NUR 3300 Exam 1 – Nursing Practice II – (2026)
200-Question Practice Exam with Correct Answers &
Detailed Rationales
William Paterson University
Exam 1 Overview
NUR 3300 – Nursing Practice II at William Paterson University provides students with
clinical practicum experience delivering therapeutic nursing care to clients at all stages
of human development during periods of changing health and illness. Students apply
the nursing process, clinical judgment, and evidence-based practice to provide safe,
quality patient care.
Exam 1 focuses on the following core topics:
• Fluid and Electrolyte Balance (imbalances, assessment, interventions)
• Acid-Base Balance (metabolic and respiratory disorders)
• IV Therapy and Blood Administration
• Fundamental Nursing Skills (infection control, medication administration, safety)
• Maternal-Newborn Nursing (antepartum assessment, fetal development, prenatal
care)
• Family Dynamics and Cultural Competence
• Nursing Process and Clinical Judgment
• Pharmacology Basics (medication calculations, routes, safety)
SECTION 1: Fluid and Electrolyte Balance (Questions 1-40)
,1. A patient has a serum sodium of 118 mEq/L. Which finding requires immediate
intervention?
A) Thirst
B) Seizure activity
C) Muscle cramps
D) Dry mucous membranes
Answer: B
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death. This is a medical emergency requiring immediate
intervention with hypertonic saline. Thirst, muscle cramps, and dry mucous membranes
are signs of hypernatremia or dehydration.
2. Which ECG change is characteristic of hyperkalemia?
A) Prominent U wave
B) Peaked T waves
C) ST elevation
D) Prolonged PR interval
Answer: B
Rationale: Hyperkalemia causes tall, peaked (tented) T waves. Prominent U waves occur
in hypokalemia. ST elevation is seen in myocardial infarction, and prolonged PR interval
can occur in first-degree heart block.
3. A patient with heart failure has a potassium level of 5.9 mEq/L. Which
medication should the nurse prepare to administer?
A) Spironolactone
B) Potassium chloride
C) Sodium polystyrene sulfonate (Kayexalate)
D) Furosemide
,Answer: C
Rationale: Sodium polystyrene sulfonate (Kayexalate) binds potassium in the
gastrointestinal tract and promotes its excretion, making it specific for treating
hyperkalemia. Furosemide can help but is not the primary treatment. Spironolactone is a
potassium-sparing diuretic that would worsen hyperkalemia. Potassium chloride would
increase potassium levels.
4. A postoperative patient's serum calcium is 6.5 mg/dL. The nurse expects which
finding?
A) Positive Trousseau's sign
B) Hyperactive reflexes
C) Muscle twitching
D) All of the above
Answer: D
Rationale: Hypocalcemia (normal 8.5-10.5 mg/dL) causes neuromuscular irritability,
including positive Trousseau's sign (carpal spasm with blood pressure cuff inflation),
hyperactive reflexes, and muscle twitching. Severe hypocalcemia can cause tetany and
laryngeal stridor.
5. A patient is receiving IV furosemide. The nurse should monitor for which
electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B
Rationale: Loop diuretics (furosemide) cause potassium wasting by inhibiting the sodium-
potassium-chloride cotransporter in the loop of Henle. The nurse should monitor
, potassium levels and assess for signs of hypokalemia (muscle weakness, cardiac
arrhythmias).
6. Which lab value indicates adequate treatment for hypernatremia?
A) Serum Na 155 mEq/L
B) Serum Na 145 mEq/L
C) Urine specific gravity 1.035
D) Urine output 30 mL/hr
Answer: B
Rationale: Normal serum sodium is 135-145 mEq/L. A serum sodium of 145 mEq/L
indicates the hypernatremia has been corrected to normal range. A urine specific gravity
of 1.035 indicates concentrated urine, which may be seen in dehydration. Urine output of
30 mL/hr is the minimum acceptable output.
7. A patient with burns has serum potassium of 6.2 mEq/L. Which intervention is
priority?
A) Administer IV calcium gluconate
B) Administer sodium bicarbonate
C) Initiate hemodialysis
D) Administer insulin with dextrose
Answer: A
Rationale: In hyperkalemia with ECG changes, IV calcium gluconate is the priority to
stabilize the cardiac membrane and prevent arrhythmias. Insulin with dextrose and
sodium bicarbonate shift potassium into cells. Hemodialysis is used for severe or
refractory hyperkalemia.
200-Question Practice Exam with Correct Answers &
Detailed Rationales
William Paterson University
Exam 1 Overview
NUR 3300 – Nursing Practice II at William Paterson University provides students with
clinical practicum experience delivering therapeutic nursing care to clients at all stages
of human development during periods of changing health and illness. Students apply
the nursing process, clinical judgment, and evidence-based practice to provide safe,
quality patient care.
Exam 1 focuses on the following core topics:
• Fluid and Electrolyte Balance (imbalances, assessment, interventions)
• Acid-Base Balance (metabolic and respiratory disorders)
• IV Therapy and Blood Administration
• Fundamental Nursing Skills (infection control, medication administration, safety)
• Maternal-Newborn Nursing (antepartum assessment, fetal development, prenatal
care)
• Family Dynamics and Cultural Competence
• Nursing Process and Clinical Judgment
• Pharmacology Basics (medication calculations, routes, safety)
SECTION 1: Fluid and Electrolyte Balance (Questions 1-40)
,1. A patient has a serum sodium of 118 mEq/L. Which finding requires immediate
intervention?
A) Thirst
B) Seizure activity
C) Muscle cramps
D) Dry mucous membranes
Answer: B
Rationale: Severe hyponatremia (<120 mEq/L) causes cerebral edema, leading to
seizures, coma, and death. This is a medical emergency requiring immediate
intervention with hypertonic saline. Thirst, muscle cramps, and dry mucous membranes
are signs of hypernatremia or dehydration.
2. Which ECG change is characteristic of hyperkalemia?
A) Prominent U wave
B) Peaked T waves
C) ST elevation
D) Prolonged PR interval
Answer: B
Rationale: Hyperkalemia causes tall, peaked (tented) T waves. Prominent U waves occur
in hypokalemia. ST elevation is seen in myocardial infarction, and prolonged PR interval
can occur in first-degree heart block.
3. A patient with heart failure has a potassium level of 5.9 mEq/L. Which
medication should the nurse prepare to administer?
A) Spironolactone
B) Potassium chloride
C) Sodium polystyrene sulfonate (Kayexalate)
D) Furosemide
,Answer: C
Rationale: Sodium polystyrene sulfonate (Kayexalate) binds potassium in the
gastrointestinal tract and promotes its excretion, making it specific for treating
hyperkalemia. Furosemide can help but is not the primary treatment. Spironolactone is a
potassium-sparing diuretic that would worsen hyperkalemia. Potassium chloride would
increase potassium levels.
4. A postoperative patient's serum calcium is 6.5 mg/dL. The nurse expects which
finding?
A) Positive Trousseau's sign
B) Hyperactive reflexes
C) Muscle twitching
D) All of the above
Answer: D
Rationale: Hypocalcemia (normal 8.5-10.5 mg/dL) causes neuromuscular irritability,
including positive Trousseau's sign (carpal spasm with blood pressure cuff inflation),
hyperactive reflexes, and muscle twitching. Severe hypocalcemia can cause tetany and
laryngeal stridor.
5. A patient is receiving IV furosemide. The nurse should monitor for which
electrolyte imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Answer: B
Rationale: Loop diuretics (furosemide) cause potassium wasting by inhibiting the sodium-
potassium-chloride cotransporter in the loop of Henle. The nurse should monitor
, potassium levels and assess for signs of hypokalemia (muscle weakness, cardiac
arrhythmias).
6. Which lab value indicates adequate treatment for hypernatremia?
A) Serum Na 155 mEq/L
B) Serum Na 145 mEq/L
C) Urine specific gravity 1.035
D) Urine output 30 mL/hr
Answer: B
Rationale: Normal serum sodium is 135-145 mEq/L. A serum sodium of 145 mEq/L
indicates the hypernatremia has been corrected to normal range. A urine specific gravity
of 1.035 indicates concentrated urine, which may be seen in dehydration. Urine output of
30 mL/hr is the minimum acceptable output.
7. A patient with burns has serum potassium of 6.2 mEq/L. Which intervention is
priority?
A) Administer IV calcium gluconate
B) Administer sodium bicarbonate
C) Initiate hemodialysis
D) Administer insulin with dextrose
Answer: A
Rationale: In hyperkalemia with ECG changes, IV calcium gluconate is the priority to
stabilize the cardiac membrane and prevent arrhythmias. Insulin with dextrose and
sodium bicarbonate shift potassium into cells. Hemodialysis is used for severe or
refractory hyperkalemia.
