NSG 3800 Adult Health Exam 1
Comprehensive Practice Examination 2026
1. Which age group is at highest risk for dehydration?
A) Young adults aged 20-30 years
B) Middle-aged adults aged 40-50 years
C) Geriatric population
D) Adolescents aged 13-18 years
ANSWER: C) Geriatric population
Rationale: The geriatric population is at increased risk for dehydration due to physiological changes
including decreased total body water percentage, increased adipose tissue, and decreased muscle mass.
These changes reduce fluid reserves and impair the body's ability to maintain fluid balance. Additionally,
older adults often have diminished thirst sensation and may have cognitive or physical limitations that
affect their ability to access fluids independently.
2. A nurse is caring for a dehydrated elderly patient. Which assessment finding would be most
concerning?
A) Skin turgor slightly decreased
B) Hematocrit level of 48% in a female patient
C) Dry mucous membranes
D) Urine output of 40 mL/hr
,ANSWER: B) Hematocrit level of 48% in a female patient
Rationale: A hematocrit of 48% in a female patient is elevated above the normal range (36-47% for
females) and indicates hemoconcentration from fluid volume deficit. In elderly patients, even small
changes in hematocrit can cause severe symptoms due to reduced physiological reserve. This finding is
reportable and requires prompt intervention. The other options represent expected findings in
dehydration but are not as immediately concerning.
3. When an adult patient is dehydrated, what happens to the hematocrit level?
A) Decreases due to hemodilution
B) Remains unchanged
C) Increases due to hemoconcentration
D) Fluctuates randomly
ANSWER: C) Increases due to hemoconcentration
Rationale: In dehydration, there is a fluid volume deficit, which results in a higher concentration of red
blood cells relative to plasma volume. This hemoconcentration causes the hematocrit to rise above
normal levels (greater than 47% in females, greater than 52% in males). The increase occurs because the
ratio of red blood cells to total blood volume increases as plasma volume decreases.
4. Which of the following laboratory values would indicate fluid volume deficit?
A) Decreased BUN and decreased creatinine
B) Elevated BUN and elevated hematocrit
C) Decreased sodium and decreased hemoglobin
D) Elevated hemoglobin and decreased BUN
ANSWER: B) Elevated BUN and elevated hematocrit
,Rationale: In fluid volume deficit, BUN increases due to decreased renal perfusion and increased
reabsorption of urea. Hematocrit increases due to hemoconcentration. This combination of elevated
BUN and elevated hematocrit is a classic indicator of dehydration. The BUN to creatinine ratio may also
be elevated (>20:1) in prerenal azotemia caused by volume depletion.
5. A nurse is monitoring a patient's fluid status. Which four labs should be evaluated to assess for fluid
volume deficit or overload?
A) BUN, Creatinine, Hgb, Hct, Sodium, Specific gravity
B) WBC, Platelets, PT, PTT
C) Glucose, Potassium, Chloride, CO2
D) Liver enzymes, Albumin, Total protein
ANSWER: A) BUN, Creatinine, Hgb, Hct, Sodium, Specific gravity
Rationale: The key laboratory indicators for assessing fluid status include BUN (elevated in dehydration),
creatinine (elevated in dehydration), hemoglobin and hematocrit (elevated in hemoconcentration),
sodium (can be altered depending on type of dehydration), and specific gravity (elevated in
concentrated urine). These values provide comprehensive information about fluid balance and renal
function.
6. A patient is prescribed furosemide. What electrolyte imbalances should the nurse monitor for?
A) Hyperkalemia and hypernatremia
B) Hypokalemia and hyponatremia
C) Hypercalcemia and hypermagnesemia
D) Hypochloremia and hyperphosphatemia
ANSWER: B) Hypokalemia and hyponatremia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, leading to increased excretion of sodium, potassium, and chloride. This results in
, hypokalemia (low potassium) and hyponatremia (low sodium). Patients on furosemide may require
potassium supplementation to prevent complications such as cardiac arrhythmias.
7. Thiazide diuretics commonly cause which electrolyte imbalances?
A) Hyperkalemia and hypernatremia
B) Hypokalemia, hyponatremia, hypochloremia, and hypocalcemia
C) Hypokalemia, hyponatremia, hypochloremia, and hypercalcemia
D) Hyperkalemia, hypernatremia, hyperchloremia, and hypercalcemia
ANSWER: C) Hypokalemia, hyponatremia, hypochloremia, and hypercalcemia
Rationale: Thiazide diuretics increase excretion of sodium, potassium, and chloride while decreasing
calcium excretion, leading to hypokalemia, hyponatremia, hypochloremia, and hypercalcemia. The
calcium-sparing effect occurs because thiazides enhance calcium reabsorption in the distal convoluted
tubule, which can be beneficial for patients with osteoporosis but may cause hypercalcemia in
susceptible patients.
8. A patient has a serum sodium level of 155 mEq/L. Which type of fluid should the nurse anticipate
administering?
A) 0.9% normal saline
B) 0.45% normal saline
C) Lactated Ringer's solution
D) 5% dextrose in water
ANSWER: B) 0.45% normal saline
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Hypotonic fluids such as 0.45% normal
saline (half-strength normal saline) should be administered to dilute the extracellular fluid and lower
sodium concentration. The hypotonic solution has a lower osmolality than plasma, allowing water to
move into cells and reduce the elevated sodium concentration.
Comprehensive Practice Examination 2026
1. Which age group is at highest risk for dehydration?
A) Young adults aged 20-30 years
B) Middle-aged adults aged 40-50 years
C) Geriatric population
D) Adolescents aged 13-18 years
ANSWER: C) Geriatric population
Rationale: The geriatric population is at increased risk for dehydration due to physiological changes
including decreased total body water percentage, increased adipose tissue, and decreased muscle mass.
These changes reduce fluid reserves and impair the body's ability to maintain fluid balance. Additionally,
older adults often have diminished thirst sensation and may have cognitive or physical limitations that
affect their ability to access fluids independently.
2. A nurse is caring for a dehydrated elderly patient. Which assessment finding would be most
concerning?
A) Skin turgor slightly decreased
B) Hematocrit level of 48% in a female patient
C) Dry mucous membranes
D) Urine output of 40 mL/hr
,ANSWER: B) Hematocrit level of 48% in a female patient
Rationale: A hematocrit of 48% in a female patient is elevated above the normal range (36-47% for
females) and indicates hemoconcentration from fluid volume deficit. In elderly patients, even small
changes in hematocrit can cause severe symptoms due to reduced physiological reserve. This finding is
reportable and requires prompt intervention. The other options represent expected findings in
dehydration but are not as immediately concerning.
3. When an adult patient is dehydrated, what happens to the hematocrit level?
A) Decreases due to hemodilution
B) Remains unchanged
C) Increases due to hemoconcentration
D) Fluctuates randomly
ANSWER: C) Increases due to hemoconcentration
Rationale: In dehydration, there is a fluid volume deficit, which results in a higher concentration of red
blood cells relative to plasma volume. This hemoconcentration causes the hematocrit to rise above
normal levels (greater than 47% in females, greater than 52% in males). The increase occurs because the
ratio of red blood cells to total blood volume increases as plasma volume decreases.
4. Which of the following laboratory values would indicate fluid volume deficit?
A) Decreased BUN and decreased creatinine
B) Elevated BUN and elevated hematocrit
C) Decreased sodium and decreased hemoglobin
D) Elevated hemoglobin and decreased BUN
ANSWER: B) Elevated BUN and elevated hematocrit
,Rationale: In fluid volume deficit, BUN increases due to decreased renal perfusion and increased
reabsorption of urea. Hematocrit increases due to hemoconcentration. This combination of elevated
BUN and elevated hematocrit is a classic indicator of dehydration. The BUN to creatinine ratio may also
be elevated (>20:1) in prerenal azotemia caused by volume depletion.
5. A nurse is monitoring a patient's fluid status. Which four labs should be evaluated to assess for fluid
volume deficit or overload?
A) BUN, Creatinine, Hgb, Hct, Sodium, Specific gravity
B) WBC, Platelets, PT, PTT
C) Glucose, Potassium, Chloride, CO2
D) Liver enzymes, Albumin, Total protein
ANSWER: A) BUN, Creatinine, Hgb, Hct, Sodium, Specific gravity
Rationale: The key laboratory indicators for assessing fluid status include BUN (elevated in dehydration),
creatinine (elevated in dehydration), hemoglobin and hematocrit (elevated in hemoconcentration),
sodium (can be altered depending on type of dehydration), and specific gravity (elevated in
concentrated urine). These values provide comprehensive information about fluid balance and renal
function.
6. A patient is prescribed furosemide. What electrolyte imbalances should the nurse monitor for?
A) Hyperkalemia and hypernatremia
B) Hypokalemia and hyponatremia
C) Hypercalcemia and hypermagnesemia
D) Hypochloremia and hyperphosphatemia
ANSWER: B) Hypokalemia and hyponatremia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the ascending
loop of Henle, leading to increased excretion of sodium, potassium, and chloride. This results in
, hypokalemia (low potassium) and hyponatremia (low sodium). Patients on furosemide may require
potassium supplementation to prevent complications such as cardiac arrhythmias.
7. Thiazide diuretics commonly cause which electrolyte imbalances?
A) Hyperkalemia and hypernatremia
B) Hypokalemia, hyponatremia, hypochloremia, and hypocalcemia
C) Hypokalemia, hyponatremia, hypochloremia, and hypercalcemia
D) Hyperkalemia, hypernatremia, hyperchloremia, and hypercalcemia
ANSWER: C) Hypokalemia, hyponatremia, hypochloremia, and hypercalcemia
Rationale: Thiazide diuretics increase excretion of sodium, potassium, and chloride while decreasing
calcium excretion, leading to hypokalemia, hyponatremia, hypochloremia, and hypercalcemia. The
calcium-sparing effect occurs because thiazides enhance calcium reabsorption in the distal convoluted
tubule, which can be beneficial for patients with osteoporosis but may cause hypercalcemia in
susceptible patients.
8. A patient has a serum sodium level of 155 mEq/L. Which type of fluid should the nurse anticipate
administering?
A) 0.9% normal saline
B) 0.45% normal saline
C) Lactated Ringer's solution
D) 5% dextrose in water
ANSWER: B) 0.45% normal saline
Rationale: A sodium level of 155 mEq/L indicates hypernatremia. Hypotonic fluids such as 0.45% normal
saline (half-strength normal saline) should be administered to dilute the extracellular fluid and lower
sodium concentration. The hypotonic solution has a lower osmolality than plasma, allowing water to
move into cells and reduce the elevated sodium concentration.
