HESI Case Study: Fluid Balance – Questions With
Precise Solutions
An older adult with CAD and HTN was brought to the ED by her daughter
because she has become increasingly weak and confused. The client was
found by a neighbor wandering her neighborhood unable to locate her home.
The client's daughter tells the RN that her mother takes a "water pill" for her
BP 2-3x/day. The label on the med bottle that she brought to the hospital
states, "hydrochlorothiazide. Take 1 tablet daily". The client is admitted with
fluid volume deficit.
Vital signs: Orthostatic Changes
Since the client has a fluid volume deficit, the nurse anticipates a decrease in
which VS when she changes position?
a. Respiratory rate
b. BP
c. Temp
d. Pulse rate Accurate Answer:- BP
The nurse plans to assess the client for orthostatic VS changes. Which action
will the nurse take first?
a. Assist the client to a standing position
b. Position the client in a supine position
c. Elevate the head of the client's bed
d. Dangle the client's feet at the bedside Accurate Answer:- Position the
client in a supine position
The nurse takes the first BP measurement. After recording the first BP
measurement, what action will the nurse take?
a. Count the client's radial pulse rate
b. Remove the BP cuff
c. Help the client change positions
d. Assess for an auscultatory gap Accurate Answer:- Count the client's
radial pulse rate
, Age-related Risk Factors
The nurse discusses factors that contributed to the client's fluid volume deficit
with her and her daughter, and receives orders for labs to be obtained.
Which problem often occurs in older client's and may have contributed to the
fluid volume deficit the client is experiencing?
a. Decreased hepatic blood flow
b. Decreased drug absorption
c. Decrease drug half-life
d. Decreased GI acidity Accurate Answer:- Decreased hepatic blood
flow
The nurse is aware that older clients often experience an increase in the
amount of free, unbound drug molecules, which has the potential to increase
the pharmacological effects of the drug.
Which lab test will the nurse monitor to determine if this may be a factor
contributing to the client's problem?
a. Serum creatinine
b. Serum protein
c. AST
d. BUN Accurate Answer:- Serum protein
Which labs would the nurse expect the HCP to order? (choose all that apply)
a. BUN
b. Serum creatine
c. Urine specific gravity and osmolality
d. Liver function panel
e. None of these Accurate Answer:- BUN
Serum creatine
Urine specific gravity and osmolality
Liver function panel
Assessment
Precise Solutions
An older adult with CAD and HTN was brought to the ED by her daughter
because she has become increasingly weak and confused. The client was
found by a neighbor wandering her neighborhood unable to locate her home.
The client's daughter tells the RN that her mother takes a "water pill" for her
BP 2-3x/day. The label on the med bottle that she brought to the hospital
states, "hydrochlorothiazide. Take 1 tablet daily". The client is admitted with
fluid volume deficit.
Vital signs: Orthostatic Changes
Since the client has a fluid volume deficit, the nurse anticipates a decrease in
which VS when she changes position?
a. Respiratory rate
b. BP
c. Temp
d. Pulse rate Accurate Answer:- BP
The nurse plans to assess the client for orthostatic VS changes. Which action
will the nurse take first?
a. Assist the client to a standing position
b. Position the client in a supine position
c. Elevate the head of the client's bed
d. Dangle the client's feet at the bedside Accurate Answer:- Position the
client in a supine position
The nurse takes the first BP measurement. After recording the first BP
measurement, what action will the nurse take?
a. Count the client's radial pulse rate
b. Remove the BP cuff
c. Help the client change positions
d. Assess for an auscultatory gap Accurate Answer:- Count the client's
radial pulse rate
, Age-related Risk Factors
The nurse discusses factors that contributed to the client's fluid volume deficit
with her and her daughter, and receives orders for labs to be obtained.
Which problem often occurs in older client's and may have contributed to the
fluid volume deficit the client is experiencing?
a. Decreased hepatic blood flow
b. Decreased drug absorption
c. Decrease drug half-life
d. Decreased GI acidity Accurate Answer:- Decreased hepatic blood
flow
The nurse is aware that older clients often experience an increase in the
amount of free, unbound drug molecules, which has the potential to increase
the pharmacological effects of the drug.
Which lab test will the nurse monitor to determine if this may be a factor
contributing to the client's problem?
a. Serum creatinine
b. Serum protein
c. AST
d. BUN Accurate Answer:- Serum protein
Which labs would the nurse expect the HCP to order? (choose all that apply)
a. BUN
b. Serum creatine
c. Urine specific gravity and osmolality
d. Liver function panel
e. None of these Accurate Answer:- BUN
Serum creatine
Urine specific gravity and osmolality
Liver function panel
Assessment
