NSG 318 FINAL EXAM TARGET TEST
BANK 100 CORE CLINICAL QUESTIONS
WITH DETAILED CORRECT ANSWERS
and RATIONALES CORRECT VERIFIED
ANSWERS GRADE A+ ULTIMATE STUDY
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NSG 318: Final Exam Comprehensive Test Bank
(Questions 1–150)
Section I: Fluid, Electrolyte, and Acid-Base Dynamics
1. A nurse is evaluating a client who has a serum potassium
level of 6.4 mEq/L and notices peaked T-waves on the
EKG monitor. Which of the following continuous
prescription interventions should the nurse anticipate
executing first to protect the client's cardiac conduction
system?
A. Administer oral sodium polystyrene sulfonate
suspension.
B. Administer intravenous 10% calcium gluconate
injection.
C. Initiate a continuous intravenous infusion of regular
insulin with dextrose.
D. Obtain a 24-hour urine collection for creatinine
clearance.
Correct Answer: B. Rationale: Intravenous
calcium gluconate does not lower serum potassium levels
but immediately stabilizes the myocardial cell membrane,
raising the threshold for excitation to prevent lethal
ventricular dysrhythmias.
,2. A nurse is reviewing the arterial blood gas (ABG) results of
a client who has been vomiting continuously for 48 hours.
The results are: pH 7.51, PaCO2 44 mm Hg, and HCO3 36
mEq/L. The nurse should identify these values as
reflecting which of the following acid-base imbalances?
A. Uncompensated respiratory alkalosis.
B. Fully compensated respiratory acidosis.
C. Uncompensated metabolic alkalosis.
D. Partially compensated metabolic acidosis.
Correct Answer: C. Rationale: A pH above 7.45
indicates alkalosis. The elevated HCO3 (>26 mEq/L)
confirms a metabolic origin, matching the clinical history
of losing gastric hydrochloric acid through persistent
vomiting. The normal PaCO2 shows no lung
compensation yet.
3. A nurse is caring for an older adult client who has
developed Syndrome of Inappropriate Antidiuretic
Hormone (SIADH) secondary to an occult lung
malignancy. Which of the following metabolic
configurations should the nurse expect to manage?
A. Hypernatremia paired with high fluid volume deficits.
B. Dilutional hyponatremia accompanied by fluid
volume excess.
C. Severe hypokalemic metabolic alkalosis with osmotic
diuresis.
D. Isolated hypocalcemia resulting from thyroid gland
compression.
Correct Answer: B. Rationale: SIADH involves
excessive release of antidiuretic hormone, causing the
kidneys to reabsorb water into the vascular space. This
expands extracellular fluid volume and dilutes serum
sodium levels, leading to dilutional hyponatremia.
4. A nurse is evaluating the renal function of an 82-year-old
client to ensure safe dosing of a water-soluble medication.
, Which of the following laboratory values provides the
most accurate estimation of renal clearance in an older
adult client?
A. A random static serum creatinine level of 0.8 mg/dL.
B. Blood urea nitrogen (BUN) level of 16 mg/dL.
C. Calculated glomerular filtration rate (eGFR) or
creatinine clearance.
D. Total 24-hour urinary volume output.
Correct Answer: C. Rationale: Serum creatinine
levels can remain deceptively normal in older adults due
to age-related declines in muscle mass (creatinine is a
muscle breakdown product). Glomerular filtration rate
accounts for age, weight, and sex, providing an accurate
measure of kidney function.
5. A nurse is assessing a client who has severe hypocalcemia
secondary to hypoparathyroidism. Which of the following
clinical findings should the nurse expect to observe?
A. Hypoactive deep tendon reflexes and severe
constipation.
B. Flaccid paralysis and a shortened QT interval on an
electrocardiogram.
C. Positive Chvostek's sign consisting of facial
muscle twitching when tapped.
D. Polyuria and bounding peripheral pulses.
Correct Answer: C. Rationale: Hypocalcemia
increases neuromuscular irritability. A positive
Chvostek's sign (facial twitching when the facial nerve is
tapped) and Trousseau's sign (carpal spasm during blood
pressure check) are classic indicators of low calcium.
Section II: Cardiovascular Function and
Hemodynamic Assessment
, 6. A nurse is assessing an electrocardiogram (ECG) rhythm
strip for a client and notes a completely chaotic rhythm
with no identifiable P-waves and irregular, jagged QRS
complexes. The client is unresponsive, pulseless, and
apneic. Which of the following actions must the nurse
execute immediately?
A. Administer an intravenous bolus of amiodarone.
B. Perform immediate synchronized cardioversion at 50
Joules.
C. Initiate high-quality CPR and prepare for
immediate unsynchronized defibrillation.
D. Prepare the client for urgent transvenous pacemaker
insertion.
Correct Answer: C. Rationale: Ventricular
fibrillation is a lethal, pulseless dysrhythmia. The
immediate, highest priority interventions are bystander
CPR and rapid unsynchronized defibrillation to reset the
heart's electrical conduction system.
7. A nurse is evaluating a client who has left-sided heart
failure. Which of the following clinical manifestations
should the nurse expect to find during the respiratory
assessment?
A. Jugular venous distention and hepatojugular reflux.
B. Dyspnea, orthopnea, and crackles in the lung
bases.
C. Bilateral pitting dependent ankle edema.
D. Splenomegaly and shifting abdominal ascites.
Correct Answer: B. Rationale: Left-sided heart
failure causes blood to back up into the pulmonary veins
and capillaries, increasing hydrostatic pressure and
forcing fluid into the alveoli, resulting in pulmonary
congestion, crackles, and dyspnea.
8. A nurse is reviewing the laboratory results of a client who
has a history of mechanical heart valve replacement and
BANK 100 CORE CLINICAL QUESTIONS
WITH DETAILED CORRECT ANSWERS
and RATIONALES CORRECT VERIFIED
ANSWERS GRADE A+ ULTIMATE STUDY
GUIDE | 100% PASS GUARANTEE |
INSTANT DOWNLOAD
NSG 318: Final Exam Comprehensive Test Bank
(Questions 1–150)
Section I: Fluid, Electrolyte, and Acid-Base Dynamics
1. A nurse is evaluating a client who has a serum potassium
level of 6.4 mEq/L and notices peaked T-waves on the
EKG monitor. Which of the following continuous
prescription interventions should the nurse anticipate
executing first to protect the client's cardiac conduction
system?
A. Administer oral sodium polystyrene sulfonate
suspension.
B. Administer intravenous 10% calcium gluconate
injection.
C. Initiate a continuous intravenous infusion of regular
insulin with dextrose.
D. Obtain a 24-hour urine collection for creatinine
clearance.
Correct Answer: B. Rationale: Intravenous
calcium gluconate does not lower serum potassium levels
but immediately stabilizes the myocardial cell membrane,
raising the threshold for excitation to prevent lethal
ventricular dysrhythmias.
,2. A nurse is reviewing the arterial blood gas (ABG) results of
a client who has been vomiting continuously for 48 hours.
The results are: pH 7.51, PaCO2 44 mm Hg, and HCO3 36
mEq/L. The nurse should identify these values as
reflecting which of the following acid-base imbalances?
A. Uncompensated respiratory alkalosis.
B. Fully compensated respiratory acidosis.
C. Uncompensated metabolic alkalosis.
D. Partially compensated metabolic acidosis.
Correct Answer: C. Rationale: A pH above 7.45
indicates alkalosis. The elevated HCO3 (>26 mEq/L)
confirms a metabolic origin, matching the clinical history
of losing gastric hydrochloric acid through persistent
vomiting. The normal PaCO2 shows no lung
compensation yet.
3. A nurse is caring for an older adult client who has
developed Syndrome of Inappropriate Antidiuretic
Hormone (SIADH) secondary to an occult lung
malignancy. Which of the following metabolic
configurations should the nurse expect to manage?
A. Hypernatremia paired with high fluid volume deficits.
B. Dilutional hyponatremia accompanied by fluid
volume excess.
C. Severe hypokalemic metabolic alkalosis with osmotic
diuresis.
D. Isolated hypocalcemia resulting from thyroid gland
compression.
Correct Answer: B. Rationale: SIADH involves
excessive release of antidiuretic hormone, causing the
kidneys to reabsorb water into the vascular space. This
expands extracellular fluid volume and dilutes serum
sodium levels, leading to dilutional hyponatremia.
4. A nurse is evaluating the renal function of an 82-year-old
client to ensure safe dosing of a water-soluble medication.
, Which of the following laboratory values provides the
most accurate estimation of renal clearance in an older
adult client?
A. A random static serum creatinine level of 0.8 mg/dL.
B. Blood urea nitrogen (BUN) level of 16 mg/dL.
C. Calculated glomerular filtration rate (eGFR) or
creatinine clearance.
D. Total 24-hour urinary volume output.
Correct Answer: C. Rationale: Serum creatinine
levels can remain deceptively normal in older adults due
to age-related declines in muscle mass (creatinine is a
muscle breakdown product). Glomerular filtration rate
accounts for age, weight, and sex, providing an accurate
measure of kidney function.
5. A nurse is assessing a client who has severe hypocalcemia
secondary to hypoparathyroidism. Which of the following
clinical findings should the nurse expect to observe?
A. Hypoactive deep tendon reflexes and severe
constipation.
B. Flaccid paralysis and a shortened QT interval on an
electrocardiogram.
C. Positive Chvostek's sign consisting of facial
muscle twitching when tapped.
D. Polyuria and bounding peripheral pulses.
Correct Answer: C. Rationale: Hypocalcemia
increases neuromuscular irritability. A positive
Chvostek's sign (facial twitching when the facial nerve is
tapped) and Trousseau's sign (carpal spasm during blood
pressure check) are classic indicators of low calcium.
Section II: Cardiovascular Function and
Hemodynamic Assessment
, 6. A nurse is assessing an electrocardiogram (ECG) rhythm
strip for a client and notes a completely chaotic rhythm
with no identifiable P-waves and irregular, jagged QRS
complexes. The client is unresponsive, pulseless, and
apneic. Which of the following actions must the nurse
execute immediately?
A. Administer an intravenous bolus of amiodarone.
B. Perform immediate synchronized cardioversion at 50
Joules.
C. Initiate high-quality CPR and prepare for
immediate unsynchronized defibrillation.
D. Prepare the client for urgent transvenous pacemaker
insertion.
Correct Answer: C. Rationale: Ventricular
fibrillation is a lethal, pulseless dysrhythmia. The
immediate, highest priority interventions are bystander
CPR and rapid unsynchronized defibrillation to reset the
heart's electrical conduction system.
7. A nurse is evaluating a client who has left-sided heart
failure. Which of the following clinical manifestations
should the nurse expect to find during the respiratory
assessment?
A. Jugular venous distention and hepatojugular reflux.
B. Dyspnea, orthopnea, and crackles in the lung
bases.
C. Bilateral pitting dependent ankle edema.
D. Splenomegaly and shifting abdominal ascites.
Correct Answer: B. Rationale: Left-sided heart
failure causes blood to back up into the pulmonary veins
and capillaries, increasing hydrostatic pressure and
forcing fluid into the alveoli, resulting in pulmonary
congestion, crackles, and dyspnea.
8. A nurse is reviewing the laboratory results of a client who
has a history of mechanical heart valve replacement and
