NURS 172 Exam| COMPLETE QUESTIONS WITH 100%
RATED CORRECT ANSWERS | GRADED A+ | 100%
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The client who has undergone an exploratory laparotomy and subsequent removal of
a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at
150 mL/hr via an IV pump. Which data should be reported to the HCP?
1. The pump keeps sounding an alarm that the high pressure has been reached.
2. Intake is 1800 mL, NGT output is 550 mL, and Foley output 950 mL.
3. On auscultation, crackles and rales in all lung fields are noted.
4. Client has negative pedal edema and an increasing level of consciousness. - ANSWER-Answer: 3
1. The pump is alerting the nurse that there is
resistance distal to the pump; this does not
requiring notifying the HCP.
2. The client has an 1800 mL intake and total
output of 1500 mL. The body has an insensible loss of approximately 400 mL per day through the skin,
respirations, and other body functions. This would not warrant notifying the HCP.
3. Crackles and rales in all lung fields indicate
that the body is not able to process the
amounts of fluids being infused. This
should be brought to the HCP's attention.
4. Negative pedal edema and an increasing level of consciousness indicate that the client is not
experiencing a problem.
TEST-TAKING HINT: The question requires the test taker to distinguish nursing problems
from client problems. Option "1" is a nursing
problem and options "2" and "4" are expected
results, so the HCP does not need to be notified. Only one option—"3"—contains abnormal or life-
threatening information.
,The client diagnosed with diabetes insipidus weighed 180 pounds when the daily
weight was taken yesterday. This morning's weight is 175.6 pounds. One liter of fluid
weighs approximately 2.2 pounds. How much fluid has the client lost?_______ - ANSWER-Answer: 2000
mL has been lost. First, determine how many pounds the client has lost:
180 - 175.6 = 4.4 pounds lost
Then, based on the fact that 1 liter of fluid weighs 2.2 pounds, determine how many liters of fluid have
been lost.
4.4 ÷ 2.2 = 2 liters lost
Then, because the question asks for the answer in milliliters convert 2 liters into milliliters.
2 x 1000 = 2000 mL
TEST-TAKING HINT: The test taker must be able to work basic math problems. This problem has several
steps. Sometimes it is helpful to write out what is occurring at each step, such as 4.4 divided by 2.2 kg
per pound. This can help the test taker realize if a step has been overlooked.
The nurse writes the nursing problem of "fluid volume excess" (FVE). Which intervention
should be included in the plan of care?
1. Change the IV fluid from 0.9% NS to D5W.
2. Restrict the client's sodium in the diet.
3. Monitor blood glucose levels.
4. Prepare the client for hemodialysis. - ANSWER-Answer: 2
1. The nursing plan of care does not include
changing the HCP's orders.
2. Fluid volume excess refers to an isotonic
expansion of the extracellular fluid by an
abnormal expansion of water and sodium.
Therefore sodium is restricted to allow the
body to excrete the extra volume.
, 3. High blood glucose levels result in viscous
blood and cause the kidneys to try and fix the
problem by excreting the glucose through
increasing the urine output, which results in
fluid volume deficits.
4. If the FVE is the result of renal failure, then
hemodialysis may be ordered, but this information was not provided in the stem of the question.
TEST-TAKING HINT: Option "1" is not a nursing prerogative. The test taker should not read into the
question.
The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention
should be implemented?
1. Encourage fluids orally.
2. Administer 10% saline solution IVPB.
3. Administer antidiuretic hormone intranasally.
4. Place on seizure precautions - ANSWER-Answer: 4
1. The client probably will be placed on fluid restriction. Fluids should not be encouraged for a client
with a low sodium level (135-145 mEq/L).
2. Hypertonic solutions of saline are 3% to 5%, not 10%, because of the extreme nature of hypertonic
solutions. Hypertonic solutions of saline may be used but very cautiously because if the sodium levels
are increased too rapidly, a massive fluid shift can occur in the body, resulting in neurological damage
and heart failure.
3. The antidiuretic hormone (vasopressin) would cause water retention in the body and increase the
problem.
4. Clients with sodium levels less than 120 mEq/L are at risk for seizures as a compli- cation. The lower
the sodium level, the greater the risk of a seizure.
TEST-TAKING HINTS: The test taker must memorize certain common lab values and understand how
deviations in the electrolytes affect the body.
RATED CORRECT ANSWERS | GRADED A+ | 100%
satisfaction guaranteed
The client who has undergone an exploratory laparotomy and subsequent removal of
a large intestinal tumor has a nasogastric tube (NGT) in place and an IV running at
150 mL/hr via an IV pump. Which data should be reported to the HCP?
1. The pump keeps sounding an alarm that the high pressure has been reached.
2. Intake is 1800 mL, NGT output is 550 mL, and Foley output 950 mL.
3. On auscultation, crackles and rales in all lung fields are noted.
4. Client has negative pedal edema and an increasing level of consciousness. - ANSWER-Answer: 3
1. The pump is alerting the nurse that there is
resistance distal to the pump; this does not
requiring notifying the HCP.
2. The client has an 1800 mL intake and total
output of 1500 mL. The body has an insensible loss of approximately 400 mL per day through the skin,
respirations, and other body functions. This would not warrant notifying the HCP.
3. Crackles and rales in all lung fields indicate
that the body is not able to process the
amounts of fluids being infused. This
should be brought to the HCP's attention.
4. Negative pedal edema and an increasing level of consciousness indicate that the client is not
experiencing a problem.
TEST-TAKING HINT: The question requires the test taker to distinguish nursing problems
from client problems. Option "1" is a nursing
problem and options "2" and "4" are expected
results, so the HCP does not need to be notified. Only one option—"3"—contains abnormal or life-
threatening information.
,The client diagnosed with diabetes insipidus weighed 180 pounds when the daily
weight was taken yesterday. This morning's weight is 175.6 pounds. One liter of fluid
weighs approximately 2.2 pounds. How much fluid has the client lost?_______ - ANSWER-Answer: 2000
mL has been lost. First, determine how many pounds the client has lost:
180 - 175.6 = 4.4 pounds lost
Then, based on the fact that 1 liter of fluid weighs 2.2 pounds, determine how many liters of fluid have
been lost.
4.4 ÷ 2.2 = 2 liters lost
Then, because the question asks for the answer in milliliters convert 2 liters into milliliters.
2 x 1000 = 2000 mL
TEST-TAKING HINT: The test taker must be able to work basic math problems. This problem has several
steps. Sometimes it is helpful to write out what is occurring at each step, such as 4.4 divided by 2.2 kg
per pound. This can help the test taker realize if a step has been overlooked.
The nurse writes the nursing problem of "fluid volume excess" (FVE). Which intervention
should be included in the plan of care?
1. Change the IV fluid from 0.9% NS to D5W.
2. Restrict the client's sodium in the diet.
3. Monitor blood glucose levels.
4. Prepare the client for hemodialysis. - ANSWER-Answer: 2
1. The nursing plan of care does not include
changing the HCP's orders.
2. Fluid volume excess refers to an isotonic
expansion of the extracellular fluid by an
abnormal expansion of water and sodium.
Therefore sodium is restricted to allow the
body to excrete the extra volume.
, 3. High blood glucose levels result in viscous
blood and cause the kidneys to try and fix the
problem by excreting the glucose through
increasing the urine output, which results in
fluid volume deficits.
4. If the FVE is the result of renal failure, then
hemodialysis may be ordered, but this information was not provided in the stem of the question.
TEST-TAKING HINT: Option "1" is not a nursing prerogative. The test taker should not read into the
question.
The client is admitted with a serum sodium level of 110 mEq/L. Which nursing intervention
should be implemented?
1. Encourage fluids orally.
2. Administer 10% saline solution IVPB.
3. Administer antidiuretic hormone intranasally.
4. Place on seizure precautions - ANSWER-Answer: 4
1. The client probably will be placed on fluid restriction. Fluids should not be encouraged for a client
with a low sodium level (135-145 mEq/L).
2. Hypertonic solutions of saline are 3% to 5%, not 10%, because of the extreme nature of hypertonic
solutions. Hypertonic solutions of saline may be used but very cautiously because if the sodium levels
are increased too rapidly, a massive fluid shift can occur in the body, resulting in neurological damage
and heart failure.
3. The antidiuretic hormone (vasopressin) would cause water retention in the body and increase the
problem.
4. Clients with sodium levels less than 120 mEq/L are at risk for seizures as a compli- cation. The lower
the sodium level, the greater the risk of a seizure.
TEST-TAKING HINTS: The test taker must memorize certain common lab values and understand how
deviations in the electrolytes affect the body.
