Foundation Exam #5 Summer 2025
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Free Foundation Exam #5 Summer 2025 Questions
1. 18. The healthcare provider (HCP) has ordered a hypotonic intravenous (IV) solution to be administered. Which IV bag will the nurse prepare?
- A. 0.45% Normal Saline
- B. Dextrose 5% in Lactated Ringers
- C. Lactated Ringers (LR)
- D. 0.9% Normal Saline
Explanation
A hypotonic IV solution has a lower osmolarity than plasma, causing water to move from the extracellular space into the cells. 0.45% Normal Saline (½ NS) is hypotonic and is used to treat conditions such as cellular dehydration or hypernatremia. It helps rehydrate cells without adding excess sodium to the bloodstream.
2. 28. A client's labs have just resulted in the EHR. The nurse notes which of the following laboratory values is an acidotic pH?
- A. pH of 7.38
- B. pH of 7.4
- C. pH of 7.0
- D. pH of 7.7
Explanation
The normal blood pH range is 7.35 to 7.45. A pH below 7.35 indicates acidosis, meaning there is an excess of hydrogen ions or a loss of bicarbonate, which can result from conditions such as respiratory failure, diabetic ketoacidosis, or renal dysfunction. A pH of 7.0 is significantly acidotic and can lead to impaired cellular function and cardiac instability if not corrected promptly.
3. 10. The nurse administers 0.45% Normal Saline intravenous (IV) to a client. In which direction will the fluid shift?
- A. Intracellular to Extracellular
- B. Extracellular to Intracellular
- C. Hypercellular to Interstitial
- D. Hypertonic to Homeostatic
Explanation
0.45% Normal Saline is a hypotonic IV solution, meaning it has a lower solute concentration than plasma. When infused, water moves from the extracellular space (blood and interstitial fluid) into the intracellular space (cells) to balance osmotic pressure. This shift causes cells to swell as they take in water. Hypotonic fluids are often used to treat cellular dehydration, such as in diabetic ketoacidosis (DKA) or hypernatremia.
4. 38. The nurse prepares an 80-year-old client with type 2 diabetes for hip replacement surgery. The client weighs 400 pounds and is 5 feet 2 inches tall and smokes 2 packs of cigarettes per day. Which factors increase this client's risk for surgical complications? Select all that apply. One, some, or all options may be correct.
- A. Delayed wound healing
- B. Obesity
- C. No family history of anesthesia complications
- D. Good clotting times are shown in the client's labs
- E. Age
Explanation
A. Delayed wound healing: This client has type 2 diabetes and smokes heavily, both of which impair circulation and oxygenation to tissues, resulting in delayed wound healing and increased risk for infection after surgery. B. Obesity: The client’s extreme obesity (400 lbs, 5'2") increases the risk for respiratory compromise, wound dehiscence, poor circulation, and difficulty with anesthesia and postoperative mobility, making recovery more challenging. E. Age: At 80 years old, the client’s decreased physiological reserve, slower metabolism, and reduced organ function increase the likelihood of postoperative complications such as pneumonia, infection, or delayed healing.
5. 22. While planning care for a client, a nurse understands that providing integrative care includes treating which of the following?
- A. Mind-body-spirit of clients.
- B. Disease, spirit, and family interactions.
- C. Desires and emotions of the client.
- D. Muscles, nerves, and spine disorders.
Explanation
Integrative care focuses on treating the whole person—the mind, body, and spirit—rather than just the disease. It blends conventional medical treatments with evidence-based complementary therapies to support overall wellness, balance, and healing. This approach emphasizes the client’s physical, emotional, mental, and spiritual needs, promoting harmony and self-care for long-term health.
6. 1. The health care provider (HCP) asks the nurse to monitor the fluid volume status of a client diagnosed with heart failure and a second client at risk for clinical dehydration. The nurse knows that which task is the most effective nursing intervention for monitoring both of these clients?
- A. Assess each client's self-charting of I/Os.
- B. Administer extra IV fluids to both clients.
- C. Weigh each client every morning.
- D. Assess calcium levels for both clients now.
Explanation
Daily weight measurement is the most reliable and effective indicator of fluid volume status in both heart failure and dehydration. A sudden weight gain indicates fluid retention (as seen in heart failure), while weight loss suggests fluid deficit (as in dehydration). Monitoring weights at the same time each day, on the same scale, and under similar conditions provides consistent data to evaluate fluid balance accurately.
7. 11. Which of the following scenarios demonstrate that client learning has taken place?
- A. A client listens to a nurse's review of the warning signs of a stroke.
- B. A client demonstrates how to take his blood pressure at home.
- C. A client reviews written information about resources for cancer survivors.
- D. A client attends a spinal cord injury support group.
Explanation
Learning is demonstrated by a change in behavior or the application of knowledge. When the client demonstrates how to take his blood pressure at home, it shows that he has not only received information but also understood and applied it correctly, reflecting effective teaching and learning. Psychomotor skill demonstration is a clear, observable indicator that learning has occurred.
8. 5. A client’s labs have just resulted in the EHR. The nurse notes which of the following laboratory values is a basic pH?
- A. pH of 7.6
- B. pH of 7.2
- C. pH of 7.35
- D. pH of 7.3
Explanation
The normal blood pH range is 7.35 to 7.45. A pH greater than 7.45 indicates alkalosis (basic pH), while a pH below 7.35 indicates acidosis. Therefore, a pH of 7.6 reflects a basic or alkaline state, suggesting that the client may be experiencing metabolic or respiratory alkalosis. The nurse should assess for potential causes such as hyperventilation, excessive vomiting, or overuse of antacids.
9. 37. A client with fluid volume deficit has oxygen saturation level of 90%, serum sodium of 142 mEq/L, serum chloride 106 mEq/L, serum magnesium 2.2 mg/dL, albumin 4 g/dL, AST 30 U/L, and serum potassium of 2.9 mEq/L from daily labs. The nurse reports to the healthcare provider her assessment and lab findings. Which laboratory result is critical and should the nurse have the HCP repeat back?
- A. Chloride 106 mEq/L
- B. Magnesium 2.2 mg/dL
- C. Potassium 2.9 mEq/L
- D. Sodium 142 mEq/L
Explanation
A potassium level of 2.9 mEq/L indicates hypokalemia, which is a critical electrolyte imbalance. Potassium is essential for cardiac electrical conduction and muscle contraction. Low levels can cause life-threatening arrhythmias, muscle weakness, and respiratory compromise. This finding must be reported immediately, and the nurse should have the provider repeat back the value to confirm understanding and ensure prompt intervention, such as potassium replacement and cardiac monitoring.
10. 20. During a dressing change, the client tells the nurse that he closes his eyes and thinks about waves coming up on the beach. He states this helps with pain and anxiety associated with dressing changes. The nurse recognizes this client is using which CAM practice?
- A. Tai Chi
- B. Reiki Therapy
- C. Guided Imagery
- D. Prayer
Explanation
Guided imagery is a complementary and alternative medicine (CAM) practice that uses mental visualization to promote relaxation and reduce pain or anxiety. By imagining soothing scenes, such as ocean waves or peaceful landscapes, the client can calm the mind, reduce stress responses, and lower pain perception. It is often used during medical procedures, wound care, or anxiety-provoking situations to enhance comfort.
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