NSG 3100 Exam 4 Actual Exam 2026/2027 – Comprehensive
Fundamentals of Nursing Practice I Assessment with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Fluid, Electrolyte, & Acid-Base Balance
Q1: A 42-year-old patient presents to the emergency department with severe vomiting
for the past 48 hours. The nurse anticipates which electrolyte imbalance as the priority
concern?
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Severe vomiting causes potassium loss through gastric fluid. Hypokalemia
(K+ <3.5 mEq/L) is a priority because it causes life-threatening cardiac dysrhythmias,
muscle weakness, and decreased deep tendon reflexes. Hyperkalemia is incorrect
because vomiting causes potassium loss, not retention. Hypercalcemia and
hyponatremia may occur but are not the priority concern in this scenario.
Q2: The nurse is reviewing laboratory results for a patient with chronic kidney disease.
Which finding requires immediate intervention?
,A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L [CORRECT]
C. Calcium 9.8 mg/dL
D. Magnesium 1.8 mg/dL
Correct Answer: B
Rationale: Normal potassium is 3.5–5.0 mEq/L. A level of 6.2 mEq/L indicates
hyperkalemia, which can cause fatal ventricular dysrhythmias and requires immediate
intervention. Sodium 140 is within normal range (136–145). Calcium 9.8 is normal
(9–10.5). Magnesium 1.8 is normal (1.3–2.1).
Q3: A patient with a history of chronic lung disease presents with confusion and
lethargy. Arterial blood gas analysis reveals pH 7.30, PaCO2 58 mmHg, and HCO3 24
mEq/L. The nurse recognizes this as which acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis [CORRECT]
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: B
Rationale: Respiratory acidosis is characterized by decreased pH (<7.35) and increased
PaCO2 (>45 mmHg) due to hypoventilation. Chronic lung disease impairs CO2
elimination. The normal HCO3 indicates the kidneys have not yet compensated.
, Metabolic acidosis would show decreased HCO3. Metabolic alkalosis shows increased
pH and HCO3. Respiratory alkalosis shows decreased PaCO2.
Q4: The nurse is caring for a patient receiving intravenous potassium chloride. Which
action by the nursing student requires immediate correction?
A. Diluting the potassium in 100 mL of normal saline
B. Administering the infusion via an IV pump
C. Giving potassium chloride IV push [CORRECT]
D. Monitoring cardiac rhythm during administration
Correct Answer: C
Rationale: Potassium must NEVER be given IV push because it causes immediate
cardiac arrest. It must always be diluted and administered slowly via infusion pump with
cardiac monitoring. Diluting in appropriate volume, using an IV pump, and monitoring
cardiac rhythm are all correct practices.
Q5: A patient reports numbness and tingling of the fingers and a positive Chvostek's
sign is elicited. The nurse anticipates which electrolyte imbalance?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia [CORRECT]
D. Hypomagnesemia
Fundamentals of Nursing Practice I Assessment with
Detailed Rationales | 100% Verified | Pass Guaranteed – A+
Graded
Section A: Fluid, Electrolyte, & Acid-Base Balance
Q1: A 42-year-old patient presents to the emergency department with severe vomiting
for the past 48 hours. The nurse anticipates which electrolyte imbalance as the priority
concern?
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Severe vomiting causes potassium loss through gastric fluid. Hypokalemia
(K+ <3.5 mEq/L) is a priority because it causes life-threatening cardiac dysrhythmias,
muscle weakness, and decreased deep tendon reflexes. Hyperkalemia is incorrect
because vomiting causes potassium loss, not retention. Hypercalcemia and
hyponatremia may occur but are not the priority concern in this scenario.
Q2: The nurse is reviewing laboratory results for a patient with chronic kidney disease.
Which finding requires immediate intervention?
,A. Sodium 140 mEq/L
B. Potassium 6.2 mEq/L [CORRECT]
C. Calcium 9.8 mg/dL
D. Magnesium 1.8 mg/dL
Correct Answer: B
Rationale: Normal potassium is 3.5–5.0 mEq/L. A level of 6.2 mEq/L indicates
hyperkalemia, which can cause fatal ventricular dysrhythmias and requires immediate
intervention. Sodium 140 is within normal range (136–145). Calcium 9.8 is normal
(9–10.5). Magnesium 1.8 is normal (1.3–2.1).
Q3: A patient with a history of chronic lung disease presents with confusion and
lethargy. Arterial blood gas analysis reveals pH 7.30, PaCO2 58 mmHg, and HCO3 24
mEq/L. The nurse recognizes this as which acid-base disturbance?
A. Metabolic acidosis
B. Respiratory acidosis [CORRECT]
C. Metabolic alkalosis
D. Respiratory alkalosis
Correct Answer: B
Rationale: Respiratory acidosis is characterized by decreased pH (<7.35) and increased
PaCO2 (>45 mmHg) due to hypoventilation. Chronic lung disease impairs CO2
elimination. The normal HCO3 indicates the kidneys have not yet compensated.
, Metabolic acidosis would show decreased HCO3. Metabolic alkalosis shows increased
pH and HCO3. Respiratory alkalosis shows decreased PaCO2.
Q4: The nurse is caring for a patient receiving intravenous potassium chloride. Which
action by the nursing student requires immediate correction?
A. Diluting the potassium in 100 mL of normal saline
B. Administering the infusion via an IV pump
C. Giving potassium chloride IV push [CORRECT]
D. Monitoring cardiac rhythm during administration
Correct Answer: C
Rationale: Potassium must NEVER be given IV push because it causes immediate
cardiac arrest. It must always be diluted and administered slowly via infusion pump with
cardiac monitoring. Diluting in appropriate volume, using an IV pump, and monitoring
cardiac rhythm are all correct practices.
Q5: A patient reports numbness and tingling of the fingers and a positive Chvostek's
sign is elicited. The nurse anticipates which electrolyte imbalance?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia [CORRECT]
D. Hypomagnesemia
