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QUESTION #1
Fundamentals of Nursing Exam 2 Fundamentals
A client is admitted to the hospital for a fever of unknown origin. The nursing assessment reveals profuse diaphoresis; dry, sticky mucous membranes; weakness; disorientation; and a decreasing level of consciousness. The data suggest which of the following electrolyte imbalances?
A Hyperkalemia
B Hypercalcemia
C Hypernatremia
D Hypermagnesemia

Explanations

A
Hyperkalemia primarily affects cardiac rhythm and neuromuscular function and does not cause dry mucous membranes or severe dehydration signs.
B
Hypercalcemia may cause lethargy and confusion but is not typically associated with profuse diaphoresis and severe fluid loss.
C
Excessive fluid loss from fever and diaphoresis leads to concentrated sodium levels, causing dehydration, dry mucous membranes, and neurological changes.
D
Hypermagnesemia causes hypotension, respiratory depression, and decreased reflexes, usually related to renal failure or magnesium overuse.
QUESTION #2
Fundamentals of Nursing Exam 2 Fundamentals
A client is admitted to the hospital with thrombocytopenia and is in need of a platelet transfusion. Which statement accurately describes the primary function of platelets?
A “Platelets are used when antibiotic therapy is ineffective.”
B “Platelets are effective in increasing blood volume.”
C “Platelets are effective in raising hematocrit and hemoglobin levels.
D “Platelets help the clotting process by sticking to the lining of the blood vessels.”

Explanations

A
Platelets have no role in fighting infection or replacing antibiotic therapy.
B
Blood volume is increased by fluids or packed red blood cells, not platelets.
C
Hematocrit and hemoglobin levels are increased by red blood cell transfusions, not platelets.
D
Platelets adhere to damaged vessel walls and form a plug to initiate clot formation and prevent bleeding.
QUESTION #3
Fundamentals of Nursing Exam 2 Fundamentals
The nurse suspects that an older adult may have a fluid and electrolyte imbalance. Which assessment best reflects fluid and electrolyte balance in an older adult?
A Serum laboratory values
B Intake and output results
C Condition of the skin
D Presence of tenting

Explanations

A
Lab values such as sodium, potassium, BUN, and creatinine provide the most accurate and objective reflection of fluid and electrolyte status in older adults.
B
I&O is helpful but may be inaccurate or incomplete and does not directly measure electrolyte balance.
C
Skin changes are unreliable indicators in older adults due to normal age-related loss of skin elasticity.
D
Skin tenting is an unreliable sign of dehydration in older adults because of decreased turgor with aging.
QUESTION #4
Fundamentals of Nursing Exam 2 Fundamentals
Which should a nurse do to encourage a confused client to drink more fluid?
A Serve fluid at a tepid temperature.
B Explain the reason for the desired intake.
C Offer the client something to drink every hour.
D Leave a pitcher of water at the client’s bedside.

Explanations

A
Temperature preference varies and does not reliably increase intake in a confused client.
B
A confused client may not understand or retain explanations, making this ineffective.
C
Frequent, simple prompting is the most effective way to increase fluid intake in confused clients.
D
A confused client may not recognize thirst or remember to drink independently.
QUESTION #5
Fundamentals of Nursing Exam 2 Fundamentals
Hydrochlorothiazide, a diuretic, is prescribed for a client who is retaining fluid. The nurse should encourage the client to ingest nutrients that contain which electrolyte?
A Magnesium
B Potassium
C Calcium
D Sodium

Explanations

A
Magnesium levels may be affected by diuretics, but potassium loss is the most clinically significant concern with hydrochlorothiazide.
B
Thiazide diuretics increase urinary potassium excretion, placing the client at risk for hypokalemia unless potassium intake is increased.
C
Thiazide diuretics actually decrease calcium excretion and may increase serum calcium levels.
D
Sodium intake should be limited, not increased, because excess sodium promotes fluid retention.
QUESTION #6
Fundamentals of Nursing Exam 2 Fundamentals
The nurse evaluates a client’s fluid balance by monitoring the client’s intake and output. Which must the nurse understand about the ratio of the client’s fluid intake to output?
A Intake should be much higher than the fluid output.
B Intake should be slightly more than the output.
C Intake should be lower than the urine output.
D Intake should be equal to the urine output.

Explanations

A
Excessively higher intake can lead to fluid overload and is not normal for balanced fluid status.
B
Intake normally exceeds output slightly to account for insensible losses such as perspiration and respiration.
C
This would place the client at risk for dehydration and hypovolemia.
D
Output includes more than urine alone, so intake must be slightly higher to maintain balance.
QUESTION #7
Fundamentals of Nursing Exam 2 Fundamentals
A client has been blind in one eye for several years because of complications associated with diabetes mellitus. The client is admitted to the hospital with a detached retina that results in loss of sight in the other eye. Which should the nurse do to assist this client with meals?
A Explain to the client where items are located on the plate according to the hours of a clock.
B Encourage eating one food at a time according to the preference of the client.
C Order finger foods that are permitted on the client’s diet.
D Feed the client the prescribed meals.

Explanations

A
The clock-face method promotes independence and allows a newly blind client to locate food safely and confidently.
B
This does not adequately help the client identify food placement and may increase frustration.
C
Finger foods may help but do not promote full independence or address orientation to meal setup.
D
Feeding the client reduces independence and should only be done if the client cannot safely feed themselves.
QUESTION #8
Fundamentals of Nursing Exam 2 Fundamentals
The nurse is reviewing the laboratory findings of a client to assess the client’s nutritional status. Which of the following laboratory results is an indicator of inadequate protein intake?
A High hemoglobin
B Low serum albumin
C Low specific gravity
D High blood urea nitrogen

Explanations

A
Elevated hemoglobin is not associated with protein deficiency and more commonly reflects dehydration or polycythemia.
B
Albumin is a protein synthesized by the liver, and low levels indicate poor protein intake or impaired protein synthesis.
C
Low urine specific gravity reflects dilute urine or hydration status, not protein intake.
D
Elevated BUN is often related to dehydration or renal impairment rather than inadequate protein intake.
QUESTION #9
Fundamentals of Nursing Exam 2 Fundamentals
An occupational health nurse is facilitating a group discussion on weight reduction. Which of the following is the most common contributing factor to obesity?
A Sedentary lifestyle
B Low metabolic rate
C Hormonal imbalance
D Excessive caloric intake

Explanations

A
Lack of physical activity contributes to weight gain, but obesity most commonly results from caloric intake exceeding energy expenditure.
B
True metabolic disorders are relatively uncommon causes of obesity in the general population.
C
Endocrine disorders such as hypothyroidism account for a small percentage of obesity cases.
D
Consistently consuming more calories than the body needs is the primary and most common cause of obesity.
QUESTION #10
Fundamentals of Nursing Exam 2 Fundamentals
An older adult tends to bruise easily, and the primary health-care provider recommends that the client eat foods high in vitamin K. In addition to teaching the client about food sources of vitamin K, the nurse should include nutrients that must be ingested for vitamin K to be absorbed. Which foods that increase the absorption of vitamin K should be included in the teaching plan?
A Carbohydrates
B Starches
C Proteins
D Fats

Explanations

A
Carbohydrates do not play a role in the absorption of fat-soluble vitamins such as vitamin K.
B
Starches are a type of carbohydrate and do not enhance vitamin K absorption.
C
Proteins are essential for tissue repair and enzymes but are not required for vitamin K absorption.
D
Vitamin K is a fat-soluble vitamin and requires dietary fat for proper absorption in the gastrointestinal tract.
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