NSG 3100 Exam 4 — Exam Questions with
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
1. A client has a serum sodium level of 120 mEq/L. Which
assessment is the nurse's priority?
A. Bowel sounds
B. Peripheral pulses
C. Neurological status
D. Skin color
Rationale: A sodium level of 120 mEq/L represents significant
hyponatremia. Low serum sodium can cause water to move into
brain cells, resulting in cerebral edema and neurological
manifestations such as headache, confusion, lethargy, seizures,
and decreased level of consciousness. Because severe
neurological complications can occur rapidly, neurological
assessment is the priority. The nurse should monitor level of
consciousness, orientation, behavior, pupil response, and seizure
activity.
,2. Which food should the nurse identify as a common dietary
restriction shared by clients who practice Islam and Judaism?
A. Beef
B. Fish
C. Eggs
D. Pork products
Rationale: Both Islamic dietary practices and Jewish kosher
dietary practices prohibit pork and pork-derived products.
Nurses should assess individual cultural and religious
preferences rather than making assumptions about a client's
diet. Respecting dietary practices promotes culturally competent
care and can improve nutritional intake and the client's
willingness to participate in the plan of care.
3. A client wants to increase dietary intake of vitamin C. Which
food is an appropriate recommendation?
A. White rice
B. Tomatoes
C. Butter
D. Chicken
Rationale: Tomatoes are a useful dietary source of vitamin C.
Vitamin C supports collagen synthesis, wound healing, immune
function, and iron absorption. Other good sources include citrus
,fruits, strawberries, bell peppers, broccoli, and other fruits and
vegetables. Foods such as butter and chicken are not significant
sources of vitamin C.
4. A child is brought to the emergency department after
ingesting a large quantity of aspirin. Which acid-base
disturbance should the nurse recognize as a potential
complication?
A. Respiratory acidosis only
B. Metabolic alkalosis only
C. Metabolic acidosis
D. Respiratory alkalosis only
Rationale: Salicylate toxicity can produce complex acid-base
abnormalities, particularly respiratory alkalosis early in toxicity
followed by metabolic acidosis as toxicity progresses. Salicylates
interfere with cellular metabolism and can contribute to
accumulation of organic acids. A poisoned child requires urgent
assessment and treatment because severe acid-base
disturbances, altered mental status, and other systemic
complications may develop.
5. Which action by a nurse administering medications through
an enteral feeding tube requires correction?
, A. Flushing the tube before medication administration
B. Administering medications separately when appropriate
C. Flushing the tube after medication administration
D. Adding medications directly to the enteral feeding formula
Rationale: Medications should not routinely be mixed directly
into enteral feeding formula. Doing so can alter medication
absorption, cause incompatibilities, contaminate the feeding, or
result in an inaccurate medication dose if the entire feeding is
not consumed. Medications should be administered according
to their formulation and compatibility requirements, with
appropriate tube flushing before and after administration.
6. Which food is appropriate for a client prescribed a full-liquid
diet?
A. Raw apple slices
B. Toast
C. Yogurt
D. Grilled chicken
Rationale: A full-liquid diet includes foods that are liquid or
become liquid at room temperature and generally includes
items such as milk, yogurt, pudding, custards, strained cream
soups, and nutritional liquid supplements. Solid foods such as
toast, raw fruit, and grilled meat are not permitted on a full-
liquid diet.
Correct Answers (VerifiedAnswers) Plus
Rationales 2026 Q&A Instant Download PDF
1. A client has a serum sodium level of 120 mEq/L. Which
assessment is the nurse's priority?
A. Bowel sounds
B. Peripheral pulses
C. Neurological status
D. Skin color
Rationale: A sodium level of 120 mEq/L represents significant
hyponatremia. Low serum sodium can cause water to move into
brain cells, resulting in cerebral edema and neurological
manifestations such as headache, confusion, lethargy, seizures,
and decreased level of consciousness. Because severe
neurological complications can occur rapidly, neurological
assessment is the priority. The nurse should monitor level of
consciousness, orientation, behavior, pupil response, and seizure
activity.
,2. Which food should the nurse identify as a common dietary
restriction shared by clients who practice Islam and Judaism?
A. Beef
B. Fish
C. Eggs
D. Pork products
Rationale: Both Islamic dietary practices and Jewish kosher
dietary practices prohibit pork and pork-derived products.
Nurses should assess individual cultural and religious
preferences rather than making assumptions about a client's
diet. Respecting dietary practices promotes culturally competent
care and can improve nutritional intake and the client's
willingness to participate in the plan of care.
3. A client wants to increase dietary intake of vitamin C. Which
food is an appropriate recommendation?
A. White rice
B. Tomatoes
C. Butter
D. Chicken
Rationale: Tomatoes are a useful dietary source of vitamin C.
Vitamin C supports collagen synthesis, wound healing, immune
function, and iron absorption. Other good sources include citrus
,fruits, strawberries, bell peppers, broccoli, and other fruits and
vegetables. Foods such as butter and chicken are not significant
sources of vitamin C.
4. A child is brought to the emergency department after
ingesting a large quantity of aspirin. Which acid-base
disturbance should the nurse recognize as a potential
complication?
A. Respiratory acidosis only
B. Metabolic alkalosis only
C. Metabolic acidosis
D. Respiratory alkalosis only
Rationale: Salicylate toxicity can produce complex acid-base
abnormalities, particularly respiratory alkalosis early in toxicity
followed by metabolic acidosis as toxicity progresses. Salicylates
interfere with cellular metabolism and can contribute to
accumulation of organic acids. A poisoned child requires urgent
assessment and treatment because severe acid-base
disturbances, altered mental status, and other systemic
complications may develop.
5. Which action by a nurse administering medications through
an enteral feeding tube requires correction?
, A. Flushing the tube before medication administration
B. Administering medications separately when appropriate
C. Flushing the tube after medication administration
D. Adding medications directly to the enteral feeding formula
Rationale: Medications should not routinely be mixed directly
into enteral feeding formula. Doing so can alter medication
absorption, cause incompatibilities, contaminate the feeding, or
result in an inaccurate medication dose if the entire feeding is
not consumed. Medications should be administered according
to their formulation and compatibility requirements, with
appropriate tube flushing before and after administration.
6. Which food is appropriate for a client prescribed a full-liquid
diet?
A. Raw apple slices
B. Toast
C. Yogurt
D. Grilled chicken
Rationale: A full-liquid diet includes foods that are liquid or
become liquid at room temperature and generally includes
items such as milk, yogurt, pudding, custards, strained cream
soups, and nutritional liquid supplements. Solid foods such as
toast, raw fruit, and grilled meat are not permitted on a full-
liquid diet.
