A nurse is caring for a client who has emphysema and has difficulty with mobility. The client receives home health care and spends most of his day in a reclining chair. Which of the following physiological responses to prolonged immobility should the nurse expect?

Decreased RBC production

Increased calcium excretion

Increased insulin production

Decreased sodium excretion

Answer and Explanation

The Correct Answer is B

A. Prolonged immobility does not directly decrease red blood cell (RBC) production. RBC production is primarily regulated by erythropoietin from the kidneys and oxygen demand, which may not be significantly altered by immobility alone.
B. Increased calcium excretion is a well-documented effect of immobility. When a person is immobile, bone resorption increases, leading to the release of calcium into the bloodstream and subsequent excretion through the urine. This can increase the risk of kidney stones and osteoporosis.
C. Immobility typically reduces metabolic demand and insulin sensitivity rather than increasing insulin production. Insulin resistance is more commonly associated with prolonged immobility.
D. Immobility does not directly affect sodium excretion in a way that would cause it to decrease. Sodium balance is primarily regulated by the kidneys and other hormonal mechanisms unrelated to immobility.

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Correct Answer is D

Explanation

A. Dextrose 5% in water (D5W) does not contain enough glucose to meet the client's caloric needs and prevent hypoglycemia during a delay in TPN.
B. Lactated Ringer's solution is primarily used for fluid and electrolyte replacement but does not provide sufficient glucose to prevent hypoglycemia in a client dependent on TPN.
C. While 0.9% sodium chloride can maintain fluid balance, it does not contain glucose, making it unsuitable for preventing hypoglycemia in a client on TPN.
D. Dextrose 10% in water (D10W) is the appropriate choice because it provides a higher concentration of glucose, helping to prevent hypoglycemia until the next TPN container is available.

A. weight-bearing exercise B. Vitamin A depletion C. Calcium D. Exposure to sunlight

Correct Answer is D

Explanation

A. Weight-bearing exercise is important for bone health but does not directly trigger vitamin D synthesis. It helps utilize vitamin D in the process of bone remodeling.
B. Vitamin A depletion is unrelated to vitamin D synthesis. Both vitamins have distinct roles in the body and are metabolized independently.
C. Calcium is essential for bone health and works synergistically with vitamin D, but it does not trigger vitamin D formation. Vitamin D enhances calcium absorption in the gut.
D. Exposure to sunlight, specifically ultraviolet B (UVB) rays, triggers the synthesis of vitamin D in the skin. This process converts 7-dehydrocholesterol to previtamin D3, which is then metabolized into active vitamin D.

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A nurse is caring for a client who has emphysema and has difficulty with mobility. The client receives home health care and spends most of his day in a reclining chair. Which of the following physiological responses to prolonged immobility should the nurse expect?

Nursing Test Bank

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