GALEN COLLEGE OF NURSING
NUR 504 Final Exam
Practice Question Bank
Advanced Pathophysiology — NCLEX-Style Practice Questions with
Rationales
Comprehensive Review: Fluids & Electrolytes, Cardiac, Respiratory, Endocrine
& More
Edition 1 · July 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales 2
NUR 504 · Galen College of Nursing Page 1
,NUR 504 FINAL EXAM PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Advanced Pathophysiology — Comprehensive Final Review
1 How many tablets should be administered using the formula Desired ÷ Have ×
Quantity?
A This formula calculates the number of tablets to administer
B This formula calculates mL/hr for IV pumps
C This formula calculates IV flow rate in drops/min
D This formula calculates total daily dosage
Why A is correct: Desired ÷ Have × Quantity is the formula used to calculate the number
of tablets to administer.
B — mL/hr is calculated differently.
C — Drops/min requires a different formula.
D — Total daily dosage is not calculated with this formula.
,2 Isotonic fluids have what effect on body fluids?
A Pull water out of the cells
B Push water into the cells
C Stay in the space — expand extracellular/intravascular volume without major fluid
shifts
D Cause major fluid shifts into cells
Why C is correct: Isotonic fluids "stay in the space" and expand the
extracellular/intravascular volume without causing major fluid shifts.
A — This describes hypertonic fluids.
B — This describes hypotonic fluids.
D — This is not the effect of isotonic fluids.
3 Which of the following is an example of an isotonic fluid?
A 3% NaCl
B 0.9% Normal Saline (NS) and Lactated Ringer's (LR)
C 0.45% NS
D D5W
Why B is correct: 0.9% Normal Saline and Lactated Ringer's are isotonic fluids.
A — 3% NaCl is hypertonic.
C — 0.45% NS is hypotonic.
D — D5W is isotonic in the bag but becomes hypotonic in the body.
, 4 What is the effect of hypertonic fluids on body fluids?
A Pull water out of the cells (Cell → bloodstream)
B Push water into the cells (Bloodstream → cell)
C Stay in the space with no fluid shifts
D Have no effect on cellular fluid
Why A is correct: Hypertonic fluids pull water out of the cells and into the bloodstream.
B — This describes hypotonic fluids.
C — This describes isotonic fluids.
D — Hypertonic fluids do have an effect.
5 What is Trousseau's sign and what condition does it indicate?
A Carpopedal spasm with BP cuff inflation; indicates hypercalcemia
B Carpopedal spasm with BP cuff inflation; indicates hypocalcemia
C Facial twitching with tapping; indicates hypomagnesemia
D Muscle rigidity with passive stretch; indicates hypokalemia
Why B is correct: Trousseau's sign is carpopedal spasm during BP cuff inflation and
indicates hypocalcemia.
A — It indicates hypocalcemia, not hypercalcemia.
C — This describes Chvostek's sign.
D — This is not Trousseau's sign.
NUR 504 Final Exam
Practice Question Bank
Advanced Pathophysiology — NCLEX-Style Practice Questions with
Rationales
Comprehensive Review: Fluids & Electrolytes, Cardiac, Respiratory, Endocrine
& More
Edition 1 · July 2026
Table of Contents
1. Instructions for Use 2
2. Practice Questions with Answers & Rationales 2
NUR 504 · Galen College of Nursing Page 1
,NUR 504 FINAL EXAM PRACTICE GUIDE INSTRUCTIONS & PRACTICE QUESTIONS
How to Use This Guide
Read each stem, choose your answer, then check the rationale directly below it. The correct
option is marked, and each wrong option is explained so you understand why it's wrong — not
just that it is.
Category: Advanced Pathophysiology — Comprehensive Final Review
1 How many tablets should be administered using the formula Desired ÷ Have ×
Quantity?
A This formula calculates the number of tablets to administer
B This formula calculates mL/hr for IV pumps
C This formula calculates IV flow rate in drops/min
D This formula calculates total daily dosage
Why A is correct: Desired ÷ Have × Quantity is the formula used to calculate the number
of tablets to administer.
B — mL/hr is calculated differently.
C — Drops/min requires a different formula.
D — Total daily dosage is not calculated with this formula.
,2 Isotonic fluids have what effect on body fluids?
A Pull water out of the cells
B Push water into the cells
C Stay in the space — expand extracellular/intravascular volume without major fluid
shifts
D Cause major fluid shifts into cells
Why C is correct: Isotonic fluids "stay in the space" and expand the
extracellular/intravascular volume without causing major fluid shifts.
A — This describes hypertonic fluids.
B — This describes hypotonic fluids.
D — This is not the effect of isotonic fluids.
3 Which of the following is an example of an isotonic fluid?
A 3% NaCl
B 0.9% Normal Saline (NS) and Lactated Ringer's (LR)
C 0.45% NS
D D5W
Why B is correct: 0.9% Normal Saline and Lactated Ringer's are isotonic fluids.
A — 3% NaCl is hypertonic.
C — 0.45% NS is hypotonic.
D — D5W is isotonic in the bag but becomes hypotonic in the body.
, 4 What is the effect of hypertonic fluids on body fluids?
A Pull water out of the cells (Cell → bloodstream)
B Push water into the cells (Bloodstream → cell)
C Stay in the space with no fluid shifts
D Have no effect on cellular fluid
Why A is correct: Hypertonic fluids pull water out of the cells and into the bloodstream.
B — This describes hypotonic fluids.
C — This describes isotonic fluids.
D — Hypertonic fluids do have an effect.
5 What is Trousseau's sign and what condition does it indicate?
A Carpopedal spasm with BP cuff inflation; indicates hypercalcemia
B Carpopedal spasm with BP cuff inflation; indicates hypocalcemia
C Facial twitching with tapping; indicates hypomagnesemia
D Muscle rigidity with passive stretch; indicates hypokalemia
Why B is correct: Trousseau's sign is carpopedal spasm during BP cuff inflation and
indicates hypocalcemia.
A — It indicates hypocalcemia, not hypercalcemia.
C — This describes Chvostek's sign.
D — This is not Trousseau's sign.
