Exam 3)Fundamentals of Nursing Exam 3: NCLEX Questions &
Answers
1. When assessing a patient with hypotonic fluid volume excess (FVE) the nurse can expect to find:
a. Hyponatremia
b. Confusion
c. Headache
d. All of the above - ANSWER:D all of the above
Rationale_Na+ decreases with FVE, confusion may result from cerebral swelling as well as headache for
the same reason.
2. The nurse evaluates that discharge teaching has been effective when the patient with hypocalcemia
states:
a. "I shouldn't take antacids such as TUMS."
b. "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
c. "I'll need to cut down on my protein in my diet."
d. "I will watch my urine for signs of kidney stones." - ANSWER:B I should notify my healthcare provider if
I start to feel tingling or numbness around my mouth
Rationale_Circumoral paresthesia is a sign of impending tetany (intermittent and involuntary muscle
spasms caused by low Ca+) and should alert the patient to contact the physician.
3. A 28 year old patient is admitted with severe bleeding from a fractured femur. Which intravenous fluid
does the nurse anticipate would be ordered as the most appropriate to replace that fluid loss?
a. Normal Saline
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline - ANSWER:A Normal Saline
Rationale NS is an isotonic fluid and is appropriate for fluid (blood) loss
,4. When caring for a patient at risk for fluid overload the nurse notices that overnight the patient gained
6 pounds. The nurse interprets this as:
a. A 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain - ANSWER:A a 3L fluid gain
Rationale_1 kg equals 1 liter
5. You are working in the ER of a local hospital. A patient comes in "feeling ill". The doctor orders
electrolytes on the patient and finds that the Na+ is 135, the K+ is 2.7, chloride is 95 and C02 is 26. You
would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
c. Na+ supplements PO
d. Chloride PO - ANSWER:B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When able, K+ orally is the best and safest method
of replacement.
6. The skin turgor assessment of a patient with hypernatremia as a result of extracellular fluid loss would
show:
a. No skin "tenting"
b. Prolonged skin "tenting"
c. Prolonged pitting edema
d. Widespread non-pitting edema - ANSWER:B Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration, fluid loss has less elasticity of the skin.
Edema is not present in fluid loss but in fluid overload.
7. Marathon runners are at risk for fluid volume deficit. Which of the following is a related factor?
a. Decreased diuresis
b. Disease related processes
c. Decreased breathing and perspiration
, d. Increased breathing and perspiration - ANSWER:D Increased breathing and perspiration
Rationale_Fluid losses increase through increased respirations and increased perspiration from heavy
physical activity.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would expect his
lab values to reveal:
a. Total serum calcium level below 8.5 mEq/L
b. Total serum calcium level above 10.1 mEq/L
c. Normal serum calcium level - ANSWER:A Total serum calcium level below 8.5 mEq/L
Rationale_Chevostek's sign is associated with hypocalcemia and is a hyperexcitability of the facial nerve
when stimulated in front of the earlobe.
9. In addition to its responsibility for fluid balance sodium is also responsible for:
a. Good eyesight and vitamin balance
b. Bone structure
c. Impulse transmission
d. Muscle mass - ANSWER:C impulse transmission
Rationale_Na+ transmits nerve impulses and contracts muscles.
10. An 83-year- old patient with heart failure develops hypokalemia as a result of diuretic therapy. The
nurse suggests that she increase her dietary intake of potassium. Which foods should she consume?
a. Chocolate, mushrooms, and bananas
b. Canned soups, peas and mild
c. Apples, whole wheat bread, and oatmeal
d. Dairy products and whole grains - ANSWER:A Chocolate, mushrooms, and bananas
Rationale These items have higher K+ than the other food choices.
11. Your patient is a 24-year-old college student who has been vomiting for 3 days. Compared to an
infant, the patient's body contains how much water by weight?
a. More
Answers
1. When assessing a patient with hypotonic fluid volume excess (FVE) the nurse can expect to find:
a. Hyponatremia
b. Confusion
c. Headache
d. All of the above - ANSWER:D all of the above
Rationale_Na+ decreases with FVE, confusion may result from cerebral swelling as well as headache for
the same reason.
2. The nurse evaluates that discharge teaching has been effective when the patient with hypocalcemia
states:
a. "I shouldn't take antacids such as TUMS."
b. "I should notify my healthcare provider if I start to feel tingling or numbness around my mouth."
c. "I'll need to cut down on my protein in my diet."
d. "I will watch my urine for signs of kidney stones." - ANSWER:B I should notify my healthcare provider if
I start to feel tingling or numbness around my mouth
Rationale_Circumoral paresthesia is a sign of impending tetany (intermittent and involuntary muscle
spasms caused by low Ca+) and should alert the patient to contact the physician.
3. A 28 year old patient is admitted with severe bleeding from a fractured femur. Which intravenous fluid
does the nurse anticipate would be ordered as the most appropriate to replace that fluid loss?
a. Normal Saline
b. 3% saline
c. 5% dextrose in water
d. 5% dextrose in 0.225 saline - ANSWER:A Normal Saline
Rationale NS is an isotonic fluid and is appropriate for fluid (blood) loss
,4. When caring for a patient at risk for fluid overload the nurse notices that overnight the patient gained
6 pounds. The nurse interprets this as:
a. A 3L fluid gain
b. Impending renal failure
c. Excessive diuresis
d. A 6 L fluid gain - ANSWER:A a 3L fluid gain
Rationale_1 kg equals 1 liter
5. You are working in the ER of a local hospital. A patient comes in "feeling ill". The doctor orders
electrolytes on the patient and finds that the Na+ is 135, the K+ is 2.7, chloride is 95 and C02 is 26. You
would expect the doctor to order:
a. Na+ supplements IV
b. K+ supplements PO
c. Na+ supplements PO
d. Chloride PO - ANSWER:B K+ supplements PO
Rationale_K+ is very low, the other values are normal. When able, K+ orally is the best and safest method
of replacement.
6. The skin turgor assessment of a patient with hypernatremia as a result of extracellular fluid loss would
show:
a. No skin "tenting"
b. Prolonged skin "tenting"
c. Prolonged pitting edema
d. Widespread non-pitting edema - ANSWER:B Prolonged skin "tenting"
Rationale_Poor skin turgor is a measure of tissue hydration, fluid loss has less elasticity of the skin.
Edema is not present in fluid loss but in fluid overload.
7. Marathon runners are at risk for fluid volume deficit. Which of the following is a related factor?
a. Decreased diuresis
b. Disease related processes
c. Decreased breathing and perspiration
, d. Increased breathing and perspiration - ANSWER:D Increased breathing and perspiration
Rationale_Fluid losses increase through increased respirations and increased perspiration from heavy
physical activity.
8. During shift report, you are told that your patient has a positive Chvostek's sign. You would expect his
lab values to reveal:
a. Total serum calcium level below 8.5 mEq/L
b. Total serum calcium level above 10.1 mEq/L
c. Normal serum calcium level - ANSWER:A Total serum calcium level below 8.5 mEq/L
Rationale_Chevostek's sign is associated with hypocalcemia and is a hyperexcitability of the facial nerve
when stimulated in front of the earlobe.
9. In addition to its responsibility for fluid balance sodium is also responsible for:
a. Good eyesight and vitamin balance
b. Bone structure
c. Impulse transmission
d. Muscle mass - ANSWER:C impulse transmission
Rationale_Na+ transmits nerve impulses and contracts muscles.
10. An 83-year- old patient with heart failure develops hypokalemia as a result of diuretic therapy. The
nurse suggests that she increase her dietary intake of potassium. Which foods should she consume?
a. Chocolate, mushrooms, and bananas
b. Canned soups, peas and mild
c. Apples, whole wheat bread, and oatmeal
d. Dairy products and whole grains - ANSWER:A Chocolate, mushrooms, and bananas
Rationale These items have higher K+ than the other food choices.
11. Your patient is a 24-year-old college student who has been vomiting for 3 days. Compared to an
infant, the patient's body contains how much water by weight?
a. More
