NSG 3100 EXAM 4 PRACTICE QUESTIONS &
ANSWERS | GALEN COLLEGE | 2026/2027
STUDY GUIDE | 200 QUESTIONS WITH
DETAILED RATIONALES | GUARANTEED PASS
| GRADED A+ | NEWEST!
1. A client has a serum sodium level of 120 mEq/L. Which assessment is the nurse's
priority?
A. Bowel sounds
B. Neurological status
C. Skin integrity
D. Peripheral pulses
Answer: B. Neurological status
Rationale: Severe hyponatremia can cause cerebral edema and neurological manifestations
such as confusion, seizures, and decreased level of consciousness.
2. Which finding is an early indication of fluid volume deficit?
A. Bradycardia
B. Tachycardia
C. Bounding pulse
D. Hypertension
Answer: B. Tachycardia
Rationale: Tachycardia is an early compensatory response to decreased circulating blood
volume.
3. Which assessment finding is most consistent with fluid volume excess?
A. Flat neck veins
B. Dry mucous membranes
C. Peripheral edema
D. Poor skin turgor
Answer: C. Peripheral edema
Rationale: Excess fluid commonly produces dependent edema, weight gain, jugular venous
distention, and pulmonary congestion.
,4. Which measurement is generally the most sensitive indicator of changes in a client's
fluid balance?
A. Skin turgor
B. Daily weight
C. Blood pressure
D. Urine color
Answer: B. Daily weight
Rationale: Daily weight provides a sensitive indication of fluid gain or loss. Approximately 1
kg of weight change corresponds to about 1 liter of fluid.
5. A client has prolonged diarrhea and develops muscle weakness and an irregular
pulse. Which electrolyte imbalance should the nurse suspect?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Gastrointestinal losses can decrease potassium levels. Hypokalemia may cause
muscle weakness and potentially dangerous cardiac dysrhythmias.
6. Which food should a client on a sodium-restricted diet limit?
A. Fresh apple
B. Fresh cucumber
C. Canned soup
D. Brown rice
Answer: C. Canned soup
Rationale: Processed and canned foods frequently contain substantial amounts of sodium.
7. Which finding is most characteristic of hypernatremia?
A. Intense thirst
B. Positive Chvostek sign
C. Muscle tetany
D. Severe bradycardia
Answer: A. Intense thirst
,Rationale: Hypernatremia commonly causes thirst, dry mucous membranes, restlessness, and
neurological changes.
8. A client has a potassium level of 6.2 mEq/L. Which assessment is the priority?
A. Cardiac rhythm
B. Bowel sounds
C. Skin temperature
D. Visual acuity
Answer: A. Cardiac rhythm
Rationale: Significant hyperkalemia can produce life-threatening cardiac conduction
abnormalities and dysrhythmias.
9. Which finding is associated with hypocalcemia?
A. Muscle tetany
B. Decreased neuromuscular excitability
C. Flaccid muscles only
D. Polyuria
Answer: A. Muscle tetany
Rationale: Low calcium increases neuromuscular excitability and can cause tetany, muscle
spasms, and positive Chvostek or Trousseau signs.
10. Which assessment finding is associated with hypercalcemia?
A. Tetany
B. Muscle spasms
C. Constipation
D. Positive Trousseau sign
Answer: C. Constipation
Rationale: Hypercalcemia can decrease neuromuscular activity and may cause constipation,
weakness, lethargy, and increased urination.
11. A client has a serum magnesium level of 1.1 mg/dL. Which finding should the nurse
anticipate?
A. Neuromuscular irritability
B. Respiratory depression
C. Severe hypotension from excess magnesium
D. Absent reflexes
, Answer: A. Neuromuscular irritability
Rationale: Hypomagnesemia may cause tremors, muscle cramps, hyperreflexia, and
neuromuscular irritability.
12. Which client is at greatest risk for fluid volume deficit?
A. Client receiving IV fluids
B. Client with persistent vomiting and diarrhea
C. Client with heart failure and edema
D. Client receiving enteral nutrition
Answer: B. Client with persistent vomiting and diarrhea
Rationale: Vomiting and diarrhea can cause significant fluid and electrolyte losses.
13. Which finding should the nurse associate with dehydration?
A. Moist mucous membranes
B. Concentrated urine
C. Weight gain
D. Bounding pulse
Answer: B. Concentrated urine
Rationale: Fluid deficit causes the kidneys to conserve water, resulting in more concentrated
urine.
14. A client has metabolic acidosis. Which respiratory response should the nurse
expect?
A. Slow, shallow respirations
B. Rapid, deep respirations
C. Complete apnea
D. Irregular respirations only during sleep
Answer: B. Rapid, deep respirations
Rationale: The respiratory system compensates for metabolic acidosis by increasing
ventilation to eliminate carbon dioxide.
15. Which arterial blood gas value represents normal blood pH?
A. 6.90
B. 7.10
ANSWERS | GALEN COLLEGE | 2026/2027
STUDY GUIDE | 200 QUESTIONS WITH
DETAILED RATIONALES | GUARANTEED PASS
| GRADED A+ | NEWEST!
1. A client has a serum sodium level of 120 mEq/L. Which assessment is the nurse's
priority?
A. Bowel sounds
B. Neurological status
C. Skin integrity
D. Peripheral pulses
Answer: B. Neurological status
Rationale: Severe hyponatremia can cause cerebral edema and neurological manifestations
such as confusion, seizures, and decreased level of consciousness.
2. Which finding is an early indication of fluid volume deficit?
A. Bradycardia
B. Tachycardia
C. Bounding pulse
D. Hypertension
Answer: B. Tachycardia
Rationale: Tachycardia is an early compensatory response to decreased circulating blood
volume.
3. Which assessment finding is most consistent with fluid volume excess?
A. Flat neck veins
B. Dry mucous membranes
C. Peripheral edema
D. Poor skin turgor
Answer: C. Peripheral edema
Rationale: Excess fluid commonly produces dependent edema, weight gain, jugular venous
distention, and pulmonary congestion.
,4. Which measurement is generally the most sensitive indicator of changes in a client's
fluid balance?
A. Skin turgor
B. Daily weight
C. Blood pressure
D. Urine color
Answer: B. Daily weight
Rationale: Daily weight provides a sensitive indication of fluid gain or loss. Approximately 1
kg of weight change corresponds to about 1 liter of fluid.
5. A client has prolonged diarrhea and develops muscle weakness and an irregular
pulse. Which electrolyte imbalance should the nurse suspect?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Answer: B. Hypokalemia
Rationale: Gastrointestinal losses can decrease potassium levels. Hypokalemia may cause
muscle weakness and potentially dangerous cardiac dysrhythmias.
6. Which food should a client on a sodium-restricted diet limit?
A. Fresh apple
B. Fresh cucumber
C. Canned soup
D. Brown rice
Answer: C. Canned soup
Rationale: Processed and canned foods frequently contain substantial amounts of sodium.
7. Which finding is most characteristic of hypernatremia?
A. Intense thirst
B. Positive Chvostek sign
C. Muscle tetany
D. Severe bradycardia
Answer: A. Intense thirst
,Rationale: Hypernatremia commonly causes thirst, dry mucous membranes, restlessness, and
neurological changes.
8. A client has a potassium level of 6.2 mEq/L. Which assessment is the priority?
A. Cardiac rhythm
B. Bowel sounds
C. Skin temperature
D. Visual acuity
Answer: A. Cardiac rhythm
Rationale: Significant hyperkalemia can produce life-threatening cardiac conduction
abnormalities and dysrhythmias.
9. Which finding is associated with hypocalcemia?
A. Muscle tetany
B. Decreased neuromuscular excitability
C. Flaccid muscles only
D. Polyuria
Answer: A. Muscle tetany
Rationale: Low calcium increases neuromuscular excitability and can cause tetany, muscle
spasms, and positive Chvostek or Trousseau signs.
10. Which assessment finding is associated with hypercalcemia?
A. Tetany
B. Muscle spasms
C. Constipation
D. Positive Trousseau sign
Answer: C. Constipation
Rationale: Hypercalcemia can decrease neuromuscular activity and may cause constipation,
weakness, lethargy, and increased urination.
11. A client has a serum magnesium level of 1.1 mg/dL. Which finding should the nurse
anticipate?
A. Neuromuscular irritability
B. Respiratory depression
C. Severe hypotension from excess magnesium
D. Absent reflexes
, Answer: A. Neuromuscular irritability
Rationale: Hypomagnesemia may cause tremors, muscle cramps, hyperreflexia, and
neuromuscular irritability.
12. Which client is at greatest risk for fluid volume deficit?
A. Client receiving IV fluids
B. Client with persistent vomiting and diarrhea
C. Client with heart failure and edema
D. Client receiving enteral nutrition
Answer: B. Client with persistent vomiting and diarrhea
Rationale: Vomiting and diarrhea can cause significant fluid and electrolyte losses.
13. Which finding should the nurse associate with dehydration?
A. Moist mucous membranes
B. Concentrated urine
C. Weight gain
D. Bounding pulse
Answer: B. Concentrated urine
Rationale: Fluid deficit causes the kidneys to conserve water, resulting in more concentrated
urine.
14. A client has metabolic acidosis. Which respiratory response should the nurse
expect?
A. Slow, shallow respirations
B. Rapid, deep respirations
C. Complete apnea
D. Irregular respirations only during sleep
Answer: B. Rapid, deep respirations
Rationale: The respiratory system compensates for metabolic acidosis by increasing
ventilation to eliminate carbon dioxide.
15. Which arterial blood gas value represents normal blood pH?
A. 6.90
B. 7.10
