EXAM QUESTIONS AND ANSWERS + RATIONALES | STUDY
GUIDE | 100% CORRECT
1. A nurse is teaching a patient about a low-sodium diet. Which food choice indicates effective
teaching?
A) Canned tomato soup
B) Fresh apple
C) Smoked ham
D) Cottage cheese
Correct Answer: B) Fresh apple
Rationale: Fresh fruits and vegetables are naturally low in sodium. Canned soups, smoked meats,
and cheeses are typically high in sodium . This indicates the patient understands the dietary
restriction.
2. The nurse is caring for a patient with fluid volume excess. Which finding is expected?
A) Poor skin turgor
B) Flat neck veins
C) Bounding pulses and crackles in the lungs
D) Orthostatic hypotension
Correct Answer: C) Bounding pulses and crackles in the lungs
Rationale: Fluid overload increases circulating volume, causing bounding pulses, distended neck
veins, and pulmonary congestion with crackles . Poor skin turgor and orthostatic hypotension
indicate fluid volume deficit.
3. A patient’s arterial blood gas shows pH 7.30, PaCO₂ 55 mmHg, HCO₃⁻ 26 mEq/L. This acid-
base imbalance is most likely caused by which condition?
,A) Severe vomiting
B) Chronic obstructive pulmonary disease (COPD)
C) Diabetic ketoacidosis
D) Hyperventilation
Correct Answer: B) Chronic obstructive pulmonary disease (COPD)
Rationale: The pH is acidic (<7.35), PaCO₂ is elevated (>45 mmHg - respiratory acidosis), and
HCO₃⁻ is slightly elevated (partial metabolic compensation). COPD is a common cause of
chronic respiratory acidosis .
4. The nurse is caring for a patient with hypomagnesemia. Which clinical manifestation should
the nurse expect?
A) Hypoactive deep tendon reflexes
B) Bradycardia
C) Tremors, hyperactive reflexes, and tetany
D) Lethargy and confusion
Correct Answer: C) Tremors, hyperactive reflexes, and tetany
Rationale: Low magnesium increases neuromuscular excitability, causing tremors, hyperreflexia,
tetany, and positive Chvostek/Trousseau signs . Hypoactive reflexes and bradycardia are seen in
hypermagnesemia.
5. A patient is admitted with a serum sodium of 118 mEq/L. Which priority intervention should
the nurse implement?
A) Encourage increased oral fluid intake
B) Monitor for signs of cerebral edema and institute seizure precautions
C) Administer hypertonic saline without monitoring
D) Place the patient on a high-fiber diet
,Correct Answer: B) Monitor for signs of cerebral edema and institute seizure precautions
Rationale: Severe hyponatremia (<120 mEq/L) can cause cerebral edema, confusion, seizures,
and coma . Safety measures and careful monitoring are critical. Hypertonic saline must be
administered slowly per order.
6. The nurse is administering 0.9% normal saline to a patient with hypovolemia. This fluid is
classified as:
A) Hypotonic
B) Isotonic
C) Hypertonic
D) Colloid
Correct Answer: B) Isotonic
Rationale: 0.9% sodium chloride has the same osmolarity as plasma (about 308 mOsm/L) and
expands extracellular volume without shifting water between compartments .
7. A patient receiving furosemide (Lasix) is at risk for which electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypercalcemia
D) Hypophosphatemia
Correct Answer: B) Hypokalemia
Rationale: Furosemide is a loop diuretic that promotes potassium loss in the urine, leading to
hypokalemia . Potassium supplementation and monitoring are essential.
, 8. The nurse is caring for a patient with a serum potassium level of 2.9 mEq/L. Which ECG
change should the nurse anticipate?
A) Peaked T waves
B) Widened QRS complex
C) U wave and flattened T wave
D) Shortened QT interval
Correct Answer: C) U wave and flattened T wave
Rationale: Hypokalemia causes a U wave, flattened or inverted T waves, and ST segment
depression . Peaked T waves and widened QRS are associated with hyperkalemia.
9. A patient is admitted with a serum sodium of 118 mEq/L. The nurse should implement which
priority intervention?
A) Encourage increased oral fluid intake
B) Monitor for signs of cerebral edema and institute seizure precautions
C) Administer hypertonic saline without monitoring
D) Place the patient on a high-fiber diet
Correct Answer: B) Monitor for signs of cerebral edema and institute seizure precautions
Rationale: Severe hyponatremia can cause cerebral edema, confusion, seizures, and coma. Safety
measures and careful monitoring are critical .
10. Which electrolyte imbalance is most commonly associated with tumor lysis syndrome?
A) Hypocalcemia
B) Hyperkalemia
C) Hyponatremia
D) Hypomagnesemia