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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. This response is appropriate because it shows empathy, respect, and interest in the client's feelings and thoughts. It also invites the client to explore and clarify their meaning of purpose and how it relates to their retirement.
B. This response is dismissive of the client’s concern.

C. While hobbies can be fulfilling, this response does not address the client's feelings of purposelessness directly.
D. This response minimizes the client's feelings and does not offer constructive solutions to address their concerns.

A. Tell the client about the benefits of the surgery. B. Inform the client that it is too late to stop the surgery. C. Let the client know that their surgeon will be notified of their decision. D. Reassure the client that it is expected to be nervous before surgery.

Correct Answer is C

Explanation

A. While educating the client about the benefits of surgery is important, it is not appropriate to dismiss the client's concerns in this situation.

B. It is important to respect the client's autonomy and decision-making process. If the client expresses a desire to reconsider the surgery, their wishes should be respected.
C. The nurse should respect the client's decision and communicate their wishes to the surgical team for further discussion and decision-making.
D. While reassurance is important, it should be provided in a way that acknowledges and respects the client's concerns and decisions.

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A nurse is caring for a client who has an extracellular fluid volume deficit. Which of the following findings should the nurse expect?

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