RN Exam Practice
Reduction of Risk PotentialQuestion 232 of 2368

The client lies supine for five minutes, then stands. Blood pressure falls from 128/78 mm Hg to 104/70 mm Hg, and the client feels dizzy. Which action should the nurse take?

  1. Document the finding as an expected change after standing
  2. Have the client walk the hallway to improve circulation
  3. Restrict oral fluids and recheck the pressure in four hours
  4. Report orthostatic hypotension and put fall precautions in place
Show answer

Correct answer: Report orthostatic hypotension and put fall precautions in place

A drop in systolic pressure of 20 mm Hg or more, or dizziness, is abnormal. It should be reported and falls prevented.

Source: Nursing Fundamentals, 2nd edition (Open RN, Chippewa Valley Technical College, 2024), Fluids and Electrolytes: Planning Interventions. Licensed under CC BY 4.0.

Practice the topic "Reduction of Risk Potential"

Questions last reviewed: 18 October 2026