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The Nurse Obtains All of the Following Assessment Data About

Question 26

Multiple Choice

The nurse obtains all of the following assessment data about a patient with fluid-volume deficit caused by a massive burn injury. Which of the following assessment data will be of greatest concern?


A) Oral fluid intake is 100 ml for the last 8 hours.
B) The blood pressure is 90/40 mm Hg.
C) Urine output is 30 ml over the last hour.
D) There is prolonged skin tenting over the sternum.

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