Chamberlain NR 324 Exam 1 (pdf) | 2026/2027 | Adult Health I Q&A |
Med-Surg Nursing
1. A nurse is reviewing the concept of fluid and electrolyte balance. Which of
the following correctly describes the primary function of the sodium-
potassium pump?
A) To move sodium into the cell and potassium out of the cell
B) To move potassium into the cell and sodium out of the cell
C) To move both sodium and potassium into the cell
D) To move both sodium and potassium out of the cell
Correct Answer: To move potassium into the cell and sodium out of the cell
Rationale: The sodium-potassium pump is an active transport mechanism
that uses ATP to move three sodium ions out of the cell and two potassium
ions into the cell, maintaining the cell's resting membrane potential. This
creates a concentration gradient essential for nerve impulse transmission
and muscle contraction. Option A describes the reverse of the actual
mechanism, and options C and D are incorrect.
2. A nurse is assessing a client who has a serum potassium level of 6.8
mEq/L. Which of the following electrocardiogram (ECG) changes should the
nurse expect to observe?
A) Tall, peaked T-waves
B) Flattened T-waves
C) ST-segment depression
D) Prolonged PR interval
Correct Answer: Tall, peaked T-waves
,Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by
tall, peaked T-waves on the ECG. Flattened T-waves and ST-segment
depression are associated with hypokalemia. Hyperkalemia can also progress
to widened QRS complexes and ventricular fibrillation if left untreated.
3. A nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. The nurse should monitor the client for which of the
following acid-base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the
stomach, leading to a loss of hydrogen ions. This results in an increase in
serum bicarbonate (HCO3⁻) and a subsequent metabolic alkalosis. The loss
of gastric acid through vomiting or suction is a classic cause of metabolic
alkalosis.
4. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.30,
PaCO₂ 50 mmHg, HCO₃ 24 mEq/L. The nurse should interpret this as which of
the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
,Rationale: The pH is low (7.30), indicating acidosis. The PaCO₂ is elevated (50
mmHg, normal 35-45), indicating a respiratory cause. In respiratory acidosis,
there is an accumulation of carbon dioxide due to hypoventilation. The HCO₃
is normal, suggesting this is an acute, uncompensated respiratory acidosis.
5. A nurse is providing discharge teaching to a client prescribed an inhaled
corticosteroid for asthma management. Which of the following instructions
should the nurse include?
A) "Rinse your mouth with water after each use."
B) "Use this medication immediately after your rescue inhaler."
C) "Take this medication only when you have an asthma attack."
D) "Shake the inhaler vigorously for 10 seconds before each use."
Correct Answer: "Rinse your mouth with water after each use."
Rationale: Inhaled corticosteroids can cause oral thrush (candidiasis) and
hoarseness. Rinsing the mouth with water after inhalation helps remove
residual medication from the oral cavity, reducing the risk of these side
effects. This medication is for long-term control and should be used daily, not
just during an attack.
6. A client with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest and pursed-lip breathing. Which of the following is the primary
rationale for teaching pursed-lip breathing?
A) To increase the respiratory rate
B) To increase oxygen intake
C) To keep the airways open longer by preventing airway collapse
D) To reduce the work of breathing
, Correct Answer: To keep the airways open longer by preventing airway
collapse
Rationale: In COPD, the airways tend to collapse during exhalation due to
loss of elastic recoil. Pursed-lip breathing creates backpressure in the
airways, which helps to keep them open longer, facilitating more complete
exhalation and preventing air trapping. This improves gas exchange and
reduces dyspnea.
7. A nurse is assessing a client who is taking hydrochlorothiazide for
hypertension. Which of the following electrolyte imbalances is a potential
adverse effect of this medication?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that increases potassium
excretion in the distal convoluted tubule. This can lead to hypokalemia, a
common adverse effect. Patients should be monitored for signs of low
potassium, such as muscle weakness and cardiac arrhythmias.
8. A nurse is teaching a client about the correct technique for using a
metered-dose inhaler (MDI). Which of the following statements by the client
indicates understanding?
A) "I will activate the inhaler and then inhale quickly."
B) "I will hold my breath for 10 seconds after inhalation."
C) "I will exhale fully before placing the inhaler in my mouth."
D) "I will shake the inhaler well before each use."
Med-Surg Nursing
1. A nurse is reviewing the concept of fluid and electrolyte balance. Which of
the following correctly describes the primary function of the sodium-
potassium pump?
A) To move sodium into the cell and potassium out of the cell
B) To move potassium into the cell and sodium out of the cell
C) To move both sodium and potassium into the cell
D) To move both sodium and potassium out of the cell
Correct Answer: To move potassium into the cell and sodium out of the cell
Rationale: The sodium-potassium pump is an active transport mechanism
that uses ATP to move three sodium ions out of the cell and two potassium
ions into the cell, maintaining the cell's resting membrane potential. This
creates a concentration gradient essential for nerve impulse transmission
and muscle contraction. Option A describes the reverse of the actual
mechanism, and options C and D are incorrect.
2. A nurse is assessing a client who has a serum potassium level of 6.8
mEq/L. Which of the following electrocardiogram (ECG) changes should the
nurse expect to observe?
A) Tall, peaked T-waves
B) Flattened T-waves
C) ST-segment depression
D) Prolonged PR interval
Correct Answer: Tall, peaked T-waves
,Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by
tall, peaked T-waves on the ECG. Flattened T-waves and ST-segment
depression are associated with hypokalemia. Hyperkalemia can also progress
to widened QRS complexes and ventricular fibrillation if left untreated.
3. A nurse is caring for a client with a nasogastric tube attached to low
intermittent suction. The nurse should monitor the client for which of the
following acid-base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the
stomach, leading to a loss of hydrogen ions. This results in an increase in
serum bicarbonate (HCO3⁻) and a subsequent metabolic alkalosis. The loss
of gastric acid through vomiting or suction is a classic cause of metabolic
alkalosis.
4. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.30,
PaCO₂ 50 mmHg, HCO₃ 24 mEq/L. The nurse should interpret this as which of
the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
,Rationale: The pH is low (7.30), indicating acidosis. The PaCO₂ is elevated (50
mmHg, normal 35-45), indicating a respiratory cause. In respiratory acidosis,
there is an accumulation of carbon dioxide due to hypoventilation. The HCO₃
is normal, suggesting this is an acute, uncompensated respiratory acidosis.
5. A nurse is providing discharge teaching to a client prescribed an inhaled
corticosteroid for asthma management. Which of the following instructions
should the nurse include?
A) "Rinse your mouth with water after each use."
B) "Use this medication immediately after your rescue inhaler."
C) "Take this medication only when you have an asthma attack."
D) "Shake the inhaler vigorously for 10 seconds before each use."
Correct Answer: "Rinse your mouth with water after each use."
Rationale: Inhaled corticosteroids can cause oral thrush (candidiasis) and
hoarseness. Rinsing the mouth with water after inhalation helps remove
residual medication from the oral cavity, reducing the risk of these side
effects. This medication is for long-term control and should be used daily, not
just during an attack.
6. A client with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest and pursed-lip breathing. Which of the following is the primary
rationale for teaching pursed-lip breathing?
A) To increase the respiratory rate
B) To increase oxygen intake
C) To keep the airways open longer by preventing airway collapse
D) To reduce the work of breathing
, Correct Answer: To keep the airways open longer by preventing airway
collapse
Rationale: In COPD, the airways tend to collapse during exhalation due to
loss of elastic recoil. Pursed-lip breathing creates backpressure in the
airways, which helps to keep them open longer, facilitating more complete
exhalation and preventing air trapping. This improves gas exchange and
reduces dyspnea.
7. A nurse is assessing a client who is taking hydrochlorothiazide for
hypertension. Which of the following electrolyte imbalances is a potential
adverse effect of this medication?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
Rationale: Hydrochlorothiazide is a thiazide diuretic that increases potassium
excretion in the distal convoluted tubule. This can lead to hypokalemia, a
common adverse effect. Patients should be monitored for signs of low
potassium, such as muscle weakness and cardiac arrhythmias.
8. A nurse is teaching a client about the correct technique for using a
metered-dose inhaler (MDI). Which of the following statements by the client
indicates understanding?
A) "I will activate the inhaler and then inhale quickly."
B) "I will hold my breath for 10 seconds after inhalation."
C) "I will exhale fully before placing the inhaler in my mouth."
D) "I will shake the inhaler well before each use."
