Nursing Assessment and Intervention Quiz
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Questions and Answers

What assessment would concern the nurse the most when preparing to administer 0.9% NaCl to a dehydrated 76-year-old patient?

  • Urine output the past 3 hours is 75 ml (correct)
  • Pt. states he has not had a B.M. for 2 days
  • Tenting of skin is noted
  • Radial pulse 100
  • What action will the nurse take after a patient receiving a fluid bolus of 500ml over an hour shows symptoms of AP 110, pulse-ox. 90%, BP 140/96, and dyspnea?

  • Put the patient in high Fowler's position (correct)
  • Weigh the patient
  • Recheck the vital signs in 60 min
  • Encourage oral fluids now
  • Which lab results will the nurse need to report to the physician right away for a hospitalized patient with low back pain?

  • BUN 40, potassium 4.9, creatinine 4.1 (correct)
  • Sodium 134, potassium 3.5, BUN 10
  • BUN 18, potassium 4.9, calcium 9.1
  • Blood urea nitrogen 10, sodium 146, potassium 4.7
  • What action will the nurse take if a patient ordered an IV of NS at 50ml/hr. for 8 hours has only received 100ml of IV fluid for the shift?

    <p>Increase the infusion rate to catch up the amount behind</p> Signup and view all the answers

    Which solution would the nurse anticipate being ordered to replace fluid loss for a patient receiving fluid resuscitation for a burn sustained 3 hours ago?

    <p>Lactated Ringer’s</p> Signup and view all the answers

    Which patients need IV fluids? Select all that apply.

    <p>A patient with diabetic ketoacidosis and a blood sugar of 504</p> Signup and view all the answers

    A 60 year old patient with no previous lung disease is receiving Normal Saline at 150ml/hour and begins to experience shortness of breath and the pulse oximeter is 90%. Which action would the LPN take first?

    <p>Notify physician of the patient’s symptoms.</p> Signup and view all the answers

    What will the nurse do if the patient's vitals are temp. 98.0, pulse 109, resp. 20, BP 84/48, and pulse oximeter 95% when the infusion of 0.45% normal saline is alarming due to an empty bag?

    <p>Notify the physician of the vital signs and ask for an IV solution that is not hypotonic.</p> Signup and view all the answers

    Which statement made by the nurse indicates understanding of isotonic solutions?

    <p>&quot;It will cause fluid to shift into the intravascular space.&quot;</p> Signup and view all the answers

    What action will the LPN take when a 17-year-old patient presents to an Ohio hospital Emergency Department and needs an IV started stat?

    <p>Notify an Emergency room RN about the IV order.</p> Signup and view all the answers

    What action will the LPN take when receiving an order to start Gentamycin (Cydomycin) by IVPB route for a 19-year-old female who is MRDD?

    <p>Disregard the order, as the LPN cannot han…</p> Signup and view all the answers

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