,NSG 3850 Exam 2 | Questions & Verified
Answers | 2026 Edition | Galen College
1. A patient presents with confusion, lethargy, and a serum sodium level of 118 mEq/L. Which
assessment finding does the nurse anticipate?
A) Weak pulse and hypotension
B) Thirst and dry mucous membranes
C) Seizures and coma
D) Cardiac dysrhythmias and muscle weakness
Correct Answer: Seizures and coma
Rationale: Severe hyponatremia (sodium <120 mEq/L) leads to cerebral edema due to water shifting into
brain cells, resulting in neurological symptoms such as seizures and coma. Thirst and dry mucous
membranes are signs of hypernatremia, while cardiac dysrhythmias are more characteristic of
electrolyte imbalances like hyperkalemia or hypokalemia.
2. The fraction of total body water (TBW) contained in the intracellular space in adults is approximately:
A) Three-fourths
B) Two-thirds
C) One-half
D) One-third
Correct Answer: Two-thirds
Rationale: Approximately two-thirds (65-75%) of total body water is located within the intracellular fluid
(ICF) compartment, which is the primary fluid compartment of the body. The remaining one-third is in
the extracellular space.
3. Which electrolyte imbalances are associated with increased neuromuscular excitability?
A) Hypokalemia and hyperphosphatemia
,B) Hyperkalemia and hypophosphatemia
C) Hypocalcemia and hypomagnesemia
D) Hypercalcemia and hypermagnesemia
Correct Answer: Hypocalcemia and hypomagnesemia
Rationale: Both hypocalcemia and hypomagnesemia increase neuronal membrane excitability, leading
to tetany, muscle cramps, and paresthesias. Hypercalcemia and hypermagnesemia have a depressant
effect on neuromuscular function.
4. The amount of gas remaining in the lungs after a maximal expiration is called the:
A) Residual volume
B) Functional residual capacity
C) Expiratory reserve volume
D) Vital capacity
Correct Answer: Residual volume
Rationale: Residual volume is the amount of gas remaining in the lungs after a maximal expiration. This
air cannot be voluntarily exhaled and helps to keep the alveoli open.
5. A patient with a history of heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance
is the patient at highest risk for developing?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
Correct Answer: Hypokalemia
, Rationale: Furosemide is a loop diuretic that inhibits sodium and potassium reabsorption in the loop of
Henle, leading to increased potassium excretion in the urine. This places the patient at high risk for
hypokalemia.
6. Which ABG value is consistent with a diagnosis of respiratory acidosis?
A) pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B) pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
C) pH 7.35, PaCO2 40 mmHg, HCO3 24 mEq/L
D) pH 7.45, PaCO2 48 mmHg, HCO3 30 mEq/L
Correct Answer: pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mmHg).
The HCO3 is normal (22-26) in the acute phase, indicating the primary problem is respiratory.
7. A patient with chronic obstructive pulmonary disease (COPD) has a barrel chest and uses accessory
muscles to breathe. These findings are most consistent with which condition?
A) Chronic bronchitis
B) Emphysema
C) Asthma
D) Sarcoidosis
Correct Answer: Emphysema
Rationale: Emphysema is characterized by destructive changes of the alveolar walls without fibrosis,
leading to air trapping and a barrel chest. Patients often use accessory muscles and have prolonged
expiration to overcome airway resistance.
8. A patient presents with a productive cough and parenchymal infiltrates on chest X-ray. The nurse
suspects which condition?
A) Bacterial pneumonia
Answers | 2026 Edition | Galen College
1. A patient presents with confusion, lethargy, and a serum sodium level of 118 mEq/L. Which
assessment finding does the nurse anticipate?
A) Weak pulse and hypotension
B) Thirst and dry mucous membranes
C) Seizures and coma
D) Cardiac dysrhythmias and muscle weakness
Correct Answer: Seizures and coma
Rationale: Severe hyponatremia (sodium <120 mEq/L) leads to cerebral edema due to water shifting into
brain cells, resulting in neurological symptoms such as seizures and coma. Thirst and dry mucous
membranes are signs of hypernatremia, while cardiac dysrhythmias are more characteristic of
electrolyte imbalances like hyperkalemia or hypokalemia.
2. The fraction of total body water (TBW) contained in the intracellular space in adults is approximately:
A) Three-fourths
B) Two-thirds
C) One-half
D) One-third
Correct Answer: Two-thirds
Rationale: Approximately two-thirds (65-75%) of total body water is located within the intracellular fluid
(ICF) compartment, which is the primary fluid compartment of the body. The remaining one-third is in
the extracellular space.
3. Which electrolyte imbalances are associated with increased neuromuscular excitability?
A) Hypokalemia and hyperphosphatemia
,B) Hyperkalemia and hypophosphatemia
C) Hypocalcemia and hypomagnesemia
D) Hypercalcemia and hypermagnesemia
Correct Answer: Hypocalcemia and hypomagnesemia
Rationale: Both hypocalcemia and hypomagnesemia increase neuronal membrane excitability, leading
to tetany, muscle cramps, and paresthesias. Hypercalcemia and hypermagnesemia have a depressant
effect on neuromuscular function.
4. The amount of gas remaining in the lungs after a maximal expiration is called the:
A) Residual volume
B) Functional residual capacity
C) Expiratory reserve volume
D) Vital capacity
Correct Answer: Residual volume
Rationale: Residual volume is the amount of gas remaining in the lungs after a maximal expiration. This
air cannot be voluntarily exhaled and helps to keep the alveoli open.
5. A patient with a history of heart failure is prescribed furosemide (Lasix). Which electrolyte imbalance
is the patient at highest risk for developing?
A) Hyperkalemia
B) Hyponatremia
C) Hypokalemia
D) Hypercalcemia
Correct Answer: Hypokalemia
, Rationale: Furosemide is a loop diuretic that inhibits sodium and potassium reabsorption in the loop of
Henle, leading to increased potassium excretion in the urine. This places the patient at high risk for
hypokalemia.
6. Which ABG value is consistent with a diagnosis of respiratory acidosis?
A) pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
B) pH 7.50, PaCO2 30 mmHg, HCO3 22 mEq/L
C) pH 7.35, PaCO2 40 mmHg, HCO3 24 mEq/L
D) pH 7.45, PaCO2 48 mmHg, HCO3 30 mEq/L
Correct Answer: pH 7.30, PaCO2 50 mmHg, HCO3 24 mEq/L
Rationale: Respiratory acidosis is characterized by a low pH (<7.35) and an elevated PaCO2 (>45 mmHg).
The HCO3 is normal (22-26) in the acute phase, indicating the primary problem is respiratory.
7. A patient with chronic obstructive pulmonary disease (COPD) has a barrel chest and uses accessory
muscles to breathe. These findings are most consistent with which condition?
A) Chronic bronchitis
B) Emphysema
C) Asthma
D) Sarcoidosis
Correct Answer: Emphysema
Rationale: Emphysema is characterized by destructive changes of the alveolar walls without fibrosis,
leading to air trapping and a barrel chest. Patients often use accessory muscles and have prolonged
expiration to overcome airway resistance.
8. A patient presents with a productive cough and parenchymal infiltrates on chest X-ray. The nurse
suspects which condition?
A) Bacterial pneumonia
