2026 GRADED A+ EXAM
NURS 346 MIDTERM EXAM ACTUAL QUESTIONS AND WELL REVISED
ANSWERS - LATEST AND COMPLETE UPDATE WITH VERIFIED SOLUTIONS
2026-2027
Question 1
A patient with dehydration is most likely to exhibit which finding?
A. Decreased hematocrit
B. Increased hematocrit
C. Hyponatremia
D. Hypoglycemia
Correct Answer: B. Increased hematocrit
Rationale:
Dehydration causes hemoconcentration, which elevates hematocrit and BUN. Fluid loss reduces
plasma volume, concentrating blood components.
Question 2
Which electrolyte imbalance causes muscle weakness and cardiac dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Rationale:
Potassium is essential for neuromuscular and cardiac function. Low potassium causes muscle
weakness and ECG changes (U waves, arrhythmias).
Question 3
Left-sided heart failure primarily results in:
,2026 GRADED A+ EXAM
A. Peripheral edema
B. Pulmonary congestion
C. Ascites
D. Hepatomegaly
Correct Answer: B. Pulmonary congestion
Rationale:
Left-sided heart failure reduces cardiac output and causes fluid backup in the lungs, leading to
crackles and dyspnea.
Question 4
Metabolic acidosis is most commonly caused by:
A. Vomiting
B. Diabetic ketoacidosis
C. Hyperventilation
D. Excess antacid use
Correct Answer: B. Diabetic ketoacidosis
Rationale:
DKA produces ketones, which are acidic and lower serum pH, resulting in metabolic acidosis.
Question 5
The most common cause of myocardial infarction is:
A. Coronary artery spasm
B. Atherosclerotic plaque rupture
C. Viral infection
D. Valvular disease
Correct Answer: B. Atherosclerotic plaque rupture
Rationale:
Plaque rupture triggers thrombus formation, obstructing coronary blood flow and causing
ischemia.
,2026 GRADED A+ EXAM
Question 6
A patient with COPD retains CO₂ due to:
A. Increased oxygen intake
B. Airway obstruction and air trapping
C. Increased hemoglobin
D. Excess surfactant
Correct Answer: B. Airway obstruction and air trapping
Rationale:
COPD causes airflow limitation, trapping CO₂ and impairing gas exchange.
Question 7
Hyperthyroidism is characterized by:
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Hypotension
Correct Answer: C. Heat intolerance
Rationale:
Increased metabolism causes heat intolerance, tachycardia, and weight loss.
Question 8
Acute kidney injury is identified by:
A. Increased urine output
B. Elevated creatinine
C. Decreased potassium
D. Hypocalcemia
Correct Answer: B. Elevated creatinine
Rationale:
AKI reduces glomerular filtration, causing creatinine and BUN to rise.
, 2026 GRADED A+ EXAM
Question 9
Right-sided heart failure commonly presents with:
A. Pulmonary crackles
B. Peripheral edema
C. Orthopnea
D. Dry cough
Correct Answer: B. Peripheral edema
Rationale:
Right-sided failure causes systemic venous congestion, leading to swelling in the legs and
abdomen.
Question 10
Leukocytosis most commonly indicates:
A. Anemia
B. Infection
C. Dehydration
D. Hypoxia
Correct Answer: B. Infection
Rationale:
Elevated white blood cells occur in response to bacterial or inflammatory processes.
Question 11
Peaked T waves on ECG are most associated with:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Rationale:
High potassium affects cardiac conduction, producing peaked T waves and risk of arrhythmias.
NURS 346 MIDTERM EXAM ACTUAL QUESTIONS AND WELL REVISED
ANSWERS - LATEST AND COMPLETE UPDATE WITH VERIFIED SOLUTIONS
2026-2027
Question 1
A patient with dehydration is most likely to exhibit which finding?
A. Decreased hematocrit
B. Increased hematocrit
C. Hyponatremia
D. Hypoglycemia
Correct Answer: B. Increased hematocrit
Rationale:
Dehydration causes hemoconcentration, which elevates hematocrit and BUN. Fluid loss reduces
plasma volume, concentrating blood components.
Question 2
Which electrolyte imbalance causes muscle weakness and cardiac dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B. Hypokalemia
Rationale:
Potassium is essential for neuromuscular and cardiac function. Low potassium causes muscle
weakness and ECG changes (U waves, arrhythmias).
Question 3
Left-sided heart failure primarily results in:
,2026 GRADED A+ EXAM
A. Peripheral edema
B. Pulmonary congestion
C. Ascites
D. Hepatomegaly
Correct Answer: B. Pulmonary congestion
Rationale:
Left-sided heart failure reduces cardiac output and causes fluid backup in the lungs, leading to
crackles and dyspnea.
Question 4
Metabolic acidosis is most commonly caused by:
A. Vomiting
B. Diabetic ketoacidosis
C. Hyperventilation
D. Excess antacid use
Correct Answer: B. Diabetic ketoacidosis
Rationale:
DKA produces ketones, which are acidic and lower serum pH, resulting in metabolic acidosis.
Question 5
The most common cause of myocardial infarction is:
A. Coronary artery spasm
B. Atherosclerotic plaque rupture
C. Viral infection
D. Valvular disease
Correct Answer: B. Atherosclerotic plaque rupture
Rationale:
Plaque rupture triggers thrombus formation, obstructing coronary blood flow and causing
ischemia.
,2026 GRADED A+ EXAM
Question 6
A patient with COPD retains CO₂ due to:
A. Increased oxygen intake
B. Airway obstruction and air trapping
C. Increased hemoglobin
D. Excess surfactant
Correct Answer: B. Airway obstruction and air trapping
Rationale:
COPD causes airflow limitation, trapping CO₂ and impairing gas exchange.
Question 7
Hyperthyroidism is characterized by:
A. Bradycardia
B. Weight gain
C. Heat intolerance
D. Hypotension
Correct Answer: C. Heat intolerance
Rationale:
Increased metabolism causes heat intolerance, tachycardia, and weight loss.
Question 8
Acute kidney injury is identified by:
A. Increased urine output
B. Elevated creatinine
C. Decreased potassium
D. Hypocalcemia
Correct Answer: B. Elevated creatinine
Rationale:
AKI reduces glomerular filtration, causing creatinine and BUN to rise.
, 2026 GRADED A+ EXAM
Question 9
Right-sided heart failure commonly presents with:
A. Pulmonary crackles
B. Peripheral edema
C. Orthopnea
D. Dry cough
Correct Answer: B. Peripheral edema
Rationale:
Right-sided failure causes systemic venous congestion, leading to swelling in the legs and
abdomen.
Question 10
Leukocytosis most commonly indicates:
A. Anemia
B. Infection
C. Dehydration
D. Hypoxia
Correct Answer: B. Infection
Rationale:
Elevated white blood cells occur in response to bacterial or inflammatory processes.
Question 11
Peaked T waves on ECG are most associated with:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
Correct Answer: B. Hyperkalemia
Rationale:
High potassium affects cardiac conduction, producing peaked T waves and risk of arrhythmias.
