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NUR 1020 Exam 2 | Full Questions and Answers |
2026 Update | 100% Correct - Broward College
SECTION 1: Fluid & Electrolyte Balance (Questions 1-12)
Q1: A patient with congestive heart failure is receiving IV furosemide 40mg daily. The
nurse should monitor for which electrolyte imbalance as the highest priority?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Correct because loop diuretics such as furosemide increase renal excretion of
potassium, placing patients at significant risk for hypokalemia, which can precipitate life-
threatening cardiac dysrhythmias. Standard nursing practice requires monitoring serum
potassium levels and assessing for signs of hypokalemia including muscle weakness,
fatigue, and cardiac irregularities in patients receiving loop diuretics.
Q2: A patient presents with muscle weakness, fatigue, constipation, and EKG changes
showing flattened T waves and prominent U waves. Which electrolyte imbalance is most
likely present?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because hypokalemia (serum potassium <3.5 mEq/L) presents with
muscle weakness, fatigue, constipation, and characteristic EKG changes including
flattened T waves, ST-segment depression, and prominent U waves. Standard nursing
practice requires recognizing these clinical manifestations to initiate appropriate
potassium replacement therapy and cardiac monitoring.
Q3: A patient with severe vomiting has the following arterial blood gas results: pH 7.50,
PaCO2 48 mmHg, HCO3- 35 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
,2
Correct Answer: B
Rationale: Correct because metabolic alkalosis is characterized by an elevated pH (>7.45)
with elevated bicarbonate (>26 mEq/L) and a compensatory increase in PaCO2. Standard
nursing practice requires analyzing ABG values systematically: the pH is alkalotic, the
primary disturbance is metabolic (elevated HCO3-), and the elevated PaCO2 represents
appropriate respiratory compensation.
Q4: A patient with diabetic ketoacidosis has ABG results: pH 7.28, PaCO2 24 mmHg,
HCO3- 14 mEq/L. Which interpretation is most accurate?
A. Uncompensated metabolic acidosis
B. Partially compensated metabolic acidosis
C. Respiratory acidosis with metabolic compensation
D. Fully compensated metabolic alkalosis
Correct Answer: B
Rationale: Correct because the pH is acidotic (<7.35), the HCO3- is decreased indicating
metabolic acidosis as the primary disturbance, and the PaCO2 is decreased below
normal (35-45 mmHg) representing respiratory compensation through hyperventilation.
Standard nursing practice recognizes this as partially compensated metabolic acidosis
because the pH has not returned to the normal range despite compensatory
mechanisms.
Q5: A patient is receiving 0.9% sodium chloride (normal saline) at 125 mL/hr via
peripheral IV. The nurse notes the IV site is cool, pale, and swollen with sluggish flow.
Which complication has most likely occurred?
A. Phlebitis
B. Infiltration
C. Extravasation
D. Air embolism
Correct Answer: B
Rationale: Correct because infiltration occurs when IV fluid leaks into the surrounding
subcutaneous tissue, presenting with coolness, pallor, swelling, and decreased or
absent flow at the IV site. Standard nursing practice requires discontinuing the infusion,
elevating the extremity, and restarting the IV at a different site to prevent tissue damage
and ensure therapeutic delivery.
Q6: A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum
sodium of 118 mEq/L. Which nursing intervention is the highest priority?
A. Administer 3% hypertonic saline rapidly to correct sodium
B. Restrict free water intake and monitor neurologic status
, 3
C. Encourage oral fluid intake to dilute serum sodium
D. Administer furosemide to promote sodium excretion
Correct Answer: B
Rationale: Correct because SIADH treatment focuses on restricting free water intake to
correct dilutional hyponatremia gradually, with neurologic monitoring essential due to
risk of cerebral edema and seizures from severe hyponatremia. Standard nursing
practice requires fluid restriction, frequent neuro checks, and gradual sodium correction
to prevent osmotic demyelination syndrome from overly rapid correction.
Q7: A postoperative patient has a serum calcium of 6.8 mg/dL. Which assessment finding
is most consistent with this laboratory value?
A. Positive Trousseau's sign and Chvostek's sign
B. Hyperactive deep tendon reflexes and diarrhea
C. Shortened QT interval and hypertension
D. Decreased neuromuscular excitability and lethargy
Correct Answer: A
Rationale: Correct because hypocalcemia (serum calcium <8.5 mg/dL) increases
neuromuscular excitability, producing positive Trousseau's sign (carpal spasm with
blood pressure cuff inflation) and Chvostek's sign (facial muscle twitching with facial
nerve tapping). Standard nursing practice requires immediate assessment for these
signs and cardiac monitoring due to risk of tetany and laryngospasm in severe
hypocalcemia.
Q8: A patient with chronic kidney disease has a serum phosphorus of 6.2 mg/dL and a
serum calcium of 7.8 mg/dL. Which complication is the nurse most concerned about?
A. Hyperparathyroidism
B. Renal osteodystrophy
C. Hypophosphatemia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because elevated phosphorus and decreased calcium in chronic
kidney disease disrupt calcium-phosphorus homeostasis, leading to secondary
hyperparathyroidism and renal osteodystrophy characterized by bone demineralization
and increased fracture risk. Standard nursing practice requires administering phosphate
binders with meals, monitoring calcium and phosphorus levels, and assessing for bone
pain and fractures.
NUR 1020 Exam 2 | Full Questions and Answers |
2026 Update | 100% Correct - Broward College
SECTION 1: Fluid & Electrolyte Balance (Questions 1-12)
Q1: A patient with congestive heart failure is receiving IV furosemide 40mg daily. The
nurse should monitor for which electrolyte imbalance as the highest priority?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Correct because loop diuretics such as furosemide increase renal excretion of
potassium, placing patients at significant risk for hypokalemia, which can precipitate life-
threatening cardiac dysrhythmias. Standard nursing practice requires monitoring serum
potassium levels and assessing for signs of hypokalemia including muscle weakness,
fatigue, and cardiac irregularities in patients receiving loop diuretics.
Q2: A patient presents with muscle weakness, fatigue, constipation, and EKG changes
showing flattened T waves and prominent U waves. Which electrolyte imbalance is most
likely present?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because hypokalemia (serum potassium <3.5 mEq/L) presents with
muscle weakness, fatigue, constipation, and characteristic EKG changes including
flattened T waves, ST-segment depression, and prominent U waves. Standard nursing
practice requires recognizing these clinical manifestations to initiate appropriate
potassium replacement therapy and cardiac monitoring.
Q3: A patient with severe vomiting has the following arterial blood gas results: pH 7.50,
PaCO2 48 mmHg, HCO3- 35 mEq/L. Which acid-base disorder is present?
A. Respiratory acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Metabolic acidosis
,2
Correct Answer: B
Rationale: Correct because metabolic alkalosis is characterized by an elevated pH (>7.45)
with elevated bicarbonate (>26 mEq/L) and a compensatory increase in PaCO2. Standard
nursing practice requires analyzing ABG values systematically: the pH is alkalotic, the
primary disturbance is metabolic (elevated HCO3-), and the elevated PaCO2 represents
appropriate respiratory compensation.
Q4: A patient with diabetic ketoacidosis has ABG results: pH 7.28, PaCO2 24 mmHg,
HCO3- 14 mEq/L. Which interpretation is most accurate?
A. Uncompensated metabolic acidosis
B. Partially compensated metabolic acidosis
C. Respiratory acidosis with metabolic compensation
D. Fully compensated metabolic alkalosis
Correct Answer: B
Rationale: Correct because the pH is acidotic (<7.35), the HCO3- is decreased indicating
metabolic acidosis as the primary disturbance, and the PaCO2 is decreased below
normal (35-45 mmHg) representing respiratory compensation through hyperventilation.
Standard nursing practice recognizes this as partially compensated metabolic acidosis
because the pH has not returned to the normal range despite compensatory
mechanisms.
Q5: A patient is receiving 0.9% sodium chloride (normal saline) at 125 mL/hr via
peripheral IV. The nurse notes the IV site is cool, pale, and swollen with sluggish flow.
Which complication has most likely occurred?
A. Phlebitis
B. Infiltration
C. Extravasation
D. Air embolism
Correct Answer: B
Rationale: Correct because infiltration occurs when IV fluid leaks into the surrounding
subcutaneous tissue, presenting with coolness, pallor, swelling, and decreased or
absent flow at the IV site. Standard nursing practice requires discontinuing the infusion,
elevating the extremity, and restarting the IV at a different site to prevent tissue damage
and ensure therapeutic delivery.
Q6: A patient with syndrome of inappropriate antidiuretic hormone (SIADH) has a serum
sodium of 118 mEq/L. Which nursing intervention is the highest priority?
A. Administer 3% hypertonic saline rapidly to correct sodium
B. Restrict free water intake and monitor neurologic status
, 3
C. Encourage oral fluid intake to dilute serum sodium
D. Administer furosemide to promote sodium excretion
Correct Answer: B
Rationale: Correct because SIADH treatment focuses on restricting free water intake to
correct dilutional hyponatremia gradually, with neurologic monitoring essential due to
risk of cerebral edema and seizures from severe hyponatremia. Standard nursing
practice requires fluid restriction, frequent neuro checks, and gradual sodium correction
to prevent osmotic demyelination syndrome from overly rapid correction.
Q7: A postoperative patient has a serum calcium of 6.8 mg/dL. Which assessment finding
is most consistent with this laboratory value?
A. Positive Trousseau's sign and Chvostek's sign
B. Hyperactive deep tendon reflexes and diarrhea
C. Shortened QT interval and hypertension
D. Decreased neuromuscular excitability and lethargy
Correct Answer: A
Rationale: Correct because hypocalcemia (serum calcium <8.5 mg/dL) increases
neuromuscular excitability, producing positive Trousseau's sign (carpal spasm with
blood pressure cuff inflation) and Chvostek's sign (facial muscle twitching with facial
nerve tapping). Standard nursing practice requires immediate assessment for these
signs and cardiac monitoring due to risk of tetany and laryngospasm in severe
hypocalcemia.
Q8: A patient with chronic kidney disease has a serum phosphorus of 6.2 mg/dL and a
serum calcium of 7.8 mg/dL. Which complication is the nurse most concerned about?
A. Hyperparathyroidism
B. Renal osteodystrophy
C. Hypophosphatemia
D. Hypercalcemia
Correct Answer: B
Rationale: Correct because elevated phosphorus and decreased calcium in chronic
kidney disease disrupt calcium-phosphorus homeostasis, leading to secondary
hyperparathyroidism and renal osteodystrophy characterized by bone demineralization
and increased fracture risk. Standard nursing practice requires administering phosphate
binders with meals, monitoring calcium and phosphorus levels, and assessing for bone
pain and fractures.
