A client who experienced extensive burns is receiving intravenous fluids to replace fluid
loss. The nurse would monitor for which initial symptom of fluid overload.
a. Crackles in the lungs
b. Decreased heart rate
c. Decreased blood pressure
d. Cyanosis of nail beds - (correct answer)A
2. A client is taking furosemide. At each clinic visit, the nurse will assess for which
adverse effect?
a. Rapid weight loss
b. Xanthopsia
c. Hyporeflexia
d. Bronchospasm - (correct answer)C
3. Which clinical manifestations indicate to the nurse that the client has an inadequate
fluid volume? Select all that apply. One, some, or all responses may be correct.
a. Decreased urine
b. Hypotension
c. Dyspnea
d. Dry mucous membranes
e. Lung crackles
f. Poor skin turgor - (correct answer)A,B,D,F
4. Which clinical finding would the nurse anticipate when admitting a client with an
extracellular fluid volume excess?
a. Rapid, thready pulse
b. Distended jugular veins
, c. Elevated hematocrit level
d. Increased serum sodium levels - (correct answer)B
5. When caring for a client who was admitted with heart failure, which action by the
nurse will be most effective in determining whether the client's fluid overload is
improving?
a. Weighing the client
b. Monitoring the intake and output
c. Assessing the extent of pitting edema
d. Asking client about subjective symptoms - (correct answer)A
6. The nurse is evaluating the effectiveness of a treatment for a client with excessive
fluid volume. Which clinical finding indicates that treatment was successful?
a. Clear breath sounds
b. Positive pedal pulses
c. Normal potassium level
d. Decreased urine specific gravity - (correct answer)A
7. A client is admitted with dehydration. Which findings should the nurse expect the
client to exhibit? Select all that apply. One, some, or all responses may be correct.
a. Supple skin turgor
b. Rapid, thready pulse
c. Decreased hematocrit
d. Elevated specific gravity
e. Adventitious breath sounds - (correct answer)B,D
8. A client is prone to hyponatremia. Which factors would the nurse identify that can
precipitate hyponatremia? Select all that apply. One, some, or all responses may be
correct.
loss. The nurse would monitor for which initial symptom of fluid overload.
a. Crackles in the lungs
b. Decreased heart rate
c. Decreased blood pressure
d. Cyanosis of nail beds - (correct answer)A
2. A client is taking furosemide. At each clinic visit, the nurse will assess for which
adverse effect?
a. Rapid weight loss
b. Xanthopsia
c. Hyporeflexia
d. Bronchospasm - (correct answer)C
3. Which clinical manifestations indicate to the nurse that the client has an inadequate
fluid volume? Select all that apply. One, some, or all responses may be correct.
a. Decreased urine
b. Hypotension
c. Dyspnea
d. Dry mucous membranes
e. Lung crackles
f. Poor skin turgor - (correct answer)A,B,D,F
4. Which clinical finding would the nurse anticipate when admitting a client with an
extracellular fluid volume excess?
a. Rapid, thready pulse
b. Distended jugular veins
, c. Elevated hematocrit level
d. Increased serum sodium levels - (correct answer)B
5. When caring for a client who was admitted with heart failure, which action by the
nurse will be most effective in determining whether the client's fluid overload is
improving?
a. Weighing the client
b. Monitoring the intake and output
c. Assessing the extent of pitting edema
d. Asking client about subjective symptoms - (correct answer)A
6. The nurse is evaluating the effectiveness of a treatment for a client with excessive
fluid volume. Which clinical finding indicates that treatment was successful?
a. Clear breath sounds
b. Positive pedal pulses
c. Normal potassium level
d. Decreased urine specific gravity - (correct answer)A
7. A client is admitted with dehydration. Which findings should the nurse expect the
client to exhibit? Select all that apply. One, some, or all responses may be correct.
a. Supple skin turgor
b. Rapid, thready pulse
c. Decreased hematocrit
d. Elevated specific gravity
e. Adventitious breath sounds - (correct answer)B,D
8. A client is prone to hyponatremia. Which factors would the nurse identify that can
precipitate hyponatremia? Select all that apply. One, some, or all responses may be
correct.
