NUR 3250 Med-Surg / NSG
3250 Adult Health 1 Bundle
Exams with complete solutions
1. A client has a serum potassium of 2.8 mEq/L. Which assessment finding
should the nurse expect?
• A. Tall peaked T waves
• B. Muscle weakness and fatigue
• C. Hypertension
• D. Decreased deep tendon reflexes only
Answer: B
Rationale: Hypokalemia causes muscle weakness, fatigue, and decreased reflexes.
Tall peaked T waves are seen in hyperkalemia.
2. Which IV fluid is isotonic?
• A. 0.45% NaCl
• B. 0.9% NaCl
• C. 3% NaCl
• D. 0.225% NaCl
Answer: B
Rationale: 0.9% NaCl (normal saline) is isotonic. 0.45% and 0.225% are hypotonic;
3% is hypertonic.
,3. A client with hyperkalemia is given calcium gluconate. What is the purpose?
• A. Lower potassium level
• B. Protect the heart from dysrhythmias
• C. Increase urine output
• D. Replace calcium stores
Answer: B
Rationale: Calcium gluconate stabilizes the myocardium but does not lower
potassium. Insulin/glucose and kayexalate actually lower K+.
4. A client with heart failure has edema. Which assessment is most important?
• A. Daily weight
• B. Skin turgor
• C. Capillary refill
• D. Pupil response
Answer: A
Rationale: Daily weight is the most reliable indicator of fluid retention or loss.
5. Which finding indicates fluid volume deficit?
• A. Bounding pulse
• B. Crackles in lungs
• C. Poor skin turgor
• D. Jugular vein distention
Answer: C
Rationale: Poor skin turgor, dry mucous membranes, and thirst indicate
dehydration. The others indicate fluid overload.
,6. A client receiving furosemide should be monitored for which electrolyte
imbalance?
• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hypercalcemia
Answer: B
Rationale: Loop diuretics cause potassium loss. Monitor K+ and encourage
potassium-rich foods.
7. Manifestations of hypocalcemia include:
• A. Positive Trousseau sign
• B. Hypertension
• C. Bradycardia
• D. Warm flushed skin
Answer: A
Rationale: Trousseau and Chvostek signs are classic for hypocalcemia, along with
tingling and muscle spasms.
8. A client has a magnesium level of 1.0 mEq/L. Which food should the nurse
recommend?
• A. Bananas
• B. Dark leafy greens
• C. White bread
, • D. Apples
Answer: B
Rationale: Dark leafy greens, nuts, and whole grains are high in magnesium.
9. Which client is at highest risk for hyperkalemia?
• A. Client on furosemide
• B. Client with renal failure
• C. Client with vomiting
• D. Client on nasogastric suction
Answer: B
Rationale: The kidneys excrete potassium; renal failure leads to retention.
10. A client with syndrome of inappropriate antidiuretic hormone (SIADH) will
likely have:
• A. Decreased urine output
• B. Increased serum sodium
• C. Polyuria
• D. Decreased ADH
Answer: A
Rationale: SIADH causes water retention, concentrated urine, and dilutional
hyponatremia.
UNIT 2: CARDIOVASCULAR (Q11–25)
11. A client with acute myocardial infarction (MI) reports chest pain. What is the
priority action?
3250 Adult Health 1 Bundle
Exams with complete solutions
1. A client has a serum potassium of 2.8 mEq/L. Which assessment finding
should the nurse expect?
• A. Tall peaked T waves
• B. Muscle weakness and fatigue
• C. Hypertension
• D. Decreased deep tendon reflexes only
Answer: B
Rationale: Hypokalemia causes muscle weakness, fatigue, and decreased reflexes.
Tall peaked T waves are seen in hyperkalemia.
2. Which IV fluid is isotonic?
• A. 0.45% NaCl
• B. 0.9% NaCl
• C. 3% NaCl
• D. 0.225% NaCl
Answer: B
Rationale: 0.9% NaCl (normal saline) is isotonic. 0.45% and 0.225% are hypotonic;
3% is hypertonic.
,3. A client with hyperkalemia is given calcium gluconate. What is the purpose?
• A. Lower potassium level
• B. Protect the heart from dysrhythmias
• C. Increase urine output
• D. Replace calcium stores
Answer: B
Rationale: Calcium gluconate stabilizes the myocardium but does not lower
potassium. Insulin/glucose and kayexalate actually lower K+.
4. A client with heart failure has edema. Which assessment is most important?
• A. Daily weight
• B. Skin turgor
• C. Capillary refill
• D. Pupil response
Answer: A
Rationale: Daily weight is the most reliable indicator of fluid retention or loss.
5. Which finding indicates fluid volume deficit?
• A. Bounding pulse
• B. Crackles in lungs
• C. Poor skin turgor
• D. Jugular vein distention
Answer: C
Rationale: Poor skin turgor, dry mucous membranes, and thirst indicate
dehydration. The others indicate fluid overload.
,6. A client receiving furosemide should be monitored for which electrolyte
imbalance?
• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hypercalcemia
Answer: B
Rationale: Loop diuretics cause potassium loss. Monitor K+ and encourage
potassium-rich foods.
7. Manifestations of hypocalcemia include:
• A. Positive Trousseau sign
• B. Hypertension
• C. Bradycardia
• D. Warm flushed skin
Answer: A
Rationale: Trousseau and Chvostek signs are classic for hypocalcemia, along with
tingling and muscle spasms.
8. A client has a magnesium level of 1.0 mEq/L. Which food should the nurse
recommend?
• A. Bananas
• B. Dark leafy greens
• C. White bread
, • D. Apples
Answer: B
Rationale: Dark leafy greens, nuts, and whole grains are high in magnesium.
9. Which client is at highest risk for hyperkalemia?
• A. Client on furosemide
• B. Client with renal failure
• C. Client with vomiting
• D. Client on nasogastric suction
Answer: B
Rationale: The kidneys excrete potassium; renal failure leads to retention.
10. A client with syndrome of inappropriate antidiuretic hormone (SIADH) will
likely have:
• A. Decreased urine output
• B. Increased serum sodium
• C. Polyuria
• D. Decreased ADH
Answer: A
Rationale: SIADH causes water retention, concentrated urine, and dilutional
hyponatremia.
UNIT 2: CARDIOVASCULAR (Q11–25)
11. A client with acute myocardial infarction (MI) reports chest pain. What is the
priority action?
