NURSING COURSE · OBJECTIVE ASSESSMENT
A+ VERIFIED
NSG 3130 Exam 4 Fundamental Concepts
and Skills for Nursing Practice II — Complete
Official Exam
130 Questions Full Rationales Verified Answers
A+ 6 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Fluid, Electrolyte & Acid-Base Balance
02 Perioperative Nursing Care
03 Wound Care & Tissue Integrity
04 Musculoskeletal & Mobility
05 Sensory, Neurological & Cognitive Function
06 Palliative & End-of-Life Care
ABOUT THIS ASSESSMENT
Build mastery in fundamental nursing concepts and skills — from fluid, electrolyte, and acid-base balance to perioperative nursing, wound care and tissue
integrity, musculoskeletal and mobility, sensory, neurological, and cognitive function, and palliative and end-of-life care. This original study bank targets
application and analysis skills for NSG 3130 Exam 4, with full rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
75% Intermediate (Nursing Course) Application / Analysis
STUVIA ACTUAL EXAM Page 1
,SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q1. A 68-year-old client with heart failure is receiving intravenous furosemide. The nurse notes muscle weakness, flattened T waves, and a
serum potassium of 2.9 mEq/L. The priority nursing action is to:
A. Encourage increased oral fluid intake immediately
B. Place the client in Trendelenburg position
C. Administer an additional dose of furosemide
D. Notify the provider and prepare to administer potassium supplementation as ordered
Correct Answer: D
Rationale:
Hypokalemia (K+ < 3.5 mEq/L) with ECG changes requires prompt provider notification and potassium replacement. Additional loop diuretic would worsen the
deficit. Fluid intake alone does not correct potassium.
Q2. A client with prolonged vomiting has arterial blood gas results: pH 7.50, PaCO2 48 mm Hg, HCO3− 36 mEq/L. The nurse interprets these
values as which acid-base imbalance?
A. Respiratory acidosis, uncompensated
B. Respiratory alkalosis, uncompensated
C. Metabolic acidosis, fully compensated
D. Metabolic alkalosis, partially compensated
Correct Answer: D
Rationale:
Elevated pH and elevated HCO3− indicate metabolic alkalosis. The slightly elevated PaCO2 shows respiratory compensation has begun, so the imbalance is
partially compensated.
Q3. A post-operative client is receiving 0.9% sodium chloride at 125 mL/hr. The nurse assesses crackles in the lung bases, bounding pulses,
and a weight gain of 1.2 kg in 24 hours. These findings most likely indicate:
A. Fluid volume deficit
B. Hyponatremia only
C. Fluid volume excess
D. Normal post-operative fluid shift
Correct Answer: C
Rationale:
Crackles, bounding pulses, and rapid weight gain are classic signs of fluid volume excess. Isotonic fluid at a high rate can precipitate overload, especially in older or
cardiac clients.
Q4. A client with chronic kidney disease has a serum calcium of 7.2 mg/dL and reports circumoral tingling. The nurse anticipates which
additional assessment finding?
A. Positive Trousseau or Chvostek sign
B. Negative Trousseau and Chvostek signs
C. Bradycardia and hypotension only
D. Flushed skin and bounding pulses
Correct Answer: A
Rationale:
Hypocalcemia increases neuromuscular excitability, producing positive Trousseau and Chvostek signs as well as circumoral paresthesias. These are key clinical
indicators of low calcium.
Q5. A client with diabetic ketoacidosis has a serum potassium of 5.8 mEq/L before insulin therapy is started. After insulin and fluid resuscitation
begin, the nurse monitors closely for which change?
A. Further rise in serum potassium
B. Immediate hypernatremia
C. No change in potassium because insulin does not affect it
D. Rapid fall in serum potassium requiring replacement
Correct Answer: D
Rationale:
Insulin drives potassium into cells. Clients with DKA may present with hyperkalemia yet have total-body potassium depletion; insulin therapy can precipitate
life-threatening hypokalemia.
STUVIA ACTUAL EXAM · Page 2
, SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q6. A nurse is teaching a client with mild hyponatremia about dietary sodium. The client asks which foods are relatively high in sodium. The
best response includes:
A. Fresh fruits and unsalted vegetables only
B. Processed meats, canned soups, and salted snack foods
C. Whole-grain breads without added salt
D. Fresh poultry and fish prepared without seasoning
Correct Answer: B
Rationale:
Processed and canned foods are common high-sodium sources. Fresh fruits, unsalted vegetables, and unseasoned meats are lower in sodium and preferred when
sodium restriction is needed.
Q7. A client receiving total parenteral nutrition develops a serum phosphate of 1.4 mg/dL. The nurse recognizes that severe hypophosphatemia
can lead to which complication?
A. Impaired diaphragmatic contractility and respiratory failure
B. Hyperreflexia and muscle spasms only
C. Immediate hypercalcemia
D. Increased bone density within hours
Correct Answer: A
Rationale:
Phosphate is required for ATP production. Severe hypophosphatemia can cause muscle weakness, including respiratory muscle failure, and is a medical
emergency.
Q8. Arterial blood gas results for a client with COPD show pH 7.36, PaCO2 58 mm Hg, HCO3− 32 mEq/L. The nurse correctly interprets this as:
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Correct Answer: C
Rationale:
pH is within normal range (7.35–7.45) while PaCO2 and HCO3− are both elevated. This pattern indicates chronic respiratory acidosis that has been fully
compensated by renal retention of bicarbonate.
Q9. A client with heart failure is prescribed spironolactone. The nurse includes which teaching point about this medication’s effect on
electrolytes?
A. It increases potassium excretion and may cause hypokalemia
B. It has no effect on serum potassium levels
C. It is potassium-sparing and can cause hyperkalemia if combined with potassium supplements
D. It lowers sodium and potassium equally in all clients
Correct Answer: C
Rationale:
Spironolactone is an aldosterone antagonist that spares potassium. Concurrent potassium supplements or ACE inhibitors raise the risk of hyperkalemia; levels
must be monitored.
Q10. A client who has been NPO for 48 hours after abdominal surgery has a serum sodium of 128 mEq/L. The nurse anticipates which type of
intravenous fluid may be ordered?
A. 0.45% sodium chloride (hypotonic)
B. D5W only
C. 3% sodium chloride (hypertonic) if severe neurologic symptoms are present
D. Lactated Ringer’s without any sodium adjustment
Correct Answer: C
Rationale:
Symptomatic or severe hyponatremia may require careful administration of hypertonic saline under close monitoring. Hypotonic fluids would worsen the dilutional
state.
STUVIA ACTUAL EXAM · Page 3
A+ VERIFIED
NSG 3130 Exam 4 Fundamental Concepts
and Skills for Nursing Practice II — Complete
Official Exam
130 Questions Full Rationales Verified Answers
A+ 6 100%
QUESTIONS SECTIONS RATIONALES
Complete coverage Core exam domains Every answer explained
WHAT THIS COVERS
01 Fluid, Electrolyte & Acid-Base Balance
02 Perioperative Nursing Care
03 Wound Care & Tissue Integrity
04 Musculoskeletal & Mobility
05 Sensory, Neurological & Cognitive Function
06 Palliative & End-of-Life Care
ABOUT THIS ASSESSMENT
Build mastery in fundamental nursing concepts and skills — from fluid, electrolyte, and acid-base balance to perioperative nursing, wound care and tissue
integrity, musculoskeletal and mobility, sensory, neurological, and cognitive function, and palliative and end-of-life care. This original study bank targets
application and analysis skills for NSG 3130 Exam 4, with full rationales for every answer. For review use only; not an institutional proctored assessment.
PASSING SCORE LEVEL FORMAT
75% Intermediate (Nursing Course) Application / Analysis
STUVIA ACTUAL EXAM Page 1
,SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q1. A 68-year-old client with heart failure is receiving intravenous furosemide. The nurse notes muscle weakness, flattened T waves, and a
serum potassium of 2.9 mEq/L. The priority nursing action is to:
A. Encourage increased oral fluid intake immediately
B. Place the client in Trendelenburg position
C. Administer an additional dose of furosemide
D. Notify the provider and prepare to administer potassium supplementation as ordered
Correct Answer: D
Rationale:
Hypokalemia (K+ < 3.5 mEq/L) with ECG changes requires prompt provider notification and potassium replacement. Additional loop diuretic would worsen the
deficit. Fluid intake alone does not correct potassium.
Q2. A client with prolonged vomiting has arterial blood gas results: pH 7.50, PaCO2 48 mm Hg, HCO3− 36 mEq/L. The nurse interprets these
values as which acid-base imbalance?
A. Respiratory acidosis, uncompensated
B. Respiratory alkalosis, uncompensated
C. Metabolic acidosis, fully compensated
D. Metabolic alkalosis, partially compensated
Correct Answer: D
Rationale:
Elevated pH and elevated HCO3− indicate metabolic alkalosis. The slightly elevated PaCO2 shows respiratory compensation has begun, so the imbalance is
partially compensated.
Q3. A post-operative client is receiving 0.9% sodium chloride at 125 mL/hr. The nurse assesses crackles in the lung bases, bounding pulses,
and a weight gain of 1.2 kg in 24 hours. These findings most likely indicate:
A. Fluid volume deficit
B. Hyponatremia only
C. Fluid volume excess
D. Normal post-operative fluid shift
Correct Answer: C
Rationale:
Crackles, bounding pulses, and rapid weight gain are classic signs of fluid volume excess. Isotonic fluid at a high rate can precipitate overload, especially in older or
cardiac clients.
Q4. A client with chronic kidney disease has a serum calcium of 7.2 mg/dL and reports circumoral tingling. The nurse anticipates which
additional assessment finding?
A. Positive Trousseau or Chvostek sign
B. Negative Trousseau and Chvostek signs
C. Bradycardia and hypotension only
D. Flushed skin and bounding pulses
Correct Answer: A
Rationale:
Hypocalcemia increases neuromuscular excitability, producing positive Trousseau and Chvostek signs as well as circumoral paresthesias. These are key clinical
indicators of low calcium.
Q5. A client with diabetic ketoacidosis has a serum potassium of 5.8 mEq/L before insulin therapy is started. After insulin and fluid resuscitation
begin, the nurse monitors closely for which change?
A. Further rise in serum potassium
B. Immediate hypernatremia
C. No change in potassium because insulin does not affect it
D. Rapid fall in serum potassium requiring replacement
Correct Answer: D
Rationale:
Insulin drives potassium into cells. Clients with DKA may present with hyperkalemia yet have total-body potassium depletion; insulin therapy can precipitate
life-threatening hypokalemia.
STUVIA ACTUAL EXAM · Page 2
, SECTION 1: Fluid, Electrolyte & Acid-Base Balance
Q6. A nurse is teaching a client with mild hyponatremia about dietary sodium. The client asks which foods are relatively high in sodium. The
best response includes:
A. Fresh fruits and unsalted vegetables only
B. Processed meats, canned soups, and salted snack foods
C. Whole-grain breads without added salt
D. Fresh poultry and fish prepared without seasoning
Correct Answer: B
Rationale:
Processed and canned foods are common high-sodium sources. Fresh fruits, unsalted vegetables, and unseasoned meats are lower in sodium and preferred when
sodium restriction is needed.
Q7. A client receiving total parenteral nutrition develops a serum phosphate of 1.4 mg/dL. The nurse recognizes that severe hypophosphatemia
can lead to which complication?
A. Impaired diaphragmatic contractility and respiratory failure
B. Hyperreflexia and muscle spasms only
C. Immediate hypercalcemia
D. Increased bone density within hours
Correct Answer: A
Rationale:
Phosphate is required for ATP production. Severe hypophosphatemia can cause muscle weakness, including respiratory muscle failure, and is a medical
emergency.
Q8. Arterial blood gas results for a client with COPD show pH 7.36, PaCO2 58 mm Hg, HCO3− 32 mEq/L. The nurse correctly interprets this as:
A. Uncompensated respiratory acidosis
B. Uncompensated metabolic alkalosis
C. Fully compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Correct Answer: C
Rationale:
pH is within normal range (7.35–7.45) while PaCO2 and HCO3− are both elevated. This pattern indicates chronic respiratory acidosis that has been fully
compensated by renal retention of bicarbonate.
Q9. A client with heart failure is prescribed spironolactone. The nurse includes which teaching point about this medication’s effect on
electrolytes?
A. It increases potassium excretion and may cause hypokalemia
B. It has no effect on serum potassium levels
C. It is potassium-sparing and can cause hyperkalemia if combined with potassium supplements
D. It lowers sodium and potassium equally in all clients
Correct Answer: C
Rationale:
Spironolactone is an aldosterone antagonist that spares potassium. Concurrent potassium supplements or ACE inhibitors raise the risk of hyperkalemia; levels
must be monitored.
Q10. A client who has been NPO for 48 hours after abdominal surgery has a serum sodium of 128 mEq/L. The nurse anticipates which type of
intravenous fluid may be ordered?
A. 0.45% sodium chloride (hypotonic)
B. D5W only
C. 3% sodium chloride (hypertonic) if severe neurologic symptoms are present
D. Lactated Ringer’s without any sodium adjustment
Correct Answer: C
Rationale:
Symptomatic or severe hyponatremia may require careful administration of hypertonic saline under close monitoring. Hypotonic fluids would worsen the dilutional
state.
STUVIA ACTUAL EXAM · Page 3
