NR 226 Adult Health I - Exam 3 Study Guide 2026 |Chamberlain
College
1. A patient presents with a serum sodium level of 128 mEq/L. Which nursing
intervention is a priority?
A. Encourage increased fluid intake
B. Implement seizure precautions
C. Administer a diuretic as ordered
D. Provide a high-salt snack
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) puts the patient at risk for cerebral
edema and seizures. Safety through seizure precautions is the priority.
2. Which ECG change is most characteristic of a patient with a serum potassium
level of 6.2 mEq/L?
A. Flat T waves
B. Prominent U waves
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall, peaked T waves
and widened QRS complexes.
,3. A nurse is caring for a patient with hypocalcemia. Which sign should the nurse
look for?
A. Negative Trousseau’s sign
B. Positive Chvostek’s sign
C. Hypoactive bowel sounds
D. Decreased deep tendon reflexes
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to a positive
Chvostek’s sign (facial twitching) and Trousseau’s sign (carpal spasm).
4. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45)
indicating a respiratory cause.
5. What is the primary goal of the ‘Time Out’ procedure in the operating room?
A. To ensure the surgeon is ready
B. To document the anesthesia start time
C. To verify the correct patient, site, and procedure
D. To confirm the patient’s insurance coverage
Answer: C
Rationale: The surgical ‘Time Out’ is a safety protocol to prevent wrong-site, wrong-
procedure, and wrong-person surgery.
, 6. Which electrolyte imbalance is most commonly associated with the use of
loop diuretics like Furosemide?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: A
Rationale: Loop diuretics cause the kidneys to excrete more water, sodium, and potassium,
often leading to hypokalemia.
7. A patient has a pH of 7.50, a PaCO2 of 30 mmHg, and an HCO3 of 24 mEq/L.
What is the likely cause?
A. Opiate overdose
B. Diarrhea
C. Hyperventilation
D. Prolonged vomiting
Answer: C
Rationale: The ABG shows Respiratory Alkalosis (high pH, low CO2), which is commonly
caused by hyperventilation (blowing off too much CO2).
8. When suctioning a tracheostomy, what is the maximum amount of time the
nurse should apply suction?
A. 10-15 seconds
B. 5 seconds
C. 20-30 seconds
D. 1 minute
Answer: A
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and mucosal
damage.
College
1. A patient presents with a serum sodium level of 128 mEq/L. Which nursing
intervention is a priority?
A. Encourage increased fluid intake
B. Implement seizure precautions
C. Administer a diuretic as ordered
D. Provide a high-salt snack
Answer: B
Rationale: Hyponatremia (sodium < 135 mEq/L) puts the patient at risk for cerebral
edema and seizures. Safety through seizure precautions is the priority.
2. Which ECG change is most characteristic of a patient with a serum potassium
level of 6.2 mEq/L?
A. Flat T waves
B. Prominent U waves
C. ST-segment depression
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) typically causes tall, peaked T waves
and widened QRS complexes.
,3. A nurse is caring for a patient with hypocalcemia. Which sign should the nurse
look for?
A. Negative Trousseau’s sign
B. Positive Chvostek’s sign
C. Hypoactive bowel sounds
D. Decreased deep tendon reflexes
Answer: B
Rationale: Hypocalcemia increases neuromuscular excitability, leading to a positive
Chvostek’s sign (facial twitching) and Trousseau’s sign (carpal spasm).
4. A patient’s ABG results are: pH 7.30, PaCO2 52 mmHg, and HCO3 26 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45)
indicating a respiratory cause.
5. What is the primary goal of the ‘Time Out’ procedure in the operating room?
A. To ensure the surgeon is ready
B. To document the anesthesia start time
C. To verify the correct patient, site, and procedure
D. To confirm the patient’s insurance coverage
Answer: C
Rationale: The surgical ‘Time Out’ is a safety protocol to prevent wrong-site, wrong-
procedure, and wrong-person surgery.
, 6. Which electrolyte imbalance is most commonly associated with the use of
loop diuretics like Furosemide?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypermagnesemia
Answer: A
Rationale: Loop diuretics cause the kidneys to excrete more water, sodium, and potassium,
often leading to hypokalemia.
7. A patient has a pH of 7.50, a PaCO2 of 30 mmHg, and an HCO3 of 24 mEq/L.
What is the likely cause?
A. Opiate overdose
B. Diarrhea
C. Hyperventilation
D. Prolonged vomiting
Answer: C
Rationale: The ABG shows Respiratory Alkalosis (high pH, low CO2), which is commonly
caused by hyperventilation (blowing off too much CO2).
8. When suctioning a tracheostomy, what is the maximum amount of time the
nurse should apply suction?
A. 10-15 seconds
B. 5 seconds
C. 20-30 seconds
D. 1 minute
Answer: A
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and mucosal
damage.
