Complex Care Test Exam Review Questions
with all Answers verified for accuracy
Updated 2024/2025
A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you
expect the patient to be started on?
A. 5% Dextrose in 0.9% Saline
B. 0.33% saline
C. 0.225% saline
D. 0.9% Normal Saline - correct answer D
A client involved in a motor vehicle crash presents to the ER with severe internal bleeding. The
client is severely hypotensive and unresponsive. The nurse anticipates that which IV solution
will most likely be prescribed to increase intravascular volume, replace immediate blood loss
volume, and increase blood pressure?
A. 5% dextrose in lactated ringers
B. 0.33% sodium chloride (1/3 normal saline)
C. 0.225% sodium chloride (1/4 normal saline)
D. 0.45% sodium chloride (1/2 normal saline) - correct answer A
A nurse is caring for a client who has a serum sodium level 133 meq/L and serum potassium
level 3.4 meq/L. The nurse should recognize that which of the following treatments can result in
these laboratory findings?
A. Three tap water enemas
B. 0.9% sodium chloride solution IV at 50 ml/hr
C. 5% dextrose in water solution with 20 meq of K+ IV at 80 ml/hr
D. Antibiotic therapy - correct answer A
Three tap water enemas can result in a decrease in serum sodium and potassium. Tap water is
hypotonic, and gastrointestinal losses are isotonic. This creates an imbalance and solute
dilution.
A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning.
The nurse should monitor for which of the following electrolyte imbalances?
,A. Hypercalcemia
B. Hyponatremia
C. Hyperphosphatemia
D. Hypomagnesemia - correct answer B
The nurse should monitor the client for hyponatremia. Nasogastric losses are isotonic and
contain sodium.
A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the
following conditions as being associated with this electrolyte imbalance?
A. Diabetic ketoacidosis
B. Heart failure
C. Cushing's syndrome
D. Thyroidectomy - correct answer A
Hyperkalemia, an increase in serum potassium, is a laboratory finding associated with diabetic
ketoacidosis.
A nurse is assessing a client for Chvostek's sign. Which of the following techniques should the
nurse use to perform this test?
A. Apply a blood pressure cuff to the client's arm.
B. Place the stethoscope bell over the client's carotid artery.
C. Tap lightly on the client's cheek.
D. Ask the client to lower her chin to her chest. - correct answer C
The nurse taps the client's cheek over the facial nerve just below and anterior to the ear to elicit
Chvostek's sign. A positive response is indicated when the client exhibits facial twitching on this
side of her face.
A client's kidneys are retaining increased amounts of sodium. The nurse plans care, anticipating
that the kidneys also are retaining greater amounts of which substances?
A. Calcium and Chloride
,B. Chloride and bicarbonate
C. Potassium and Phosphates
D. Aluminum and magnesium - correct answer B
The nurse is caring for a client who takes furosemide (Lasix) and digoxin (Lanoxin). The client's
potassium (K+) level is 2.5 meq/L (2.5 mmol/L). Which additional assessment will the nurse
make?
A. Heart rate
B. Blood pressure (BP)
C. Increases in edema
D. Sodium level - correct answer A
The nurse is teaching a client who is taking a potassium-sparing diuretic about precautions
while taking this medication. Which of these does the nurse teach the client to avoid or use
cautiously? SELECT ALL THAT APPLY.
A. Apples
B. Bananas
C. ACE inhibitors
D. Grapes
E. Salt substitute - correct answer B, C, E
The pt has a serum phosphate level of 4.7 mg/dl. Which interdisciplinary treatments would the
nurse expect for this pt? Select all that apply.
A. IV normal saline
B. Calcium containing antacids
C. IV potassium phosphate
D. Encouraging milk intake
E. Increasing vitamin D intake - correct answer A, B
Serum phosphate level of 4.7 mg/dl indicates hyperphosphatemia. IV normal saline promotes
renal excretion of phosphate.
, The nurse anticipates that the pt with hyperphosphatemia secondary to renal failure will require
A. Calcium supplements
B. Potassium supplements
C. Magnesium supplements
D. Fluid replacement therapy - correct answer A
The nurse is instructing the client with chronic renal failure to maintain adequate nutritional
intake. Which diet would be most appropriate?
A. High-carbohydrate, high-protein
B. High-calcium, high-potassium, high-protein
C. Low-protein, low-sodium, low-potassium
D. Low-protein, high-potassium - correct answer C
The nurse is caring for a client who is receiving intravenous (IV) magnesium sulfate. Which
assessment parameter is critical?
A. Monitoring 24-hour urine output
B. Asking the client about feeling depressed
C. Assessing the blood pressure hourly
D. Monitoring the serum calcium levels - correct answer C
Magnesium is responsible for (1) neuromuscular transmission and cardiovascular tone → if you
are giving magnesium → possible hypermagnesemia =
- loss of deep tendon reflexes
- hypotension secondary to vasodilation
- arrythmias, bradycardia, heart blocks
- drowsiness
The RN is assessing a 70-year-old client admitted to the unit with severe dehydration. Which
finding requires immediate intervention by the nurse?
A. Client behavior that changes from anxious to lethargic
B. Deep furrows on the surface of the tongue
with all Answers verified for accuracy
Updated 2024/2025
A patient is being admitted with dehydration due to nausea and vomiting. Which fluid would you
expect the patient to be started on?
A. 5% Dextrose in 0.9% Saline
B. 0.33% saline
C. 0.225% saline
D. 0.9% Normal Saline - correct answer D
A client involved in a motor vehicle crash presents to the ER with severe internal bleeding. The
client is severely hypotensive and unresponsive. The nurse anticipates that which IV solution
will most likely be prescribed to increase intravascular volume, replace immediate blood loss
volume, and increase blood pressure?
A. 5% dextrose in lactated ringers
B. 0.33% sodium chloride (1/3 normal saline)
C. 0.225% sodium chloride (1/4 normal saline)
D. 0.45% sodium chloride (1/2 normal saline) - correct answer A
A nurse is caring for a client who has a serum sodium level 133 meq/L and serum potassium
level 3.4 meq/L. The nurse should recognize that which of the following treatments can result in
these laboratory findings?
A. Three tap water enemas
B. 0.9% sodium chloride solution IV at 50 ml/hr
C. 5% dextrose in water solution with 20 meq of K+ IV at 80 ml/hr
D. Antibiotic therapy - correct answer A
Three tap water enemas can result in a decrease in serum sodium and potassium. Tap water is
hypotonic, and gastrointestinal losses are isotonic. This creates an imbalance and solute
dilution.
A nurse is caring for a client who has a nasogastric tube attached to low intermittent suctioning.
The nurse should monitor for which of the following electrolyte imbalances?
,A. Hypercalcemia
B. Hyponatremia
C. Hyperphosphatemia
D. Hypomagnesemia - correct answer B
The nurse should monitor the client for hyponatremia. Nasogastric losses are isotonic and
contain sodium.
A nurse is assessing a client who has hyperkalemia. The nurse should identify which of the
following conditions as being associated with this electrolyte imbalance?
A. Diabetic ketoacidosis
B. Heart failure
C. Cushing's syndrome
D. Thyroidectomy - correct answer A
Hyperkalemia, an increase in serum potassium, is a laboratory finding associated with diabetic
ketoacidosis.
A nurse is assessing a client for Chvostek's sign. Which of the following techniques should the
nurse use to perform this test?
A. Apply a blood pressure cuff to the client's arm.
B. Place the stethoscope bell over the client's carotid artery.
C. Tap lightly on the client's cheek.
D. Ask the client to lower her chin to her chest. - correct answer C
The nurse taps the client's cheek over the facial nerve just below and anterior to the ear to elicit
Chvostek's sign. A positive response is indicated when the client exhibits facial twitching on this
side of her face.
A client's kidneys are retaining increased amounts of sodium. The nurse plans care, anticipating
that the kidneys also are retaining greater amounts of which substances?
A. Calcium and Chloride
,B. Chloride and bicarbonate
C. Potassium and Phosphates
D. Aluminum and magnesium - correct answer B
The nurse is caring for a client who takes furosemide (Lasix) and digoxin (Lanoxin). The client's
potassium (K+) level is 2.5 meq/L (2.5 mmol/L). Which additional assessment will the nurse
make?
A. Heart rate
B. Blood pressure (BP)
C. Increases in edema
D. Sodium level - correct answer A
The nurse is teaching a client who is taking a potassium-sparing diuretic about precautions
while taking this medication. Which of these does the nurse teach the client to avoid or use
cautiously? SELECT ALL THAT APPLY.
A. Apples
B. Bananas
C. ACE inhibitors
D. Grapes
E. Salt substitute - correct answer B, C, E
The pt has a serum phosphate level of 4.7 mg/dl. Which interdisciplinary treatments would the
nurse expect for this pt? Select all that apply.
A. IV normal saline
B. Calcium containing antacids
C. IV potassium phosphate
D. Encouraging milk intake
E. Increasing vitamin D intake - correct answer A, B
Serum phosphate level of 4.7 mg/dl indicates hyperphosphatemia. IV normal saline promotes
renal excretion of phosphate.
, The nurse anticipates that the pt with hyperphosphatemia secondary to renal failure will require
A. Calcium supplements
B. Potassium supplements
C. Magnesium supplements
D. Fluid replacement therapy - correct answer A
The nurse is instructing the client with chronic renal failure to maintain adequate nutritional
intake. Which diet would be most appropriate?
A. High-carbohydrate, high-protein
B. High-calcium, high-potassium, high-protein
C. Low-protein, low-sodium, low-potassium
D. Low-protein, high-potassium - correct answer C
The nurse is caring for a client who is receiving intravenous (IV) magnesium sulfate. Which
assessment parameter is critical?
A. Monitoring 24-hour urine output
B. Asking the client about feeling depressed
C. Assessing the blood pressure hourly
D. Monitoring the serum calcium levels - correct answer C
Magnesium is responsible for (1) neuromuscular transmission and cardiovascular tone → if you
are giving magnesium → possible hypermagnesemia =
- loss of deep tendon reflexes
- hypotension secondary to vasodilation
- arrythmias, bradycardia, heart blocks
- drowsiness
The RN is assessing a 70-year-old client admitted to the unit with severe dehydration. Which
finding requires immediate intervention by the nurse?
A. Client behavior that changes from anxious to lethargic
B. Deep furrows on the surface of the tongue
