MCA 1 - Cline - Exam 1 Samuel Merritt
University MCA 1 - Test #1 Inflamation,
immune response, infection, fluid &
electrolytes, diabetes, delegation Questions
With Complete Solutions
SECTION 1: FLUID & ELECTROLYTE BALANCE
Question #1
A patient presents with confusion, muscle twitching, and a serum sodium level of 125 mEq/L.
Which condition is the patient most likely experiencing?
A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypokalemia
Correct Answer: B) Hyponatremia
, Rationale:
Hyponatremia is defined as serum sodium <135 mEq/L. The shift of water into cells causes
cellular edema, leading to headache, irritability, difficulty concentrating, confusion, vomiting,
seizures, and coma. This patient's confusion and muscle twitching, combined with a sodium of
125, are classic signs of hyponatremia. Sodium is the most abundant cation in the ECF and is
essential for nerve impulse transmission and fluid balance.
Question #2
Which serum potassium level would the nurse expect to see in a patient with metabolic
alkalosis?
A) 5.0 mEq/L
B) 4.5 mEq/L
C) 3.2 mEq/L
D) 5.5 mEq/L
Correct Answer: C) 3.2 mEq/L
Rationale:
Hypokalemia (serum potassium <3.5 mEq/L) is associated with metabolic alkalosis due to
potassium shifting into cells or loss through the GI tract or kidneys. Clinical manifestations
include skeletal muscle weakness, paresthesias, constipation, and cardiac changes (flattened T
wave, depressed ST segment). Potassium is the primary intracellular cation and is critical for
cardiac conduction and muscle contraction.
Question #3
A patient with renal failure has a serum potassium of 6.2 mEq/L. Which ECG change would the
nurse expect to observe?
A) Flattened T waves
B) Peaked T waves
, C) ST depression
D) U waves
Correct Answer: B) Peaked T waves
Rationale:
Hyperkalemia (serum potassium >5.0 mEq/L) most commonly results from impaired renal
excretion. Peaked or tall, tented T waves are a classic and early ECG finding in hyperkalemia.
Clinical manifestations include fatigue, confusion, tetany, muscle cramps, and weakness. As
potassium increases further, loss of muscle tone and respiratory muscle weakness can occur,
leading to respiratory arrest. NEVER administer potassium IV push — this can cause fatal cardiac
arrhythmias.
Question #4
A patient with heart failure is placed on a fluid restriction. Which lab value would be most
helpful in monitoring fluid status?
A) Serum sodium
B) BUN
C) Creatinine
D) Daily weight
Correct Answer: D) Daily weight
Rationale:
Daily weight is one of the best indicators of fluid balance, as each kilogram of weight change
approximates 1 liter of fluid. BUN is a measure of dehydration, while creatinine is a measure of
kidney function. Daily weights at the same time each day, using the same scale, and with the
patient wearing similar clothing are essential for accurate monitoring of fluid volume status.
Question #5
University MCA 1 - Test #1 Inflamation,
immune response, infection, fluid &
electrolytes, diabetes, delegation Questions
With Complete Solutions
SECTION 1: FLUID & ELECTROLYTE BALANCE
Question #1
A patient presents with confusion, muscle twitching, and a serum sodium level of 125 mEq/L.
Which condition is the patient most likely experiencing?
A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypokalemia
Correct Answer: B) Hyponatremia
, Rationale:
Hyponatremia is defined as serum sodium <135 mEq/L. The shift of water into cells causes
cellular edema, leading to headache, irritability, difficulty concentrating, confusion, vomiting,
seizures, and coma. This patient's confusion and muscle twitching, combined with a sodium of
125, are classic signs of hyponatremia. Sodium is the most abundant cation in the ECF and is
essential for nerve impulse transmission and fluid balance.
Question #2
Which serum potassium level would the nurse expect to see in a patient with metabolic
alkalosis?
A) 5.0 mEq/L
B) 4.5 mEq/L
C) 3.2 mEq/L
D) 5.5 mEq/L
Correct Answer: C) 3.2 mEq/L
Rationale:
Hypokalemia (serum potassium <3.5 mEq/L) is associated with metabolic alkalosis due to
potassium shifting into cells or loss through the GI tract or kidneys. Clinical manifestations
include skeletal muscle weakness, paresthesias, constipation, and cardiac changes (flattened T
wave, depressed ST segment). Potassium is the primary intracellular cation and is critical for
cardiac conduction and muscle contraction.
Question #3
A patient with renal failure has a serum potassium of 6.2 mEq/L. Which ECG change would the
nurse expect to observe?
A) Flattened T waves
B) Peaked T waves
, C) ST depression
D) U waves
Correct Answer: B) Peaked T waves
Rationale:
Hyperkalemia (serum potassium >5.0 mEq/L) most commonly results from impaired renal
excretion. Peaked or tall, tented T waves are a classic and early ECG finding in hyperkalemia.
Clinical manifestations include fatigue, confusion, tetany, muscle cramps, and weakness. As
potassium increases further, loss of muscle tone and respiratory muscle weakness can occur,
leading to respiratory arrest. NEVER administer potassium IV push — this can cause fatal cardiac
arrhythmias.
Question #4
A patient with heart failure is placed on a fluid restriction. Which lab value would be most
helpful in monitoring fluid status?
A) Serum sodium
B) BUN
C) Creatinine
D) Daily weight
Correct Answer: D) Daily weight
Rationale:
Daily weight is one of the best indicators of fluid balance, as each kilogram of weight change
approximates 1 liter of fluid. BUN is a measure of dehydration, while creatinine is a measure of
kidney function. Daily weights at the same time each day, using the same scale, and with the
patient wearing similar clothing are essential for accurate monitoring of fluid volume status.
Question #5
