NUR 170-171 ADVANCED NURSING
CONCEPTS EXAM 4 B QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L. Which
acid-base imbalance does this represent?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45
mmHg indicates a respiratory cause, and since the HCO3 is normal, it is uncompensated
respiratory acidosis.
2. Which clinical manifestation is a hallmark sign of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH)?
A. Hypernatremia and dehydration
B. Dilutional hyponatremia and fluid retention
C. Polyuria and dilute urine
,D. Elevated serum osmolality
Answer: B
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
reabsorption in the kidneys, which causes dilutional hyponatremia and fluid volume
excess.
3. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse anticipate administering first to stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide
Answer: B
Conceptual Explanation: While other medications lower potassium levels, Calcium
Gluconate is the priority to stabilize the myocardium and prevent lethal dysrhythmias.
4. Which assessment finding is most characteristic of Right-Sided Heart Failure?
A. Pulmonary crackles
B. Dyspnea on exertion
C. Jugular Venous Distention (JVD)
D. Paroxysmal nocturnal dyspnea
, Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly, whereas crackles and dyspnea are
associated with left-sided failure.
5. When caring for a patient in Diabetic Ketoacidosis (DKA), which IV fluid is typically
administered once the blood glucose drops to 250 mg/dL?
A. 0.9% Normal Saline
B. 5% Dextrose in 0.45% Normal Saline
C. Lactated Ringer’s
D. 0.45% Normal Saline only
Answer: B
Conceptual Explanation: Dextrose is added to prevent hypoglycemia and cerebral edema
as blood sugar levels drop rapidly during insulin therapy.
6. Which of the following is a classic sign of Hypocalcemia?
A. Polyuria
B. Trousseau’s sign
C. Constipation
D. Hyperreflexia
Answer: B
CONCEPTS EXAM 4 B QUESTIONS AND
CORRECT ANSWERS 2026/2027
1. A patient presents with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 24 mEq/L. Which
acid-base imbalance does this represent?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: A
Conceptual Explanation: A pH below 7.35 indicates acidosis. An elevated PaCO2 above 45
mmHg indicates a respiratory cause, and since the HCO3 is normal, it is uncompensated
respiratory acidosis.
2. Which clinical manifestation is a hallmark sign of Syndrome of Inappropriate Antidiuretic
Hormone (SIADH)?
A. Hypernatremia and dehydration
B. Dilutional hyponatremia and fluid retention
C. Polyuria and dilute urine
,D. Elevated serum osmolality
Answer: B
Conceptual Explanation: SIADH involves excessive ADH release, leading to water
reabsorption in the kidneys, which causes dilutional hyponatremia and fluid volume
excess.
3. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8 mEq/L. Which
medication should the nurse anticipate administering first to stabilize the cardiac membrane?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Regular Insulin and Dextrose
D. Furosemide
Answer: B
Conceptual Explanation: While other medications lower potassium levels, Calcium
Gluconate is the priority to stabilize the myocardium and prevent lethal dysrhythmias.
4. Which assessment finding is most characteristic of Right-Sided Heart Failure?
A. Pulmonary crackles
B. Dyspnea on exertion
C. Jugular Venous Distention (JVD)
D. Paroxysmal nocturnal dyspnea
, Answer: C
Conceptual Explanation: Right-sided heart failure causes systemic venous congestion,
leading to JVD, peripheral edema, and hepatomegaly, whereas crackles and dyspnea are
associated with left-sided failure.
5. When caring for a patient in Diabetic Ketoacidosis (DKA), which IV fluid is typically
administered once the blood glucose drops to 250 mg/dL?
A. 0.9% Normal Saline
B. 5% Dextrose in 0.45% Normal Saline
C. Lactated Ringer’s
D. 0.45% Normal Saline only
Answer: B
Conceptual Explanation: Dextrose is added to prevent hypoglycemia and cerebral edema
as blood sugar levels drop rapidly during insulin therapy.
6. Which of the following is a classic sign of Hypocalcemia?
A. Polyuria
B. Trousseau’s sign
C. Constipation
D. Hyperreflexia
Answer: B
