A client presents to the emergency department complaining of several days of nausea and vomiting with weakness and dizziness. The client's vital signs are: Pulse 110, BP 88/56, RR 24, SpO2 95% on room air, temperature of 100.2. The client's lung sounds are clear bilaterally. Which of the following IV fluids would the nurse expect to administer?

Dextrose in water

6.45% Sodium Chloride

10% Dextrose in water

0.9% Sodium Chloride

Answer and Explanation

The Correct Answer is D

A. Dextrose in water is typically used for hydration and to provide some calories. However, this client is presenting with hypotension (BP 88/56), tachycardia (Pulse 110), and weakness, likely due to fluid loss from vomiting. This client needs fluid resuscitation with a solution that will help restore circulating volume, and Dextrose in water does not contain sodium, which is necessary for fluid balance in this case.
B. 6.45% Sodium Chloride is a hypertonic saline solution, which would increase the osmolarity of the blood and pull fluid into the bloodstream. This would not be the first choice for this patient, as it could exacerbate dehydration and electrolyte imbalances.
C. 10% Dextrose in water is also a hypertonic solution that would provide energy but would not adequately address the client's fluid volume deficit or hypotension.
D. 0.9% Sodium Chloride is normal saline, which is an isotonic solution and is the most appropriate choice for fluid resuscitation in this client. It will help restore circulating blood volume, stabilize blood pressure, and provide the necessary hydration to address the client's symptoms of dehydration.

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Correct Answer is ["B","D","E"]

Explanation

A. Intact motor function is not a sign of compartment syndrome. Motor deficits, rather than intact function, would raise concern for this condition.
B. A capillary refill time of 5 seconds is prolonged and indicates impaired circulation, which is a sign of compartment syndrome.
C. A bounding pulse is not consistent with compartment syndrome. Pulses may initially remain normal but can diminish as the condition progresses.
D. Pallor to the lower extremity suggests compromised blood flow, which is a hallmark of compartment syndrome.
E. Numbness and tingling (paresthesia) indicate nerve compression, a common symptom of compartment syndrome.

A. Lispro lasts 24 hours and does not have to be timed with meals. B. 60 minutes before meals. C. 15-30 minutes before meals. D. 2-6 hours before meals.

Correct Answer is C

Explanation

A. This statement is incorrect. Lispro is a rapid-acting insulin, and its duration of action is much shorter than 24 hours. It is typically effective for about 3-5 hours.
B. Administering Lispro 60 minutes before meals would be too early, as it peaks in about 1-2 hours after injection and works best when given closer to meal times.
C. Lispro should be administered 15-30 minutes before meals to match the onset of action, which begins within 15 minutes of injection. This timing allows the insulin to be active when blood glucose rises after eating.
D. Lispro does not require administration 2-6 hours before meals, as this would not align with its rapid onset of action.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who was admitted for a closed femur fracture. Which of the following signs and symptoms would alert the nurse that the client is experiencing compartment syndrome?

Correct Answer is ["B","D","E"]

Explanation

The nurse is planning care for a client with type 1 diabetes mellitus. When planning administration for rapid-acting insulin Lispro, the nurse knows to administer it during which timeframe based on the onset of action?

Correct Answer is C

Explanation

A nurse is assessing a client who has a sodium level of 116 mEq/L. Which of the following adverse findings would the nurse anticipate?

A nurse is preparing to administer an infusion of intravenous fluids to a client who is at risk for fluid volume overload. Which of the following manifestations would indicate hypervolemia? (Select all that apply)

A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?

A nurse is preparing to administer total parental nutrition (TPN) 1800 mL to infuse over 24 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

The nurse is reviewing laboratory results for a client admitted for renal failure and notes the following: Sodium 144 mEq/L and Potassium 6.6 mEq/L. Which of the following should be the priority intervention?

A nurse is caring for four hospitalized clients. Which of the following clients should the nurse identify as being at risk for fluid volume deficit?

A nurse is caring for a client who had IV fluids initiated at 0330. The IV fluids are infusing at 120 mL/hr. The nurse should record how many mL of IV fluids on the intake record at 0600?

The nurse is caring for a client who is diabetic and has a blood glucose level of 30 mg/dL. The client is unconscious and has a 20-gauge peripheral IV in the antecubital area. After securing the client's airway, what medication should the nurse plan to administer first?