Exam 1: NSG3130 / NSG 3130 (Latest 2026/2027)
Fundamental Concepts & Skills for Nursing Practice II |
100% Correct Questions & Answers - Galen
Section 1: Fluid and Electrolyte Balance (Questions 1–40)
1. A patient has a serum sodium level of 128 mEq/L. The nurse
anticipates which assessment finding?
A. Dry mucous membranes
B. Thirst
C. Confusion and lethargy
D. Hyperreflexia
Answer: C
Rationale: Hyponatremia (serum sodium <135 mEq/L) causes cerebral edema due to
fluid shifts into the brain, leading to confusion, lethargy, and seizures. Dry mucous
membranes and thirst are signs of hypernatremia. Hyperreflexia is seen with
hypocalcemia.
2. A patient with heart failure is on a fluid restriction. The nurse
should include which instruction?
A. "You can drink as much as you want if you take your diuretic"
B. "Measure all fluids you drink and include foods that melt, like ice cream and gelatin"
C. "Only count water and coffee as fluids"
D. "You can save all your fluid for the evening"
,Answer: B
Rationale: Fluid restrictions include all liquids, including foods that become liquid at
room temperature (ice cream, gelatin, soup, popsicles). Spacing fluids throughout the
day is better than saving them for evening. Diuretics do not eliminate the need for fluid
restriction.
3. A patient has a serum potassium level of 6.8 mEq/L. Which
electrocardiogram (ECG) change should the nurse expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. ST-segment depression
Answer: C
Rationale: Hyperkalemia (serum potassium >5.0 mEq/L) causes peaked T waves, which
can progress to widened QRS and ventricular fibrillation. Flattened T waves and
prominent U waves are seen in hypokalemia. ST-segment depression is seen in
hypokalemia and ischemia.
4. Which electrolyte is the major intracellular cation?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B
Rationale: Potassium is the major intracellular cation (inside cells). Sodium is the major
extracellular cation. Calcium and magnesium are also primarily extracellular.
,5. Which intravenous fluid is isotonic?
A. 0.9% normal saline
B. 0.45% normal saline
C. 5% dextrose in water
D. 3% normal saline
Answer: A
Rationale: 0.9% normal saline is an isotonic solution. 0.45% normal saline is hypotonic,
5% dextrose in water is isotonic in the bag but becomes hypotonic in the body, and 3%
normal saline is hypertonic.
6. A patient is on a potassium-sparing diuretic. Which laboratory
value should the nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Potassium-sparing diuretics (spironolactone, amiloride, triamterene) block
potassium excretion, increasing the risk of hyperkalemia. The nurse should monitor
serum potassium closely, especially in patients with renal impairment or on ACE
inhibitors.
7. A patient with hypokalemia is prescribed potassium chloride.
Which route of administration is most appropriate?
, A. IV push
B. Oral
C. IV bolus over 10 minutes
D. Subcutaneous
Answer: B
Rationale: Oral potassium is preferred for mild to moderate hypokalemia. IV potassium
should never be given as a push or bolus because it can cause cardiac arrest. IV
potassium is diluted and infused at a maximum rate of 10 mEq/hour through a
peripheral IV (or 20 mEq/hour through a central line).
8. The nurse is assessing a patient with fluid volume deficit
(dehydration). Which finding is expected?
A. Edema
B. Distended neck veins
C. Dry mucous membranes
D. Crackles in lung bases
Answer: C
Rationale: Dry mucous membranes are a classic sign of fluid volume deficit. Edema,
distended neck veins, and crackles in lung bases are signs of fluid volume excess. Other
signs of dehydration include poor skin turgor, tachycardia, and hypotension.
9. What is the normal serum sodium range?
A. 135–145 mEq/L
B. 135–145 mEq/L
C. 150–160 mEq/L
D. 120–130 mEq/L
Answer: A
Fundamental Concepts & Skills for Nursing Practice II |
100% Correct Questions & Answers - Galen
Section 1: Fluid and Electrolyte Balance (Questions 1–40)
1. A patient has a serum sodium level of 128 mEq/L. The nurse
anticipates which assessment finding?
A. Dry mucous membranes
B. Thirst
C. Confusion and lethargy
D. Hyperreflexia
Answer: C
Rationale: Hyponatremia (serum sodium <135 mEq/L) causes cerebral edema due to
fluid shifts into the brain, leading to confusion, lethargy, and seizures. Dry mucous
membranes and thirst are signs of hypernatremia. Hyperreflexia is seen with
hypocalcemia.
2. A patient with heart failure is on a fluid restriction. The nurse
should include which instruction?
A. "You can drink as much as you want if you take your diuretic"
B. "Measure all fluids you drink and include foods that melt, like ice cream and gelatin"
C. "Only count water and coffee as fluids"
D. "You can save all your fluid for the evening"
,Answer: B
Rationale: Fluid restrictions include all liquids, including foods that become liquid at
room temperature (ice cream, gelatin, soup, popsicles). Spacing fluids throughout the
day is better than saving them for evening. Diuretics do not eliminate the need for fluid
restriction.
3. A patient has a serum potassium level of 6.8 mEq/L. Which
electrocardiogram (ECG) change should the nurse expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. ST-segment depression
Answer: C
Rationale: Hyperkalemia (serum potassium >5.0 mEq/L) causes peaked T waves, which
can progress to widened QRS and ventricular fibrillation. Flattened T waves and
prominent U waves are seen in hypokalemia. ST-segment depression is seen in
hypokalemia and ischemia.
4. Which electrolyte is the major intracellular cation?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Answer: B
Rationale: Potassium is the major intracellular cation (inside cells). Sodium is the major
extracellular cation. Calcium and magnesium are also primarily extracellular.
,5. Which intravenous fluid is isotonic?
A. 0.9% normal saline
B. 0.45% normal saline
C. 5% dextrose in water
D. 3% normal saline
Answer: A
Rationale: 0.9% normal saline is an isotonic solution. 0.45% normal saline is hypotonic,
5% dextrose in water is isotonic in the bag but becomes hypotonic in the body, and 3%
normal saline is hypertonic.
6. A patient is on a potassium-sparing diuretic. Which laboratory
value should the nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B
Rationale: Potassium-sparing diuretics (spironolactone, amiloride, triamterene) block
potassium excretion, increasing the risk of hyperkalemia. The nurse should monitor
serum potassium closely, especially in patients with renal impairment or on ACE
inhibitors.
7. A patient with hypokalemia is prescribed potassium chloride.
Which route of administration is most appropriate?
, A. IV push
B. Oral
C. IV bolus over 10 minutes
D. Subcutaneous
Answer: B
Rationale: Oral potassium is preferred for mild to moderate hypokalemia. IV potassium
should never be given as a push or bolus because it can cause cardiac arrest. IV
potassium is diluted and infused at a maximum rate of 10 mEq/hour through a
peripheral IV (or 20 mEq/hour through a central line).
8. The nurse is assessing a patient with fluid volume deficit
(dehydration). Which finding is expected?
A. Edema
B. Distended neck veins
C. Dry mucous membranes
D. Crackles in lung bases
Answer: C
Rationale: Dry mucous membranes are a classic sign of fluid volume deficit. Edema,
distended neck veins, and crackles in lung bases are signs of fluid volume excess. Other
signs of dehydration include poor skin turgor, tachycardia, and hypotension.
9. What is the normal serum sodium range?
A. 135–145 mEq/L
B. 135–145 mEq/L
C. 150–160 mEq/L
D. 120–130 mEq/L
Answer: A
