CORRECT ANSWERS 2026
A nurse is admitting a client who reports nausea, vomiting, and weakness. Upon assessment, the cl
ient has dry oral mucous membranes, temperature 38.5° C (101.3° F), pulse 92/min, respirations
24/min, skin cool with tenting present, and blood pressure 102/64 mm Hg. His urine is
concentrated with a hig h specific gravity. Which of the following are clinical manifestations of fluid
volume deficit? (Select all that ap ply.)
A. Decreased skin turgor
B. Concentrated urine
C. Bradycardia
D. Low-grade fever
E. Tachypnea - CORRECT ANSWER -
A. CORRECT: Decreased skin turgor is a clinical manifestation present with fluid volume deficit. Skin
turgor is decreased to due to the lack of fluid within the body and results in dryness of the skin.
B. CORRECT: Concentrated urine is a clinical manifestation present with fluid volume deficit. The
urine is concentrated due to urinary output being decreased.
D. CORRECT: Low-grade fever is a clinical manifestation present with fluid volume deficit. Low-
grade fever
is one of the body's ways to maintain homeostasis to compensate for lack of fluid within the body.
E. CORRECT: Tachypnea is a clinical manifestation present with fluid volume deficit. Increased
respirations are the body's way to obtain oxygen due to the lack of fluid volume within the body.
A nurse is admitting an older adult client who is experiencing dyspnea, weakness, and weight gain
of 2 lb, with 1+ bilateral edema of the lower extremities. Upon assessment, the client has a tempe
rature
37.2° C (99° F), pulse 96/min, respirations 26/min, oxygen saturation 94% on 3 L oxygen via nasal
cannula, and blood pressure 152/96 mm Hg. Which of the following clinical manifestations are indi
cative
, of fluid volume excess? (Select all that apply.)
A. Dyspnea
B. Edema
C. Bradycardia
D. Hypertension
E. Weakness - CORRECT ANSWER -
A. CORRECT: Dyspnea is a clinical manifestation present with fluid volume excess. Dyspnea is due t
o
an excess of fluids within the body and lungs, and the client is struggling to breath to obtain oxyg
en.
B. CORRECT: Edema is a clinical manifestation present with fluid volume excess. Edema is due to th
e
excess of fluid within the body. Weight gain can be a result of edema.
D. CORRECT: Hypertension is a clinical manifestation related to fluid volume excess. Blood pressure
rises as the heart must work harder due to the excess fluid.
E. CORRECT: Weakness is a clinical manifestation present with fluid volume excess. Weakness is due
to the excess fluid that is retained, which depletes energy and increases the workload for the body
.
A nurse is caring for a client who is dehydrated. Which of the following clinical manifestations shou
ld
the nurse assess for that is indicative of fluid volume deficit?
A. Moist skin
B. Distended neck veins
C. Increased urinary output
D. Tachycardia - CORRECT ANSWER -
D. CORRECT: Tachycardia is an attempt to maintain blood pressure, a clinical manifestation
indicative of fluid volume deficit.
A nurse is caring for an older adult client in a long-
term care facility. The client has become weak and