Nursing Fundamentals Exam 3 Questions With Complete
Solutions
. A patient with Alzheimer's Disease is admitted with suspected
dehydration after her daughter reports that the patient has
refused to drink anything for the past 3 days. The doctor orders
several laboratory tests. Which laboratory result is most
expected with dehydration?
a. Urine specific gravity of 1.005
b. Serum sodium of 150 mEq/L
c. Hematocrit of 38% Correct Answers B serum sodium of 150
mEq/L
Rationale_Decreased water intake leads to increased serum
concentration and increased Na+
1. When assessing a patient with hypotonic fluid volume excess
(FVE) the nurse can expect to find:
a. Hyponatremia
b. Confusion
c. Headache
d. All of the above Correct Answers D all of the above
Rationale_Na+ decreases with FVE, confusion may result from
cerebral swelling as well as headache for the same reason.
2. The nurse evaluates that discharge teaching has been effective
when the patient with hypocalcemia states:
a. "I shouldn't take antacids such as TUMS."
b. "I should notify my healthcare provider if I start to feel
tingling or numbness around my mouth."
,c. "I'll need to cut down on my protein in my diet."
d. "I will watch my urine for signs of kidney stones." Correct
Answers B I should notify my healthcare provider if I start to
feel tingling or numbness around my mouth
Rationale_Circumoral paresthesia is a sign of impending tetany
(intermittent and involuntary muscle spasms caused by low
Ca+) and should alert the patient to contact the physician.
3. A 28 year old patient is admitted with severe bleeding from a
fractured femur. Which intravenous fluid does the nurse
anticipate would be ordered as the most appropriate to replace
that fluid loss?
a. Normal Saline
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline Correct Answers A Normal
Saline
Rationale NS is an isotonic fluid and is appropriate for fluid
(blood) loss
4. When caring for a patient at risk for fluid overload the nurse
notices that overnight the patient gained 6 pounds. The nurse
interprets this as:
a. A 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain Correct Answers A a 3L fluid gain
Rationale_1 kg equals 1 liter
, 5. You are working in the ER of a local hospital. A patient
comes in "feeling ill". The doctor orders electrolytes on the
patient and finds that the Na+ is 135, the K+ is 2.7, chloride is
95 and C02 is 26. You would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
c. Na+ supplements PO
d. Chloride PO Correct Answers B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When
able, K+ orally is the best and safest method of replacement.
6. The skin turgor assessment of a patient with hypernatremia as
a result of extracellular fluid loss would show:
a. No skin "tenting"
b. Prolonged skin "tenting"
c. Prolonged pitting edema
d. Widespread non-pitting edema Correct Answers B
Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration,
fluid loss has less elasticity of the skin. Edema is not present in
fluid loss but in fluid overload.
7. Marathon runners are at risk for fluid volume deficit. Which
of the following is a related factor?
a. Decreased diuresis
b. Disease related processes
c. Decreased breathing and perspiration
Solutions
. A patient with Alzheimer's Disease is admitted with suspected
dehydration after her daughter reports that the patient has
refused to drink anything for the past 3 days. The doctor orders
several laboratory tests. Which laboratory result is most
expected with dehydration?
a. Urine specific gravity of 1.005
b. Serum sodium of 150 mEq/L
c. Hematocrit of 38% Correct Answers B serum sodium of 150
mEq/L
Rationale_Decreased water intake leads to increased serum
concentration and increased Na+
1. When assessing a patient with hypotonic fluid volume excess
(FVE) the nurse can expect to find:
a. Hyponatremia
b. Confusion
c. Headache
d. All of the above Correct Answers D all of the above
Rationale_Na+ decreases with FVE, confusion may result from
cerebral swelling as well as headache for the same reason.
2. The nurse evaluates that discharge teaching has been effective
when the patient with hypocalcemia states:
a. "I shouldn't take antacids such as TUMS."
b. "I should notify my healthcare provider if I start to feel
tingling or numbness around my mouth."
,c. "I'll need to cut down on my protein in my diet."
d. "I will watch my urine for signs of kidney stones." Correct
Answers B I should notify my healthcare provider if I start to
feel tingling or numbness around my mouth
Rationale_Circumoral paresthesia is a sign of impending tetany
(intermittent and involuntary muscle spasms caused by low
Ca+) and should alert the patient to contact the physician.
3. A 28 year old patient is admitted with severe bleeding from a
fractured femur. Which intravenous fluid does the nurse
anticipate would be ordered as the most appropriate to replace
that fluid loss?
a. Normal Saline
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline Correct Answers A Normal
Saline
Rationale NS is an isotonic fluid and is appropriate for fluid
(blood) loss
4. When caring for a patient at risk for fluid overload the nurse
notices that overnight the patient gained 6 pounds. The nurse
interprets this as:
a. A 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain Correct Answers A a 3L fluid gain
Rationale_1 kg equals 1 liter
, 5. You are working in the ER of a local hospital. A patient
comes in "feeling ill". The doctor orders electrolytes on the
patient and finds that the Na+ is 135, the K+ is 2.7, chloride is
95 and C02 is 26. You would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
c. Na+ supplements PO
d. Chloride PO Correct Answers B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When
able, K+ orally is the best and safest method of replacement.
6. The skin turgor assessment of a patient with hypernatremia as
a result of extracellular fluid loss would show:
a. No skin "tenting"
b. Prolonged skin "tenting"
c. Prolonged pitting edema
d. Widespread non-pitting edema Correct Answers B
Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration,
fluid loss has less elasticity of the skin. Edema is not present in
fluid loss but in fluid overload.
7. Marathon runners are at risk for fluid volume deficit. Which
of the following is a related factor?
a. Decreased diuresis
b. Disease related processes
c. Decreased breathing and perspiration
