A nurse is caring for a client who has fluid volume deficit and is receiving a continuous IV infusion. Which of the following findings indicates the treatment has been effective?
Oliguria
Elastic skin turgor
Tachycardia
Dry mucous membranes
The Correct Answer is B
A) Oliguria, or decreased urine output, is a sign of fluid volume deficit rather than an indication that the treatment has been effective. In a client with fluid volume deficit, the kidneys conserve water to maintain fluid balance, leading to decreased urine output.
B) Elastic skin turgor is a reliable indicator of hydration status. When a client's fluid volume deficit is improving, their skin turgor returns to normal. Elastic skin turgor means that the skin quickly returns to its normal position after being pinched and released, indicating adequate hydration.
C) Tachycardia, or an increased heart rate, is a compensatory mechanism that the body uses to maintain cardiac output in response to fluid volume deficit. While tachycardia may initially be present in a client with fluid volume deficit, it is not an indication that treatment has been effective.
D) Dry mucous membranes are a manifestation of dehydration and fluid volume deficit. Moist mucous membranes indicate hydration status, and their dryness suggests dehydration. Dry mucous membranes are not indicative of effective treatment for fluid volume deficit.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Increased glycosylated hemoglobin (HbA1c) is not an indication of a successful weight loss program. In fact, it typically indicates poor blood sugar control and may suggest worsening diabetes management or insulin resistance. Successful weight loss and improved lifestyle habits should lead to better blood sugar control and a reduction in HbA1c levels.
B) Increased low-density lipoprotein (LDL) cholesterol is not an indication of a successful weight loss program. Elevated LDL cholesterol levels are associated with an increased risk of cardiovascular disease and are often a target for reduction in weight management interventions. Therefore, successful weight loss should be associated with a decrease in LDL cholesterol levels.
C) Increased total cholesterol levels are not indicative of a successful weight loss program. High cholesterol levels, especially when accompanied by elevated LDL cholesterol and decreased high-density lipoprotein (HDL) cholesterol, are associated with an increased risk of cardiovascular disease. Successful weight loss should lead to improvements in lipid profiles, including reductions in total cholesterol levels.
D) Increased high-density lipoprotein (HDL) cholesterol is an indication of a successful weight loss program. HDL cholesterol, often referred to as "good" cholesterol, plays a protective role in cardiovascular health by helping to remove excess cholesterol from the bloodstream and transporting it to the liver for excretion. Higher levels of HDL cholesterol are associated with a reduced risk of cardiovascular disease. Therefore, an increase in HDL cholesterol levels following a weight loss program suggests improved cardiovascular health and metabolic outcomes.
Correct Answer is C
Explanation
A) The client is immune to the rubella virus:
A negative rubella titer indicates that the client is not immune to the rubella virus. Therefore, this interpretation is incorrect.
B) The client requires a rubella vaccination at this time:
A negative rubella titer indicates susceptibility to rubella and the need for vaccination. However, administering a live virus vaccine like rubella during pregnancy is contraindicated due to the risk of fetal harm. Therefore, this interpretation is incorrect.
C) The client requires a rubella immunization following delivery:
A negative rubella titer during pregnancy indicates susceptibility to rubella. After delivery, the client should receive a rubella immunization to prevent rubella infection in future pregnancies. Rubella vaccination is safe postpartum and helps protect the mother and future pregnancies. Therefore, this interpretation is correct.
D) The client is not experiencing a rubella infection at this time:
A rubella titer measures the level of antibodies to the rubella virus, not the presence of an active infection. A negative rubella titer indicates the absence of immunity to rubella, not the absence of an active infection. Therefore, this interpretation is incorrect.
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