WGU C165 – Integrated Physiologic Concepts
Practice Exam
120 Multiple-Choice Practice Questions with Answers & Rationales
Covering fluid & electrolyte balance, acid-base balance, hemodynamics, immunity &
inflammation, and cellular regulation
1. A client has a serum sodium level of 150 mEq/L. This value indicates:
A. Hypernatremia
B. Hyponatremia
C. Normal sodium level
D. Hypokalemia
Correct Answer: A. Hypernatremia
Rationale: Normal serum sodium is 135-145 mEq/L; 150 mEq/L exceeds this range,
indicating hypernatremia.
2. Which hormone is primarily responsible for water reabsorption in the renal
collecting ducts?
A. Antidiuretic hormone (ADH)
B. Aldosterone
C. Renin
D. Parathyroid hormone
Correct Answer: A. Antidiuretic hormone (ADH)
Rationale: ADH (vasopressin) increases water permeability in the collecting ducts,
promoting water reabsorption and concentrating urine.
,3. A client with heart failure develops peripheral edema. This fluid shift is best
explained by:
A. Increased hydrostatic pressure forcing fluid into the interstitial space
B. Decreased hydrostatic pressure
C. Increased plasma oncotic pressure
D. Decreased capillary permeability
Correct Answer: A. Increased hydrostatic pressure forcing fluid into the
interstitial space
Rationale: Heart failure raises venous hydrostatic pressure, pushing more fluid out of
capillaries into interstitial tissue, causing edema.
4. Which electrolyte imbalance is most associated with cardiac dysrhythmias
and peaked T waves on ECG?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypomagnesemia
Correct Answer: A. Hyperkalemia
Rationale: Hyperkalemia alters cardiac cell repolarization, classically producing peaked
T waves and risk for dangerous dysrhythmias.
5. A client with prolonged vomiting is at greatest risk for developing:
A. Hypokalemia and metabolic alkalosis
B. Hyperkalemia and metabolic acidosis
C. Hypernatremia only
D. Respiratory acidosis
Correct Answer: A. Hypokalemia and metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (H+) and potassium, leading to
metabolic alkalosis and hypokalemia.
,6. Which of the following best describes 'third spacing'?
A. Fluid shifting into a body space where it is not easily exchanged with the rest of
extracellular fluid
B. Normal fluid movement between intracellular and extracellular compartments
C. Fluid loss through the kidneys only
D. Fluid gain within blood vessels
Correct Answer: A. Fluid shifting into a body space where it is not easily
exchanged with the rest of extracellular fluid
Rationale: Third spacing refers to abnormal fluid accumulation in areas like the
peritoneal cavity, reducing effective circulating volume.
7. A client has a serum potassium of 2.9 mEq/L. Which assessment finding
would the nurse expect?
A. Muscle weakness and decreased bowel sounds
B. Muscle spasms and hyperactive bowel sounds
C. Peaked T waves on ECG
D. Tetany
Correct Answer: A. Muscle weakness and decreased bowel sounds
Rationale: Hypokalemia (normal 3.5-5.0 mEq/L) causes muscle weakness and
decreased GI motility due to impaired neuromuscular function.
8. Which of the following is a primary regulator of calcium and phosphate
balance?
A. Parathyroid hormone (PTH)
B. Antidiuretic hormone
C. Aldosterone
D. Atrial natriuretic peptide
Correct Answer: A. Parathyroid hormone (PTH)
Rationale: PTH increases serum calcium by promoting bone resorption, renal
reabsorption of calcium, and activation of vitamin D.
, 9. A client with chronic kidney disease is at risk for which electrolyte imbalance
due to decreased renal excretion?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia only
D. Hypophosphatemia
Correct Answer: A. Hyperkalemia
Rationale: Failing kidneys cannot adequately excrete potassium, leading to a buildup
and risk of hyperkalemia.
10. Which fluid compartment contains the largest proportion of total body water?
A. Intracellular fluid
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
Correct Answer: A. Intracellular fluid
Rationale: Intracellular fluid accounts for roughly two-thirds of total body water, more
than the combined extracellular compartments.
11. A client presents with tetany, muscle cramps, and a positive Trousseau's
sign. These findings suggest:
A. Hypocalcemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypernatremia
Correct Answer: A. Hypocalcemia
Rationale: Trousseau's sign and tetany are classic findings of hypocalcemia, reflecting
increased neuromuscular excitability.
Practice Exam
120 Multiple-Choice Practice Questions with Answers & Rationales
Covering fluid & electrolyte balance, acid-base balance, hemodynamics, immunity &
inflammation, and cellular regulation
1. A client has a serum sodium level of 150 mEq/L. This value indicates:
A. Hypernatremia
B. Hyponatremia
C. Normal sodium level
D. Hypokalemia
Correct Answer: A. Hypernatremia
Rationale: Normal serum sodium is 135-145 mEq/L; 150 mEq/L exceeds this range,
indicating hypernatremia.
2. Which hormone is primarily responsible for water reabsorption in the renal
collecting ducts?
A. Antidiuretic hormone (ADH)
B. Aldosterone
C. Renin
D. Parathyroid hormone
Correct Answer: A. Antidiuretic hormone (ADH)
Rationale: ADH (vasopressin) increases water permeability in the collecting ducts,
promoting water reabsorption and concentrating urine.
,3. A client with heart failure develops peripheral edema. This fluid shift is best
explained by:
A. Increased hydrostatic pressure forcing fluid into the interstitial space
B. Decreased hydrostatic pressure
C. Increased plasma oncotic pressure
D. Decreased capillary permeability
Correct Answer: A. Increased hydrostatic pressure forcing fluid into the
interstitial space
Rationale: Heart failure raises venous hydrostatic pressure, pushing more fluid out of
capillaries into interstitial tissue, causing edema.
4. Which electrolyte imbalance is most associated with cardiac dysrhythmias
and peaked T waves on ECG?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypomagnesemia
Correct Answer: A. Hyperkalemia
Rationale: Hyperkalemia alters cardiac cell repolarization, classically producing peaked
T waves and risk for dangerous dysrhythmias.
5. A client with prolonged vomiting is at greatest risk for developing:
A. Hypokalemia and metabolic alkalosis
B. Hyperkalemia and metabolic acidosis
C. Hypernatremia only
D. Respiratory acidosis
Correct Answer: A. Hypokalemia and metabolic alkalosis
Rationale: Vomiting causes loss of gastric acid (H+) and potassium, leading to
metabolic alkalosis and hypokalemia.
,6. Which of the following best describes 'third spacing'?
A. Fluid shifting into a body space where it is not easily exchanged with the rest of
extracellular fluid
B. Normal fluid movement between intracellular and extracellular compartments
C. Fluid loss through the kidneys only
D. Fluid gain within blood vessels
Correct Answer: A. Fluid shifting into a body space where it is not easily
exchanged with the rest of extracellular fluid
Rationale: Third spacing refers to abnormal fluid accumulation in areas like the
peritoneal cavity, reducing effective circulating volume.
7. A client has a serum potassium of 2.9 mEq/L. Which assessment finding
would the nurse expect?
A. Muscle weakness and decreased bowel sounds
B. Muscle spasms and hyperactive bowel sounds
C. Peaked T waves on ECG
D. Tetany
Correct Answer: A. Muscle weakness and decreased bowel sounds
Rationale: Hypokalemia (normal 3.5-5.0 mEq/L) causes muscle weakness and
decreased GI motility due to impaired neuromuscular function.
8. Which of the following is a primary regulator of calcium and phosphate
balance?
A. Parathyroid hormone (PTH)
B. Antidiuretic hormone
C. Aldosterone
D. Atrial natriuretic peptide
Correct Answer: A. Parathyroid hormone (PTH)
Rationale: PTH increases serum calcium by promoting bone resorption, renal
reabsorption of calcium, and activation of vitamin D.
, 9. A client with chronic kidney disease is at risk for which electrolyte imbalance
due to decreased renal excretion?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia only
D. Hypophosphatemia
Correct Answer: A. Hyperkalemia
Rationale: Failing kidneys cannot adequately excrete potassium, leading to a buildup
and risk of hyperkalemia.
10. Which fluid compartment contains the largest proportion of total body water?
A. Intracellular fluid
B. Interstitial fluid
C. Intravascular fluid
D. Transcellular fluid
Correct Answer: A. Intracellular fluid
Rationale: Intracellular fluid accounts for roughly two-thirds of total body water, more
than the combined extracellular compartments.
11. A client presents with tetany, muscle cramps, and a positive Trousseau's
sign. These findings suggest:
A. Hypocalcemia
B. Hypercalcemia
C. Hyperkalemia
D. Hypernatremia
Correct Answer: A. Hypocalcemia
Rationale: Trousseau's sign and tetany are classic findings of hypocalcemia, reflecting
increased neuromuscular excitability.
