,NR 324 Exam 1 Adult Health I | Questions And Answers | 2026/2027
CHAMBERLAIN
1.** A nurse is assessing a client who has a sodium level of 128 mEq/L.
Which of the following manifestations should the nurse expect?
A) Thirst and dry mucous membranes
B) Muscle cramps and hyperreflexia
C) Confusion and headache
D) Tachycardia and hypotension
**Correct Answer:** C) Confusion and headache
**Rationale:** Hyponatremia (serum sodium <135 mEq/L) causes cerebral
edema, leading to confusion, headache, nausea, and seizures. Thirst and dry
mucous membranes (A) are signs of hypernatremia (dehydration). Muscle
cramps and hyperreflexia (B) are associated with hypocalcemia. Tachycardia
and hypotension (D) are signs of hypovolemia, not specifically hyponatremia.
**2.** A client is receiving IV fluids of 0.9% Normal Saline at 125 mL/hr. The
client's serum sodium is 148 mEq/L. Which action should the nurse take?
A) Decrease the IV fluid rate
B) Switch the IV fluid to 0.45% Normal Saline
C) Continue the IV fluid as prescribed
D) Add potassium chloride to the IV fluids
**Correct Answer:** B) Switch the IV fluid to 0.45% Normal Saline
,**Rationale:** Hypernatremia (serum sodium >145 mEq/L) indicates a water
deficit relative to sodium. Treatment involves correcting the water deficit with
hypotonic fluids (e.g., 0.45% NaCl or 5% dextrose in water). Decreasing the
rate (A) or continuing the current fluid (C) would not correct the underlying
problem. Potassium chloride (D) is not indicated for hypernatremia.
**3.** A nurse is assessing a client who has a potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect?
A) Peaked T waves
B) U waves
C) T wave flattening
D) Prolonged PR interval
**Correct Answer:** A) Peaked T waves
**Rationale:** Hyperkalemia (serum potassium >5.0 mEq/L) is characterized
by peaked (tall, tented) T waves on ECG. U waves (B) and T wave flattening
(C) are associated with hypokalemia. Prolonged PR interval (D) can occur
with hyperkalemia but peaked T waves are the classic early finding.
**4.** A client with renal failure has a serum potassium of 6.2 mEq/L. Which
of the following is a priority nursing intervention?
A) Notify the healthcare provider and prepare for interventions
B) Administer potassium supplements
C) Encourage the client to drink more fluids
D) Administer a loop diuretic
, **Correct Answer:** A) Notify the healthcare provider and prepare for
interventions
**Rationale:** A potassium level of 6.2 mEq/L is critically elevated and can
cause life-threatening cardiac arrhythmias. The provider must be notified
immediately. Interventions may include insulin with glucose, calcium
gluconate, or dialysis.
**5.** A nurse is caring for a client with hypokalemia. Which of the following
assessment findings is most concerning?
A) Muscle weakness
B) Cardiac arrhythmias
C) Constipation
D) Fatigue
**Correct Answer:** B) Cardiac arrhythmias
**Rationale:** Hypokalemia (serum potassium <3.5 mEq/L) can cause life-
threatening cardiac arrhythmias. Muscle weakness (A), constipation (C), and
fatigue (D) are symptoms of hypokalemia but cardiac arrhythmias pose the
greatest immediate risk.
**6.** A client is prescribed furosemide for heart failure. Which electrolyte
imbalance should the nurse monitor?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
CHAMBERLAIN
1.** A nurse is assessing a client who has a sodium level of 128 mEq/L.
Which of the following manifestations should the nurse expect?
A) Thirst and dry mucous membranes
B) Muscle cramps and hyperreflexia
C) Confusion and headache
D) Tachycardia and hypotension
**Correct Answer:** C) Confusion and headache
**Rationale:** Hyponatremia (serum sodium <135 mEq/L) causes cerebral
edema, leading to confusion, headache, nausea, and seizures. Thirst and dry
mucous membranes (A) are signs of hypernatremia (dehydration). Muscle
cramps and hyperreflexia (B) are associated with hypocalcemia. Tachycardia
and hypotension (D) are signs of hypovolemia, not specifically hyponatremia.
**2.** A client is receiving IV fluids of 0.9% Normal Saline at 125 mL/hr. The
client's serum sodium is 148 mEq/L. Which action should the nurse take?
A) Decrease the IV fluid rate
B) Switch the IV fluid to 0.45% Normal Saline
C) Continue the IV fluid as prescribed
D) Add potassium chloride to the IV fluids
**Correct Answer:** B) Switch the IV fluid to 0.45% Normal Saline
,**Rationale:** Hypernatremia (serum sodium >145 mEq/L) indicates a water
deficit relative to sodium. Treatment involves correcting the water deficit with
hypotonic fluids (e.g., 0.45% NaCl or 5% dextrose in water). Decreasing the
rate (A) or continuing the current fluid (C) would not correct the underlying
problem. Potassium chloride (D) is not indicated for hypernatremia.
**3.** A nurse is assessing a client who has a potassium level of 6.8 mEq/L.
Which ECG change should the nurse expect?
A) Peaked T waves
B) U waves
C) T wave flattening
D) Prolonged PR interval
**Correct Answer:** A) Peaked T waves
**Rationale:** Hyperkalemia (serum potassium >5.0 mEq/L) is characterized
by peaked (tall, tented) T waves on ECG. U waves (B) and T wave flattening
(C) are associated with hypokalemia. Prolonged PR interval (D) can occur
with hyperkalemia but peaked T waves are the classic early finding.
**4.** A client with renal failure has a serum potassium of 6.2 mEq/L. Which
of the following is a priority nursing intervention?
A) Notify the healthcare provider and prepare for interventions
B) Administer potassium supplements
C) Encourage the client to drink more fluids
D) Administer a loop diuretic
, **Correct Answer:** A) Notify the healthcare provider and prepare for
interventions
**Rationale:** A potassium level of 6.2 mEq/L is critically elevated and can
cause life-threatening cardiac arrhythmias. The provider must be notified
immediately. Interventions may include insulin with glucose, calcium
gluconate, or dialysis.
**5.** A nurse is caring for a client with hypokalemia. Which of the following
assessment findings is most concerning?
A) Muscle weakness
B) Cardiac arrhythmias
C) Constipation
D) Fatigue
**Correct Answer:** B) Cardiac arrhythmias
**Rationale:** Hypokalemia (serum potassium <3.5 mEq/L) can cause life-
threatening cardiac arrhythmias. Muscle weakness (A), constipation (C), and
fatigue (D) are symptoms of hypokalemia but cardiac arrhythmias pose the
greatest immediate risk.
**6.** A client is prescribed furosemide for heart failure. Which electrolyte
imbalance should the nurse monitor?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
