,NSG 3850 Exam 1 | Pathophysiology for Nurses II (2026/2027)
PDF | Nursing | Galen College
1. Which of the following best describes the composition of the intracellular
fluid compartment?
A) High in sodium and chloride, low in potassium
B) Rich in potassium, magnesium, and phosphates; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate, low in protein
Correct Answer: Rich in potassium, magnesium, and phosphates; low in sodium
and chloride
Rationale: The intracellular compartment (cytosol) maintains high
concentrations of potassium, magnesium, and phosphates essential for enzyme
activity and energy production, while keeping sodium and chloride low to
prevent osmotic imbalances. The ECF is high in sodium and chloride. This
gradient is maintained by the Na+/K+ ATPase pump.
2. What is the primary function of antidiuretic hormone (ADH) in fluid
regulation?
A) To increase urine output by promoting water excretion
B) To promote water reabsorption in the renal collecting ducts
C) To stimulate sodium excretion in the distal tubules
D) To dilate the afferent arterioles of the glomerulus
,Correct Answer: To promote water reabsorption in the renal collecting ducts
Rationale: ADH, also called vasopressin, is released by the posterior pituitary in
response to increased serum osmolality or decreased blood volume. It acts on
the collecting ducts of the kidneys to promote water reabsorption,
concentrating urine and restoring fluid balance.
3. A patient receiving tube feedings develops hypernatremia. What is the most
likely cause?
A) Excessive sodium in the feedings
B) Inadequate water intake
C) Kidney failure
D) Ectopic ADH production
Correct Answer: Inadequate water intake
Rationale: Tube-fed patients are at highest risk for hypernatremia due to
inadequate free water intake. Many tube feeding formulas are hypertonic and
require supplemental water administration to prevent dehydration and
hypernatremia.
4. A patient with eclampsia is receiving intravenous magnesium sulfate. To
determine if the infusion rate is too high, the nurse should regularly:
A) Check blood pressure for hypertension
, B) Check the patellar reflex; if it becomes weak or absent, the infusion rate is
likely too high
C) Monitor for hyperactive deep tendon reflexes
D) Assess for muscle spasms
Correct Answer: Check the patellar reflex; if it becomes weak or absent, the
infusion rate is likely too high
Rationale: Magnesium sulfate toxicity causes decreased neuromuscular
excitability, leading to hypoactive or absent deep tendon reflexes. This typically
occurs before respiratory depression or cardiac arrest. The patellar reflex is
easily assessed and serves as an early warning sign of magnesium toxicity.
5. Clinical manifestations of moderate to severe hypokalemia include:
A) Muscle spasms and rapid respirations
B) Muscle weakness and cardiac dysrhythmias
C) Confusion and irritability
D) Vomiting and diarrhea
Correct Answer: Muscle weakness and cardiac dysrhythmias
Rationale: Hypokalemia (low serum potassium) affects neuromuscular and
cardiac function. Common manifestations include muscle weakness, fatigue, leg
cramps, and cardiac dysrhythmias such as premature ventricular contractions
and ventricular tachycardia.
PDF | Nursing | Galen College
1. Which of the following best describes the composition of the intracellular
fluid compartment?
A) High in sodium and chloride, low in potassium
B) Rich in potassium, magnesium, and phosphates; low in sodium and chloride
C) Equal concentrations of sodium and potassium
D) High in sodium and bicarbonate, low in protein
Correct Answer: Rich in potassium, magnesium, and phosphates; low in sodium
and chloride
Rationale: The intracellular compartment (cytosol) maintains high
concentrations of potassium, magnesium, and phosphates essential for enzyme
activity and energy production, while keeping sodium and chloride low to
prevent osmotic imbalances. The ECF is high in sodium and chloride. This
gradient is maintained by the Na+/K+ ATPase pump.
2. What is the primary function of antidiuretic hormone (ADH) in fluid
regulation?
A) To increase urine output by promoting water excretion
B) To promote water reabsorption in the renal collecting ducts
C) To stimulate sodium excretion in the distal tubules
D) To dilate the afferent arterioles of the glomerulus
,Correct Answer: To promote water reabsorption in the renal collecting ducts
Rationale: ADH, also called vasopressin, is released by the posterior pituitary in
response to increased serum osmolality or decreased blood volume. It acts on
the collecting ducts of the kidneys to promote water reabsorption,
concentrating urine and restoring fluid balance.
3. A patient receiving tube feedings develops hypernatremia. What is the most
likely cause?
A) Excessive sodium in the feedings
B) Inadequate water intake
C) Kidney failure
D) Ectopic ADH production
Correct Answer: Inadequate water intake
Rationale: Tube-fed patients are at highest risk for hypernatremia due to
inadequate free water intake. Many tube feeding formulas are hypertonic and
require supplemental water administration to prevent dehydration and
hypernatremia.
4. A patient with eclampsia is receiving intravenous magnesium sulfate. To
determine if the infusion rate is too high, the nurse should regularly:
A) Check blood pressure for hypertension
, B) Check the patellar reflex; if it becomes weak or absent, the infusion rate is
likely too high
C) Monitor for hyperactive deep tendon reflexes
D) Assess for muscle spasms
Correct Answer: Check the patellar reflex; if it becomes weak or absent, the
infusion rate is likely too high
Rationale: Magnesium sulfate toxicity causes decreased neuromuscular
excitability, leading to hypoactive or absent deep tendon reflexes. This typically
occurs before respiratory depression or cardiac arrest. The patellar reflex is
easily assessed and serves as an early warning sign of magnesium toxicity.
5. Clinical manifestations of moderate to severe hypokalemia include:
A) Muscle spasms and rapid respirations
B) Muscle weakness and cardiac dysrhythmias
C) Confusion and irritability
D) Vomiting and diarrhea
Correct Answer: Muscle weakness and cardiac dysrhythmias
Rationale: Hypokalemia (low serum potassium) affects neuromuscular and
cardiac function. Common manifestations include muscle weakness, fatigue, leg
cramps, and cardiac dysrhythmias such as premature ventricular contractions
and ventricular tachycardia.
