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NSG3130 / NSG 3130 Fundamental II Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Fluid, Electrolyte, and Acid-Base Balance | Q1 – Q15
Section 2 | Medication Administration and Dosage Calculations | Q16 – Q30
Section 3 | Oxygenation and Respiratory Care | Q31 – Q45
Section 4 | Nutrition, Elimination, and Mobility | Q46 – Q60
Section 5 | Perioperative Nursing and Wound Care | Q61 – Q75
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
Question 1 of 75
A 68-year-old female client is admitted to the medical-surgical unit with acute gastroenteritis.
She has been vomiting for 2 days and reports feeling "dizzy when I stand up." The nurse assesses
orthostatic hypotension, dry mucous membranes, and decreased skin turgor. Her current serum
sodium is 148 mEq/L. Based on these assessment findings, the nurse anticipates which primary
intravenous prescription to restore intravascular volume?
A. Administer 0.45% sodium chloride (Half Normal Saline)
B. Initiate a infusion of 5% Dextrose in Water (D5W)
C. Infuse 0.9% sodium chloride (Normal Saline) ✓ CORRECT
D. Prepare a transfusion of packed red blood cells
Correct Answer: C
Rationale: The client is exhibiting signs of isotonic fluid volume deficit, and 0.9% sodium
chloride is an isotonic solution that effectively expands the intravascular compartment without
,2
causing fluid shifts between compartments. 0.45% sodium chloride is hypotonic and could cause
fluid to shift into cells, exacerbating intracellular dehydration, while D5W is also hypotonic once
the dextrose is metabolized. In clinical practice, Normal Saline is the standard initial
resuscitation fluid for clients with dehydration and hypotension.
Question 2 of 75
While reviewing the morning laboratory results for a client with chronic kidney disease, the
nurse notes a potassium level of 6.5 mEq/L. The client is currently complaining of nausea and
generalized weakness. Upon assessment of the cardiac rhythm, the nurse recognizes which
electrocardiographic change as the most critical priority requiring immediate intervention?
A. Presence of U waves
B. Tall, peaked T waves ✓ CORRECT
C. Prolonged PR interval
D. Depressed ST segment
Correct Answer: B
Rationale: Tall, peaked T waves are the earliest and most characteristic ECG manifestation of
hyperkalemia, indicating the need for immediate cardiac protective measures. U waves are
classically associated with hypokalemia, while prolonged PR intervals and ST depression are
less specific to hyperkalemia and may represent other electrolyte imbalances or ischemia. Rapid
identification of these changes is vital because severe hyperkalemia can progress to life-
threatening arrhythmias such as ventricular fibrillation.
Question 3 of 75
A 22-year-old male client presents to the emergency department with a severe exacerbation of
asthma. Arterial blood gas results are as follows: pH 7.30, PaCO2 48 mm Hg, and HCO3- 24
mEq/L. The nurse interprets these results as indicative of which acid-base disorder?
,3
A. Uncompensated respiratory acidosis ✓ CORRECT
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
Rationale: The pH is below the normal range of 7.35, indicating acidemia, and the PaCO2 is
elevated, which represents the respiratory component causing the acidity. The HCO3- is normal,
signifying that the kidneys have not yet begun to retain bicarbonate to compensate for the
respiratory retention of carbon dioxide. If compensation were occurring, the HCO3- would be
elevated to buffer the acidotic state.
Question 4 of 75
An 80-year-old resident in a long-term care facility has a serum calcium level of 7.8 mg/dL.
During the nursing assessment, which finding would the nurse most likely attribute to this
specific electrolyte imbalance?
A. Positive Chvostek’s sign ✓ CORRECT
B. Weak peripheral pulses
C. Hyperactive bowel sounds
D. Flushing of the skin
Correct Answer: A
Rationale: Positive Chvostek’s sign is a clinical indicator of neuromuscular irritability caused by
hypocalcemia, which results from increased nerve excitability. Weak peripheral pulses and
flushing are more commonly associated with hypercalcemia, while hyperactive bowel sounds are
not a typical manifestation of low calcium levels. Testing for Chvostek’s sign involves tapping
the facial nerve to observe for facial muscle spasm.
, 4
Question 5 of 75
The nurse is caring for a client who is postoperative day 1 following a total hip replacement. The
client has been receiving 0.9% Normal Saline at 100 mL/hr since surgery. The nurse notes that
the client’s lungs have crackles bilaterally at the bases, and the client has gained 2 kg since
admission. The nurse should immediately prioritize which intervention?
A. Administer a prescribed diuretic
B. Increase the intravenous fluid rate
C. Decrease the intravenous fluid rate ✓ CORRECT
D. Elevate the head of the bed to 90 degrees
Correct Answer: C
Rationale: The client is exhibiting signs of fluid volume excess, evidenced by weight gain,
crackles in the lungs, and a history of aggressive fluid replacement, so decreasing the IV rate is
the priority action to prevent pulmonary edema. Administering a diuretic may be necessary if
prescribed, but the first nursing action is to stop the source of the fluid overload. Elevating the
head of the bed assists with breathing but does not address the underlying cause of the overload.
Question 6 of 75
A client with heart failure is prescribed furosemide 40 mg PO daily. The nurse is monitoring for
potential complications of this therapy. Which laboratory value would be of greatest concern to
the nurse when assessing for the most common adverse effect of loop diuretics?
A. Increased serum sodium
B. Decreased serum potassium ✓ CORRECT
C. Increased serum magnesium
D. Decreased serum calcium
NSG3130 / NSG 3130 Fundamental II Actual
Exam 2026/2027 | Complete Exam-Style
Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Fluid, Electrolyte, and Acid-Base Balance | Q1 – Q15
Section 2 | Medication Administration and Dosage Calculations | Q16 – Q30
Section 3 | Oxygenation and Respiratory Care | Q31 – Q45
Section 4 | Nutrition, Elimination, and Mobility | Q46 – Q60
Section 5 | Perioperative Nursing and Wound Care | Q61 – Q75
SECTION 1: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
Question 1 of 75
A 68-year-old female client is admitted to the medical-surgical unit with acute gastroenteritis.
She has been vomiting for 2 days and reports feeling "dizzy when I stand up." The nurse assesses
orthostatic hypotension, dry mucous membranes, and decreased skin turgor. Her current serum
sodium is 148 mEq/L. Based on these assessment findings, the nurse anticipates which primary
intravenous prescription to restore intravascular volume?
A. Administer 0.45% sodium chloride (Half Normal Saline)
B. Initiate a infusion of 5% Dextrose in Water (D5W)
C. Infuse 0.9% sodium chloride (Normal Saline) ✓ CORRECT
D. Prepare a transfusion of packed red blood cells
Correct Answer: C
Rationale: The client is exhibiting signs of isotonic fluid volume deficit, and 0.9% sodium
chloride is an isotonic solution that effectively expands the intravascular compartment without
,2
causing fluid shifts between compartments. 0.45% sodium chloride is hypotonic and could cause
fluid to shift into cells, exacerbating intracellular dehydration, while D5W is also hypotonic once
the dextrose is metabolized. In clinical practice, Normal Saline is the standard initial
resuscitation fluid for clients with dehydration and hypotension.
Question 2 of 75
While reviewing the morning laboratory results for a client with chronic kidney disease, the
nurse notes a potassium level of 6.5 mEq/L. The client is currently complaining of nausea and
generalized weakness. Upon assessment of the cardiac rhythm, the nurse recognizes which
electrocardiographic change as the most critical priority requiring immediate intervention?
A. Presence of U waves
B. Tall, peaked T waves ✓ CORRECT
C. Prolonged PR interval
D. Depressed ST segment
Correct Answer: B
Rationale: Tall, peaked T waves are the earliest and most characteristic ECG manifestation of
hyperkalemia, indicating the need for immediate cardiac protective measures. U waves are
classically associated with hypokalemia, while prolonged PR intervals and ST depression are
less specific to hyperkalemia and may represent other electrolyte imbalances or ischemia. Rapid
identification of these changes is vital because severe hyperkalemia can progress to life-
threatening arrhythmias such as ventricular fibrillation.
Question 3 of 75
A 22-year-old male client presents to the emergency department with a severe exacerbation of
asthma. Arterial blood gas results are as follows: pH 7.30, PaCO2 48 mm Hg, and HCO3- 24
mEq/L. The nurse interprets these results as indicative of which acid-base disorder?
,3
A. Uncompensated respiratory acidosis ✓ CORRECT
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic acidosis
D. Respiratory alkalosis
Correct Answer: A
Rationale: The pH is below the normal range of 7.35, indicating acidemia, and the PaCO2 is
elevated, which represents the respiratory component causing the acidity. The HCO3- is normal,
signifying that the kidneys have not yet begun to retain bicarbonate to compensate for the
respiratory retention of carbon dioxide. If compensation were occurring, the HCO3- would be
elevated to buffer the acidotic state.
Question 4 of 75
An 80-year-old resident in a long-term care facility has a serum calcium level of 7.8 mg/dL.
During the nursing assessment, which finding would the nurse most likely attribute to this
specific electrolyte imbalance?
A. Positive Chvostek’s sign ✓ CORRECT
B. Weak peripheral pulses
C. Hyperactive bowel sounds
D. Flushing of the skin
Correct Answer: A
Rationale: Positive Chvostek’s sign is a clinical indicator of neuromuscular irritability caused by
hypocalcemia, which results from increased nerve excitability. Weak peripheral pulses and
flushing are more commonly associated with hypercalcemia, while hyperactive bowel sounds are
not a typical manifestation of low calcium levels. Testing for Chvostek’s sign involves tapping
the facial nerve to observe for facial muscle spasm.
, 4
Question 5 of 75
The nurse is caring for a client who is postoperative day 1 following a total hip replacement. The
client has been receiving 0.9% Normal Saline at 100 mL/hr since surgery. The nurse notes that
the client’s lungs have crackles bilaterally at the bases, and the client has gained 2 kg since
admission. The nurse should immediately prioritize which intervention?
A. Administer a prescribed diuretic
B. Increase the intravenous fluid rate
C. Decrease the intravenous fluid rate ✓ CORRECT
D. Elevate the head of the bed to 90 degrees
Correct Answer: C
Rationale: The client is exhibiting signs of fluid volume excess, evidenced by weight gain,
crackles in the lungs, and a history of aggressive fluid replacement, so decreasing the IV rate is
the priority action to prevent pulmonary edema. Administering a diuretic may be necessary if
prescribed, but the first nursing action is to stop the source of the fluid overload. Elevating the
head of the bed assists with breathing but does not address the underlying cause of the overload.
Question 6 of 75
A client with heart failure is prescribed furosemide 40 mg PO daily. The nurse is monitoring for
potential complications of this therapy. Which laboratory value would be of greatest concern to
the nurse when assessing for the most common adverse effect of loop diuretics?
A. Increased serum sodium
B. Decreased serum potassium ✓ CORRECT
C. Increased serum magnesium
D. Decreased serum calcium
