,NSG3100/NSG 3100 Exam 4 | Fundamental Concepts & Skills
for Nursing Practice | Galen College | Q & A | 2026/2027
Edition (PDF)
1. A client has a serum sodium level of 120 mEq/L. The nurse should prioritize monitoring which body
system?
A) Cardiac
B) Respiratory
C) Neurological
D) Renal
Correct Answer: Neurological
Rationale: Severe hyponatremia (sodium <125 mEq/L) causes water to shift into brain cells, leading to
cerebral edema. Neurological changes like confusion, seizures, and coma are the primary concerns and
represent the greatest immediate threat to the client. Cardiac, respiratory, and renal assessments, while
important, are secondary in this life-threatening situation.
2. Which finding is an early compensatory mechanism indicating a fluid volume deficit?
A) Bradycardia
B) Hypotension
C) Tachycardia
D) Increased urine output
Correct Answer: Tachycardia
Rationale: Tachycardia is an early compensatory mechanism in fluid volume deficit. The heart rate
increases to maintain cardiac output when circulating blood volume decreases. Hypotension is a later
sign, and bradycardia and increased urine output are not associated with hypovolemia.
,3. A nurse is assessing a client who has had diarrhea for 48 hours. The client reports fatigue, muscle
weakness, and an irregular pulse. Which laboratory value should the nurse correlate with these
findings?
A) Serum phosphate of 4.0 mEq/L
B) Serum magnesium of 2.0 mEq/L
C) Serum calcium of 9.5 mEq/L
D) Serum potassium of 2.8 mEq/L
Correct Answer: Serum potassium of 2.8 mEq/L
Rationale: Prolonged diarrhea causes significant potassium loss. Hypokalemia (normal range 3.5-5.0
mEq/L) results in fatigue, muscle weakness, leg cramps, and cardiac dysrhythmias (irregular pulse). The
other options are within normal ranges and do not correlate with the client's symptoms.
4. What is the single best indicator of a client's fluid status?
A) Skin turgor
B) Intake and output
C) Daily body weight
D) Urine specific gravity
Correct Answer: Daily body weight
Rationale: Daily body weight is the most sensitive and reliable measure of fluid balance. A change of 1 kg
corresponds to approximately 1 liter of fluid. Weight gain may indicate fluid retention, while weight loss
may indicate dehydration.
5. A client is prescribed furosemide (Lasix). The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
, Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that blocks sodium and water reabsorption in the ascending
loop of Henle. This also leads to increased potassium excretion, which can result in hypokalemia.
6. The nurse is providing teaching to clients regarding intake of dietary potassium. Which client is most
at risk for developing a potassium imbalance?
A) A client with fatty stools from taking an over-the-counter weight loss product
B) A client who experiences anorexia
C) A client with chronic heart failure treated with diuretics
D) A client taking very large doses of vitamin D
Correct Answer: A client with chronic heart failure treated with diuretics
Rationale: Clients with heart failure often take loop or thiazide diuretics, which increase potassium loss
through the kidneys, placing them at high risk for hypokalemia. Fatty stools and anorexia may affect fat-
soluble vitamin absorption, and large doses of vitamin D can affect calcium, not potassium.
7. A client's laboratory results show a serum potassium of 5.8 mEq/L. Which nursing action is the
priority?
A) Encourage potassium-rich foods
B) Administer potassium supplements as prescribed
C) Assess the cardiac rhythm and notify the provider
D) Instruct the client to increase fluid intake
Correct Answer: Assess the cardiac rhythm and notify the provider
Rationale: A potassium level of 5.8 mEq/L indicates hyperkalemia. Hyperkalemia can cause life-
threatening cardiac dysrhythmias. The priority is to assess the cardiac rhythm and notify the healthcare
provider immediately for further orders.
for Nursing Practice | Galen College | Q & A | 2026/2027
Edition (PDF)
1. A client has a serum sodium level of 120 mEq/L. The nurse should prioritize monitoring which body
system?
A) Cardiac
B) Respiratory
C) Neurological
D) Renal
Correct Answer: Neurological
Rationale: Severe hyponatremia (sodium <125 mEq/L) causes water to shift into brain cells, leading to
cerebral edema. Neurological changes like confusion, seizures, and coma are the primary concerns and
represent the greatest immediate threat to the client. Cardiac, respiratory, and renal assessments, while
important, are secondary in this life-threatening situation.
2. Which finding is an early compensatory mechanism indicating a fluid volume deficit?
A) Bradycardia
B) Hypotension
C) Tachycardia
D) Increased urine output
Correct Answer: Tachycardia
Rationale: Tachycardia is an early compensatory mechanism in fluid volume deficit. The heart rate
increases to maintain cardiac output when circulating blood volume decreases. Hypotension is a later
sign, and bradycardia and increased urine output are not associated with hypovolemia.
,3. A nurse is assessing a client who has had diarrhea for 48 hours. The client reports fatigue, muscle
weakness, and an irregular pulse. Which laboratory value should the nurse correlate with these
findings?
A) Serum phosphate of 4.0 mEq/L
B) Serum magnesium of 2.0 mEq/L
C) Serum calcium of 9.5 mEq/L
D) Serum potassium of 2.8 mEq/L
Correct Answer: Serum potassium of 2.8 mEq/L
Rationale: Prolonged diarrhea causes significant potassium loss. Hypokalemia (normal range 3.5-5.0
mEq/L) results in fatigue, muscle weakness, leg cramps, and cardiac dysrhythmias (irregular pulse). The
other options are within normal ranges and do not correlate with the client's symptoms.
4. What is the single best indicator of a client's fluid status?
A) Skin turgor
B) Intake and output
C) Daily body weight
D) Urine specific gravity
Correct Answer: Daily body weight
Rationale: Daily body weight is the most sensitive and reliable measure of fluid balance. A change of 1 kg
corresponds to approximately 1 liter of fluid. Weight gain may indicate fluid retention, while weight loss
may indicate dehydration.
5. A client is prescribed furosemide (Lasix). The nurse should monitor for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
, Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that blocks sodium and water reabsorption in the ascending
loop of Henle. This also leads to increased potassium excretion, which can result in hypokalemia.
6. The nurse is providing teaching to clients regarding intake of dietary potassium. Which client is most
at risk for developing a potassium imbalance?
A) A client with fatty stools from taking an over-the-counter weight loss product
B) A client who experiences anorexia
C) A client with chronic heart failure treated with diuretics
D) A client taking very large doses of vitamin D
Correct Answer: A client with chronic heart failure treated with diuretics
Rationale: Clients with heart failure often take loop or thiazide diuretics, which increase potassium loss
through the kidneys, placing them at high risk for hypokalemia. Fatty stools and anorexia may affect fat-
soluble vitamin absorption, and large doses of vitamin D can affect calcium, not potassium.
7. A client's laboratory results show a serum potassium of 5.8 mEq/L. Which nursing action is the
priority?
A) Encourage potassium-rich foods
B) Administer potassium supplements as prescribed
C) Assess the cardiac rhythm and notify the provider
D) Instruct the client to increase fluid intake
Correct Answer: Assess the cardiac rhythm and notify the provider
Rationale: A potassium level of 5.8 mEq/L indicates hyperkalemia. Hyperkalemia can cause life-
threatening cardiac dysrhythmias. The priority is to assess the cardiac rhythm and notify the healthcare
provider immediately for further orders.
