Fluid, Electrolyte, And Acid Base Problems (Practice Mode)
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- 1.A client’s nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to the fluid management should be delegated to a nursing assistant?
- A.
Administer IV fluids as prescribed by the physician.
- B.
Provide straws and offer fluids between meals.
- C.
Develop plan for added fluid intake over 24 hours
- D.
Teach family members to assist client with fluid intake
- 2.The client also has the nursing diagnosis Decreased Cardiac Output related to decrease plasma volume. Which finding on assessment supports this nursing diagnosis?
- A.
Flattened neck veins when client is in supine position
- B.
Full and bounding pedal and post-tibial pulses
- C.
Pitting edema located in feet, ankles, and calves
- D.
Shallow respirations with crackles on auscultation
- 3.The nursing care plan for the client with dehydration includes interventions for oral health. Which interventions are within the scope of practice for the LPN/LVN being supervised by the nurse? (Choose all that apply.)
- A.
Remind client to avoid commercial mouthwashes.
- B.
Encourage mouth rinsing with warm saline.
- C.
Assess lips, tongue, and mucous membranes
- D.
Provide mouth care every 2 hours while client is awake
- E.
Seek dietary consult to increase fluids on meal trays.
- 4.The physician has written the following orders for the client with Excess Fluid volume. The client’s morning assessment includes bounding peripheral pulses, weight gain of 2 pounds, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time?
- A.
Weight client every morning.
- B.
Maintain accurate intake and output.
- C.
Restrict fluid to 1500 mL per day
- D.
Administer furosemide (Lasix) 40 mg IV push
- 5.You have been pulled to the telemetry unit for the day. The monitor informs you that the client has developed prominent U waves. Which laboratory value should you check immediately?
- A.
Sodium
- B.
Potassium
- C.
Magnesium
- D.
Calcium
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