Galen NUR 254 Med-Surg 1 Exam 2 Study Guide: 50
Verified MCQ & ABG Rationale (2026 Edition)
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Part 1: Fluid & Electrolyte Imbalances
1. A patient with heart failure is admitted with a Potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate administering to move potassium into the
intracellular space?
A) Furosemide
B) Regular Insulin and Dextrose 50%
C) Spironolactone
D) Magnesium Sulfate
Insulin shifts potassium into cells. Dextrose is given simultaneously to prevent
hypoglycemia.
2. A nurse is caring for a patient with a Sodium level of 120 mEq/L. The provider orders
an infusion of 3% Sodium Chloride. What is the priority nursing assessment?
A) Peripheral edema
B) Lung sounds (crackles) and neurological status
C) Hourly urine output
D) Skin turgor
3% NS is hypertonic; it pulls fluid into the vascular space, risking pulmonary edema and
fluid overload.
3. While assessing a patient with Hypocalcemia, the nurse inflates a blood pressure cuff
on the patient’s arm. The patient’s hand develops a carpal spasm. How should this be
documented?
A) Positive Chvostek’s sign
B) Positive Trousseau’s sign
C) Positive Babinski sign
D) Negative Allen test
Trousseau’s sign is a carpal spasm induced by ischemia, indicating neuromuscular
irritability from low calcium.
4. A patient has a Magnesium level of 1.1 mEq/L. Which assessment finding is most
consistent with this lab value?
, A) Diminished deep tendon reflexes (DTRs)
B) Hyperactive deep tendon reflexes (DTRs) and tremors
C) Lethargy and bradycardia
D) Hypotension
Low magnesium "speeds up" the nervous system, leading to hyperreflexia and
potential seizures.
5. A patient taking Furosemide (Lasix) reports muscle weakness and leg cramps. The
nurse suspects which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Loop diuretics are potassium-wasting; low potassium (hypokalemia) causes muscle
weakness.
6. A patient is admitted with Hypernatremia (Sodium 158 mEq/L). Which IV fluid is most
appropriate for this patient?
A) 0.9% Normal Saline
B) 0.45% Normal Saline
C) 3% Normal Saline
D) Lactated Ringer's
Hypernatremia requires a hypotonic solution to dilute the sodium and hydrate the cells.
7. A patient with renal failure has a Magnesium level of 3.8 mEq/L. Which finding would
cause the most concern?
A) Hyperactive bowel sounds
B) Absent deep tendon reflexes and respiratory depression
C) Tachycardia
D) Increased thirst
High magnesium acts as a sedative, suppressing the central nervous system and
reflexes.
8. A patient has been undergoing prolonged nasogastric (NG) suctioning. Which
electrolyte imbalance should the nurse prioritize?
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Gastric fluids are rich in potassium; suctioning removes it, leading to low levels.
Verified MCQ & ABG Rationale (2026 Edition)
INSTANT PDF DOWNLOAD
Part 1: Fluid & Electrolyte Imbalances
1. A patient with heart failure is admitted with a Potassium level of 6.5 mEq/L. Which
medication should the nurse anticipate administering to move potassium into the
intracellular space?
A) Furosemide
B) Regular Insulin and Dextrose 50%
C) Spironolactone
D) Magnesium Sulfate
Insulin shifts potassium into cells. Dextrose is given simultaneously to prevent
hypoglycemia.
2. A nurse is caring for a patient with a Sodium level of 120 mEq/L. The provider orders
an infusion of 3% Sodium Chloride. What is the priority nursing assessment?
A) Peripheral edema
B) Lung sounds (crackles) and neurological status
C) Hourly urine output
D) Skin turgor
3% NS is hypertonic; it pulls fluid into the vascular space, risking pulmonary edema and
fluid overload.
3. While assessing a patient with Hypocalcemia, the nurse inflates a blood pressure cuff
on the patient’s arm. The patient’s hand develops a carpal spasm. How should this be
documented?
A) Positive Chvostek’s sign
B) Positive Trousseau’s sign
C) Positive Babinski sign
D) Negative Allen test
Trousseau’s sign is a carpal spasm induced by ischemia, indicating neuromuscular
irritability from low calcium.
4. A patient has a Magnesium level of 1.1 mEq/L. Which assessment finding is most
consistent with this lab value?
, A) Diminished deep tendon reflexes (DTRs)
B) Hyperactive deep tendon reflexes (DTRs) and tremors
C) Lethargy and bradycardia
D) Hypotension
Low magnesium "speeds up" the nervous system, leading to hyperreflexia and
potential seizures.
5. A patient taking Furosemide (Lasix) reports muscle weakness and leg cramps. The
nurse suspects which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hyponatremia
Loop diuretics are potassium-wasting; low potassium (hypokalemia) causes muscle
weakness.
6. A patient is admitted with Hypernatremia (Sodium 158 mEq/L). Which IV fluid is most
appropriate for this patient?
A) 0.9% Normal Saline
B) 0.45% Normal Saline
C) 3% Normal Saline
D) Lactated Ringer's
Hypernatremia requires a hypotonic solution to dilute the sodium and hydrate the cells.
7. A patient with renal failure has a Magnesium level of 3.8 mEq/L. Which finding would
cause the most concern?
A) Hyperactive bowel sounds
B) Absent deep tendon reflexes and respiratory depression
C) Tachycardia
D) Increased thirst
High magnesium acts as a sedative, suppressing the central nervous system and
reflexes.
8. A patient has been undergoing prolonged nasogastric (NG) suctioning. Which
electrolyte imbalance should the nurse prioritize?
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Gastric fluids are rich in potassium; suctioning removes it, leading to low levels.
