NURSING FUNDAMENTALS · GALEN COLLEGE
NSG 3100 EXAM 4 | ACTUAL QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100% CORRECT -
GALEN
A+
Complete Blueprint Coverage · Verified Rationales
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Fluid and Electrolyte Balance
Section 2: Acid-Base Imbalances
Section 3: Medication Administration and Safety
Section 4: Oxygenation and Respiratory Management
Section 5: Perfusion, Circulation, and Related Interventions
STUVIAACTUALEXAM
, SECTION 1: FLUID AND ELECTROLYTE BALANCE
Question 1
A 72-year-old client with heart failure is receiving IV furosemide. The morning laboratory results show serum potassium
2.9 mEq/L and the client reports muscle weakness. Which nursing action is the priority?
A. Encourage the client to eat a banana and continue the scheduled diuretic dose.
B. Hold the next dose of furosemide, notify the provider, and prepare to administer potassium replacement as ordered.
C. Increase the IV infusion rate of the current fluid to dilute the low potassium concentration.
D. Document the finding as an expected effect of loop diuretic therapy and reassess in 4 hours.
Correct Answer: B
Rationale:
Serum potassium of 2.9 mEq/L with muscle weakness indicates clinically significant hypokalemia, a common and dangerous adverse
effect of loop diuretics. The diuretic must be held and the provider notified so replacement can be ordered; continuing the drug or
simply documenting delays needed treatment.
Question 2
A postoperative client has been NPO for 36 hours and is receiving only isotonic IV fluids at 75 mL/hr. Assessment
reveals dry mucous membranes, poor skin turgor, and a serum sodium of 149 mEq/L. Which fluid imbalance is most
consistent with these findings?
A. Fluid volume overload with dilutional hyponatremia.
B. Fluid volume deficit with hypernatremia related to inadequate free-water intake.
C. Syndrome of inappropriate antidiuretic hormone secretion causing water retention.
D. Acute kidney injury producing oliguria and fluid retention.
Correct Answer: B
Rationale:
Prolonged NPO status with limited free water and ongoing insensible losses produces hypertonic dehydration (hypernatremia) and
signs of volume deficit. Fluid overload would lower sodium; SIADH causes hyponatremia; oliguria is not described.
Question 3
A client with chronic kidney disease has a serum calcium of 7.1 mg/dL and reports tingling around the mouth and in the
fingers. Which assessment finding should the nurse anticipate when testing for neuromuscular irritability?
A. Negative Trousseau and Chvostek signs indicating adequate calcium stores.
B. Positive Chvostek sign (facial muscle twitching when the facial nerve is tapped).
C. Decreased deep-tendon reflexes and muscle flaccidity from calcium excess.
D. Bounding peripheral pulses related to increased cardiac contractility.
Correct Answer: B
Rationale:
Hypocalcemia increases neuromuscular excitability and produces positive Chvostek and Trousseau signs. Hypercalcemia would
decrease reflexes; the other options describe opposite or unrelated findings.
Question 4
A client is receiving a continuous IV infusion of 3% sodium chloride for severe hyponatremia. The nurse monitors closely
for which complication that can occur with rapid correction of sodium?
A. Central pontine myelinolysis from overly rapid rise in serum sodium.
B. Acute hyperkalemia caused by sodium-potassium exchange at the cellular level.
C. Severe metabolic alkalosis from chloride excess in the hypertonic solution.
D. Hypovolemic shock secondary to fluid shift into the intracellular compartment.
Correct Answer: A
Rationale:
Overly rapid correction of chronic hyponatremia with hypertonic saline can cause osmotic demyelination (central pontine
myelinolysis). Hypertonic saline expands extracellular volume; it does not primarily cause hyperkalemia or intracellular fluid shifts that
produce shock.
NSG 3100 EXAM 4 | 2026/2027 UPDATE - GALEN Page 2
NSG 3100 EXAM 4 | ACTUAL QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100% CORRECT -
GALEN
A+
Complete Blueprint Coverage · Verified Rationales
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
Section 1: Fluid and Electrolyte Balance
Section 2: Acid-Base Imbalances
Section 3: Medication Administration and Safety
Section 4: Oxygenation and Respiratory Management
Section 5: Perfusion, Circulation, and Related Interventions
STUVIAACTUALEXAM
, SECTION 1: FLUID AND ELECTROLYTE BALANCE
Question 1
A 72-year-old client with heart failure is receiving IV furosemide. The morning laboratory results show serum potassium
2.9 mEq/L and the client reports muscle weakness. Which nursing action is the priority?
A. Encourage the client to eat a banana and continue the scheduled diuretic dose.
B. Hold the next dose of furosemide, notify the provider, and prepare to administer potassium replacement as ordered.
C. Increase the IV infusion rate of the current fluid to dilute the low potassium concentration.
D. Document the finding as an expected effect of loop diuretic therapy and reassess in 4 hours.
Correct Answer: B
Rationale:
Serum potassium of 2.9 mEq/L with muscle weakness indicates clinically significant hypokalemia, a common and dangerous adverse
effect of loop diuretics. The diuretic must be held and the provider notified so replacement can be ordered; continuing the drug or
simply documenting delays needed treatment.
Question 2
A postoperative client has been NPO for 36 hours and is receiving only isotonic IV fluids at 75 mL/hr. Assessment
reveals dry mucous membranes, poor skin turgor, and a serum sodium of 149 mEq/L. Which fluid imbalance is most
consistent with these findings?
A. Fluid volume overload with dilutional hyponatremia.
B. Fluid volume deficit with hypernatremia related to inadequate free-water intake.
C. Syndrome of inappropriate antidiuretic hormone secretion causing water retention.
D. Acute kidney injury producing oliguria and fluid retention.
Correct Answer: B
Rationale:
Prolonged NPO status with limited free water and ongoing insensible losses produces hypertonic dehydration (hypernatremia) and
signs of volume deficit. Fluid overload would lower sodium; SIADH causes hyponatremia; oliguria is not described.
Question 3
A client with chronic kidney disease has a serum calcium of 7.1 mg/dL and reports tingling around the mouth and in the
fingers. Which assessment finding should the nurse anticipate when testing for neuromuscular irritability?
A. Negative Trousseau and Chvostek signs indicating adequate calcium stores.
B. Positive Chvostek sign (facial muscle twitching when the facial nerve is tapped).
C. Decreased deep-tendon reflexes and muscle flaccidity from calcium excess.
D. Bounding peripheral pulses related to increased cardiac contractility.
Correct Answer: B
Rationale:
Hypocalcemia increases neuromuscular excitability and produces positive Chvostek and Trousseau signs. Hypercalcemia would
decrease reflexes; the other options describe opposite or unrelated findings.
Question 4
A client is receiving a continuous IV infusion of 3% sodium chloride for severe hyponatremia. The nurse monitors closely
for which complication that can occur with rapid correction of sodium?
A. Central pontine myelinolysis from overly rapid rise in serum sodium.
B. Acute hyperkalemia caused by sodium-potassium exchange at the cellular level.
C. Severe metabolic alkalosis from chloride excess in the hypertonic solution.
D. Hypovolemic shock secondary to fluid shift into the intracellular compartment.
Correct Answer: A
Rationale:
Overly rapid correction of chronic hyponatremia with hypertonic saline can cause osmotic demyelination (central pontine
myelinolysis). Hypertonic saline expands extracellular volume; it does not primarily cause hyperkalemia or intracellular fluid shifts that
produce shock.
NSG 3100 EXAM 4 | 2026/2027 UPDATE - GALEN Page 2
