[Document title]
NSG 3850 Actual Exam 1 Patho 2
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Part 1: Fluid and Electrolyte Homeostasis
Q1. A patient is admitted with confusion, muscle weakness, and a serum sodium level of 125 mEq/L. The
nurse recognizes these symptoms are most likely due to which imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: B. A serum sodium level of 125 mEq/L is diagnostic of hyponatremia (normal ~135-145
mEq/L). The neurologic symptoms are a hallmark of this condition due to cellular swelling and cerebral
edema as water shifts into brain cells.
Q2. Decreased neuromuscular excitability is often the result of:
A. Hypercalcemia and hypermagnesemia
B. Hypomagnesemia and hyperkalemia
C. Hypocalcemia and hypokalemia
D. Hypernatremia and hypomagnesemia
Answer: A. Both hypercalcemia and hypermagnesemia decrease neuromuscular excitability by
stabilizing the nerve cell membrane and raising the threshold for firing action potentials.
Q3. The fraction of total body water (TBW) volume contained in the intracellular space in adults is:
A. Three-fourths
B. Two-thirds
C. One-half
D. One-third
Answer: B. In adults, approximately two-thirds of the total body water is located inside the cells, within
the intracellular fluid (ICF) compartment.
Q4. Which electrolyte has a higher concentration in the extracellular fluid than in the intracellular fluid?
A. Sodium
B. Phosphate
C. Magnesium
D. Potassium
Answer: A. Sodium is the primary cation in the extracellular fluid (ECF), while potassium is the major
intracellular cation.
Q5. What is likely to lead to hyponatremia?
A. Insufficient ADH secretion
B. Excess aldosterone secretion
C. Administration of IV normal saline
D. Frequent NG tube irrigation with water
Answer: D. Frequent irrigation of a nasogastric (NG) tube with water can lead to water intoxication and
dilutional hyponatremia, as free water is absorbed.
Part 2: Electrolyte Imbalances
, [Document title]
Q6. A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop:
A. Hypokalemia
B. Hyperkalemia
C. Hypophosphatemia
D. Hyperphosphatemia
Answer: C. Overuse of magnesium-aluminum antacids binds phosphate in the gut, preventing its
absorption and leading to hypophosphatemia over time.
Q7. Which electrolyte imbalances cause increased neuromuscular excitability?
A. Hypokalemia and hyperphosphatemia
B. Hyperkalemia and hypophosphatemia
C. Hypocalcemia and hypomagnesemia
D. Hypercalcemia and hypermagnesemia
Answer: C. Both hypocalcemia and hypomagnesemia increase neuromuscular excitability by making
nerve cell membranes more permeable to sodium, which can lead to symptoms like tetany.
Q8. A person with hyperparathyroidism is likely to develop:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: D. Hyperparathyroidism leads to an excess of parathyroid hormone (PTH), which increases
bone resorption, releasing calcium into the blood and causing hypercalcemia.
Q9. Clinical manifestations of severe symptomatic hypophosphatemia are caused by:
A. Excess proteins
B. Renal damage
C. Deficiency of ATP
D. Hypocalcemia
Answer: C. Phosphate is a critical component of adenosine triphosphate (ATP). Severe
hypophosphatemia leads to ATP depletion, causing widespread cellular dysfunction and symptoms like
muscle weakness and respiratory failure.
Part 3: Acid-Base Balance
Q10. A patient with a prolonged history of vomiting develops metabolic alkalosis. Which electrolyte
imbalance is most likely to accompany this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B. Loss of gastric acid (HCl) from vomiting leads to metabolic alkalosis. The kidneys
compensate by excreting potassium to conserve hydrogen ions, leading to hypokalemia. Volume
depletion also stimulates aldosterone, which further increases potassium excretion.
Q11. The nurse notes that a patient's arterial blood gas (ABG) results show: pH 7.32, PaCO₂ 50 mm Hg,
and HCO₃⁻ 26 mEq/L. These findings are consistent with:
NSG 3850 Actual Exam 1 Patho 2
,[Document title]
,[Document title]
Part 1: Fluid and Electrolyte Homeostasis
Q1. A patient is admitted with confusion, muscle weakness, and a serum sodium level of 125 mEq/L. The
nurse recognizes these symptoms are most likely due to which imbalance?
A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: B. A serum sodium level of 125 mEq/L is diagnostic of hyponatremia (normal ~135-145
mEq/L). The neurologic symptoms are a hallmark of this condition due to cellular swelling and cerebral
edema as water shifts into brain cells.
Q2. Decreased neuromuscular excitability is often the result of:
A. Hypercalcemia and hypermagnesemia
B. Hypomagnesemia and hyperkalemia
C. Hypocalcemia and hypokalemia
D. Hypernatremia and hypomagnesemia
Answer: A. Both hypercalcemia and hypermagnesemia decrease neuromuscular excitability by
stabilizing the nerve cell membrane and raising the threshold for firing action potentials.
Q3. The fraction of total body water (TBW) volume contained in the intracellular space in adults is:
A. Three-fourths
B. Two-thirds
C. One-half
D. One-third
Answer: B. In adults, approximately two-thirds of the total body water is located inside the cells, within
the intracellular fluid (ICF) compartment.
Q4. Which electrolyte has a higher concentration in the extracellular fluid than in the intracellular fluid?
A. Sodium
B. Phosphate
C. Magnesium
D. Potassium
Answer: A. Sodium is the primary cation in the extracellular fluid (ECF), while potassium is the major
intracellular cation.
Q5. What is likely to lead to hyponatremia?
A. Insufficient ADH secretion
B. Excess aldosterone secretion
C. Administration of IV normal saline
D. Frequent NG tube irrigation with water
Answer: D. Frequent irrigation of a nasogastric (NG) tube with water can lead to water intoxication and
dilutional hyponatremia, as free water is absorbed.
Part 2: Electrolyte Imbalances
, [Document title]
Q6. A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop:
A. Hypokalemia
B. Hyperkalemia
C. Hypophosphatemia
D. Hyperphosphatemia
Answer: C. Overuse of magnesium-aluminum antacids binds phosphate in the gut, preventing its
absorption and leading to hypophosphatemia over time.
Q7. Which electrolyte imbalances cause increased neuromuscular excitability?
A. Hypokalemia and hyperphosphatemia
B. Hyperkalemia and hypophosphatemia
C. Hypocalcemia and hypomagnesemia
D. Hypercalcemia and hypermagnesemia
Answer: C. Both hypocalcemia and hypomagnesemia increase neuromuscular excitability by making
nerve cell membranes more permeable to sodium, which can lead to symptoms like tetany.
Q8. A person with hyperparathyroidism is likely to develop:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: D. Hyperparathyroidism leads to an excess of parathyroid hormone (PTH), which increases
bone resorption, releasing calcium into the blood and causing hypercalcemia.
Q9. Clinical manifestations of severe symptomatic hypophosphatemia are caused by:
A. Excess proteins
B. Renal damage
C. Deficiency of ATP
D. Hypocalcemia
Answer: C. Phosphate is a critical component of adenosine triphosphate (ATP). Severe
hypophosphatemia leads to ATP depletion, causing widespread cellular dysfunction and symptoms like
muscle weakness and respiratory failure.
Part 3: Acid-Base Balance
Q10. A patient with a prolonged history of vomiting develops metabolic alkalosis. Which electrolyte
imbalance is most likely to accompany this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypercalcemia
Answer: B. Loss of gastric acid (HCl) from vomiting leads to metabolic alkalosis. The kidneys
compensate by excreting potassium to conserve hydrogen ions, leading to hypokalemia. Volume
depletion also stimulates aldosterone, which further increases potassium excretion.
Q11. The nurse notes that a patient's arterial blood gas (ABG) results show: pH 7.32, PaCO₂ 50 mm Hg,
and HCO₃⁻ 26 mEq/L. These findings are consistent with:
