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NSG 3800 EXAM 1 2026/2027 | NURSING PRACTICE
– ADULT HEALTH II | 40 VERIFIED Q&A | DETAILED
RATIONALES | PASS GUARANTEED – A+ GRADED
SECTION 1: FLUID & ELECTROLYTE IMBALANCES – Questions 1-15
Q1: Hypernatremia Assessment Priority
For a client with a serum sodium of 155 mEq/L, the nurse should first assess for which clinical
manifestation?
A. Confusion and muscle twitching
B. Jugular vein distention
C. Tachycardia and hypotension
D. Periorbital edema
Correct Answer: A
Rationale: Hypernatremia (sodium >145 mEq/L) causes intracellular dehydration, primarily affecting
the central nervous system. Early signs include confusion, restlessness, and muscle twitching. Jugular
vein distention and edema indicate hypervolemia, not hypernatremia .
Q2: Hypotonic Solution Identification
The nurse identifies 0.45% sodium chloride as which type of intravenous solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Correct Answer: B
Rationale: 0.45% NaCl is a hypotonic solution, with an osmolality lower than plasma. It shifts water
into cells and is used for hypernatremia. Isotonic solutions (0.9% NaCl, LR) expand intravascular
volume. Hypertonic solutions draw fluid from cells .
Q3: SIADH Specific Gravity Monitoring
In caring for a client with SIADH, the nurse monitors specific gravity every 4 hours to assess:
A. Nutritional status
B. Potassium balance
C. Fluid volume status
D. Calcium balance
, 2
Correct Answer: C
Rationale: SIADH causes water retention, diluting body fluids and decreasing specific gravity.
Tracking specific gravity helps detect fluid volume excess or deficit. It does not directly measure
nutrition, potassium, or calcium .
Q4: Fluid Volume Deficit Priority Sign
The #1 sign of fluid volume deficit is:
A. Hypotension
B. Decreased urine output
C. Tachycardia
D. Dry mucous membranes
Correct Answer: C
Rationale: Tachycardia is the earliest compensatory mechanism for hypovolemia, as the heart rate
increases to maintain cardiac output. Blood pressure drops later. Dry membranes and oliguria are
also present but not the number one sign .
Q5: Hyperkalemia Priority Complication
When caring for a client with a potassium level of 5.2 mEq/L, the nurse should monitor for which
priority complication?
A. Cardiac dysrhythmias
B. Polyuria
C. Tetany
D. Muscle weakness
Correct Answer: A
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves, widened QRS, and
potentially fatal arrhythmias. While muscle weakness may occur, cardiac monitoring is the priority .
Q6: Hyperventilation Acid-Base Imbalance
The nurse is caring for a client experiencing hyperventilation from anxiety. This is most likely to
cause which acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: The most common cause of acute respiratory alkalosis is hyperventilation, which can be
triggered by extreme anxiety. Hyperventilation causes a decrease in PaCO2, leading to alkalosis .
NSG 3800 EXAM 1 2026/2027 | NURSING PRACTICE
– ADULT HEALTH II | 40 VERIFIED Q&A | DETAILED
RATIONALES | PASS GUARANTEED – A+ GRADED
SECTION 1: FLUID & ELECTROLYTE IMBALANCES – Questions 1-15
Q1: Hypernatremia Assessment Priority
For a client with a serum sodium of 155 mEq/L, the nurse should first assess for which clinical
manifestation?
A. Confusion and muscle twitching
B. Jugular vein distention
C. Tachycardia and hypotension
D. Periorbital edema
Correct Answer: A
Rationale: Hypernatremia (sodium >145 mEq/L) causes intracellular dehydration, primarily affecting
the central nervous system. Early signs include confusion, restlessness, and muscle twitching. Jugular
vein distention and edema indicate hypervolemia, not hypernatremia .
Q2: Hypotonic Solution Identification
The nurse identifies 0.45% sodium chloride as which type of intravenous solution?
A. Isotonic
B. Hypotonic
C. Hypertonic
D. Colloid
Correct Answer: B
Rationale: 0.45% NaCl is a hypotonic solution, with an osmolality lower than plasma. It shifts water
into cells and is used for hypernatremia. Isotonic solutions (0.9% NaCl, LR) expand intravascular
volume. Hypertonic solutions draw fluid from cells .
Q3: SIADH Specific Gravity Monitoring
In caring for a client with SIADH, the nurse monitors specific gravity every 4 hours to assess:
A. Nutritional status
B. Potassium balance
C. Fluid volume status
D. Calcium balance
, 2
Correct Answer: C
Rationale: SIADH causes water retention, diluting body fluids and decreasing specific gravity.
Tracking specific gravity helps detect fluid volume excess or deficit. It does not directly measure
nutrition, potassium, or calcium .
Q4: Fluid Volume Deficit Priority Sign
The #1 sign of fluid volume deficit is:
A. Hypotension
B. Decreased urine output
C. Tachycardia
D. Dry mucous membranes
Correct Answer: C
Rationale: Tachycardia is the earliest compensatory mechanism for hypovolemia, as the heart rate
increases to maintain cardiac output. Blood pressure drops later. Dry membranes and oliguria are
also present but not the number one sign .
Q5: Hyperkalemia Priority Complication
When caring for a client with a potassium level of 5.2 mEq/L, the nurse should monitor for which
priority complication?
A. Cardiac dysrhythmias
B. Polyuria
C. Tetany
D. Muscle weakness
Correct Answer: A
Rationale: Hyperkalemia alters cardiac conduction, leading to peaked T waves, widened QRS, and
potentially fatal arrhythmias. While muscle weakness may occur, cardiac monitoring is the priority .
Q6: Hyperventilation Acid-Base Imbalance
The nurse is caring for a client experiencing hyperventilation from anxiety. This is most likely to
cause which acid-base imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: B
Rationale: The most common cause of acute respiratory alkalosis is hyperventilation, which can be
triggered by extreme anxiety. Hyperventilation causes a decrease in PaCO2, leading to alkalosis .
