A nurse is assisting with the care of a client who is hypovolemic due to blood loss following a motor-vehicle crash and needs a blood transfusion immediately. The nurse should anticipate a prescription for which of the following IV solutions while awaiting blood from a type and cross-match?

Dextrose 10% in water

Lactated Ringer's

0.33% sodium chloride

0.45% sodium chloride

Answer and Explanation

The Correct Answer is B

A. Dextrose 10% in water: Dextrose solutions provide calories but do not restore volume or replace electrolytes. They are not typically used in hypovolemic shock.

B. Lactated Ringer's: Lactated Ringer’s solution is an isotonic solution containing sodium, potassium, calcium, and lactate, which helps restore both fluid volume and electrolytes in the case of hypovolemic shock. It is commonly used while awaiting blood transfusions.

C. 0.33% sodium chloride: This is a hypotonic solution that can cause fluid to shift into cells and is not appropriate for fluid resuscitation in hypovolemia, which requires an isotonic solution.

D. 0.45% sodium chloride: This is a hypotonic solution as well, and it could worsen hypotension by causing fluid shifts into the cells, which is not ideal for treating hypovolemic shock.

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Correct Answer is C

Explanation

A. BP 178/90 mm Hg: High blood pressure can be seen in various conditions, including stress or pain. Dehydration typically leads to low blood pressure, not high, making this less likely to be an indicator of dehydration.

B. Red mucous membranes: Red mucous membranes can indicate a variety of conditions, including infection or inflammation, but it is not a classic sign of dehydration.

C. Skin tenting: Skin tenting, or the inability of the skin to return to normal after being pinched, is a classic sign of dehydration, particularly in moderate to severe cases. This indicates reduced skin turgor and is directly related to fluid volume depletion.

D. Jugular vein distention: Jugular vein distention is more indicative of fluid overload or increased central venous pressure, not dehydration.

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate. B. Restrict fluid intake. C. Obtain a 12-lead ECG. D. Administer potassium gluconate 40 mEq orally.

Correct Answer is C

Explanation

A. Have the laboratory draw a blood sample for an erythrocyte sedimentation rate (ESR): ESR measures inflammation and is unrelated to hyperkalemia.

B. Restrict fluid intake: Fluid restriction is not appropriate for hyperkalemia unless specifically related to fluid overload or renal failure.

C. Obtain a 12-lead ECG: Hyperkalemia can cause life-threatening cardiac dysrhythmias such as peaked T waves, widened QRS complexes, or asystole. ECG monitoring is essential.

D. Administer potassium gluconate 40 mEq orally: This would worsen hyperkalemia and is contraindicated.

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A nurse is assisting with the care of a client who is hypovolemic due to blood loss following a motor-vehicle crash and needs a blood transfusion immediately. The nurse should anticipate a prescription for which of the following IV solutions while awaiting blood from a type and cross-match?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client. Which of the following findings should the nurse report to the charge nurse as an indicator of dehydration?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory values for a client who takes spironolactone and notes that the client's serum potassium level is 6.8 mEq/L (3.5 -5 mEq/L). The nurse notifies the provider and anticipates that the provider will provide which of the following instructions?

Correct Answer is C

Explanation

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