A nurse is caring for a client who has an extracellular fluid volume deficit. Which of the following findings should the nurse expect?
Distended neck veins
Postural hypotension
Dependent edema
Bradycardia
The Correct Answer is B
A. Extracellular fluid volume deficit (dehydration) typically leads to decreased venous return and reduced preload, resulting in flat or collapsed neck veins, rather than distended ones.
B. In extracellular fluid volume deficit, there is a decrease in blood volume, which can result in postural hypotension when the client changes positions, due to inadequate fluid volume to maintain blood pressure.
C. Extracellular fluid volume deficit is characterized by decreased fluid volume, which leads to decreased tissue perfusion and fluid shifts out of the interstitial spaces, resulting in reduced or absent edema.
D. Bradycardia is not typically associated with extracellular fluid volume deficit.
Instead, tachycardia may occur as a compensatory mechanism to maintain cardiac output in response to decreased blood volume.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. This abbreviation can be misinterpreted as "units," "cc," or "you." It is recommended to avoid its use to prevent misinterpretation.
B. This abbreviation stands for intake and output, which is commonly used in healthcare documentation and is not on The Joint Commission's Do Not Use list.
C. IU can be mistaken for intravenous or international unit.
D. This abbreviation stands for once daily and is prone to misinterpretation, as it can be mistaken for qid (four times daily). It is recommended to avoid its use to prevent dosing errors.
E. This abbreviation stands for pro re nata, indicating "as needed" medication administration, and is not on The Joint Commission's Do Not Use list.
Correct Answer is C
Explanation
A. Sterile gloves are not necessary for collecting sputum specimens. Clean gloves are typically sufficient.
B. Sputum specimens should be collected in a sterile container to prevent contamination.
C. Early morning specimens are preferred due to increased sputum production from the overnight accumulation of secretions.
D. Mouthwash may contain substances that interfere with sputum culture results, so specimens should be collected before mouthwash use.
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