1
LEWIS: MEDICAL-SURGICAL NURSING~CHAPTER 17 EXAM
LATEST UPDATE -2026- 100+ QUESTIONS AND VERIFIED
ANSWERS ALL THE BEST
When the nurse is evaluating the fluid balance for a patient admitted for
hypervolemia associated with multiple draining wounds, the most accurate
assessment to include is:
a. skin turgor.
b. daily weight.
c. presence of edema.
d. hourly urine output.
Answer: b. daily weight.
Daily weight is the most easily obtained and accurate means of assessing volume
status. Skin turgor varies considerably with age. Considerable excess fluid volume
may be present before fluid moves into the interstitial space and causes edema.
Hourly urine outputs do not take account of fluid intake or of fluid loss through
insensible loss, sweating, or loss from the gastrointestinal tract or wounds.
When caring for an alert and oriented elderly patient with a history of
dehydration, the home health nurse will teach the patient to increase fluid intake:
a. in the late evening hours.
b. if the oral mucosa feels dry.
c. when the patient feels thirsty.
, 2
d. as soon as changes in level of consciousness (LOC) occur.
Answer: b. if the oral mucosa feels dry.
An alert, elderly patient will be able to self-assess for signs of oral dryness such as
thick oral secretions or dry-appearing mucosa. The thirst mechanism decreases
with age and is not an accurate indicator of volume depletion. Many older
patients prefer to restrict fluids slightly in the evening to improve sleep quality.
The patient will not be likely to notice and act appropriately when changes in LOC
occur.
A patient is taking potassium-wasting diuretic for treatment of hypertension. The
nurse will teach the patient to report symptoms of adverse effects such as:
a. personality changes.
b. frequent loose stools.
c. facial muscle spasms.
d. generalized weakness.
Answer: d. generalized weakness.
Generalized weakness progressing to flaccidity is a manifestation of hypokalemia.
Facial muscle spasms might occur with hypocalcemia. Loose stools are associated
with hyperkalemia. Personality changes are not associated with electrolyte
disturbances, although changes in mental status are common manifestations with
sodium excess or deficit.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient
as a diuretic. Which statement by the patient indicates that the teaching about
this medication has been effective?
, 3
a. I will try to drink at least 8 glasses of water every day.
b. I will use a salt substitute to decrease my sodium intake.
c. I will increase my intake of potassium-containing foods.
d. I will drink apple juice instead of orange juice for breakfast.
Answer: d. I will drink apple juice instead of orange juice for breakfast.
Since spironolactone is a potassium-sparing diuretic, patients should be taught to
choose low potassium foods such as apple juice rather than foods that have
higher levels of potassium, such as citrus fruits. Because the patient is using
spironolactone as a diuretic, the nurse would not encourage the patient to
increase fluid intake. Teach patients to avoid salt substitutes, which are high in
potassium.
When caring for a patient admitted with hyponatremia, which actions will the
nurse anticipate taking?
a. Restrict patient's oral free water intake.
b. Avoid use of electrolyte-containing drinks.
c. Infuse a solution of 5% dextrose in a 0.45% saline.
d. Administer vasopressin (antidiuretic hormone, [ADH]).
Answer: a. Restrict patient's oral free water intake.
To help improve serum sodium levels, water intake is restricted. Electrolyte-
containing beverages will improve the patients sodium level. Administration of
vasopressin or hypotonic IV solutions will decrease the serum sodium level
further.
LEWIS: MEDICAL-SURGICAL NURSING~CHAPTER 17 EXAM
LATEST UPDATE -2026- 100+ QUESTIONS AND VERIFIED
ANSWERS ALL THE BEST
When the nurse is evaluating the fluid balance for a patient admitted for
hypervolemia associated with multiple draining wounds, the most accurate
assessment to include is:
a. skin turgor.
b. daily weight.
c. presence of edema.
d. hourly urine output.
Answer: b. daily weight.
Daily weight is the most easily obtained and accurate means of assessing volume
status. Skin turgor varies considerably with age. Considerable excess fluid volume
may be present before fluid moves into the interstitial space and causes edema.
Hourly urine outputs do not take account of fluid intake or of fluid loss through
insensible loss, sweating, or loss from the gastrointestinal tract or wounds.
When caring for an alert and oriented elderly patient with a history of
dehydration, the home health nurse will teach the patient to increase fluid intake:
a. in the late evening hours.
b. if the oral mucosa feels dry.
c. when the patient feels thirsty.
, 2
d. as soon as changes in level of consciousness (LOC) occur.
Answer: b. if the oral mucosa feels dry.
An alert, elderly patient will be able to self-assess for signs of oral dryness such as
thick oral secretions or dry-appearing mucosa. The thirst mechanism decreases
with age and is not an accurate indicator of volume depletion. Many older
patients prefer to restrict fluids slightly in the evening to improve sleep quality.
The patient will not be likely to notice and act appropriately when changes in LOC
occur.
A patient is taking potassium-wasting diuretic for treatment of hypertension. The
nurse will teach the patient to report symptoms of adverse effects such as:
a. personality changes.
b. frequent loose stools.
c. facial muscle spasms.
d. generalized weakness.
Answer: d. generalized weakness.
Generalized weakness progressing to flaccidity is a manifestation of hypokalemia.
Facial muscle spasms might occur with hypocalcemia. Loose stools are associated
with hyperkalemia. Personality changes are not associated with electrolyte
disturbances, although changes in mental status are common manifestations with
sodium excess or deficit.
Spironolactone (Aldactone), an aldosterone antagonist, is prescribed for a patient
as a diuretic. Which statement by the patient indicates that the teaching about
this medication has been effective?
, 3
a. I will try to drink at least 8 glasses of water every day.
b. I will use a salt substitute to decrease my sodium intake.
c. I will increase my intake of potassium-containing foods.
d. I will drink apple juice instead of orange juice for breakfast.
Answer: d. I will drink apple juice instead of orange juice for breakfast.
Since spironolactone is a potassium-sparing diuretic, patients should be taught to
choose low potassium foods such as apple juice rather than foods that have
higher levels of potassium, such as citrus fruits. Because the patient is using
spironolactone as a diuretic, the nurse would not encourage the patient to
increase fluid intake. Teach patients to avoid salt substitutes, which are high in
potassium.
When caring for a patient admitted with hyponatremia, which actions will the
nurse anticipate taking?
a. Restrict patient's oral free water intake.
b. Avoid use of electrolyte-containing drinks.
c. Infuse a solution of 5% dextrose in a 0.45% saline.
d. Administer vasopressin (antidiuretic hormone, [ADH]).
Answer: a. Restrict patient's oral free water intake.
To help improve serum sodium levels, water intake is restricted. Electrolyte-
containing beverages will improve the patients sodium level. Administration of
vasopressin or hypotonic IV solutions will decrease the serum sodium level
further.
