Summer Adult Health Nursing Comprehensive
Exam | 200 Practice Questions with Expert
Rationales | 2026/2027
SECTION A: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
(Questions 1–20)
Question 1
A patient with severe vomiting and diarrhea for 3 days presents
with dizziness when standing. Which assessment finding is most
consistent with hypovolemia?
A) Bounding peripheral pulses
B) Jugular vein distention
C) Orthostatic hypotension
D) Crackles in the lung bases
Correct Answer: C
Rationale: Hypovolemia (decreased blood volume) causes
orthostatic hypotension—a drop in blood pressure when the
patient changes position. Bounding pulses (A), jugular vein
distention (B), and crackles (D) are signs of hypervolemia (fluid
overload).
Question 2
A patient's serum potassium is 6.8 mEq/L (normal: 3.5–5.0).
Which ECG change is most characteristic of hyperkalemia?
,A) U waves
B) Peaked (tall, tented) T waves
C) Prolonged PR interval
D) ST segment elevation
Correct Answer: B
Rationale: Hyperkalemia causes tall, peaked (tented) T waves on
ECG. U waves (A) are characteristic of hypokalemia. Prolonged
PR interval (C) can occur in both but is not the hallmark finding.
Question 3
A patient's serum sodium is 118 mEq/L. Which intervention
is most important?
A) Restrict oral fluid intake
B) Administer 3% hypertonic saline as ordered
C) Encourage the patient to drink more water
D) Place the patient on seizure precautions
Correct Answer: B
Rationale: Severe hyponatremia (sodium <120 mEq/L) is a
medical emergency requiring hypertonic (3%) saline to gradually
increase serum sodium and prevent cerebral edema. While
seizure precautions (D) are also important, the immediate
treatment is hypertonic saline.
Question 4
,A patient with heart failure is receiving furosemide (Lasix). Which
finding requires immediate action?
A) Weight loss of 1 kg in 24 hours
B) Serum potassium 2.9 mEq/L
C) Blood pressure 110/70 mmHg
D) Urine output 40 mL/hour
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the
risk of cardiac dysrhythmias and digoxin toxicity. Furosemide
causes potassium wasting. A potassium of 2.9 mEq/L is critically
low and requires immediate potassium replacement.
Question 5
A patient with chronic kidney disease has a serum calcium of 6.5
mg/dL (normal: 8.5–10.5). Which finding is expected?
A) Positive Chvostek's sign
B) Diarrhea
C) Hypertension
D) Polyuria
Correct Answer: A
Rationale: Hypocalcemia causes increased neuromuscular
irritability, leading to positive Chvostek's sign (facial twitching
when tapping the facial nerve). Diarrhea (B) is seen
with hypercalcemia. Hypertension (C) and polyuria (D) are not
characteristic.
, Question 6
Which IV fluid is most appropriate for a patient with
hypovolemic shock?
A) 0.9% normal saline
B) 0.45% half-normal saline
C) 5% dextrose in water (D5W)
D) Free water
Correct Answer: A
Rationale: 0.9% normal saline is an isotonic crystalloid used for
volume resuscitation in hypovolemic shock. Hypotonic solutions
(B, D) would not adequately restore intravascular volume. D5W
(C) becomes hypotonic after metabolism.
Question 7
A patient's ABG results: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 24
mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C
Exam | 200 Practice Questions with Expert
Rationales | 2026/2027
SECTION A: FLUID, ELECTROLYTE, AND ACID-BASE BALANCE
(Questions 1–20)
Question 1
A patient with severe vomiting and diarrhea for 3 days presents
with dizziness when standing. Which assessment finding is most
consistent with hypovolemia?
A) Bounding peripheral pulses
B) Jugular vein distention
C) Orthostatic hypotension
D) Crackles in the lung bases
Correct Answer: C
Rationale: Hypovolemia (decreased blood volume) causes
orthostatic hypotension—a drop in blood pressure when the
patient changes position. Bounding pulses (A), jugular vein
distention (B), and crackles (D) are signs of hypervolemia (fluid
overload).
Question 2
A patient's serum potassium is 6.8 mEq/L (normal: 3.5–5.0).
Which ECG change is most characteristic of hyperkalemia?
,A) U waves
B) Peaked (tall, tented) T waves
C) Prolonged PR interval
D) ST segment elevation
Correct Answer: B
Rationale: Hyperkalemia causes tall, peaked (tented) T waves on
ECG. U waves (A) are characteristic of hypokalemia. Prolonged
PR interval (C) can occur in both but is not the hallmark finding.
Question 3
A patient's serum sodium is 118 mEq/L. Which intervention
is most important?
A) Restrict oral fluid intake
B) Administer 3% hypertonic saline as ordered
C) Encourage the patient to drink more water
D) Place the patient on seizure precautions
Correct Answer: B
Rationale: Severe hyponatremia (sodium <120 mEq/L) is a
medical emergency requiring hypertonic (3%) saline to gradually
increase serum sodium and prevent cerebral edema. While
seizure precautions (D) are also important, the immediate
treatment is hypertonic saline.
Question 4
,A patient with heart failure is receiving furosemide (Lasix). Which
finding requires immediate action?
A) Weight loss of 1 kg in 24 hours
B) Serum potassium 2.9 mEq/L
C) Blood pressure 110/70 mmHg
D) Urine output 40 mL/hour
Correct Answer: B
Rationale: Hypokalemia (potassium <3.5 mEq/L) increases the
risk of cardiac dysrhythmias and digoxin toxicity. Furosemide
causes potassium wasting. A potassium of 2.9 mEq/L is critically
low and requires immediate potassium replacement.
Question 5
A patient with chronic kidney disease has a serum calcium of 6.5
mg/dL (normal: 8.5–10.5). Which finding is expected?
A) Positive Chvostek's sign
B) Diarrhea
C) Hypertension
D) Polyuria
Correct Answer: A
Rationale: Hypocalcemia causes increased neuromuscular
irritability, leading to positive Chvostek's sign (facial twitching
when tapping the facial nerve). Diarrhea (B) is seen
with hypercalcemia. Hypertension (C) and polyuria (D) are not
characteristic.
, Question 6
Which IV fluid is most appropriate for a patient with
hypovolemic shock?
A) 0.9% normal saline
B) 0.45% half-normal saline
C) 5% dextrose in water (D5W)
D) Free water
Correct Answer: A
Rationale: 0.9% normal saline is an isotonic crystalloid used for
volume resuscitation in hypovolemic shock. Hypotonic solutions
(B, D) would not adequately restore intravascular volume. D5W
(C) becomes hypotonic after metabolism.
Question 7
A patient's ABG results: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 24
mEq/L. The nurse interprets this as:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C
