,NR 324 Adult Health I Exam Prep —
Comprehensive Review + Practice
MCQs — Chamberlain College of
Nursing 2025/2026
Q1. A nurse is assessing an older adult client with dehydration. Which finding should the nurse expect?
A. Bounding peripheral pulses
B. Jugular venous distention
C. Orthostatic hypotension
D. Crackles in the lung bases
Correct Answer: C
Rationale: Dehydration causes hypovolemia, reducing circulating blood volume. When the client changes
position from lying to standing, blood pressure drops due to inadequate venous return, producing orthostatic
hypotension. Bounding pulses, JVD, and crackles indicate fluid overload, not depletion.
Q2. A client has a serum sodium level of 125 mEq/L. Which assessment finding is most concerning to the
nurse?
A. Dry mucous membranes
B. Thirst
C. Altered mental status
D. Fever
Correct Answer: C
,Rationale: Severe hyponatremia causes water to shift into brain cells, producing cerebral edema. Altered
mental status indicates neurological involvement and requires immediate intervention. Dry mucous
membranes, thirst, and fever are associated with hypernatremia (dehydration), not hyponatremia.
Q3. A client has a serum potassium level of 6.8 mEq/L. Which ECG finding should the nurse anticipate?
A. Flattened T waves
B. Prominent U waves
C. Tall, peaked T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia (potassium >5.0 mEq/L) causes tall, peaked (tented) T waves on ECG. Flattened T
waves and prominent U waves are characteristic of hypokalemia. Hyperkalemia also shortens the QT interval
rather than prolonging it.
Q4. A client with chronic kidney disease has a potassium level of 6.5 mEq/L. Which nursing action is the
priority?
A. Administer oral sodium polystyrene sulfonate
B. Prepare for hemodialysis
C. Place the client on a cardiac monitor
D. Administer IV calcium gluconate
Correct Answer: C
, Rationale: A potassium level of 6.5 mEq/L poses an immediate risk for life-threatening cardiac dysrhythmias.
The priority action is continuous cardiac monitoring to detect rhythm changes. While Kayexalate, dialysis, and
calcium gluconate are treatments for hyperkalemia, cardiac monitoring must be initiated first to ensure client
safety.
Q5. A client presents with muscle twitching, positive Chvostek's sign, and positive Trousseau's sign. Which
electrolyte imbalance should the nurse suspect?
A. Hypercalcemia
B. Hypocalcemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypocalcemia (calcium <8.5 mg/dL) causes increased neuromuscular excitability, leading to muscle
twitching, Chvostek's sign (facial twitching when tapping the facial nerve), and Trousseau's sign (carpal spasm
when inflating a blood pressure cuff). These signs indicate decreased serum calcium levels.
Q6. A client has the following ABG results: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L. Which acid-base
imbalance is present?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated metabolic acidosis
D. Partially compensated respiratory acidosis
Comprehensive Review + Practice
MCQs — Chamberlain College of
Nursing 2025/2026
Q1. A nurse is assessing an older adult client with dehydration. Which finding should the nurse expect?
A. Bounding peripheral pulses
B. Jugular venous distention
C. Orthostatic hypotension
D. Crackles in the lung bases
Correct Answer: C
Rationale: Dehydration causes hypovolemia, reducing circulating blood volume. When the client changes
position from lying to standing, blood pressure drops due to inadequate venous return, producing orthostatic
hypotension. Bounding pulses, JVD, and crackles indicate fluid overload, not depletion.
Q2. A client has a serum sodium level of 125 mEq/L. Which assessment finding is most concerning to the
nurse?
A. Dry mucous membranes
B. Thirst
C. Altered mental status
D. Fever
Correct Answer: C
,Rationale: Severe hyponatremia causes water to shift into brain cells, producing cerebral edema. Altered
mental status indicates neurological involvement and requires immediate intervention. Dry mucous
membranes, thirst, and fever are associated with hypernatremia (dehydration), not hyponatremia.
Q3. A client has a serum potassium level of 6.8 mEq/L. Which ECG finding should the nurse anticipate?
A. Flattened T waves
B. Prominent U waves
C. Tall, peaked T waves
D. Prolonged QT interval
Correct Answer: C
Rationale: Hyperkalemia (potassium >5.0 mEq/L) causes tall, peaked (tented) T waves on ECG. Flattened T
waves and prominent U waves are characteristic of hypokalemia. Hyperkalemia also shortens the QT interval
rather than prolonging it.
Q4. A client with chronic kidney disease has a potassium level of 6.5 mEq/L. Which nursing action is the
priority?
A. Administer oral sodium polystyrene sulfonate
B. Prepare for hemodialysis
C. Place the client on a cardiac monitor
D. Administer IV calcium gluconate
Correct Answer: C
, Rationale: A potassium level of 6.5 mEq/L poses an immediate risk for life-threatening cardiac dysrhythmias.
The priority action is continuous cardiac monitoring to detect rhythm changes. While Kayexalate, dialysis, and
calcium gluconate are treatments for hyperkalemia, cardiac monitoring must be initiated first to ensure client
safety.
Q5. A client presents with muscle twitching, positive Chvostek's sign, and positive Trousseau's sign. Which
electrolyte imbalance should the nurse suspect?
A. Hypercalcemia
B. Hypocalcemia
C. Hyperkalemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypocalcemia (calcium <8.5 mg/dL) causes increased neuromuscular excitability, leading to muscle
twitching, Chvostek's sign (facial twitching when tapping the facial nerve), and Trousseau's sign (carpal spasm
when inflating a blood pressure cuff). These signs indicate decreased serum calcium levels.
Q6. A client has the following ABG results: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 24 mEq/L. Which acid-base
imbalance is present?
A. Uncompensated metabolic acidosis
B. Uncompensated respiratory acidosis
C. Partially compensated metabolic acidosis
D. Partially compensated respiratory acidosis
