or inadequate water intake,
and patients who cannot independently access water are at high risk. Excessive vomiting
typically causes hypovolemia and possibly hyponatremia, free water flushes dilute sodium,
and SIADH causes hyponatremia through water retention.
| University of Texas at Arlington
1. Which electrolyte imbalance is most likely to cause tall, peaked T waves on an
electrocardiogram?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypernatremia
Correct Answer: Hyperkalemia
Rationale: Hyperkalemia classically produces tall, peaked T waves, widened QRS
complexes, and can progress to ventricular fibrillation. Hypokalemia produces flattened T
waves and U waves, hypocalcemia prolongs the QT interval, and hypernatremia primarily
causes neurologic and volume-related symptoms rather than peaked T waves.
2. A patient receiving 0.45% sodium chloride intravenously should be monitored for which
potential complication?
A) Cellular dehydration
B) Fluid overload and cellular swelling
C) Hypernatremia
D) Metabolic acidosis
Correct Answer: Fluid overload and cellular swelling
Rationale: 0.45% sodium chloride is hypotonic, so it moves water into cells and can cause
cellular swelling and fluid overload, particularly in patients with compromised renal or
,cardiac function. It does not cause cellular dehydration or hypernatremia; hypertonic fluids
are associated with those risks.
3. What is the primary purpose of administering 0.9% sodium chloride to a patient with
hypovolemia?
A) To expand extracellular fluid volume
B) To pull fluid out of cells
C) To provide free water for cellular hydration
D) To correct hypernatremia rapidly
Correct Answer: To expand extracellular fluid volume
Rationale: 0.9% sodium chloride is isotonic and remains primarily in the extracellular
compartment, making it appropriate for expanding extracellular fluid volume in
hypovolemia. It does not pull fluid out of cells like hypertonic fluids, provide free water like
hypotonic fluids, or rapidly correct hypernatremia.
4. Which assessment finding is most consistent with fluid volume deficit?
A) Bounding pulses and crackles
B) Orthostatic hypotension and decreased urine output
C) Peripheral edema and jugular venous distention
D) Weight gain and hypertension
Correct Answer: Orthostatic hypotension and decreased urine output
Rationale: Fluid volume deficit reduces intravascular volume, leading to orthostatic
hypotension, tachycardia, decreased urine output, and dry mucous membranes. Bounding
pulses, crackles, edema, jugular venous distention, weight gain, and hypertension suggest
fluid volume excess rather than deficit.
, 5. A patient has a serum calcium level of 7.2 mg/dL. Which clinical manifestation should the
nurse anticipate?
A) Muscle weakness and hyporeflexia
B) Tetany and positive Trousseau sign
C) Tall peaked T waves
D) Hypertension and flushing
Correct Answer: Tetany and positive Trousseau sign
Rationale: Hypocalcemia increases neuromuscular excitability, causing tetany,
paresthesias, and a positive Trousseau or Chvostek sign. Muscle weakness and hyporeflexia
suggest hypercalcemia, tall peaked T waves suggest hyperkalemia, and hypertension with
flushing is not characteristic of hypocalcemia.
6. Which patient is at greatest risk for developing hypernatremia?
A) A patient with excessive vomiting
B) A patient with an inability to access water independently
C) A patient receiving excessive free water flushes
D) A patient with syndrome of inappropriate antidiuretic hormone
Correct Answer: A patient with an inability to access water independently
Rationale: Hypernatremia most often results from water loss or inadequate water intake,
and patients who cannot independently access water are at high risk. Excessive vomiting
typically causes hypovolemia and possibly hyponatremia, free water flushes dilute sodium,
and SIADH causes hyponatremia through water retention.
