MSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition
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16. The nurse is administering intravenous fluids to a patient who is dehydrated. On the second day o
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f care, the patient‘s weight is increased by 2.25 pounds. The nurse would expect that thepatient‘s f
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luid intake has
phy
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a. equaled urine output. ii ii
b. exceeded urine output by 1 L. ii ii ii ii ii
c. exceeded urine output by 2.5 L. ii ii ii ii ii
d. exceeded urine output by 3 L. ii ii ii ii ii
ANS: B ii
A weight gain of 1 kg, or 2.2 to 2.5 lb, is equivalent to 1 L of fluid.
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DIF: i i Cognitive Level: Applying(Application) ii ii i
TOP: Nursing Process: E ii ii ii
valuationMSC: NCLEX: Physiological Integrity: Basic Care and Comfort: Nutrition i i ii ii ii ii ii ii ii
17. The nurse is caring for a patient who is receiving isotonic intravenous (IV) fluids at an infusion r
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ate of 125 mL/h. The nurse performs an assessment and notes a heart rate of 102 beats per minut
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e, a blood pressure of 160/85 mm Hg, and crackles auscultated in both lungs.Which action will t
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he nurse take?
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a. Decrease the IV fluid rate and notify the provider. ii ii ii ii ii ii ii ii
b. Increase the IV fluid rate and notify the provider. ii ii ii ii ii ii ii ii
c. Request an order for a colloidal IV solution. ii ii ii ii ii ii ii
d. Request an order for a hypertonic IV solution. ii ii ii ii ii ii ii
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