NSG 3800 ALL EXAMS BINDER – NURSING PRACTICE:
ADULT HEALTH II | 200 PRACTICE QUESTIONS WITH
CORRECT ANSWERS & DETAILED RATIONALES | 2026/2027
1. A patient with severe vomiting has a serum potassium level of 2.8 mEq/L. Which
assessment finding requires the nurse's immediate attention?
A. Muscle weakness
B. Hypoactive bowel sounds
C. Irregular cardiac rhythm
D. Increased thirst
Correct Answer: C. Irregular cardiac rhythm
Rationale: Significant hypokalemia can alter cardiac conduction and precipitate dysrhythmias.
An irregular rhythm is therefore a priority finding requiring prompt intervention and cardiac
monitoring.
2. A patient with heart failure is receiving IV fluids for dehydration. Which finding
best indicates that fluid replacement is becoming excessive?
A. Urine output of 45 mL/hr
B. New bilateral crackles
C. Moist oral mucosa
D. Heart rate of 88/min
Correct Answer: B. New bilateral crackles
Rationale: New crackles can indicate pulmonary fluid accumulation. In a patient with heart
failure, this finding may signal fluid overload and requires prompt reassessment of the fluid
therapy.
3. A patient has a serum sodium level of 118 mEq/L and becomes confused. Which
intervention is the priority?
A. Encourage free-water intake
B. Initiate seizure precautions
C. Provide a high-potassium diet
D. Restrict dietary sodium
Correct Answer: B. Initiate seizure precautions
Rationale: Severe hyponatremia can cause cerebral edema and neurologic complications,
including seizures. Immediate safety measures such as seizure precautions are appropriate while
the underlying sodium abnormality is treated.
, 4. A patient receiving IV potassium chloride reports burning at the IV site. What
should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress and continue the infusion
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly with normal saline
Correct Answer: C. Stop the infusion and assess the IV site
Rationale: Potassium chloride can cause significant tissue injury if it infiltrates. Burning at the
site warrants stopping the infusion and assessing IV patency before further administration.
5. Which finding is most consistent with hypernatremia caused by water loss?
A. Dry mucous membranes and intense thirst
B. Bounding peripheral pulses
C. Moist skin and bradycardia
D. Dependent edema
Correct Answer: A. Dry mucous membranes and intense thirst
Rationale: Hypernatremia commonly occurs when water loss exceeds sodium loss. Cellular
dehydration produces thirst and findings such as dry mucous membranes.
6. A patient with persistent diarrhea has a serum bicarbonate level of 18 mEq/L.
Which acid-base disorder is most likely?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: D. Metabolic acidosis
Rationale: Diarrhea causes loss of bicarbonate-rich intestinal fluid. Significant bicarbonate loss
lowers serum bicarbonate and can produce metabolic acidosis.
7. A patient with hypocalcemia develops facial twitching when the facial nerve is
tapped. How should the nurse interpret this finding?
A. It indicates hypermagnesemia
B. It is a manifestation of neuromuscular irritability
C. It confirms hyperkalemia
D. It indicates fluid overload
,Correct Answer: B. It is a manifestation of neuromuscular irritability
Rationale: Hypocalcemia increases neuromuscular excitability. Facial twitching with
stimulation, known as Chvostek sign, is a classic manifestation.
8. A patient has a serum magnesium level of 1.1 mg/dL. Which assessment finding
should the nurse anticipate?
A. Diminished deep-tendon reflexes
B. Severe lethargy with hypotension
C. Tremors and hyperactive reflexes
D. Respiratory depression
Correct Answer: C. Tremors and hyperactive reflexes
Rationale: Hypomagnesemia increases neuromuscular excitability and may cause tremors,
muscle cramps, and hyperactive deep-tendon reflexes. Severe cases can progress to seizures or
dysrhythmias.
9. A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
prescription should the nurse question?
A. Cardiac monitoring
B. Repeat serum potassium measurement
C. Administer IV calcium gluconate as prescribed
D. Administer potassium chloride supplementation
Correct Answer: D. Administer potassium chloride supplementation
Rationale: A potassium level of 6.2 mEq/L represents significant hyperkalemia. Additional
potassium could worsen the abnormality and increase the risk of life-threatening dysrhythmias.
10. A patient receiving a hypotonic IV solution becomes increasingly confused and
develops a headache. Which complication should the nurse suspect?
A. Intracellular dehydration
B. Cerebral cellular swelling
C. Hypercalcemia
D. Increased serum osmolality
Correct Answer: B. Cerebral cellular swelling
Rationale: Hypotonic fluids can lower serum osmolality and cause water to shift into cells.
Excessive intracellular water in the brain can produce headache, confusion, seizures, and other
neurologic manifestations.
, 11. A patient with hypovolemia has a blood pressure of 86/52 mm Hg and a heart
rate of 118/min. Which finding best supports the diagnosis?
A. Increased urine output
B. Jugular venous distention
C. Concentrated urine
D. Bilateral pulmonary crackles
Correct Answer: C. Concentrated urine
Rationale: Reduced circulating volume decreases renal perfusion and stimulates water
conservation. The resulting urine is often concentrated and urine output may decrease.
12. A patient with hyperkalemia develops muscle weakness. Which additional finding
is most concerning?
A. Peaked T waves on the ECG
B. Increased bowel sounds
C. Warm, flushed skin
D. Increased appetite
Correct Answer: A. Peaked T waves on the ECG
Rationale: Hyperkalemia can produce characteristic ECG changes, including peaked T waves,
and can progress to conduction abnormalities and cardiac arrest.
13. A patient receiving a loop diuretic has a potassium level of 3.0 mEq/L. Which
medication should the nurse recognize as potentially contributing to this
abnormality?
A. Spironolactone
B. Furosemide
C. Lisinopril
D. Amiloride
Correct Answer: B. Furosemide
Rationale: Furosemide is a loop diuretic that increases renal excretion of sodium and water and
can also increase potassium loss, contributing to hypokalemia.
14. A patient with severe hypercalcemia is receiving treatment. Which assessment
finding would indicate improvement?
A. Increasing muscle weakness
B. New confusion
ADULT HEALTH II | 200 PRACTICE QUESTIONS WITH
CORRECT ANSWERS & DETAILED RATIONALES | 2026/2027
1. A patient with severe vomiting has a serum potassium level of 2.8 mEq/L. Which
assessment finding requires the nurse's immediate attention?
A. Muscle weakness
B. Hypoactive bowel sounds
C. Irregular cardiac rhythm
D. Increased thirst
Correct Answer: C. Irregular cardiac rhythm
Rationale: Significant hypokalemia can alter cardiac conduction and precipitate dysrhythmias.
An irregular rhythm is therefore a priority finding requiring prompt intervention and cardiac
monitoring.
2. A patient with heart failure is receiving IV fluids for dehydration. Which finding
best indicates that fluid replacement is becoming excessive?
A. Urine output of 45 mL/hr
B. New bilateral crackles
C. Moist oral mucosa
D. Heart rate of 88/min
Correct Answer: B. New bilateral crackles
Rationale: New crackles can indicate pulmonary fluid accumulation. In a patient with heart
failure, this finding may signal fluid overload and requires prompt reassessment of the fluid
therapy.
3. A patient has a serum sodium level of 118 mEq/L and becomes confused. Which
intervention is the priority?
A. Encourage free-water intake
B. Initiate seizure precautions
C. Provide a high-potassium diet
D. Restrict dietary sodium
Correct Answer: B. Initiate seizure precautions
Rationale: Severe hyponatremia can cause cerebral edema and neurologic complications,
including seizures. Immediate safety measures such as seizure precautions are appropriate while
the underlying sodium abnormality is treated.
, 4. A patient receiving IV potassium chloride reports burning at the IV site. What
should the nurse do first?
A. Increase the infusion rate
B. Apply a warm compress and continue the infusion
C. Stop the infusion and assess the IV site
D. Flush the catheter rapidly with normal saline
Correct Answer: C. Stop the infusion and assess the IV site
Rationale: Potassium chloride can cause significant tissue injury if it infiltrates. Burning at the
site warrants stopping the infusion and assessing IV patency before further administration.
5. Which finding is most consistent with hypernatremia caused by water loss?
A. Dry mucous membranes and intense thirst
B. Bounding peripheral pulses
C. Moist skin and bradycardia
D. Dependent edema
Correct Answer: A. Dry mucous membranes and intense thirst
Rationale: Hypernatremia commonly occurs when water loss exceeds sodium loss. Cellular
dehydration produces thirst and findings such as dry mucous membranes.
6. A patient with persistent diarrhea has a serum bicarbonate level of 18 mEq/L.
Which acid-base disorder is most likely?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Correct Answer: D. Metabolic acidosis
Rationale: Diarrhea causes loss of bicarbonate-rich intestinal fluid. Significant bicarbonate loss
lowers serum bicarbonate and can produce metabolic acidosis.
7. A patient with hypocalcemia develops facial twitching when the facial nerve is
tapped. How should the nurse interpret this finding?
A. It indicates hypermagnesemia
B. It is a manifestation of neuromuscular irritability
C. It confirms hyperkalemia
D. It indicates fluid overload
,Correct Answer: B. It is a manifestation of neuromuscular irritability
Rationale: Hypocalcemia increases neuromuscular excitability. Facial twitching with
stimulation, known as Chvostek sign, is a classic manifestation.
8. A patient has a serum magnesium level of 1.1 mg/dL. Which assessment finding
should the nurse anticipate?
A. Diminished deep-tendon reflexes
B. Severe lethargy with hypotension
C. Tremors and hyperactive reflexes
D. Respiratory depression
Correct Answer: C. Tremors and hyperactive reflexes
Rationale: Hypomagnesemia increases neuromuscular excitability and may cause tremors,
muscle cramps, and hyperactive deep-tendon reflexes. Severe cases can progress to seizures or
dysrhythmias.
9. A patient with chronic kidney disease has a potassium level of 6.2 mEq/L. Which
prescription should the nurse question?
A. Cardiac monitoring
B. Repeat serum potassium measurement
C. Administer IV calcium gluconate as prescribed
D. Administer potassium chloride supplementation
Correct Answer: D. Administer potassium chloride supplementation
Rationale: A potassium level of 6.2 mEq/L represents significant hyperkalemia. Additional
potassium could worsen the abnormality and increase the risk of life-threatening dysrhythmias.
10. A patient receiving a hypotonic IV solution becomes increasingly confused and
develops a headache. Which complication should the nurse suspect?
A. Intracellular dehydration
B. Cerebral cellular swelling
C. Hypercalcemia
D. Increased serum osmolality
Correct Answer: B. Cerebral cellular swelling
Rationale: Hypotonic fluids can lower serum osmolality and cause water to shift into cells.
Excessive intracellular water in the brain can produce headache, confusion, seizures, and other
neurologic manifestations.
, 11. A patient with hypovolemia has a blood pressure of 86/52 mm Hg and a heart
rate of 118/min. Which finding best supports the diagnosis?
A. Increased urine output
B. Jugular venous distention
C. Concentrated urine
D. Bilateral pulmonary crackles
Correct Answer: C. Concentrated urine
Rationale: Reduced circulating volume decreases renal perfusion and stimulates water
conservation. The resulting urine is often concentrated and urine output may decrease.
12. A patient with hyperkalemia develops muscle weakness. Which additional finding
is most concerning?
A. Peaked T waves on the ECG
B. Increased bowel sounds
C. Warm, flushed skin
D. Increased appetite
Correct Answer: A. Peaked T waves on the ECG
Rationale: Hyperkalemia can produce characteristic ECG changes, including peaked T waves,
and can progress to conduction abnormalities and cardiac arrest.
13. A patient receiving a loop diuretic has a potassium level of 3.0 mEq/L. Which
medication should the nurse recognize as potentially contributing to this
abnormality?
A. Spironolactone
B. Furosemide
C. Lisinopril
D. Amiloride
Correct Answer: B. Furosemide
Rationale: Furosemide is a loop diuretic that increases renal excretion of sodium and water and
can also increase potassium loss, contributing to hypokalemia.
14. A patient with severe hypercalcemia is receiving treatment. Which assessment
finding would indicate improvement?
A. Increasing muscle weakness
B. New confusion
