NUR 439 - Quiz #10 Questions with Verified Solutions Graded A+
The RN is admitting a patient with benign prostatic hyperplasia to an acute care unit. The
patient describes an oral intake of about 1400 mL/day. What is the RN's priority concern? -
Answers Instruct the patient to increase oral intake to 2 to 3 L/day.
The patient has fluid volume deficit related to excessive fluid loss. Which action related to fluid
management should be delegated by the RN to the assistive personnel (AP)? - Answers
Providing straws and offering fluids between meals
The assistive personnel (AP) reports to the nurse that a patient's urine output for the past 24
hours has been only 360 mL. What is the nurse's priority action at this time? - Answers Contact
and notify the health care provider immediately.
The patient is at risk for poor perfusion related to decreased plasma volume. Which
assessment finding supports this risk? - Answers Flattened neck veins when the patient is in the
supine position
The nursing plan of care for an older patient with dehydration includes interventions for oral
health. Which interventions are within the scope of practice for an LPN/LVN being supervised by
an RN? Select all that apply. - Answers - Reminding the patient to avoid commercial
mouthwashes
- Encouraging mouth rinsing with warm saline
- Observing the lips, tongue, and mucous membranes
- Providing mouth care every 2 hours while the patient is awake
The health care provider has written these orders for a patient with a diagnosis of pulmonary
edema. The patient's morning assessment reveals bounding peripheral pulses, a weight gain of
2lbs, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time? -
Answers Administer furosemide 40 mg IV push.
Which statement related to dehydration made by a patient with hypovolemia is the best
indicator to the nurse of the need for additional teaching? - Answers "I will drink coffee and cola
drinks throughout the day."
The nurse has been floated to the telemetry unit for the day. The monitor technician informs the
nurse that the patient has developed prominent U waves. Which laboratory value should be
checked immediately? - Answers Potassium
A patient's potassium level is 6.7 mEq/L (6.7 mmol/L). Which intervention should the nurse
delegate to the first-year student nurse under his or her supervision? - Answers Administer
sodium polystyrene sulfonate 15 g orally
The RN is admitting a patient with benign prostatic hyperplasia to an acute care unit. The
patient describes an oral intake of about 1400 mL/day. What is the RN's priority concern? -
Answers Instruct the patient to increase oral intake to 2 to 3 L/day.
The patient has fluid volume deficit related to excessive fluid loss. Which action related to fluid
management should be delegated by the RN to the assistive personnel (AP)? - Answers
Providing straws and offering fluids between meals
The assistive personnel (AP) reports to the nurse that a patient's urine output for the past 24
hours has been only 360 mL. What is the nurse's priority action at this time? - Answers Contact
and notify the health care provider immediately.
The patient is at risk for poor perfusion related to decreased plasma volume. Which
assessment finding supports this risk? - Answers Flattened neck veins when the patient is in the
supine position
The nursing plan of care for an older patient with dehydration includes interventions for oral
health. Which interventions are within the scope of practice for an LPN/LVN being supervised by
an RN? Select all that apply. - Answers - Reminding the patient to avoid commercial
mouthwashes
- Encouraging mouth rinsing with warm saline
- Observing the lips, tongue, and mucous membranes
- Providing mouth care every 2 hours while the patient is awake
The health care provider has written these orders for a patient with a diagnosis of pulmonary
edema. The patient's morning assessment reveals bounding peripheral pulses, a weight gain of
2lbs, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time? -
Answers Administer furosemide 40 mg IV push.
Which statement related to dehydration made by a patient with hypovolemia is the best
indicator to the nurse of the need for additional teaching? - Answers "I will drink coffee and cola
drinks throughout the day."
The nurse has been floated to the telemetry unit for the day. The monitor technician informs the
nurse that the patient has developed prominent U waves. Which laboratory value should be
checked immediately? - Answers Potassium
A patient's potassium level is 6.7 mEq/L (6.7 mmol/L). Which intervention should the nurse
delegate to the first-year student nurse under his or her supervision? - Answers Administer
sodium polystyrene sulfonate 15 g orally
