RNSG 1533 Exam 2: Nutrition, Elimination,
Fluid & Electrolytes – Complete Study Guide &
Test Bank (2026 Edition)
1. A client receiving continuous enteral tube feeding via NG tube
suddenly begins coughing, choking, and shows a drop in oxygen
saturation from 96% to 88%. What is the nurse’s FIRST priority action?
A. Slow the feeding rate
B. Stop the feeding immediately
C. Check residual volume
D. Notify the provider
✅ Correct Answer: B. Stop the feeding immediately
Rationale:
This client is showing clear signs of aspiration, which can quickly lead to
airway obstruction and pneumonia. The nurse must immediately stop the
feeding to prevent further aspiration. Airway protection always takes
priority over assessment or provider notification. Once feeding is stopped,
further actions like repositioning and suctioning can be performed.
2. A client has been NPO for several days and is started on total
parenteral nutrition (TPN). Shortly after initiation, the client becomes
confused and diaphoretic. What is the nurse’s priority assessment?
,A. Blood pressure
B. Blood glucose level
C. Temperature
D. Oxygen saturation
✅ Correct Answer: B. Blood glucose level
Rationale:
TPN is high in glucose, and sudden changes can lead to hyperglycemia or
hypoglycemia, both of which affect neurological status. Confusion and
diaphoresis strongly suggest a glucose imbalance. This must be assessed
immediately to prevent severe complications like coma.
3. A client with severe diarrhea for 4 days presents with weakness, dry
mucous membranes, and decreased urine output. Which electrolyte
imbalance is most likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
✅ Correct Answer: B. Hypokalemia
Rationale:
Diarrhea leads to significant potassium loss through stool, resulting in
hypokalemia, which causes muscle weakness and can lead to life-
threatening cardiac arrhythmias if untreated.
4. A client with fluid overload is noted to have crackles in the lungs,
jugular vein distention, and weight gain of 2 kg in 48 hours. What is
the priority nursing intervention?
,A. Encourage oral fluids
B. Administer prescribed diuretics
C. Restrict sodium only
D. Elevate legs
✅ Correct Answer: B. Administer prescribed diuretics
Rationale:
This client is experiencing fluid volume excess affecting the lungs, which
threatens oxygenation. Diuretics help remove excess fluid rapidly,
improving respiratory status and reducing cardiac workload.
5. A client with hyponatremia (Na⁺ 125 mEq/L) is confused and
lethargic. What is the most serious complication the nurse should
monitor for?
A. Cardiac arrest
B. Seizures
C. Hypertension
D. Edema
✅ Correct Answer: B. Seizures
Rationale:
Hyponatremia causes cerebral edema, leading to neurological symptoms
such as confusion, lethargy, and seizures. Seizures are life-threatening and
must be prevented with prompt intervention.
6. A client has not voided for 10 hours postoperatively and reports
lower abdominal discomfort. What is the nurse’s priority action?
A. Encourage oral fluids
B. Perform bladder scan
, C. Insert catheter immediately
D. Notify provider
✅ Correct Answer: B. Perform bladder scan
Rationale:
Before any intervention, the nurse must assess for urinary retention using
a bladder scan. This prevents unnecessary catheterization and guides
appropriate care.
7. A client receiving tube feeding is lying flat in bed. What
complication is the client most at risk for?
A. Dehydration
B. Aspiration pneumonia
C. Constipation
D. Hypoglycemia
✅ Correct Answer: B. Aspiration pneumonia
8. A client with potassium level of 6.5 mEq/L reports palpitations.
What is the nurse’s priority intervention?
A. Administer potassium supplements
B. Monitor intake
C. Prepare to administer calcium gluconate
D. Encourage fluids
✅ Correct Answer: C. Prepare to administer calcium gluconate
Rationale:
Severe hyperkalemia can cause fatal arrhythmias. Calcium gluconate
stabilizes the cardiac membrane and is life-saving.
Fluid & Electrolytes – Complete Study Guide &
Test Bank (2026 Edition)
1. A client receiving continuous enteral tube feeding via NG tube
suddenly begins coughing, choking, and shows a drop in oxygen
saturation from 96% to 88%. What is the nurse’s FIRST priority action?
A. Slow the feeding rate
B. Stop the feeding immediately
C. Check residual volume
D. Notify the provider
✅ Correct Answer: B. Stop the feeding immediately
Rationale:
This client is showing clear signs of aspiration, which can quickly lead to
airway obstruction and pneumonia. The nurse must immediately stop the
feeding to prevent further aspiration. Airway protection always takes
priority over assessment or provider notification. Once feeding is stopped,
further actions like repositioning and suctioning can be performed.
2. A client has been NPO for several days and is started on total
parenteral nutrition (TPN). Shortly after initiation, the client becomes
confused and diaphoretic. What is the nurse’s priority assessment?
,A. Blood pressure
B. Blood glucose level
C. Temperature
D. Oxygen saturation
✅ Correct Answer: B. Blood glucose level
Rationale:
TPN is high in glucose, and sudden changes can lead to hyperglycemia or
hypoglycemia, both of which affect neurological status. Confusion and
diaphoresis strongly suggest a glucose imbalance. This must be assessed
immediately to prevent severe complications like coma.
3. A client with severe diarrhea for 4 days presents with weakness, dry
mucous membranes, and decreased urine output. Which electrolyte
imbalance is most likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
✅ Correct Answer: B. Hypokalemia
Rationale:
Diarrhea leads to significant potassium loss through stool, resulting in
hypokalemia, which causes muscle weakness and can lead to life-
threatening cardiac arrhythmias if untreated.
4. A client with fluid overload is noted to have crackles in the lungs,
jugular vein distention, and weight gain of 2 kg in 48 hours. What is
the priority nursing intervention?
,A. Encourage oral fluids
B. Administer prescribed diuretics
C. Restrict sodium only
D. Elevate legs
✅ Correct Answer: B. Administer prescribed diuretics
Rationale:
This client is experiencing fluid volume excess affecting the lungs, which
threatens oxygenation. Diuretics help remove excess fluid rapidly,
improving respiratory status and reducing cardiac workload.
5. A client with hyponatremia (Na⁺ 125 mEq/L) is confused and
lethargic. What is the most serious complication the nurse should
monitor for?
A. Cardiac arrest
B. Seizures
C. Hypertension
D. Edema
✅ Correct Answer: B. Seizures
Rationale:
Hyponatremia causes cerebral edema, leading to neurological symptoms
such as confusion, lethargy, and seizures. Seizures are life-threatening and
must be prevented with prompt intervention.
6. A client has not voided for 10 hours postoperatively and reports
lower abdominal discomfort. What is the nurse’s priority action?
A. Encourage oral fluids
B. Perform bladder scan
, C. Insert catheter immediately
D. Notify provider
✅ Correct Answer: B. Perform bladder scan
Rationale:
Before any intervention, the nurse must assess for urinary retention using
a bladder scan. This prevents unnecessary catheterization and guides
appropriate care.
7. A client receiving tube feeding is lying flat in bed. What
complication is the client most at risk for?
A. Dehydration
B. Aspiration pneumonia
C. Constipation
D. Hypoglycemia
✅ Correct Answer: B. Aspiration pneumonia
8. A client with potassium level of 6.5 mEq/L reports palpitations.
What is the nurse’s priority intervention?
A. Administer potassium supplements
B. Monitor intake
C. Prepare to administer calcium gluconate
D. Encourage fluids
✅ Correct Answer: C. Prepare to administer calcium gluconate
Rationale:
Severe hyperkalemia can cause fatal arrhythmias. Calcium gluconate
stabilizes the cardiac membrane and is life-saving.
