NUR 242 EXAM 2 MOST TESTED QUESTIONS AND
ANSWERS GRADED A+ WITH RATIONALES
1. Which of the following is a risk factor for fluid overload?
A) Excessive fluid replacement
B) Hypokalemia
C) Hyperglycemia
D) Hypothyroidism
Answer: A) Excessive fluid replacement
Rationale: Excessive IV fluids or rapid fluid administration can lead to fluid overload, especially in
patients with compromised cardiac or renal function.
2. A patient with late-stage kidney failure is at risk for fluid overload because:
A) The kidneys cannot excrete excess fluid
B) The liver produces too much albumin
C) The adrenal glands secrete excess aldosterone
D) The pancreas fails to regulate glucose
Answer: A) The kidneys cannot excrete excess fluid
Rationale: In kidney failure, decreased glomerular filtration rate (GFR) leads to fluid retention.
3. Which condition is associated with Syndrome of Inappropriate Antidiuretic Hormone (SIADH)?
A) Fluid overload and hyponatremia
B) Hypernatremia and dehydration
C) Hypokalemia and metabolic acidosis
D) Hypercalcemia and polyuria
Answer: A) Fluid overload and hyponatremia
Rationale: SIADH causes water retention and dilutional hyponatremia.
4. A patient with fluid overload may exhibit which cardiovascular symptom?
A) Bounding pulse and hypertension
B) Weak, thready pulse and hypotension
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C) Bradycardia and low CVP
D) Absent peripheral pulses
Answer: A) Bounding pulse and hypertension
Rationale: Excess fluid increases blood volume, leading to a strong pulse and elevated BP.
5. Which respiratory finding is most indicative of fluid overload?
A) Crackles (rales) on auscultation
B) Wheezing and stridor
C) Diminished breath sounds
D) Prolonged expiration
Answer: A) Crackles (rales) on auscultation
Rationale: Pulmonary congestion from fluid overload causes crackles due to fluid in alveoli.
6. Which lab result would be expected in fluid overload?
A) Decreased serum sodium (<135 mEq/L)
B) Elevated hematocrit (>50%)
C) Increased BUN (>20 mg/dL)
D) Hyperkalemia (>5.0 mEq/L)
Answer: A) Decreased serum sodium (<135 mEq/L)
Rationale: Dilutional hyponatremia occurs due to excess water retention.
7. The nurse notes jugular vein distention (JVD) in a patient. This suggests:
A) Fluid overload
B) Hypovolemia
C) Hypoglycemia
D) Pulmonary embolism
Answer: A) Fluid overload
Rationale: JVD indicates increased venous pressure from excess fluid volume.
8. Which intervention is most appropriate for managing fluid overload?
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A) Administer furosemide (Lasix)
B) Increase oral fluid intake
C) Infuse 0.9% NaCl rapidly
D) Encourage high-sodium foods
Answer: A) Administer furosemide (Lasix)
Rationale: Loop diuretics promote fluid excretion in overload states.
9. A complication of severe fluid overload is:
A) Pulmonary edema
B) Hypovolemic shock
C) Metabolic alkalosis
D) Hypoglycemia
Answer: A) Pulmonary edema
Rationale: Fluid shifts into lung tissue, impairing gas exchange.
10. Which medication is an osmotic diuretic used for fluid overload?
A) Mannitol
B) Metoprolol
C) Insulin
D) Acetaminophen
Answer: A) Mannitol
Rationale: Mannitol pulls fluid from tissues into the bloodstream for excretion.
Dehydration
11. A key symptom of dehydration is:
A) Dry mucous membranes
B) Bounding pulse
C) Jugular vein distension
D) Crackles in lungs
Answer: A) Dry mucous membranes
Rationale: Reduced fluid volume decreases saliva and mucosal moisture.
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12. Which vital sign change is most indicative of dehydration?
A) Tachycardia and hypotension
B) Bradycardia and hypertension
C) Normal HR and elevated BP
D) Irregular pulse and fever
Answer: A) Tachycardia and hypotension
Rationale: Low blood volume triggers compensatory tachycardia and low BP.
13. A dehydrated patient may exhibit:
A) Decreased skin turgor
B) Pitting edema
C) Moist skin
D) Weight gain
Answer: A) Decreased skin turgor
Rationale: Skin loses elasticity due to fluid loss.
14. Which lab finding supports dehydration?
A) Elevated hematocrit
B) Low serum osmolality
C) Decreased BUN
D) Hyponatremia
Answer: A) Elevated hematocrit
Rationale: Hemoconcentration occurs with fluid loss.
15. A patient with severe dehydration is at risk for:
A) Hypovolemic shock
B) Fluid overload
C) Pulmonary edema
D) Hypervolemia
Answer: A) Hypovolemic shock
Rationale: Extreme fluid loss reduces perfusion, leading to shock.
16. A patient with severe vomiting and diarrhea is at high risk for: