NR324 / NR-324 EXAM 1: ADULT HEALTH
ICOMPLETE -QUESTION BANK Graded A+
Latest Update 2026 | 100% Verified Answers | Chamberlain
University
1. A nurse is assessing a client with a serum magnesium level of 1.0 mEq/L. Which
finding should the nurse expect?
• A) Hypertension and bradycardia
• B) Hyperactive bowel sounds and diarrhea
• C) Muscle weakness and lethargy
• D) Positive Chvostek's sign and Trousseau's sign
Rationale: Normal magnesium is 1.5-2.5 mEq/L. A level of 1.0 indicates hypomagnesemia.
Hypomagnesemia causes neuromuscular irritability, resulting in positive Chvostek's and
Trousseau's signs, tremors, and cardiac dysrhythmias. Muscle weakness is seen in
hypermagnesemia.
2. A client is receiving 0.9% Normal Saline at 150 mL/hr. Which assessment finding
indicates that the client is developing fluid volume excess?
• A) Orthostatic hypotension
• B) Dry mucous membranes
• C) Decreased central venous pressure
• D) Crackles auscultated in the lung bases
Rationale: Crackles in the lung bases indicate pulmonary congestion from fluid volume
excess. Orthostatic hypotension, dry mucous membranes, and decreased CVP are signs of
fluid volume deficit. The nurse should monitor for signs of overload, especially in clients
with heart or renal impairment.
,3. The nurse is caring for a client with a serum potassium level of 2.8 mEq/L. Which
intervention should the nurse implement first?
• A) Administer IV potassium as prescribed
• B) Encourage potassium-rich foods
• C) Apply cardiac monitoring
• D) Assess the client's cardiac rhythm and respiratory status
Rationale: Hypokalemia (potassium < 3.5) can cause life-threatening cardiac
dysrhythmias and respiratory muscle weakness. The priority is to assess cardiac rhythm
and respiratory status first. IV potassium replacement should be done cautiously after
assessment.
4. Which arterial blood gas (ABG) result indicates compensated metabolic
acidosis?
• A) pH 7.32, PaCO2 48, HCO3 18
• B) pH 7.48, PaCO2 30, HCO3 22
• C) pH 7.30, PaCO2 30, HCO3 16
• D) pH 7.36, PaCO2 30, HCO3 18
Rationale: In compensated metabolic acidosis, the pH is within normal range (7.35-7.45),
but the HCO3 is low (<22) indicating the metabolic acidosis. The respiratory system
compensates by hyperventilating, which lowers PaCO2 (<35). Option D shows this pattern.
5. A client with severe diarrhea has the following ABG results: pH 7.30, PaCO2 40,
HCO3 16. The nurse interprets this as:
• A) Respiratory acidosis
• B) Metabolic acidosis
• C) Respiratory alkalosis
• D) Metabolic alkalosis
Rationale: The pH is low (acidosis). The HCO3 is low (<22) indicating a metabolic cause.
The PaCO2 is normal. This is uncompensated metabolic acidosis, likely due to bicarbonate
loss from severe diarrhea.
,6. A client is receiving a blood transfusion and develops severe hypotension,
bronchospasm, and stridor. What is the nurse's priority action?
• A) Slow the infusion to 50 mL/hr
• B) Administer epinephrine
• C) Stop the transfusion and call a rapid response
• D) Apply a non-rebreather mask
Rationale: Hypotension, bronchospasm, and stridor indicate a severe anaphylactic
transfusion reaction. The nurse must STOP the transfusion immediately, maintain the IV
line with normal saline, and call for emergency assistance (rapid response/code). This is a
life-threatening emergency.
7. A client with chronic kidney disease has a serum phosphate level of 6.2 mg/dL.
Which medication should the nurse anticipate administering with meals?
• A) Potassium chloride
• B) Sodium polystyrene sulfonate (Kayexalate)
• C) Calcium gluconate
• D) Sevelamer (Renagel)
Rationale: Sevelamer is a phosphate binder used to lower serum phosphate levels in clients
with CKD. It binds dietary phosphate in the GI tract and prevents its absorption. Calcium
acetate is another option. Kayexalate is used for hyperkalemia.
8. A client with heart failure is receiving spironolactone (Aldactone). Which lab
value requires immediate notification of the provider?
• A) Sodium 138 mEq/L
• B) Potassium 5.8 mEq/L
• C) BUN 22 mg/dL
• D) Creatinine 1.2 mg/dL
, Rationale: Spironolactone is a potassium-sparing diuretic. A potassium of 5.8 mEq/L
indicates hyperkalemia, which can cause fatal cardiac dysrhythmias. The provider must be
notified immediately, and the medication may need to be held.
9. A client with fluid volume deficit has a urine specific gravity of 1.035. The nurse
interprets this as:
• A) Normal finding
• B) Dilute urine
• C) Concentrated urine indicating dehydration
• D) Indicative of renal failure
Rationale: Normal urine specific gravity is 1.005-1.030. A value of 1.035 indicates
concentrated urine, which is expected in fluid volume deficit (dehydration) as the kidneys
retain water. Dilute urine (<1.005) is seen in fluid volume excess or diabetes insipidus.
10. The nurse is preparing to administer IV potassium chloride to a client. Which
action is correct?
• A) Administer the bolus over 5 minutes
• B) Use an IV push for rapid replacement
• C) Dilute in D5W solution
• D) Infuse via an infusion pump at a rate not exceeding 10-20 mEq/hr
Rationale: IV potassium MUST be diluted and infused via an infusion pump. The maximum
rate is typically 10-20 mEq/hr through a peripheral line (up to 40 mEq/hr through a
central line with cardiac monitoring). IV push or bolus is contraindicated and can cause
fatal cardiac arrest.
11. A client with COPD is experiencing shortness of breath. Which position will
best facilitate breathing?
• A) Supine with head flat
ICOMPLETE -QUESTION BANK Graded A+
Latest Update 2026 | 100% Verified Answers | Chamberlain
University
1. A nurse is assessing a client with a serum magnesium level of 1.0 mEq/L. Which
finding should the nurse expect?
• A) Hypertension and bradycardia
• B) Hyperactive bowel sounds and diarrhea
• C) Muscle weakness and lethargy
• D) Positive Chvostek's sign and Trousseau's sign
Rationale: Normal magnesium is 1.5-2.5 mEq/L. A level of 1.0 indicates hypomagnesemia.
Hypomagnesemia causes neuromuscular irritability, resulting in positive Chvostek's and
Trousseau's signs, tremors, and cardiac dysrhythmias. Muscle weakness is seen in
hypermagnesemia.
2. A client is receiving 0.9% Normal Saline at 150 mL/hr. Which assessment finding
indicates that the client is developing fluid volume excess?
• A) Orthostatic hypotension
• B) Dry mucous membranes
• C) Decreased central venous pressure
• D) Crackles auscultated in the lung bases
Rationale: Crackles in the lung bases indicate pulmonary congestion from fluid volume
excess. Orthostatic hypotension, dry mucous membranes, and decreased CVP are signs of
fluid volume deficit. The nurse should monitor for signs of overload, especially in clients
with heart or renal impairment.
,3. The nurse is caring for a client with a serum potassium level of 2.8 mEq/L. Which
intervention should the nurse implement first?
• A) Administer IV potassium as prescribed
• B) Encourage potassium-rich foods
• C) Apply cardiac monitoring
• D) Assess the client's cardiac rhythm and respiratory status
Rationale: Hypokalemia (potassium < 3.5) can cause life-threatening cardiac
dysrhythmias and respiratory muscle weakness. The priority is to assess cardiac rhythm
and respiratory status first. IV potassium replacement should be done cautiously after
assessment.
4. Which arterial blood gas (ABG) result indicates compensated metabolic
acidosis?
• A) pH 7.32, PaCO2 48, HCO3 18
• B) pH 7.48, PaCO2 30, HCO3 22
• C) pH 7.30, PaCO2 30, HCO3 16
• D) pH 7.36, PaCO2 30, HCO3 18
Rationale: In compensated metabolic acidosis, the pH is within normal range (7.35-7.45),
but the HCO3 is low (<22) indicating the metabolic acidosis. The respiratory system
compensates by hyperventilating, which lowers PaCO2 (<35). Option D shows this pattern.
5. A client with severe diarrhea has the following ABG results: pH 7.30, PaCO2 40,
HCO3 16. The nurse interprets this as:
• A) Respiratory acidosis
• B) Metabolic acidosis
• C) Respiratory alkalosis
• D) Metabolic alkalosis
Rationale: The pH is low (acidosis). The HCO3 is low (<22) indicating a metabolic cause.
The PaCO2 is normal. This is uncompensated metabolic acidosis, likely due to bicarbonate
loss from severe diarrhea.
,6. A client is receiving a blood transfusion and develops severe hypotension,
bronchospasm, and stridor. What is the nurse's priority action?
• A) Slow the infusion to 50 mL/hr
• B) Administer epinephrine
• C) Stop the transfusion and call a rapid response
• D) Apply a non-rebreather mask
Rationale: Hypotension, bronchospasm, and stridor indicate a severe anaphylactic
transfusion reaction. The nurse must STOP the transfusion immediately, maintain the IV
line with normal saline, and call for emergency assistance (rapid response/code). This is a
life-threatening emergency.
7. A client with chronic kidney disease has a serum phosphate level of 6.2 mg/dL.
Which medication should the nurse anticipate administering with meals?
• A) Potassium chloride
• B) Sodium polystyrene sulfonate (Kayexalate)
• C) Calcium gluconate
• D) Sevelamer (Renagel)
Rationale: Sevelamer is a phosphate binder used to lower serum phosphate levels in clients
with CKD. It binds dietary phosphate in the GI tract and prevents its absorption. Calcium
acetate is another option. Kayexalate is used for hyperkalemia.
8. A client with heart failure is receiving spironolactone (Aldactone). Which lab
value requires immediate notification of the provider?
• A) Sodium 138 mEq/L
• B) Potassium 5.8 mEq/L
• C) BUN 22 mg/dL
• D) Creatinine 1.2 mg/dL
, Rationale: Spironolactone is a potassium-sparing diuretic. A potassium of 5.8 mEq/L
indicates hyperkalemia, which can cause fatal cardiac dysrhythmias. The provider must be
notified immediately, and the medication may need to be held.
9. A client with fluid volume deficit has a urine specific gravity of 1.035. The nurse
interprets this as:
• A) Normal finding
• B) Dilute urine
• C) Concentrated urine indicating dehydration
• D) Indicative of renal failure
Rationale: Normal urine specific gravity is 1.005-1.030. A value of 1.035 indicates
concentrated urine, which is expected in fluid volume deficit (dehydration) as the kidneys
retain water. Dilute urine (<1.005) is seen in fluid volume excess or diabetes insipidus.
10. The nurse is preparing to administer IV potassium chloride to a client. Which
action is correct?
• A) Administer the bolus over 5 minutes
• B) Use an IV push for rapid replacement
• C) Dilute in D5W solution
• D) Infuse via an infusion pump at a rate not exceeding 10-20 mEq/hr
Rationale: IV potassium MUST be diluted and infused via an infusion pump. The maximum
rate is typically 10-20 mEq/hr through a peripheral line (up to 40 mEq/hr through a
central line with cardiac monitoring). IV push or bolus is contraindicated and can cause
fatal cardiac arrest.
11. A client with COPD is experiencing shortness of breath. Which position will
best facilitate breathing?
• A) Supine with head flat
