Fluid and Electrolytes
A nurse is caring for a patient with a serum calcium level of 7.2 mg/dL. Which clinical manifestation would the nurse expect to find?
A. Constipation and muscle weakness
B. Positive Trousseau’s sign
C. Polyuria and polydipsia
D. Shortened QT interval on ECG
Correct Answer: B – Positive Trousseau’s sign indicates neuromuscular irritability seen in hypocalcemia.
A nurse is teaching a patient with Type 2 DM about blood glucose monitoring. Which patient statement indicates an understanding of proper management during illness?
A. “I should stop taking insulin if I’m not eating.”
B. “I will check my blood sugar once daily when I’m sick.”
C. “I should continue checking my blood sugar every 2–4 hours.”
D. “I should avoid drinking fluids if I have nausea.”
C – Sick day rules include frequent blood glucose monitoring (every 2–4 hours).
A patient with osteoarthritis asks how to manage symptoms at home. Which nurse response is appropriate?
A. “Use high-impact exercises to strengthen your joints.”
B. “Use heat therapy to relieve stiffness.”
C. “Increase your calcium intake.”
D. “Avoid all physical activity.”
B – Heat helps reduce stiffness in osteoarthritis.
A nurse is teaching a patient with a BMI of 32. Which classification best describes this BMI?
A. Normal weight
B. Overweight
C. Obese
D. Underweight
C – A BMI of 30 or above is classified as obese.
A patient with dysphagia is at risk for aspiration. Which is the highest nursing priority?
A. Encourage fluids with meals
B. Assess gag reflex before oral intake
C. Feed the patient while lying flat to prevent fatigue
D. Offer dry crackers to stimulate swallowing
B – Gag reflex assessment is critical before feeding to prevent aspiration.
A patient is admitted with dehydration. Which of the following urine specific gravity results supports this diagnosis?
A. 1.005
B. 1.010
C. 1.020
D. 1.035
Correct Answer: D – A urine specific gravity above 1.030 is consistent with dehydration.
A nurse is educating a newly diagnosed Type 1 DM patient. Which clinical feature is MOST characteristic of Type 1 diabetes?
A. Gradual onset, usually after age 40
B. Strong link to obesity
C. Complete lack of insulin production
D. Insulin resistance
C – Type 1 DM is characterized by autoimmune destruction of beta cells and no insulin production.
A nurse assesses a patient’s wound and notes edges separated with visible intestines. What is the priority action?
A. Apply sterile gloves and close the wound
B. Cover with a dry sterile dressing
C. Place the patient in high Fowler's position
D. Cover the wound with sterile saline-soaked gauze and notify the provider
D – Evisceration requires sterile, moist gauze and immediate provider notification.
Which patient education point is MOST appropriate when planning care for a patient with obesity?
A. “Focus on fasting as a primary method for weight loss.”
B. “Avoid all carbohydrates completely.”
C. “Gradual weight loss of 1–2 pounds per week is recommended.”
D. “Exercise is not necessary if diet is controlled.”
C – Slow, steady weight loss is safest and most sustainable.
A patient with dysphagia is prescribed a mechanical soft diet. Which food should the nurse remove from the patient’s meal tray?
A. Scrambled eggs
B. Applesauce
C. Toast with peanut butter
D. Mashed potatoes
C – Toast with peanut butter is thick, sticky, and poses an aspiration risk.
A nurse is providing education to a patient with hypercalcemia. Which statement by the patient indicates a need for further teaching?
A. “I should increase my fluid intake to help flush out calcium.”
B. “I need to stay active and keep moving as much as possible.”
C. “I can take calcium supplements to help prevent muscle cramps.”
D. “I should report any signs of confusion or fatigue to my provider.”
C – Calcium supplements can worsen hypercalcemia and are contraindicated.
A patient is admitted with suspected diabetic ketoacidosis (DKA). Which lab value is the nurse MOST likely to find?
A. Blood glucose 120 mg/dL
B. pH 7.40
C. Serum ketones present
D. Bicarbonate 24 mEq/L
C – Serum ketones are a hallmark of DKA.
Which patient is at the greatest risk for delayed wound healing?
A. A 25-year-old with a simple laceration
B. A 60-year-old with controlled diabetes
C. A 70-year-old on long-term corticosteroids
D. A 50-year-old with well-controlled hypertension
C – Corticosteroids impair collagen formation and delay wound healing.
A nurse is calculating BMI for a patient who is 5'6" (66 inches) tall and weighs 220 lbs. Which classification is correct?
A. Normal weight
B. Overweight
C. Obese
D. Underweight
C – BMI = (220 ÷ 66²) x 703 ≈ 35.5 → Obese
Which nursing intervention is MOST appropriate for preventing aspiration in a patient with dysphagia?
A. Encourage large bites to reduce meal time
B. Position patient flat to conserve energy
C. Encourage coughing during meals
D. Keep the patient upright during and after meals
D – Upright positioning helps prevent aspiration during swallowing.
A patient with fluid volume deficit is being assessed. Which of the following findings should the nurse expect?
A. Bounding pulse
B. Crackles in the lungs
C. Decreased skin turgor
D. Jugular vein distention
C – Decreased skin turgor is a classic sign of dehydration.
A nurse is caring for a patient with Cushing’s syndrome who also has diabetes. Which change in glucose management should the nurse anticipate?
A. Decreased need for insulin due to adrenal suppression
B. Increased insulin requirement due to corticosteroid use
C. No change in glucose levels
D. Discontinuation of oral hypoglycemics
B – Corticosteroids increase glucose levels, requiring higher insulin doses.
A patient with osteoporosis is prescribed alendronate. Which instruction should the nurse provide?
A. “Take with food to reduce stomach upset.”
B. “Lie down for 30 minutes after taking the medication.”
C. “Take first thing in the morning with a full glass of water and remain upright for 30 minutes.”
D. “Crush the tablet for easier swallowing.”
C – Alendronate can cause esophageal irritation, and remaining upright reduces this risk
When planning care for a patient with obesity, which nursing goal is the priority?
A. Encourage fasting to promote rapid weight loss
B. Promote lifestyle modifications that support gradual, sustainable weight loss
C. Recommend a high-protein, high-fat diet
D. Eliminate all carbohydrates from the diet
B – Sustainable lifestyle changes are the safest and most effective.
A nurse is feeding a patient with dysphagia. Which action should the nurse take?
A. Tilt the patient’s head back to help with swallowing.
B. Offer water to clear the mouth between each bite.
C. Place food on the unaffected side of the mouth.
D. Use a straw to encourage fluid intake.
C – Placing food on the unaffected side improves control and safety during swallowing.
A patient asks about the role of calcium in the body. Which explanation by the nurse is appropriate?
A. “Calcium only affects muscle contraction.”
B. “Calcium is important for bone strength, nerve transmission, and blood clotting.”
C. “Calcium is not affected by diet.”
D. “Calcium levels are not routinely monitored in hospitalized patients.”
B – Calcium plays multiple critical roles in the body.
A pregnant woman is diagnosed with gestational diabetes. Which statement indicates correct understanding of the condition?
A. “I will need insulin for the rest of my life.”
B. “Gestational diabetes doesn’t require any treatment.”
C. “I need to monitor my blood sugar to prevent complications during pregnancy.”
D. “It’s the same as Type 1 diabetes.”
C – Blood sugar control is vital to prevent maternal and fetal complications.
The nurse is assessing a client with a fracture. Which finding requires immediate intervention?
A. Bruising and swelling at the site
B. Complaints of pain with movement
C. Numbness and inability to move toes
D. Slight redness around the cast
C – Neurovascular compromise (numbness, inability to move) may indicate compartment syndrome.
A nurse is developing a care plan for an obese patient. Which short-term goal is most appropriate?
A. Patient will lose 25 pounds in one month.
B. Patient will verbalize three dietary changes by discharge.
C. Patient will achieve ideal BMI within two weeks.
D. Patient will avoid all fats and carbohydrates.
B – Realistic, education-based short-term goals are appropriate and measurable.
A patient with a recent stroke has developed dysphagia. What is the priority nursing intervention?
A. Allow the patient to rest after meals.
B. Keep the patient NPO until a swallowing evaluation is completed.
C. Provide regular diet with thickened liquids.
D. Encourage coughing during meals to aid in swallowing.
B – The patient should be NPO until a speech therapist evaluates swallowing to prevent aspiration.