I (2026) PDF | Galen
Questions and Answers With rationales
2026 update
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1. A nurse is assessing a client who was admitted with dehydration.
Which of the following findings should the nurse expect?
A) Increased blood pressure
B) Distended neck veins
C) Decreased skin turgor
D) Bradycardia
Answer: C — Rationale: Dehydration leads to decreased intracellular
and extracellular fluid, causing decreased skin turgor (tenting).
Increased blood pressure, distended neck veins, and bradycardia are
associated with fluid overload, not dehydration.
2. A client with a sodium level of 126 mEq/L is at risk for which of
the following complications?
A) Seizures
B) Hyperreflexia
C) Constipation
D) Bradycardia
Answer: A — Rationale: Hyponatremia (Na < 135 mEq/L) causes
cerebral edema due to fluid shifting into the cells. This can lead to
seizure activity, confusion, and coma. Hyperreflexia is associated
with hypernatremia.
3. Which of the following intravenous solutions is isotonic?
A) 0.45% NaCl
B) 0.9% NaCl
C) D5W
D) 3% NaCl
Answer: B — Rationale: 0.9% NaCl (normal saline) is isotonic,
meaning it has the same osmolarity as blood plasma. 0.45% NaCl is
,hypotonic, D5W is initially isotonic but becomes hypotonic once
dextrose is metabolized, and 3% NaCl is hypertonic.
4. A nurse is caring for a client with hyperkalemia. Which of the
following findings should the nurse monitor for?
A) Tall, peaked T waves on ECG
B) U waves on ECG
C) Prolonged QT interval
D) Widened QRS complex with short PR
Answer: A — Rationale: Hyperkalemia causes tall, peaked T waves
and can progress to widened QRS complexes and cardiac arrest. U
waves and prolonged QT are associated with hypokalemia.
5. A client with hypocalcemia reports tingling around the mouth and
in the fingertips. Which of the following assessments should the
nurse perform?
A) Babinski reflex
B) Chvostek's sign
C) McMurray test
D) Phalen's maneuver
Answer: B — Rationale: Chvostek's sign is a facial muscle spasm
elicited by tapping the facial nerve anterior to the ear, indicating
hypocalcemia. It correlates with the tingling and numbness the
client reports (paresthesias).
6. A nurse is reviewing laboratory results for a client with metabolic
acidosis. Which of the following findings should the nurse expect?
A) pH 7.50, PaCO2 48 mmHg
B) pH 7.30, HCO3- 18 mEq/L
C) pH 7.48, HCO3- 30 mEq/L
D) pH 7.35, PaCO2 30 mmHg
Answer: B — Rationale: Metabolic acidosis is characterized by a
decreased pH (< 7.35) and a decreased bicarbonate level (< 22
mEq/L). Option A reflects respiratory acidosis with metabolic
, compensation. Option C reflects metabolic alkalosis. Option D
reflects respiratory alkalosis.
7. A client with respiratory alkalosis has a PaCO2 of 28 mmHg.
Which of the following conditions is most likely to cause this?
A) COPD exacerbation
B) Hyperventilation due to anxiety
C) Opioid overdose
D) Severe pneumonia
Answer: B — Rationale: Respiratory alkalosis is caused by
hyperventilation, which blows off too much CO2, decreasing PaCO2
(normal 35–45 mmHg). Anxiety/panic attacks are a common cause.
COPD, opioid overdose, and severe pneumonia typically cause
respiratory acidosis.
8. Which of the following is the priority nursing intervention for a
client experiencing a fluid volume deficit?
A) Encourage increased oral fluid intake
B) Administer intravenous fluids as prescribed
C) Restrict sodium intake
D) Monitor daily weight weekly
Answer: B — Rationale: When a client has a clinically significant fluid
volume deficit, the priority is to restore circulating volume through
IV fluids to prevent hypovolemic shock. Oral fluids may not be
sufficient or may be contraindicated depending on the severity.
9. A nurse is teaching a client about potassium-rich foods. Which of
the following foods should the nurse include?
A) Apples
B) Bananas
C) Rice
D) White bread