FOUNDATIONS OF PROFESSIONAL
NURSING: CASE STUDIES QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
Fluid Balance Case Study (exam 3) - ANSWER
Since Clara has a fluid volume deficit, the nurse anticipates a decrease in which vital sign when Clara
changes postiiton? - ANSWER blood pressure
The nurse plans to assess Clara for orthostatic vital sign changes. What action will the nurse take first? -
ANSWER Position Clara in a supine position
The nurse takes the first blood pressure measurement. After recording the first blood pressure
measurement, what action will the nurse take? - ANSWER Count the client's radial pulse rate
In addition to obtaining Clara's vital signs, the nurse performs additional assessments. For ongoing
evaluation of Clara's fluid volume status, it is most important to obtain which assessment data? -
ANSWER Body weight
The nurse continues to assess the client and observes that Clara's skin tents when a fold of skin over her
sternum is pinched. What action should the nurse implement? - ANSWER Document the presence of
inelastic skin turgor
Clara's daughter reports that her mother usually weighs about 137 lbs. and is 5 feet, 3 inches in height.
The nurse weighs Clara and obtains a measurement of 60 kg. The nurse explains to Clara's daughter that
Clara has lost approximately how many pounds? - ANSWER 5 lbs
60x2.2 lbs=132 lbs
137-132=5
The nurse discusses factors that contributed to Clara's fluid volume deficit with Clara and her daughter.
Which problem often occurs in the elderly and may have contributed to the fluid volume deficit Clara is
experiencing? - ANSWER Decreased hepatic blood flow
, The nurse is aware that the elderly 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 Clara's problem? - ANSWER
serum protein= drug molecules may be distributed through the body bound to plasma protein
molecules.
The nurse starts an intravenous line to administer fluids. The prescription states, "3% Normal Saline to
infuse at 100 ml/hour." The client's most recent serum sodium level is 135 mEq/L. What action should
the nurse take? - ANSWER obtain appropriante IV fluid prescription
A short while later, a prescription for 0.9% Normal Saline at 100 ml/hour is received. Clara's primary
nurse is at lunch, so another nurse hangs the solution. When checking Clara upon returning from lunch,
the primary nurse observes that a solution of 5% Dextrose and 0.9% Normal Saline is infusing at 125
ml/hour. What action should the primary nurse implement? - ANSWER Change the currently infusing
solution to 0.9% Normal Saline and change the rate to 100 ml/hour.
After hanging the correct IV solution at the correct rate of infusion, the nurse discusses the error with
the nurse who hung the first IV solution. Together, the nurses complete a variance (incident) report.
What additional action should the primary nurse take? - ANSWER Notify the healthcare provider of the
error in treatment that occurred.
The nurse who made the errors is very upset about writing a variance (incident) report and states, "I've
never made an error before. What if I get fired?" How should the primary nurse respond? - ANSWER
"Variance reports are used to find ways to prevent further errors." Variance reports are used by the risk
management department of healthcare agencies to look for patterns that contribute to errors so that
preventative measures can be institututed
Later that day, Clara's IV pump alarm sounds. The nurse notes that the IV is not infusing in the right
antecubital area, and the alarm indicates an obstruction is present. The nurse determines that all the
clamps are open and there are no kinks in the tubing. What intervention should the nurse take next? -
ANSWER Straighten the joint above the site
The nurse resolves the obstruction, and the IV solution begins to infuse. The next day the nurse observes
that the IV insertion site is inflamed and tender. The label on the IV site indicates the current IV has been
in place for 36 hours. What action should the nurse take? - ANSWER Remove the IV and restart it in a
different location.
NURSING: CASE STUDIES QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
Fluid Balance Case Study (exam 3) - ANSWER
Since Clara has a fluid volume deficit, the nurse anticipates a decrease in which vital sign when Clara
changes postiiton? - ANSWER blood pressure
The nurse plans to assess Clara for orthostatic vital sign changes. What action will the nurse take first? -
ANSWER Position Clara in a supine position
The nurse takes the first blood pressure measurement. After recording the first blood pressure
measurement, what action will the nurse take? - ANSWER Count the client's radial pulse rate
In addition to obtaining Clara's vital signs, the nurse performs additional assessments. For ongoing
evaluation of Clara's fluid volume status, it is most important to obtain which assessment data? -
ANSWER Body weight
The nurse continues to assess the client and observes that Clara's skin tents when a fold of skin over her
sternum is pinched. What action should the nurse implement? - ANSWER Document the presence of
inelastic skin turgor
Clara's daughter reports that her mother usually weighs about 137 lbs. and is 5 feet, 3 inches in height.
The nurse weighs Clara and obtains a measurement of 60 kg. The nurse explains to Clara's daughter that
Clara has lost approximately how many pounds? - ANSWER 5 lbs
60x2.2 lbs=132 lbs
137-132=5
The nurse discusses factors that contributed to Clara's fluid volume deficit with Clara and her daughter.
Which problem often occurs in the elderly and may have contributed to the fluid volume deficit Clara is
experiencing? - ANSWER Decreased hepatic blood flow
, The nurse is aware that the elderly 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 Clara's problem? - ANSWER
serum protein= drug molecules may be distributed through the body bound to plasma protein
molecules.
The nurse starts an intravenous line to administer fluids. The prescription states, "3% Normal Saline to
infuse at 100 ml/hour." The client's most recent serum sodium level is 135 mEq/L. What action should
the nurse take? - ANSWER obtain appropriante IV fluid prescription
A short while later, a prescription for 0.9% Normal Saline at 100 ml/hour is received. Clara's primary
nurse is at lunch, so another nurse hangs the solution. When checking Clara upon returning from lunch,
the primary nurse observes that a solution of 5% Dextrose and 0.9% Normal Saline is infusing at 125
ml/hour. What action should the primary nurse implement? - ANSWER Change the currently infusing
solution to 0.9% Normal Saline and change the rate to 100 ml/hour.
After hanging the correct IV solution at the correct rate of infusion, the nurse discusses the error with
the nurse who hung the first IV solution. Together, the nurses complete a variance (incident) report.
What additional action should the primary nurse take? - ANSWER Notify the healthcare provider of the
error in treatment that occurred.
The nurse who made the errors is very upset about writing a variance (incident) report and states, "I've
never made an error before. What if I get fired?" How should the primary nurse respond? - ANSWER
"Variance reports are used to find ways to prevent further errors." Variance reports are used by the risk
management department of healthcare agencies to look for patterns that contribute to errors so that
preventative measures can be institututed
Later that day, Clara's IV pump alarm sounds. The nurse notes that the IV is not infusing in the right
antecubital area, and the alarm indicates an obstruction is present. The nurse determines that all the
clamps are open and there are no kinks in the tubing. What intervention should the nurse take next? -
ANSWER Straighten the joint above the site
The nurse resolves the obstruction, and the IV solution begins to infuse. The next day the nurse observes
that the IV insertion site is inflamed and tender. The label on the IV site indicates the current IV has been
in place for 36 hours. What action should the nurse take? - ANSWER Remove the IV and restart it in a
different location.
