NSG 3800 actual Exam 1 | Nursing Practice Adult Health II |
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
UNIT 1: FLUIDS & ELECTROLYTES
Questions 1–100
1. A nurse is assessing a client for fluid-volume deficit. Which finding is
most concerning?
A. Bounding pulse
B. Crackles
C. Orthostatic hypotension
D. Peripheral edema
Correct Answer: C. Orthostatic hypotension
Rationale: Orthostatic hypotension is a classic manifestation of
decreased circulating volume. Fluid-volume excess more commonly
produces edema, bounding pulses, and pulmonary crackles.
2. Which assessment finding is most consistent with fluid-volume
excess?
A. Flat neck veins
B. Weight loss
C. Crackles in the lungs
D. Poor skin turgor
Correct Answer: C. Crackles in the lungs
,Rationale: Excess intravascular fluid can move into the pulmonary
interstitium and alveoli, producing crackles and potentially pulmonary
edema.
3. Which measurement is the most sensitive indicator of changes in
overall fluid balance?
A. Blood pressure
B. Daily body weight
C. Heart rate
D. Urine color
Correct Answer: B. Daily body weight
Rationale: Daily weight provides a sensitive estimate of fluid changes.
Approximately 1 kg of rapid weight change corresponds to about 1 L of
fluid.
4. A client has a sodium level of 128 mEq/L. Which finding requires
immediate nursing attention?
A. Mild thirst
B. Muscle cramps
C. Confusion and seizure activity
D. Dry lips
Correct Answer: C. Confusion and seizure activity
Rationale: Significant hyponatremia can cause cerebral edema and
neurologic manifestations, including confusion, decreased level of
consciousness, and seizures.
,5. Which food should the nurse recommend to a client with mild
hyponatremia who has no dietary sodium restriction?
A. Fresh apple
B. Unsalted rice
C. Canned soup
D. Plain oatmeal
Correct Answer: C. Canned soup
Rationale: Canned soups commonly contain substantial sodium. Dietary
recommendations must still be individualized based on the cause of
hyponatremia and overall health status.
6. A client with hypernatremia is most likely to demonstrate:
A. Moist mucous membranes
B. Intense thirst
C. Bradycardia
D. Hyporeflexia
Correct Answer: B. Intense thirst
Rationale: Hypernatremia commonly reflects a relative water deficit
and stimulates thirst. Neurologic changes can occur when sodium
elevation is significant.
7. Which client is at greatest risk for hypernatremia?
, A. Client with excessive free-water loss
B. Client receiving hypotonic fluids appropriately
C. Client with excessive water intake
D. Client with SIADH
Correct Answer: A. Client with excessive free-water loss
Rationale: Hypernatremia commonly results from water loss exceeding
sodium loss, such as with fever, diarrhea, diabetes insipidus, or
inadequate water intake.
8. Which finding is most characteristic of hyponatremia?
A. Confusion
B. Severe thirst only
C. Flushed dry skin only
D. Increased serum osmolality
Correct Answer: A. Confusion
Rationale: Hyponatremia can cause cerebral edema and neurologic
changes, including headache, confusion, lethargy, seizures, and
decreased consciousness.
9. A client with severe symptomatic hyponatremia is receiving IV
therapy. Which solution may be prescribed cautiously?
A. 3% sodium chloride
B. Sterile water IV
C. 0.45% sodium chloride only
D. D5W only
2026/2027 Complete Practice Questions, Correct Answers &
Detailed Rationales
UNIT 1: FLUIDS & ELECTROLYTES
Questions 1–100
1. A nurse is assessing a client for fluid-volume deficit. Which finding is
most concerning?
A. Bounding pulse
B. Crackles
C. Orthostatic hypotension
D. Peripheral edema
Correct Answer: C. Orthostatic hypotension
Rationale: Orthostatic hypotension is a classic manifestation of
decreased circulating volume. Fluid-volume excess more commonly
produces edema, bounding pulses, and pulmonary crackles.
2. Which assessment finding is most consistent with fluid-volume
excess?
A. Flat neck veins
B. Weight loss
C. Crackles in the lungs
D. Poor skin turgor
Correct Answer: C. Crackles in the lungs
,Rationale: Excess intravascular fluid can move into the pulmonary
interstitium and alveoli, producing crackles and potentially pulmonary
edema.
3. Which measurement is the most sensitive indicator of changes in
overall fluid balance?
A. Blood pressure
B. Daily body weight
C. Heart rate
D. Urine color
Correct Answer: B. Daily body weight
Rationale: Daily weight provides a sensitive estimate of fluid changes.
Approximately 1 kg of rapid weight change corresponds to about 1 L of
fluid.
4. A client has a sodium level of 128 mEq/L. Which finding requires
immediate nursing attention?
A. Mild thirst
B. Muscle cramps
C. Confusion and seizure activity
D. Dry lips
Correct Answer: C. Confusion and seizure activity
Rationale: Significant hyponatremia can cause cerebral edema and
neurologic manifestations, including confusion, decreased level of
consciousness, and seizures.
,5. Which food should the nurse recommend to a client with mild
hyponatremia who has no dietary sodium restriction?
A. Fresh apple
B. Unsalted rice
C. Canned soup
D. Plain oatmeal
Correct Answer: C. Canned soup
Rationale: Canned soups commonly contain substantial sodium. Dietary
recommendations must still be individualized based on the cause of
hyponatremia and overall health status.
6. A client with hypernatremia is most likely to demonstrate:
A. Moist mucous membranes
B. Intense thirst
C. Bradycardia
D. Hyporeflexia
Correct Answer: B. Intense thirst
Rationale: Hypernatremia commonly reflects a relative water deficit
and stimulates thirst. Neurologic changes can occur when sodium
elevation is significant.
7. Which client is at greatest risk for hypernatremia?
, A. Client with excessive free-water loss
B. Client receiving hypotonic fluids appropriately
C. Client with excessive water intake
D. Client with SIADH
Correct Answer: A. Client with excessive free-water loss
Rationale: Hypernatremia commonly results from water loss exceeding
sodium loss, such as with fever, diarrhea, diabetes insipidus, or
inadequate water intake.
8. Which finding is most characteristic of hyponatremia?
A. Confusion
B. Severe thirst only
C. Flushed dry skin only
D. Increased serum osmolality
Correct Answer: A. Confusion
Rationale: Hyponatremia can cause cerebral edema and neurologic
changes, including headache, confusion, lethargy, seizures, and
decreased consciousness.
9. A client with severe symptomatic hyponatremia is receiving IV
therapy. Which solution may be prescribed cautiously?
A. 3% sodium chloride
B. Sterile water IV
C. 0.45% sodium chloride only
D. D5W only
