NSG 3250 NURSING PRACTICE ADULT HEALTH 1 EXAM 2 QUESTIONS AND ANSWERS
A client who started a new antibiotic develops a rash and severe diarrhea. Which instruction should the
nurse provide?
A) "Continue the medication and take an over-the-counter antidiarrheal."
B) "Stop the medication immediately and contact your healthcare provider."
C) "This is a normal side effect; you do not need to do anything."
D) "Apply a topical hydrocortisone cream to the rash."
Correct Answer: "Stop the medication immediately and contact your healthcare provider."
Rationale: A rash and severe diarrhea can indicate a serious adverse reaction, such as an allergic
response or C. difficile infection. The client should stop the medication and notify the provider
immediately for further evaluation. Continuing the medication could worsen the condition.
A client presents with grouped vesicles on an erythematous base in a dermatomal pattern. Which
condition is most consistent with this presentation?
A) Herpes simplex
B) Herpes zoster (shingles)
C) Impetigo
D) Psoriasis
Correct Answer: Herpes zoster (shingles)
Rationale: Herpes zoster (shingles) is characterized by a painful, unilateral, vesicular rash that follows a
specific dermatome. The described presentation of grouped vesicles on an erythematous base in a
dermatomal pattern is classic for shingles. Herpes simplex typically affects oral or genital areas.
A client has a sodium level of 120 mEq/L. Which intervention is the priority?
A) Restrict water intake
B) Administer 3% saline IV
,C) Implement seizure precautions
D) Encourage high sodium foods
Correct Answer: Implement seizure precautions
Rationale: Severe hyponatremia (<125 mEq/L) poses a high risk for cerebral edema and seizures.
Implementing seizure precautions is the immediate safety priority while awaiting treatment orders.
Fluid restriction or hypertonic saline may be ordered by the provider.
A client with heart failure is prescribed furosemide. The nurse should monitor for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits potassium reabsorption in the loop of Henle,
leading to potassium wasting. This can result in hypokalemia, which requires monitoring and possible
potassium replacement.
Which EKG change is most indicative of hypokalemia?
A) Peaked T waves
B) U waves
C) Wide QRS complex
D) Prolonged QT interval
Correct Answer: U waves
,Rationale: The presence of U waves is a characteristic EKG finding of hypokalemia. Peaked T waves
indicate hyperkalemia, while a wide QRS complex and prolonged QT interval can occur with other
electrolyte disturbances.
The nurse is reviewing lab results. Which finding is consistent with syndrome of inappropriate
antidiuretic hormone (SIADH)?
A) Serum sodium 155 mEq/L
B) Serum sodium 125 mEq/L
C) Serum osmolality 310 mOsm/kg
D) Urine specific gravity 1.002
Correct Answer: Serum sodium 125 mEq/L
Rationale: SIADH causes water retention, leading to dilutional hyponatremia (low serum sodium) and
concentrated urine. A serum sodium of 125 mEq/L is consistent with this condition.
Which medication places a client at risk for hyperkalemia?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Mannitol
Correct Answer: Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic (aldosterone antagonist) that can cause
hyperkalemia. Furosemide and hydrochlorothiazide can cause hypokalemia, while mannitol is an
osmotic diuretic.
A client presents with muscle twitching, paresthesia, and a positive Chvostek's sign. The nurse suspects
which electrolyte imbalance?
A) Hyperkalemia
, B) Hypocalcemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypocalcemia
Rationale: Neuromuscular irritability (tetany, Chvostek's sign, Trousseau's sign) is a hallmark of
hypocalcemia. These signs indicate increased neuromuscular excitability due to low serum calcium
levels.
Which IV fluid is considered isotonic and is commonly used to expand intravascular volume in a
hypotensive client?
A) 0.45% Sodium Chloride
B) 0.9% Sodium Chloride
C) D5W (in the bag)
D) 3% Sodium Chloride
Correct Answer: 0.9% Sodium Chloride
Rationale: 0.9% Normal Saline is isotonic and remains in the intravascular space, making it ideal for
volume resuscitation. Hypotonic solutions move fluid into cells, and hypertonic solutions draw fluid out
of cells.
What illnesses require Contact Precautions?
A) Mumps, Influenza, Meningitis, Pertussis
B) Measles, TB, Varicella, COVID-19
C) MRSA, VRE, C. diff, RSV, Scabies
D) All of the above
Correct Answer: MRSA, VRE, C. diff, RSV, Scabies
A client who started a new antibiotic develops a rash and severe diarrhea. Which instruction should the
nurse provide?
A) "Continue the medication and take an over-the-counter antidiarrheal."
B) "Stop the medication immediately and contact your healthcare provider."
C) "This is a normal side effect; you do not need to do anything."
D) "Apply a topical hydrocortisone cream to the rash."
Correct Answer: "Stop the medication immediately and contact your healthcare provider."
Rationale: A rash and severe diarrhea can indicate a serious adverse reaction, such as an allergic
response or C. difficile infection. The client should stop the medication and notify the provider
immediately for further evaluation. Continuing the medication could worsen the condition.
A client presents with grouped vesicles on an erythematous base in a dermatomal pattern. Which
condition is most consistent with this presentation?
A) Herpes simplex
B) Herpes zoster (shingles)
C) Impetigo
D) Psoriasis
Correct Answer: Herpes zoster (shingles)
Rationale: Herpes zoster (shingles) is characterized by a painful, unilateral, vesicular rash that follows a
specific dermatome. The described presentation of grouped vesicles on an erythematous base in a
dermatomal pattern is classic for shingles. Herpes simplex typically affects oral or genital areas.
A client has a sodium level of 120 mEq/L. Which intervention is the priority?
A) Restrict water intake
B) Administer 3% saline IV
,C) Implement seizure precautions
D) Encourage high sodium foods
Correct Answer: Implement seizure precautions
Rationale: Severe hyponatremia (<125 mEq/L) poses a high risk for cerebral edema and seizures.
Implementing seizure precautions is the immediate safety priority while awaiting treatment orders.
Fluid restriction or hypertonic saline may be ordered by the provider.
A client with heart failure is prescribed furosemide. The nurse should monitor for which electrolyte
imbalance?
A) Hyperkalemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits potassium reabsorption in the loop of Henle,
leading to potassium wasting. This can result in hypokalemia, which requires monitoring and possible
potassium replacement.
Which EKG change is most indicative of hypokalemia?
A) Peaked T waves
B) U waves
C) Wide QRS complex
D) Prolonged QT interval
Correct Answer: U waves
,Rationale: The presence of U waves is a characteristic EKG finding of hypokalemia. Peaked T waves
indicate hyperkalemia, while a wide QRS complex and prolonged QT interval can occur with other
electrolyte disturbances.
The nurse is reviewing lab results. Which finding is consistent with syndrome of inappropriate
antidiuretic hormone (SIADH)?
A) Serum sodium 155 mEq/L
B) Serum sodium 125 mEq/L
C) Serum osmolality 310 mOsm/kg
D) Urine specific gravity 1.002
Correct Answer: Serum sodium 125 mEq/L
Rationale: SIADH causes water retention, leading to dilutional hyponatremia (low serum sodium) and
concentrated urine. A serum sodium of 125 mEq/L is consistent with this condition.
Which medication places a client at risk for hyperkalemia?
A) Furosemide
B) Spironolactone
C) Hydrochlorothiazide
D) Mannitol
Correct Answer: Spironolactone
Rationale: Spironolactone is a potassium-sparing diuretic (aldosterone antagonist) that can cause
hyperkalemia. Furosemide and hydrochlorothiazide can cause hypokalemia, while mannitol is an
osmotic diuretic.
A client presents with muscle twitching, paresthesia, and a positive Chvostek's sign. The nurse suspects
which electrolyte imbalance?
A) Hyperkalemia
, B) Hypocalcemia
C) Hyponatremia
D) Hypercalcemia
Correct Answer: Hypocalcemia
Rationale: Neuromuscular irritability (tetany, Chvostek's sign, Trousseau's sign) is a hallmark of
hypocalcemia. These signs indicate increased neuromuscular excitability due to low serum calcium
levels.
Which IV fluid is considered isotonic and is commonly used to expand intravascular volume in a
hypotensive client?
A) 0.45% Sodium Chloride
B) 0.9% Sodium Chloride
C) D5W (in the bag)
D) 3% Sodium Chloride
Correct Answer: 0.9% Sodium Chloride
Rationale: 0.9% Normal Saline is isotonic and remains in the intravascular space, making it ideal for
volume resuscitation. Hypotonic solutions move fluid into cells, and hypertonic solutions draw fluid out
of cells.
What illnesses require Contact Precautions?
A) Mumps, Influenza, Meningitis, Pertussis
B) Measles, TB, Varicella, COVID-19
C) MRSA, VRE, C. diff, RSV, Scabies
D) All of the above
Correct Answer: MRSA, VRE, C. diff, RSV, Scabies
