N120 Managing Care of Adults I Exam 1 2026/2027
Summer/Fall Questions And Correct Answers Graded
A+
A patient with multiple draining wounds is admitted for hypovolemia. Which
information
would provide the most accurate way for the nurse to evaluate fluid balance?
a. Skin turgor
b. Daily weight
c. Urine output
d. Edema presence
ANS: B
Daily weight is the most easily obtained and accurate means of assessing volume
status. Skin turgor varies considerably with age. Considerable excess fluid volume
may be present before fluid moves into the interstitial space and causes edema.
Urine outputs do not take account of fluid intake or of fluid loss through insensible
loss, sweating, or loss from the gastrointestinal tract or wounds.
,The home health nurse cares for an alert and oriented older adult patient who has a
history of
dehydration. Which instruction would the nurse give this patient?
a. "Drink more fluids in the late evening."
b. "More fluids are needed if you feel thirsty."
c. "Increase the fluids if your mouth feels dry."
d. "If you feel confused, you need more fluids."
ANS: C
An alert older patient will be able to self-assess for signs of oral dryness such as
thick oral secretions or dry-appearing mucosa. The thirst mechanism decreases
with age and is not an accurate indicator of volume depletion. Many older patients
prefer to restrict fluids slightly in the evening to improve sleep quality. The patient
will not be likely to notice and act appropriately when changes in level of
consciousness occur.
The nurse is caring for a patient who has a massive burn injury and possible
hypovolemia.
Which assessment data would be of most concern to the nurse?
a. Urine output is 30 mL/hr.
b. Blood pressure is 90/40 mm Hg.
c. Oral fluid intake is 100 mL for 8 hours.
,d. Skin tenting over the sternum is prolonged.
ANS: B
The blood pressure indicates that the patient may be developing hypovolemic
shock because of intravascular fluid loss from the burn injury. This finding will
require immediate intervention to prevent the complications associated with
systemic hypoperfusion. The poor oral intake, decreased urine output, and skin
tenting all indicate the need for increasing the patient's fluid intake but not as
urgently as the hypotension.
A patient who has a small cell cancer of the lung develops syndrome of
inappropriate
antidiuretic hormone (SIADH). The nurse would notify the health care provider
about which
assessment finding?
a. Serum hematocrit of 42%
b. Serum sodium of 120 mg/dL
c. Urinary output of 280 mL in 8 hours
d. Reported weight gain of 2.2 pounds (1 kg)
ANS: B
Hyponatremia is the most important finding to report. SIADH causes water
retention and a decrease in serum sodium level. Hyponatremia can cause confusion
and other central nervous system effects. A critically low value needs to be treated.
At least 30 mL/hr of urine output indicates adequate kidney function. The
hematocrit level is normal. Weight gain is expected with SIADH because of water
retention.
, A patient who is taking a potassium-depleting diuretic for treatment of
hypertension reports
generalized weakness. Which action would the nurse to take?
a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Recommend the patient avoid drinking orange juice with meals.
d. Suggest that the health care provider order a basic metabolic panel.
ANS: D
Generalized weakness is a manifestation of hypokalemia. After the health care
provider orders
the metabolic panel, the nurse should check the potassium level. Facial muscle
spasms might
occur with hypocalcemia. Orange juice is high in potassium and would be
advisable to drink
if the patient is hypokalemic. Loose stools are associated with hyperkalemia.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient.
Which
statement by the patient indicates that the teaching about this medication has been
effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast."
ANS: D
Because spironolactone is a potassium-sparing diuretic, teach patients to choose
Summer/Fall Questions And Correct Answers Graded
A+
A patient with multiple draining wounds is admitted for hypovolemia. Which
information
would provide the most accurate way for the nurse to evaluate fluid balance?
a. Skin turgor
b. Daily weight
c. Urine output
d. Edema presence
ANS: B
Daily weight is the most easily obtained and accurate means of assessing volume
status. Skin turgor varies considerably with age. Considerable excess fluid volume
may be present before fluid moves into the interstitial space and causes edema.
Urine outputs do not take account of fluid intake or of fluid loss through insensible
loss, sweating, or loss from the gastrointestinal tract or wounds.
,The home health nurse cares for an alert and oriented older adult patient who has a
history of
dehydration. Which instruction would the nurse give this patient?
a. "Drink more fluids in the late evening."
b. "More fluids are needed if you feel thirsty."
c. "Increase the fluids if your mouth feels dry."
d. "If you feel confused, you need more fluids."
ANS: C
An alert older patient will be able to self-assess for signs of oral dryness such as
thick oral secretions or dry-appearing mucosa. The thirst mechanism decreases
with age and is not an accurate indicator of volume depletion. Many older patients
prefer to restrict fluids slightly in the evening to improve sleep quality. The patient
will not be likely to notice and act appropriately when changes in level of
consciousness occur.
The nurse is caring for a patient who has a massive burn injury and possible
hypovolemia.
Which assessment data would be of most concern to the nurse?
a. Urine output is 30 mL/hr.
b. Blood pressure is 90/40 mm Hg.
c. Oral fluid intake is 100 mL for 8 hours.
,d. Skin tenting over the sternum is prolonged.
ANS: B
The blood pressure indicates that the patient may be developing hypovolemic
shock because of intravascular fluid loss from the burn injury. This finding will
require immediate intervention to prevent the complications associated with
systemic hypoperfusion. The poor oral intake, decreased urine output, and skin
tenting all indicate the need for increasing the patient's fluid intake but not as
urgently as the hypotension.
A patient who has a small cell cancer of the lung develops syndrome of
inappropriate
antidiuretic hormone (SIADH). The nurse would notify the health care provider
about which
assessment finding?
a. Serum hematocrit of 42%
b. Serum sodium of 120 mg/dL
c. Urinary output of 280 mL in 8 hours
d. Reported weight gain of 2.2 pounds (1 kg)
ANS: B
Hyponatremia is the most important finding to report. SIADH causes water
retention and a decrease in serum sodium level. Hyponatremia can cause confusion
and other central nervous system effects. A critically low value needs to be treated.
At least 30 mL/hr of urine output indicates adequate kidney function. The
hematocrit level is normal. Weight gain is expected with SIADH because of water
retention.
, A patient who is taking a potassium-depleting diuretic for treatment of
hypertension reports
generalized weakness. Which action would the nurse to take?
a. Assess for facial muscle spasms.
b. Ask the patient about loose stools.
c. Recommend the patient avoid drinking orange juice with meals.
d. Suggest that the health care provider order a basic metabolic panel.
ANS: D
Generalized weakness is a manifestation of hypokalemia. After the health care
provider orders
the metabolic panel, the nurse should check the potassium level. Facial muscle
spasms might
occur with hypocalcemia. Orange juice is high in potassium and would be
advisable to drink
if the patient is hypokalemic. Loose stools are associated with hyperkalemia.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient.
Which
statement by the patient indicates that the teaching about this medication has been
effective?
a. "I will try to drink at least 8 glasses of water every day."
b. "I will use a salt substitute to decrease my sodium intake."
c. "I will increase my intake of potassium-containing foods."
d. "I will drink apple juice instead of orange juice for breakfast."
ANS: D
Because spironolactone is a potassium-sparing diuretic, teach patients to choose
