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Chapter 25 Question 1 The nurse is planning the care of a 50-year-old patient with the risk of developing fluid volume deficit. Which assessment finding would have the greatest contribution to this risk? 1. Loose bowel movement one per day 2. First-degree steam burn on hand and forearm 3. Temperature of 99.6° F 4. Diuretic therapy two doses per day Question 2 A patient in the intensive care unit has developed gastrointestinal hemorrhage. The nurse would prepare to fluid resuscitate this patient with which intravenous fluid? 1. 5% dextrose and 0.45% normal saline 2. 2.5% dextrose 3. 0.45% normal saline 4. 0.9% normal saline Question 3 The nurse is assessing the effectiveness of fluid replacement therapy in a patient with the nursing diagnosis of Fluid Volume Deficit. Which assessment findings would indicate the therapy is effective? 1. Blood pressure 90/48 mm Hg 2. Weight gain of 2 pounds since yesterday 3. Urine output increase to 40 mL per hour 4. Tenting of skin 5. Serum osmolality of 284 mOm/kg Question 4 A patient with fluid volume excess has a hemoglobin level of 9.0 mg/dL. How would the nurse explain the more likely cause of this laboratory value? 1. An undiagnosed bleeding disorder exists. 2. The patient has chronic anemia. 3. The patient has iron deficiency anemia. 4. Plasma dilution has occurred due to excess fluid. Question 5 A patient being treated for fluid volume excess has blood glucose elevation. The nurse would review the patient’s medication history for which medication? 1. Furosemide (Lasix) 2. Spironolactone (Aldactone) 3. Potassium chloride (K-Dur) 4. Hydrochlorothiazide (Esidrix) Question 6 A patient comes into the emergency department with complaints of feeling weak, confused, and having abdominal cramps after spending several hours in the hot sun attending a baseball game. The patient’s blood pressure is 96/58 mm Hg. The nurse would conduct additional assessment for which condition? 1. Hyponatremia 2. Hypercalcemia 3. Hypernatremia 4. Hypocalcemia Question 7 The nurse is preparing intravenous fluids for a patient whose serum sodium is 156 mmol/L. Which types of fluid would the nurse select? 1. 10% dextrose in water 2. Lactated Ringer’s 3. 0.45% normal saline 4. 5% dextrose and 0.45% normal saline Question 8 A patient is receiving several units of packed red blood cells over several days to replace the blood lost during an active gastrointestinal bleed. The nurse would assess this patient for findings associated with which electrolyte imbalance? 1. Hyponatremia 2. Hypercalcemia 3. Hypokalemia 4. Hypomagnesaemia Question 9 A patient has a serum calcium level of 7.9 mg/dL. Which nursing interventions would be appropriate for this patient? 1. Treat tachycardia. 2. Monitor for the development of hypertension. 3. Place on seizure precautions. 4. Strain all urine. 5. Reorient as indicated. Question 10 A patient has a serum calcium level of 11.0 mg/dL. The nurse would review this patient’s medical record for which conditions? 1. History of taking thiazide diuretics 2. Diagnosis of hyperparathyroidism 3. Diagnosis of acute pancreatitis 4. Low serum magnesium level 5. Long term bedrest