Galen NSG 3100 Exam 4 | Fundamental Concepts
& Skills I (2026) Actual Q&A PDF
1. A client's serum sodium level is 120 mEq/L. What is the priority nursing
assessment?
A) Cardiovascular status and cardiac rhythm
B) Renal function and urine output
C) Respiratory status and oxygen saturation
D) Neurological status and level of consciousness
Correct Answer: Neurological status and level of consciousness
Rationale: A serum sodium of 120 mEq/L indicates severe hyponatremia,
which causes fluid shifts into brain cells, leading to cerebral edema. The
priority assessment is neurological monitoring for changes in level of
consciousness, confusion, or seizures, which are the most life-threatening
complications. While other systems may be affected, they are not the
primary systems at immediate risk.
2. The majority of the body's total fluid volume is located in which
compartment?
A) Intravascular space
B) Interstitial space
C) Intracellular space
D) Transcellular space
Correct Answer: Intracellular space
Rationale: Approximately two-thirds of total body water is located within
the intracellular space (inside cells). The remaining one-third is
extracellular, which includes intravascular and interstitial fluid
,compartments. Transcellular fluid is a small fraction of the extracellular
fluid.
3. Which isotonic solution may be ordered for fluid replacement?
A) 0.45% normal saline
B) Lactated Ringer solution
C) 3% normal saline
D) D5W
Correct Answer: Lactated Ringer solution
Rationale: Lactated Ringer solution is an isotonic crystalloid solution
used for fluid replacement. It remains in the intravascular space and does
not cause fluid shifts between compartments. Hypotonic (0.45% normal
saline) and hypertonic (3% normal saline) solutions cause fluid shifts and
are used for specific indications.
4. One of the first indications of fluid volume deficit is:
A) Bounding pulse
B) Hypertension
C) Tachycardia
D) Bradycardia
Correct Answer: Tachycardia
Rationale: Tachycardia is one of the first indications of fluid volume
deficit as the body attempts to compensate for decreased intravascular
volume. Early signs also include dry mucous membranes, decreased skin
turgor, and orthostatic hypotension.
5. A client who practices Islam or Judaism is being assisted with meal
selection. Which food item should the nurse avoid offering?
,A) Beef products
B) Pork products
C) Dairy products
D) Shellfish
Correct Answer: Pork products
Rationale: Both Islam and Judaism have dietary laws that prohibit the
consumption of pork products. The nurse should respect these religious
dietary restrictions when assisting with meal selection. Beef, dairy, and
shellfish are not universally prohibited by both religions.
6. Which of the following blood tests requires the patient to be fasting?
A) Hemoglobin
B) Prothrombin time
C) Cholesterol
D) Creatinine
Correct Answer: Cholesterol
Rationale: Cholesterol testing requires the patient to be fasting for
accurate results. Hemoglobin, prothrombin time, and creatinine do not
typically require fasting. Fasting lipid panels are standard for accurate
cholesterol and triglyceride measurements.
7. A patient has been on a high-protein, low-carbohydrate diet for the past
6 months. Which blood test result could be influenced by this diet?
A) Bilirubin
B) Creatinine
C) Blood urea nitrogen (BUN)
D) Creatine kinase
, Correct Answer: Blood urea nitrogen (BUN)
Rationale: A high-protein diet can increase blood urea nitrogen (BUN)
levels because protein metabolism produces urea as a waste product.
Creatinine reflects muscle metabolism, bilirubin reflects liver function, and
creatine kinase reflects muscle damage, none of which are directly
elevated by dietary protein intake.
8. What is the basal metabolic rate (BMR)?
A) The maximum amount of energy required during strenuous exercise
B) The minimum amount of energy required to maintain body function in
the resting, awake state
C) The energy required to digest food after a meal
D) The energy required to maintain body temperature during sleep
Correct Answer: The minimum amount of energy required to maintain
body function in the resting, awake state
Rationale: BMR is the energy expended to maintain essential
physiological functions such as breathing, circulation, and cell production
while at rest. It does not include energy for physical activity or digestion.
Option A describes maximum energy expenditure, Option C describes the
thermic effect of food, and Option D is too narrow.
9. Which of the following best describes the primary function of
metabolism?
A) The process of breaking down substances to release energy
B) The process of chemically changing nutrients into end products used to
meet energy needs of the body
C) The storage of excess nutrients for future use
D) The elimination of waste products from the body
& Skills I (2026) Actual Q&A PDF
1. A client's serum sodium level is 120 mEq/L. What is the priority nursing
assessment?
A) Cardiovascular status and cardiac rhythm
B) Renal function and urine output
C) Respiratory status and oxygen saturation
D) Neurological status and level of consciousness
Correct Answer: Neurological status and level of consciousness
Rationale: A serum sodium of 120 mEq/L indicates severe hyponatremia,
which causes fluid shifts into brain cells, leading to cerebral edema. The
priority assessment is neurological monitoring for changes in level of
consciousness, confusion, or seizures, which are the most life-threatening
complications. While other systems may be affected, they are not the
primary systems at immediate risk.
2. The majority of the body's total fluid volume is located in which
compartment?
A) Intravascular space
B) Interstitial space
C) Intracellular space
D) Transcellular space
Correct Answer: Intracellular space
Rationale: Approximately two-thirds of total body water is located within
the intracellular space (inside cells). The remaining one-third is
extracellular, which includes intravascular and interstitial fluid
,compartments. Transcellular fluid is a small fraction of the extracellular
fluid.
3. Which isotonic solution may be ordered for fluid replacement?
A) 0.45% normal saline
B) Lactated Ringer solution
C) 3% normal saline
D) D5W
Correct Answer: Lactated Ringer solution
Rationale: Lactated Ringer solution is an isotonic crystalloid solution
used for fluid replacement. It remains in the intravascular space and does
not cause fluid shifts between compartments. Hypotonic (0.45% normal
saline) and hypertonic (3% normal saline) solutions cause fluid shifts and
are used for specific indications.
4. One of the first indications of fluid volume deficit is:
A) Bounding pulse
B) Hypertension
C) Tachycardia
D) Bradycardia
Correct Answer: Tachycardia
Rationale: Tachycardia is one of the first indications of fluid volume
deficit as the body attempts to compensate for decreased intravascular
volume. Early signs also include dry mucous membranes, decreased skin
turgor, and orthostatic hypotension.
5. A client who practices Islam or Judaism is being assisted with meal
selection. Which food item should the nurse avoid offering?
,A) Beef products
B) Pork products
C) Dairy products
D) Shellfish
Correct Answer: Pork products
Rationale: Both Islam and Judaism have dietary laws that prohibit the
consumption of pork products. The nurse should respect these religious
dietary restrictions when assisting with meal selection. Beef, dairy, and
shellfish are not universally prohibited by both religions.
6. Which of the following blood tests requires the patient to be fasting?
A) Hemoglobin
B) Prothrombin time
C) Cholesterol
D) Creatinine
Correct Answer: Cholesterol
Rationale: Cholesterol testing requires the patient to be fasting for
accurate results. Hemoglobin, prothrombin time, and creatinine do not
typically require fasting. Fasting lipid panels are standard for accurate
cholesterol and triglyceride measurements.
7. A patient has been on a high-protein, low-carbohydrate diet for the past
6 months. Which blood test result could be influenced by this diet?
A) Bilirubin
B) Creatinine
C) Blood urea nitrogen (BUN)
D) Creatine kinase
, Correct Answer: Blood urea nitrogen (BUN)
Rationale: A high-protein diet can increase blood urea nitrogen (BUN)
levels because protein metabolism produces urea as a waste product.
Creatinine reflects muscle metabolism, bilirubin reflects liver function, and
creatine kinase reflects muscle damage, none of which are directly
elevated by dietary protein intake.
8. What is the basal metabolic rate (BMR)?
A) The maximum amount of energy required during strenuous exercise
B) The minimum amount of energy required to maintain body function in
the resting, awake state
C) The energy required to digest food after a meal
D) The energy required to maintain body temperature during sleep
Correct Answer: The minimum amount of energy required to maintain
body function in the resting, awake state
Rationale: BMR is the energy expended to maintain essential
physiological functions such as breathing, circulation, and cell production
while at rest. It does not include energy for physical activity or digestion.
Option A describes maximum energy expenditure, Option C describes the
thermic effect of food, and Option D is too narrow.
9. Which of the following best describes the primary function of
metabolism?
A) The process of breaking down substances to release energy
B) The process of chemically changing nutrients into end products used to
meet energy needs of the body
C) The storage of excess nutrients for future use
D) The elimination of waste products from the body
