NUR 330 exam 1 – UPDATED Questions with 100% Verified Answers
NUR 330 exam 1 – UPDATED Questions with 100%
Verified Answers
Section 1: Causes, Electrolyte, Values (Q1–Q13)
Question & Answer
Q1 electrolyte values
A •Sodium: 136-145 mEq/L •Potassium: 3.5-5 mEq/L •Calcium: 9-10.5 mg/dL •Magnesium:
1.3-2.1 mg/dL •Chloride 98-106 mEq/L
Q2 hyponatremia and causes
A •Serum sodium less than 136 mEq/L •Actual sodium deficits can occur (sodium loss): •GI fluid loss
•Excessive diaphoresis •Diuretics •Burns •Hyperglycemia •Relative sodium deficit (water gain):
•Excessive ingestion of water •Kidney failure •Heart failure •Hypotonic solution
Q3 hyponatremia-s/s
A •Cerebral changes: Caused by cerebral edema •Decreased LOC •Seizures •Coma •Weakness
•Intestinal changes •Nausea, vomiting, diarrhea •Cardiovascular changes •Due to
hypovolemia-fluid loss)- weak thready pulse, hypotension Water gain (hypervolemia)- bounding
pulse, normal to high BP
Q4 hyponatremia-treat and assess
A •Treat underlying condition •Due to sodium loss: Sodium replacement •Depending on severity: May
require hypertonic saline •Due to water gain: Water restriction •Diuretics •Nutritional therapy
•Priority: monitor for response to therapy and prevent HYPERnatremia •Assessment: I&O, daily
weight, lab values, CNS changes •Safety
Q5 hypernatremia - causes
A •Serum sodium greater than 145 mEq/L •Actual sodium excess (gain): •Hyperaldosteronism
•Kidney failure •Corticosteroids •Cushing syndrome or disease •Excessive intake or IVF with
sodium •Relative sodium excess (water loss): •Dehydration •Fever •Hyperventilation •Infection
•Excessive diaphoresis •Diarrhea
Q6 hypernatremia-s/s
A •Vary with severity •Thirst •Nervous system: •Change in LOC •Agitation or confusion •Lethargic to
comatose •Skeletal muscle: •Twitching or abnormal contractions •Cardiovascular: •Decrease
cardiac contractility •BP and pulse monitoring
Q7 hypernatremia-treat
A •Gradual lowering of serum sodium levels •When caused by fluid loss: •IV fluids (NS or D5% 0.45%
NS) •If not caused by fluid loss: •D5W •Diuretics •Nutritional therapy •Continue to assess for:
•abnormal loss of water and low water intake •over-the-counter sources of sodium •CNS changes
Q8 hypokalemia-causes
A •Below-normal serum potassium <3.5 mEq/L •Actual potassium deficits: •Medications •Cushing
syndrome or disease •GI losses •NGT suctioning •Relative potassium deficits •Alkalosis •Insulin
administration •TPN •Water intoxication (fluid excess) •
Page 1 of 16
,NUR 330 exam 1 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q9 hypokalemia-s/s
A •Medication history •Diuretics, corticosteroids, IV insulin for ketoacidosis •Cardiac changes!
•Monitor EKG, rhythm, rate, force •Respiratory changes •Muscle weakness and shallow resps
•Muscular changes •Skeletal mm weakness •Change in LOC, abdominal distension and hypoactive
BS
Q10 hypokalemia-treat
A •Prevent potassium loss, increase K+ levels and patient safety •Drug therapy: Potassium •PO: can
be liquid or pill •May cause N/V - take with food •IV: Careful administration is essential •Never give
IV push always administered through an infusion pump •Should not exceed 10 mEq/hr •Nutritional
therapy •Safety
Q11 hyperkalemia-causes
A •Serum potassium greater than 5.0 mEq/L •Rare in patients with normal renal function •Increased
risk in older adults •Causes: Impaired renal function, rapid administration of potassium,
hypoaldosteronism, medications, tissue trauma, acidosis
Q12 hyperkalemia-s/s
A •H& P •Medications •Cardiovascular: •Monitor ECG, assess labs, monitor I&O, obtain apical pulse
•Neuromuscular •Twitching, numbness, tingling •Followed by flaccid paralysis including respiratory
muscles •Intestinal •Diarrhea and hyperactive BS
Q13 hyperkalemia-treat
A •Administration of cation exchange resins (Sodium polystyrene sulfonate) •Potassium wasting
diuretics (loop) in pts with normal kidney function •Dialysis •Emergent care: IV calcium gluconate,
IV sodium bicarbonate, IV regular insulin and dextrose IV •Prevention: Administer IV potassium
replacement slowly and with an infusion pump Limitation of dietary potassium and dietary teaching
Section 2: Hypocalcemia-Causes, Hypocalcemia-S,
Hypocalcemia-Treat (Q14–Q26)
Question & Answer
Q14 hypocalcemia-causes
A •Serum level less than 9 mg/dL •Serum calcium level controlled by parathyroid hormone and
calcitonin •Causes: hypoparathyroidism, malabsorption, osteoporosis, pancreatitis, alkalosis,
multiple blood transfusions, kidney injury, medications
Q15 hypocalcemia-s/s
A •H& P •Nutritional history, medications •Neuromuscular changes •Paresthesia-numbness and
tingling •Trousseau •Chvostek sign •Cardiovascular changes •HR and ECG changes, weak thready
pulse •Intestinal changes: hyperactive BS, diarrhea •Skeletal
Q16 hypocalcemia-treat
A •Drug therapy •IV of calcium gluconate •Oral calcium and vitamin D supplements •Nutritional
therapy •Calcium rich diet •Environment management •Reduce stimulation •Injury prevention •Fall
precautions •Exercises to decrease bone calcium loss
Page 2 of 16
, NUR 330 exam 1 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q17 hypercalcemia-causes
A •Serum level greater than 10.5 mg/dL •Causes: •Malignancy •Hyperparathyroidism •bone loss
related to immobility •Diuretics •excessive oral intake •CKD •dehydration
Q18 hypercalcemia-s/s
A •Cardiovascular changes •Intial: Increase HR and BP •Prolonged hypercalcemia causes bradycardia
•Monitor for blood clotting-legs •Neuromuscular changes •Severe muscle weakness •Decreased
DTR •Intestinal changes •Decreased BS, constipation, N/V
Q19 hypercalcemia-treat
A •Drug therapy •Stop all calcium containg medications •NS administration •Loop diuretic
administration •Calcitonin administration •Cardiac monitoring •ECG monitoring •Increase mobility
•Dietary teaching, fiber for constipation •Ensure safety
Q20 hypomagnesemia-causes
A •Serum level less than 1.3 mg/dL •Causes •Malnutrition •Starvation •Pancreatitis •Alcohol use
disorder •Medications (PPI, diuretics)
Q21 hypomagnesemia-s/s
A •Cardiovascular changes •HTN •ECG changes-can be fatal •Neuromuscular changes •HYPERactive
DTR •Numbess and tingling •Chvostek and Trousseau signs may be present because
hypomagnesemia may occur with hypocalcemia •Tetany and seizures •Intestinal changes
•Decreased BS, constipation, N/V
Q22 hypomagnesemia-treat
A •Magnesium sulfate IV is administered with an infusion pump, monitor vital signs, DTR, and urine
output •Oral magnesium •Seizure precautions •Dietary teaching •Treat hypocalcemia as it often
occurs with hypomagnesemia
Q23 hypermagnesmia-cause
A •Serum level greater than 2.1 mg/dL •Rare electrolyte abnormality, because the kidneys efficiently
excrete magnesium •Causes •kidney injury •Excessive administration of magnesium •Increased
intake
Q24 hypermagnesemia-s/s
A •Cardiovascular changes •Bradycardia •Can have fatal ECG changes! •Neuromuscular changes
•Absent DTR •Voluntary muscle contractions become weaker and finally stop •CNS changes
•Change in LOC: Drowsy/lethargic •Coma
Q25 hypermagnesemia-treat
A •Observe for DTRs and changes in LOC •IV calcium gluconate- to reverse the cardiac effects
•Hemodialysis •Administration of loop diuretics, sodium chloride, and LR •Avoid medications
containing magnesium •Patient teaching regarding magnesium-containing over-the-counter
medications
Q26 isotonic IV fluids
A • Normal Saline (0.9% NaCl) • Lactated Ringer (LR) • 5% dextrose in water (D5W)
Page 3 of 16
NUR 330 exam 1 – UPDATED Questions with 100%
Verified Answers
Section 1: Causes, Electrolyte, Values (Q1–Q13)
Question & Answer
Q1 electrolyte values
A •Sodium: 136-145 mEq/L •Potassium: 3.5-5 mEq/L •Calcium: 9-10.5 mg/dL •Magnesium:
1.3-2.1 mg/dL •Chloride 98-106 mEq/L
Q2 hyponatremia and causes
A •Serum sodium less than 136 mEq/L •Actual sodium deficits can occur (sodium loss): •GI fluid loss
•Excessive diaphoresis •Diuretics •Burns •Hyperglycemia •Relative sodium deficit (water gain):
•Excessive ingestion of water •Kidney failure •Heart failure •Hypotonic solution
Q3 hyponatremia-s/s
A •Cerebral changes: Caused by cerebral edema •Decreased LOC •Seizures •Coma •Weakness
•Intestinal changes •Nausea, vomiting, diarrhea •Cardiovascular changes •Due to
hypovolemia-fluid loss)- weak thready pulse, hypotension Water gain (hypervolemia)- bounding
pulse, normal to high BP
Q4 hyponatremia-treat and assess
A •Treat underlying condition •Due to sodium loss: Sodium replacement •Depending on severity: May
require hypertonic saline •Due to water gain: Water restriction •Diuretics •Nutritional therapy
•Priority: monitor for response to therapy and prevent HYPERnatremia •Assessment: I&O, daily
weight, lab values, CNS changes •Safety
Q5 hypernatremia - causes
A •Serum sodium greater than 145 mEq/L •Actual sodium excess (gain): •Hyperaldosteronism
•Kidney failure •Corticosteroids •Cushing syndrome or disease •Excessive intake or IVF with
sodium •Relative sodium excess (water loss): •Dehydration •Fever •Hyperventilation •Infection
•Excessive diaphoresis •Diarrhea
Q6 hypernatremia-s/s
A •Vary with severity •Thirst •Nervous system: •Change in LOC •Agitation or confusion •Lethargic to
comatose •Skeletal muscle: •Twitching or abnormal contractions •Cardiovascular: •Decrease
cardiac contractility •BP and pulse monitoring
Q7 hypernatremia-treat
A •Gradual lowering of serum sodium levels •When caused by fluid loss: •IV fluids (NS or D5% 0.45%
NS) •If not caused by fluid loss: •D5W •Diuretics •Nutritional therapy •Continue to assess for:
•abnormal loss of water and low water intake •over-the-counter sources of sodium •CNS changes
Q8 hypokalemia-causes
A •Below-normal serum potassium <3.5 mEq/L •Actual potassium deficits: •Medications •Cushing
syndrome or disease •GI losses •NGT suctioning •Relative potassium deficits •Alkalosis •Insulin
administration •TPN •Water intoxication (fluid excess) •
Page 1 of 16
,NUR 330 exam 1 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q9 hypokalemia-s/s
A •Medication history •Diuretics, corticosteroids, IV insulin for ketoacidosis •Cardiac changes!
•Monitor EKG, rhythm, rate, force •Respiratory changes •Muscle weakness and shallow resps
•Muscular changes •Skeletal mm weakness •Change in LOC, abdominal distension and hypoactive
BS
Q10 hypokalemia-treat
A •Prevent potassium loss, increase K+ levels and patient safety •Drug therapy: Potassium •PO: can
be liquid or pill •May cause N/V - take with food •IV: Careful administration is essential •Never give
IV push always administered through an infusion pump •Should not exceed 10 mEq/hr •Nutritional
therapy •Safety
Q11 hyperkalemia-causes
A •Serum potassium greater than 5.0 mEq/L •Rare in patients with normal renal function •Increased
risk in older adults •Causes: Impaired renal function, rapid administration of potassium,
hypoaldosteronism, medications, tissue trauma, acidosis
Q12 hyperkalemia-s/s
A •H& P •Medications •Cardiovascular: •Monitor ECG, assess labs, monitor I&O, obtain apical pulse
•Neuromuscular •Twitching, numbness, tingling •Followed by flaccid paralysis including respiratory
muscles •Intestinal •Diarrhea and hyperactive BS
Q13 hyperkalemia-treat
A •Administration of cation exchange resins (Sodium polystyrene sulfonate) •Potassium wasting
diuretics (loop) in pts with normal kidney function •Dialysis •Emergent care: IV calcium gluconate,
IV sodium bicarbonate, IV regular insulin and dextrose IV •Prevention: Administer IV potassium
replacement slowly and with an infusion pump Limitation of dietary potassium and dietary teaching
Section 2: Hypocalcemia-Causes, Hypocalcemia-S,
Hypocalcemia-Treat (Q14–Q26)
Question & Answer
Q14 hypocalcemia-causes
A •Serum level less than 9 mg/dL •Serum calcium level controlled by parathyroid hormone and
calcitonin •Causes: hypoparathyroidism, malabsorption, osteoporosis, pancreatitis, alkalosis,
multiple blood transfusions, kidney injury, medications
Q15 hypocalcemia-s/s
A •H& P •Nutritional history, medications •Neuromuscular changes •Paresthesia-numbness and
tingling •Trousseau •Chvostek sign •Cardiovascular changes •HR and ECG changes, weak thready
pulse •Intestinal changes: hyperactive BS, diarrhea •Skeletal
Q16 hypocalcemia-treat
A •Drug therapy •IV of calcium gluconate •Oral calcium and vitamin D supplements •Nutritional
therapy •Calcium rich diet •Environment management •Reduce stimulation •Injury prevention •Fall
precautions •Exercises to decrease bone calcium loss
Page 2 of 16
, NUR 330 exam 1 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q17 hypercalcemia-causes
A •Serum level greater than 10.5 mg/dL •Causes: •Malignancy •Hyperparathyroidism •bone loss
related to immobility •Diuretics •excessive oral intake •CKD •dehydration
Q18 hypercalcemia-s/s
A •Cardiovascular changes •Intial: Increase HR and BP •Prolonged hypercalcemia causes bradycardia
•Monitor for blood clotting-legs •Neuromuscular changes •Severe muscle weakness •Decreased
DTR •Intestinal changes •Decreased BS, constipation, N/V
Q19 hypercalcemia-treat
A •Drug therapy •Stop all calcium containg medications •NS administration •Loop diuretic
administration •Calcitonin administration •Cardiac monitoring •ECG monitoring •Increase mobility
•Dietary teaching, fiber for constipation •Ensure safety
Q20 hypomagnesemia-causes
A •Serum level less than 1.3 mg/dL •Causes •Malnutrition •Starvation •Pancreatitis •Alcohol use
disorder •Medications (PPI, diuretics)
Q21 hypomagnesemia-s/s
A •Cardiovascular changes •HTN •ECG changes-can be fatal •Neuromuscular changes •HYPERactive
DTR •Numbess and tingling •Chvostek and Trousseau signs may be present because
hypomagnesemia may occur with hypocalcemia •Tetany and seizures •Intestinal changes
•Decreased BS, constipation, N/V
Q22 hypomagnesemia-treat
A •Magnesium sulfate IV is administered with an infusion pump, monitor vital signs, DTR, and urine
output •Oral magnesium •Seizure precautions •Dietary teaching •Treat hypocalcemia as it often
occurs with hypomagnesemia
Q23 hypermagnesmia-cause
A •Serum level greater than 2.1 mg/dL •Rare electrolyte abnormality, because the kidneys efficiently
excrete magnesium •Causes •kidney injury •Excessive administration of magnesium •Increased
intake
Q24 hypermagnesemia-s/s
A •Cardiovascular changes •Bradycardia •Can have fatal ECG changes! •Neuromuscular changes
•Absent DTR •Voluntary muscle contractions become weaker and finally stop •CNS changes
•Change in LOC: Drowsy/lethargic •Coma
Q25 hypermagnesemia-treat
A •Observe for DTRs and changes in LOC •IV calcium gluconate- to reverse the cardiac effects
•Hemodialysis •Administration of loop diuretics, sodium chloride, and LR •Avoid medications
containing magnesium •Patient teaching regarding magnesium-containing over-the-counter
medications
Q26 isotonic IV fluids
A • Normal Saline (0.9% NaCl) • Lactated Ringer (LR) • 5% dextrose in water (D5W)
Page 3 of 16