A nurse is caring for a client who has heart failure (HF). Which of the following should the nurse identify as a cause for the client's decreased serum osmolality?

A decrease in intracellular fluid volume

An increase in hydrostatic pressure

An increase in serum sodium

An increase in vascular fluid volume

Answer and Explanation

The Correct Answer is D

A. A decrease in intracellular fluid volume: A reduction in intracellular fluid volume often results from hypertonic conditions in the extracellular space, which can draw water out of cells. This shift can actually increase serum osmolality rather than decrease it.
B. An increase in hydrostatic pressure: Increased hydrostatic pressure promotes fluid movement from the vascular space into the interstitial tissues, contributing to edema. However, this does not significantly impact the concentration of solutes in the serum and therefore does not directly cause a decrease in osmolality.
C. An increase in serum sodium: Sodium is the main contributor to serum osmolality, so an increase in serum sodium raises osmolality. This is the opposite of what occurs in heart failure, where sodium levels are often diluted due to fluid retention.
D. An increase in vascular fluid volume: In heart failure, the kidneys retain fluid in response to decreased cardiac output, expanding the vascular volume. This excess water dilutes the concentration of solutes in the blood, such as sodium, leading to a decrease in serum osmolality.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Respiratory acidosis: Clients with COPD have chronic difficulty exhaling carbon dioxide due to airflow obstruction, leading to CO₂ retention. This accumulation of carbon dioxide causes a drop in blood pH, resulting in respiratory acidosis, a common acid-base imbalance in COPD patients.
B. Metabolic acidosis: Metabolic acidosis results from increased acid production or loss of bicarbonate through the kidneys or gastrointestinal tract, such as in diabetic ketoacidosis or severe diarrhea. It is not typically associated with impaired ventilation or chronic lung disease like COPD.
C. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. Clients with COPD generally hypoventilate rather than hyperventilate, making this acid-base imbalance unlikely in this case.
D. Metabolic alkalosis: Metabolic alkalosis is typically caused by loss of hydrogen ions through vomiting or diuretic use, or excessive bicarbonate intake. It is unrelated to the impaired gas exchange and CO₂ retention seen in clients with COPD.

A. Reports pain as 5 on a scale of 0 to 10 B. Been on bedrest for 3 days C. Last bowel movement 2 days ago D. Consumed 35% of meals for 12 hr

Correct Answer is B

Explanation

A. "Reports pain as 5 on a scale of 0 to 10": While pain is an important concern, it is not the most immediate issue in this case. The nurse should first assess for factors that could contribute to complications or more severe issues.
B. "Been on bedrest for 3 days": Prolonged bedrest increases the risk of complications such as deep vein thrombosis (DVT), pulmonary embolism, or muscle atrophy. This is the priority because the client may be at risk for serious complications due to immobility.
C. "Last bowel movement 2 days ago": While constipation can cause discomfort, it is not as urgent as the risk posed by prolonged bedrest. This issue can be addressed once other more serious complications have been ruled out.
D. "Consumed 35% of meals for 12 hr": Poor nutrition is important to monitor, but it is not the immediate concern in this case. The focus should be on potential complications related to immobility, such as clot formation or respiratory issues.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A nurse is caring for a client who has heart failure (HF). Which of the following should the nurse identify as a cause for the client's decreased serum osmolality?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGS), which of the following conditions should the nurse anticipate the client to be experiencing?

Correct Answer is A

Explanation

A nurse is caring for a client who reports pain in their lower extremities following surgery. Which of the following should the nurse address first?

Correct Answer is B

Explanation

A nurse is planning care for a client who has a spinal cord injury and spasm-induced incontinence. Which of the following medications should the nurse anticipate a prescription for?

A nurse is providing care for a group of clients who have coronary artery disease who are all scheduled for coronary artery bypass grafts (CABG). Which of the following clients is at the highest risk for complications following the surgical procedure?

A nurse is teaching a client who has peripheral arterial disease. Which of the following statements should the nurse include in the teaching to explain peripheral arterial disease?

A nurse is caring for a male Muslim client. The nurse and the provider discuss the importance of having a male provider care for the client. This discussion represents which of the following foundational critical care competencies?

A nurse is caring for a client who has respiratory failure due to ventilation-perfusion (V/Q) mismatch. The nurse should recognize that the client most likely has which of the following conditions?

A nurse is caring for a client who has spinal stenosis. Which of the following conditions should the nurse recognize as a risk factor for spinal stenosis?

A nurse is providing teaching to a client who has atrial fibrillation and reports dizziness and palpitations. Which of the following should the nurse understand is the cause of these manifestations?

A nurse is caring for a client who has deep vein thrombosis (DVT) of their right lower leg. Which of the following manifestations should the nurse expect? (Select All that Apply.)