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NURS 4405: ADULT HEALTH II EXAM 1 STUDY GUIDELATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
NURS 4405: Adult Health II Exam 1 Study Guide
250 Questions with Rationales
SECTION 1: FLUID AND ELECTROLYTE IMBALANCES (Questions 1-35)
1. A patient with heart failure is taking furosemide (Lasix). The nurse reviews the
serum potassium level, which is 3.4 mEq/L. Based on this data, which food should
the nurse encourage the client to consume?
A. Baked fish
B. Iced tea
C. Banana
D. Peas
Answer: C. Banana
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) poses a risk for cardiac arrhythmias and
requires prompt correction. Bananas are a potassium-rich food that can help raise
potassium levels . Furosemide is a loop diuretic that increases potassium excretion,
making this finding common in patients taking Lasix.
2. An increase in blood hydrostatic pressure would result in which fluid volume
disturbance?
A. Fluid volume excess, because the pressure would force fluid out through the
lymphatic system and into the interstitial compartment
B. Fluid volume deficit because the pressure would force fluid out of the interstitial
compartment and into the lymphatic system
C. Fluid volume excess because the pressure would force fluid out through the capillary
walls and into the interstitial compartment
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D. Fluid volume deficit because the pressure would force fluid out of the interstitial
compartment and into the capillaries
Answer: C. Fluid volume excess because the pressure would force fluid out through
the capillary walls and into the interstitial compartment
Rationale: Increased capillary hydrostatic pressure forces fluid out of the capillaries and
into the interstitial space, leading to fluid volume excess and edema . This mechanism
is seen in conditions such as heart failure where increased venous pressure leads to
peripheral edema.
3. A patient is receiving intravenous fluids at 150 mL/hr. Upon assessment, the
nurse notes crackles, shortness of breath, and jugular vein distention. Based on
this data, which complication of IV fluid therapy does the nurse anticipate?
A. Speed shock
B. Fluid volume excess
C. Pulmonary embolism
D. Allergic reaction
Answer: B. Fluid volume excess
Rationale: Crackles, shortness of breath, and jugular vein distention are classic signs of
fluid volume excess, which can lead to pulmonary edema. Patients receiving IV fluids
postoperatively, especially following cardiac surgery, are at increased risk for fluid
overload .
4. Which total serum calcium level would be considered normal in an adult client?
A. 9.88 mg/dL
B. 7.03 mg/dL
C. 10.5 mg/dL
D. 11.2 mg/dL
Answer: A. 9.88 mg/dL
Rationale: Normal serum calcium levels in adults range from 8.5 to 10.2 mg/dL. A level
of 9.88 mg/dL falls within this normal range . Hypocalcemia (<8.5 mg/dL) and
hypercalcemia (>10.2 mg/dL) require further evaluation and intervention.
5. A patient's phosphorus level is 2.0 mg/dL. Based on this data, which nursing
intervention is most appropriate?
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A. Enforce contact precautions
B. Encourage consumption of a high-calorie carbohydrate diet
C. Strain all urine
D. Encourage consumption of milk and yogurt
Answer: D. Encourage consumption of milk and yogurt
Rationale: The normal phosphorus level is 2.5-4.5 mg/dL. A level of 2.0 mg/dL indicates
hypophosphatemia. Milk and yogurt are phosphorus-rich foods that can help correct
this imbalance .
6. Which client statement indicates that additional teaching about sodium
restriction is required?
A. "I can use as much salt substitute as I want."
B. "I have to read the labels on foods to find out the sodium content."
C. "I should avoid adding salt when cooking."
D. "Canned soups are high in sodium."
Answer: A. "I can use as much salt substitute as I want."
Rationale: Salt substitutes often contain potassium chloride and should be used
cautiously, especially in patients with renal impairment or those taking potassium-
sparing diuretics. This statement indicates a need for further teaching .
7. A patient is exhibiting signs of severe generalized edema. Which term best
describes this condition?
A. Pitting edema
B. Anasarca
C. Hypervolemia
D. Orthopnea
Answer: B. Anasarca
Rationale: Anasarca is the term for severe, generalized edema involving all body tissues.
It is seen in severe fluid volume excess and conditions such as heart failure, liver failure,
and nephrotic syndrome .
8. A patient is diagnosed with fluid volume deficit. Which assessment finding would
the nurse expect?
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A. Jugular vein distention
B. Crackles in the lungs
C. Decreased skin turgor
D. Peripheral edema
Answer: C. Decreased skin turgor
Rationale: Decreased skin turgor is a classic sign of fluid volume deficit (dehydration).
Other signs include dry mucous membranes, decreased urine output, tachycardia, and
hypotension. JVD, crackles, and edema indicate fluid volume excess .
9. A patient is receiving IV fluids and the nurse notes edema at the IV site. Which
action should the nurse take first?
A. Apply a warm compress
B. Slow the IV rate
C. Stop the IV infusion
D. Notify the healthcare provider
Answer: C. Stop the IV infusion
Rationale: Edema at the IV site indicates infiltration. The priority action is to stop the IV
infusion and remove the catheter to prevent further fluid leakage into the surrounding
tissue .
10. A patient has a sodium level of 125 mEq/L. Which assessment finding would the
nurse expect?
A. Thirst
B. Dry mucous membranes
C. Confusion
D. Decreased urine output
Answer: C. Confusion
Rationale: Hyponatremia (Na⁺ <135 mEq/L) can cause confusion, headache, nausea,
and seizures due to cerebral edema. Severe hyponatremia is a medical emergency
requiring careful correction .
11. A patient has a potassium level of 6.2 mEq/L. Which finding would the nurse
expect?
NURS 4405: ADULT HEALTH II EXAM 1 STUDY GUIDELATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
NURS 4405: Adult Health II Exam 1 Study Guide
250 Questions with Rationales
SECTION 1: FLUID AND ELECTROLYTE IMBALANCES (Questions 1-35)
1. A patient with heart failure is taking furosemide (Lasix). The nurse reviews the
serum potassium level, which is 3.4 mEq/L. Based on this data, which food should
the nurse encourage the client to consume?
A. Baked fish
B. Iced tea
C. Banana
D. Peas
Answer: C. Banana
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) poses a risk for cardiac arrhythmias and
requires prompt correction. Bananas are a potassium-rich food that can help raise
potassium levels . Furosemide is a loop diuretic that increases potassium excretion,
making this finding common in patients taking Lasix.
2. An increase in blood hydrostatic pressure would result in which fluid volume
disturbance?
A. Fluid volume excess, because the pressure would force fluid out through the
lymphatic system and into the interstitial compartment
B. Fluid volume deficit because the pressure would force fluid out of the interstitial
compartment and into the lymphatic system
C. Fluid volume excess because the pressure would force fluid out through the capillary
walls and into the interstitial compartment
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D. Fluid volume deficit because the pressure would force fluid out of the interstitial
compartment and into the capillaries
Answer: C. Fluid volume excess because the pressure would force fluid out through
the capillary walls and into the interstitial compartment
Rationale: Increased capillary hydrostatic pressure forces fluid out of the capillaries and
into the interstitial space, leading to fluid volume excess and edema . This mechanism
is seen in conditions such as heart failure where increased venous pressure leads to
peripheral edema.
3. A patient is receiving intravenous fluids at 150 mL/hr. Upon assessment, the
nurse notes crackles, shortness of breath, and jugular vein distention. Based on
this data, which complication of IV fluid therapy does the nurse anticipate?
A. Speed shock
B. Fluid volume excess
C. Pulmonary embolism
D. Allergic reaction
Answer: B. Fluid volume excess
Rationale: Crackles, shortness of breath, and jugular vein distention are classic signs of
fluid volume excess, which can lead to pulmonary edema. Patients receiving IV fluids
postoperatively, especially following cardiac surgery, are at increased risk for fluid
overload .
4. Which total serum calcium level would be considered normal in an adult client?
A. 9.88 mg/dL
B. 7.03 mg/dL
C. 10.5 mg/dL
D. 11.2 mg/dL
Answer: A. 9.88 mg/dL
Rationale: Normal serum calcium levels in adults range from 8.5 to 10.2 mg/dL. A level
of 9.88 mg/dL falls within this normal range . Hypocalcemia (<8.5 mg/dL) and
hypercalcemia (>10.2 mg/dL) require further evaluation and intervention.
5. A patient's phosphorus level is 2.0 mg/dL. Based on this data, which nursing
intervention is most appropriate?
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A. Enforce contact precautions
B. Encourage consumption of a high-calorie carbohydrate diet
C. Strain all urine
D. Encourage consumption of milk and yogurt
Answer: D. Encourage consumption of milk and yogurt
Rationale: The normal phosphorus level is 2.5-4.5 mg/dL. A level of 2.0 mg/dL indicates
hypophosphatemia. Milk and yogurt are phosphorus-rich foods that can help correct
this imbalance .
6. Which client statement indicates that additional teaching about sodium
restriction is required?
A. "I can use as much salt substitute as I want."
B. "I have to read the labels on foods to find out the sodium content."
C. "I should avoid adding salt when cooking."
D. "Canned soups are high in sodium."
Answer: A. "I can use as much salt substitute as I want."
Rationale: Salt substitutes often contain potassium chloride and should be used
cautiously, especially in patients with renal impairment or those taking potassium-
sparing diuretics. This statement indicates a need for further teaching .
7. A patient is exhibiting signs of severe generalized edema. Which term best
describes this condition?
A. Pitting edema
B. Anasarca
C. Hypervolemia
D. Orthopnea
Answer: B. Anasarca
Rationale: Anasarca is the term for severe, generalized edema involving all body tissues.
It is seen in severe fluid volume excess and conditions such as heart failure, liver failure,
and nephrotic syndrome .
8. A patient is diagnosed with fluid volume deficit. Which assessment finding would
the nurse expect?
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A. Jugular vein distention
B. Crackles in the lungs
C. Decreased skin turgor
D. Peripheral edema
Answer: C. Decreased skin turgor
Rationale: Decreased skin turgor is a classic sign of fluid volume deficit (dehydration).
Other signs include dry mucous membranes, decreased urine output, tachycardia, and
hypotension. JVD, crackles, and edema indicate fluid volume excess .
9. A patient is receiving IV fluids and the nurse notes edema at the IV site. Which
action should the nurse take first?
A. Apply a warm compress
B. Slow the IV rate
C. Stop the IV infusion
D. Notify the healthcare provider
Answer: C. Stop the IV infusion
Rationale: Edema at the IV site indicates infiltration. The priority action is to stop the IV
infusion and remove the catheter to prevent further fluid leakage into the surrounding
tissue .
10. A patient has a sodium level of 125 mEq/L. Which assessment finding would the
nurse expect?
A. Thirst
B. Dry mucous membranes
C. Confusion
D. Decreased urine output
Answer: C. Confusion
Rationale: Hyponatremia (Na⁺ <135 mEq/L) can cause confusion, headache, nausea,
and seizures due to cerebral edema. Severe hyponatremia is a medical emergency
requiring careful correction .
11. A patient has a potassium level of 6.2 mEq/L. Which finding would the nurse
expect?
