REX-PN EXAMINATION | COMPLETE QUESTIONS
AND 100% VERIFIED ANSWERS | 2026 UPDATE
• Advance Directives -✓✓ Legal documents that allow people to choose what medical
care they wish to have if they are unable to make those decisions themselves
Living Will, Health Care Proxy
• Informed Consent -✓✓ Indicates client's participation in the decision regarding health
care
Performed by provider
Witness must be an adult
Client must be mentally and emotionally competent
• Nurse Roles -✓✓ Advocate, promote health, prevent disease, provide comfort and
safety, communicate effectively, reinforce teaching, act as a resource person
• Physical Therapist -✓✓ Examinations, testing, treat physically disabled clients to
determine functional ability and safety needs
• Occupational Therapist -✓✓ Develops adaptive devices that help chronically
ill/handicapped clients perform ADLs
• Respiratory Therapist -✓✓ Delivers treatments designed to improve client
ventilation/oxygenation status
• Speech Therapist -✓✓ Evaluates client ability to swallow safely and communicates
plan to improve swallow ability
• Nutritionist -✓✓ Assists in planning dietary measures to improve client nutritional
status
• Social Worker -✓✓ Counsels patients and families about home care services and
assists with continuing care nurse with planning discharge
• Chaplain -✓✓ Offers spiritual support and guidance for clients and families
• Transfer Reports -✓✓ Client name, age, diagnoses, current health status, plan of care,
interventions needed after transfer, special equipment, resuscitation status,
precautionary considerations, family issues
,• SBAR -✓✓ Situation
Background
Assessment
Recommendation
• Intravascular -✓✓ Fluid inside a blood vessel
• Intracellular -✓✓ Fluid inside of cells (most body fluids)
• Extracellular -✓✓ Fluid outside of cells
Includes interstitial fluids (between cells/third space) -- Blood, lymph, bone, connective
tissue, water, transcellular fluid
• Edema -✓✓ Excess fluid in the interstitial compartment causing swelling of tissue
• Weeping edema -✓✓ Small fluid leak occurs at point where pressure applied
• Diffusion -✓✓ Solute may spread throughout a solution or solvent
High to Low concentration
• Osmosis -✓✓ Diffusion of water
Low to High concentration
• Hypotonic -✓✓ Having a lower concentration of solute than another solution
Too much goes into the cell -> Cell burst
• Hypertonic -✓✓ Having a higher concentration of solute than another solution
Too much goes out of the cell -> Cell shrivels
• Isotonic -✓✓ Having the same solute concentration as another solution
Equal balance outside and inside cell
• 0.45% NaCl (1/2 Normal Saline) -✓✓ Hypotonic
Contains smaller proportion of sodium + chloride
• 0.9% saline (NS) -✓✓ Isotonic
Contains sodium + chloride in equal amount to plasma
• 5% dextrose in water (D5W) -✓✓ Isotonic
,Sugar metabolizes quickly, leaving solution diluted water
• Lactated Ringer's -✓✓ Isotonic
Replaces electrolytes in amounts similarly to plasma
• 5% dextrose in 0.45% saline -✓✓ Hypotonic
Sugar provides quick source of energy
• 3% saline -✓✓ Hypertonic
High concentration of salt in plasma dehydrates cells and tissues
• 20% dextrose in water -✓✓ Hypertonic
Rapidly increase concentration of sugar in the blood causing fluid shift to intravascular
compartment
• 10% dextrose in water (D10W) -✓✓ Hypertonic
Contains 2x the concentration of glucose found in plasma
• Kidneys -✓✓ Major role in controlling balance of fluids and electrolytes
• Adrenal Glands -✓✓ Secretes aldosterone
Control extracellular fluid volume by regulating sodium reabsorbed by kidneys
• Antiduretic hormone (ADH) -✓✓ From pituitary glands
Regulates extracellular fluid by regulating water reabsorbed by kidneys
• Dehydration (Fluid volume deficit) -✓✓ Body's fluid intake is not sufficient to meet
body's fluid needs
• Causes of FVD -✓✓ Vomiting
Diarrhea
GI suctioning
Ileostomy or colostomy drainage
Draining wounds
Burns
Fistulas
Increased urine output from diuretics
• S/S of FVD -✓✓ ↓ - skin turgor, BP, mucous, weight, urine output
↑ - pulse, temp, specific urine gravity
, Dyspnea
Dizziness/weakness
Confusion
• Interventions for FVD -✓✓ IV/oral hydration
Monitor - vitals, I&O, Hct and electrolytes, neuro status
Oxygen
Check mucous membranes/skin turgor
Daily weights
Meds - diuretics, laxatives
Test urine for specific gravity
• Fluid volume excess (FVE) -✓✓ Fluid intake or retention exceeds the body's fluid
needs
• Causes of FVE -✓✓ Overhydration
Kidney damage
HF
Long-term use of corticosteroids
Excessive sodium ingestion
Syndrome of inappropriate antidiuretic hormone (SIADH)
Wound irrigation with hypotonic fluids
• S/S of FVE -✓✓ Cough, dyspnea
Lung crackles
↑ - RR, bounding pulse, BP, weight
Pitting edema
Neck vein distention
Confusion
• Interventions for FVE -✓✓ Monitor - vitals, neuro status, I&O, Hct and electrolytes,
daily weight, edema
Semi-Fowler's position
Oxygen
Diuretics
Restrict fluids and sodium
• Sodium (Na+) -✓✓ 135 - 145
Controls fluid levels and aids in nerve and muscle function
• Potassium (K+) -✓✓ 3.5-5
Supports heart, nerve, and muscle functions
Moves nutrients into cells and waste products out of them while supporting metabolism
Avocados, bananas, cantaloupe, oranges, strawberries, tomatoes, carrots, mushrooms,
spinach, fish, pork, beef, veal, potatoes, raisins
AND 100% VERIFIED ANSWERS | 2026 UPDATE
• Advance Directives -✓✓ Legal documents that allow people to choose what medical
care they wish to have if they are unable to make those decisions themselves
Living Will, Health Care Proxy
• Informed Consent -✓✓ Indicates client's participation in the decision regarding health
care
Performed by provider
Witness must be an adult
Client must be mentally and emotionally competent
• Nurse Roles -✓✓ Advocate, promote health, prevent disease, provide comfort and
safety, communicate effectively, reinforce teaching, act as a resource person
• Physical Therapist -✓✓ Examinations, testing, treat physically disabled clients to
determine functional ability and safety needs
• Occupational Therapist -✓✓ Develops adaptive devices that help chronically
ill/handicapped clients perform ADLs
• Respiratory Therapist -✓✓ Delivers treatments designed to improve client
ventilation/oxygenation status
• Speech Therapist -✓✓ Evaluates client ability to swallow safely and communicates
plan to improve swallow ability
• Nutritionist -✓✓ Assists in planning dietary measures to improve client nutritional
status
• Social Worker -✓✓ Counsels patients and families about home care services and
assists with continuing care nurse with planning discharge
• Chaplain -✓✓ Offers spiritual support and guidance for clients and families
• Transfer Reports -✓✓ Client name, age, diagnoses, current health status, plan of care,
interventions needed after transfer, special equipment, resuscitation status,
precautionary considerations, family issues
,• SBAR -✓✓ Situation
Background
Assessment
Recommendation
• Intravascular -✓✓ Fluid inside a blood vessel
• Intracellular -✓✓ Fluid inside of cells (most body fluids)
• Extracellular -✓✓ Fluid outside of cells
Includes interstitial fluids (between cells/third space) -- Blood, lymph, bone, connective
tissue, water, transcellular fluid
• Edema -✓✓ Excess fluid in the interstitial compartment causing swelling of tissue
• Weeping edema -✓✓ Small fluid leak occurs at point where pressure applied
• Diffusion -✓✓ Solute may spread throughout a solution or solvent
High to Low concentration
• Osmosis -✓✓ Diffusion of water
Low to High concentration
• Hypotonic -✓✓ Having a lower concentration of solute than another solution
Too much goes into the cell -> Cell burst
• Hypertonic -✓✓ Having a higher concentration of solute than another solution
Too much goes out of the cell -> Cell shrivels
• Isotonic -✓✓ Having the same solute concentration as another solution
Equal balance outside and inside cell
• 0.45% NaCl (1/2 Normal Saline) -✓✓ Hypotonic
Contains smaller proportion of sodium + chloride
• 0.9% saline (NS) -✓✓ Isotonic
Contains sodium + chloride in equal amount to plasma
• 5% dextrose in water (D5W) -✓✓ Isotonic
,Sugar metabolizes quickly, leaving solution diluted water
• Lactated Ringer's -✓✓ Isotonic
Replaces electrolytes in amounts similarly to plasma
• 5% dextrose in 0.45% saline -✓✓ Hypotonic
Sugar provides quick source of energy
• 3% saline -✓✓ Hypertonic
High concentration of salt in plasma dehydrates cells and tissues
• 20% dextrose in water -✓✓ Hypertonic
Rapidly increase concentration of sugar in the blood causing fluid shift to intravascular
compartment
• 10% dextrose in water (D10W) -✓✓ Hypertonic
Contains 2x the concentration of glucose found in plasma
• Kidneys -✓✓ Major role in controlling balance of fluids and electrolytes
• Adrenal Glands -✓✓ Secretes aldosterone
Control extracellular fluid volume by regulating sodium reabsorbed by kidneys
• Antiduretic hormone (ADH) -✓✓ From pituitary glands
Regulates extracellular fluid by regulating water reabsorbed by kidneys
• Dehydration (Fluid volume deficit) -✓✓ Body's fluid intake is not sufficient to meet
body's fluid needs
• Causes of FVD -✓✓ Vomiting
Diarrhea
GI suctioning
Ileostomy or colostomy drainage
Draining wounds
Burns
Fistulas
Increased urine output from diuretics
• S/S of FVD -✓✓ ↓ - skin turgor, BP, mucous, weight, urine output
↑ - pulse, temp, specific urine gravity
, Dyspnea
Dizziness/weakness
Confusion
• Interventions for FVD -✓✓ IV/oral hydration
Monitor - vitals, I&O, Hct and electrolytes, neuro status
Oxygen
Check mucous membranes/skin turgor
Daily weights
Meds - diuretics, laxatives
Test urine for specific gravity
• Fluid volume excess (FVE) -✓✓ Fluid intake or retention exceeds the body's fluid
needs
• Causes of FVE -✓✓ Overhydration
Kidney damage
HF
Long-term use of corticosteroids
Excessive sodium ingestion
Syndrome of inappropriate antidiuretic hormone (SIADH)
Wound irrigation with hypotonic fluids
• S/S of FVE -✓✓ Cough, dyspnea
Lung crackles
↑ - RR, bounding pulse, BP, weight
Pitting edema
Neck vein distention
Confusion
• Interventions for FVE -✓✓ Monitor - vitals, neuro status, I&O, Hct and electrolytes,
daily weight, edema
Semi-Fowler's position
Oxygen
Diuretics
Restrict fluids and sodium
• Sodium (Na+) -✓✓ 135 - 145
Controls fluid levels and aids in nerve and muscle function
• Potassium (K+) -✓✓ 3.5-5
Supports heart, nerve, and muscle functions
Moves nutrients into cells and waste products out of them while supporting metabolism
Avocados, bananas, cantaloupe, oranges, strawberries, tomatoes, carrots, mushrooms,
spinach, fish, pork, beef, veal, potatoes, raisins
