A nurse is assessing four clients. Which client requires interventions for dehydration?
A client who has a urine specific gravity of 1.010
A client who has a weight gain of 2.6 lbs in 24 hours
A client who has a hematocrit of 45%
A client who has a BUN of 24 mg/dL
The Correct Answer is D
Choice A reason: Urine specific gravity of 1.010 is normal (1.005–1.030), indicating adequate hydration. Dehydration elevates specific gravity (>1.030) due to concentrated urine, so this client does not show dehydration signs, making this an incorrect choice for requiring fluid replacement interventions.
Choice B reason: Weight gain of 2.6 lbs in 24 hours suggests fluid retention, not dehydration. This may indicate hypervolemia, possibly from heart or renal failure, requiring diuretics. Dehydration involves weight loss, making this client’s finding inconsistent with dehydration needing intervention.
Choice C reason: Hematocrit of 45% is normal (38–50% males, 36–46% females). Dehydration elevates hematocrit due to hemoconcentration from reduced plasma volume. Normal hematocrit does not indicate dehydration, making this client an incorrect choice for requiring dehydration-specific fluid interventions.
Choice D reason: A BUN of 24 mg/dL is elevated (normal 7–20 mg/dL), indicating dehydration, as reduced renal perfusion concentrates blood urea nitrogen. This reflects hypovolemia, requiring fluid replacement to restore renal function and prevent acute kidney injury, making this client the priority for dehydration intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: Bradycardia is not typical in emphysema, where chronic hypoxia and hypercapnia cause tachycardia as the heart compensates for reduced oxygenation. Emphysema’s impact on lung function does not slow heart rate, making this an unexpected finding in this client with chronic respiratory disease.
Choice B reason: Barrel chest is a classic emphysema finding, resulting from chronic air trapping and lung hyperinflation. Over time, the chest wall expands, increasing the anteroposterior diameter, as alveoli lose elasticity, leading to persistent lung hyperinflation, a hallmark of advanced chronic obstructive pulmonary disease.
Choice C reason: Clubbing of the fingers occurs in emphysema due to chronic hypoxia, stimulating vascular changes in the nail beds. This leads to bulbous fingertip enlargement, reflecting long-term oxygen deprivation, a common finding in advanced COPD as the body adapts to chronic respiratory insufficiency.
Choice D reason: Cachectic appearance is common in emphysema due to increased metabolic demand from labored breathing and systemic inflammation. Muscle wasting and weight loss occur as the body prioritizes energy for respiratory effort, making cachexia a frequent finding in advanced emphysema, reflecting chronic disease burden.
Choice E reason: Weight gain is not typical in emphysema, where cachexia is common due to high metabolic demand and inflammation. Weight gain may occur in conditions like heart failure but is not a hallmark of emphysema, making this an unexpected finding in this client.
Correct Answer is ["5"]
Explanation
Step 1 is (2 grams ÷ 10 mL) Result = 0.2 grams per mL
Step 2 is (1 gram ÷ 0.2 grams per mL) Result = 5 mL
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