A nurse is caring for four hospitalized patients.
Which of the following patients should the nurse identify as being at risk for fluid volume deficit?
The patient who has left-sided heart failure and has a brain natriuretic peptide (BNP) level of 600 pg/mL.
The patient who has been NPO since midnight for endoscopy.
The patient who has gastroenteritis and is febrile.
The patient who has end-stage renal failure and is scheduled for dialysis today.
The Correct Answer is C
Choice A rationale
While heart failure can lead to fluid volume imbalances, a BNP level of 600 pg/mL alone does not indicate a risk for fluid volume deficit.
Choice B rationale
Being NPO since midnight for an endoscopy could potentially lead to fluid volume deficit, but it’s not the most likely choice. Typically, patients are adequately hydrated before and after the procedure.
Choice C rationale
A patient with gastroenteritis and a fever is at high risk for fluid volume deficit. Gastroenteritis can cause significant fluid loss through vomiting and diarrhea, and fever increases insensible water loss.
Choice D rationale
While patients with end-stage renal failure can have fluid volume imbalances, they are more likely to experience fluid volume excess, especially if they are due for dialysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Nonfat milk is generally not a trigger for GERD101112131415. It is low in fat and thus less likely to relax the lower esophageal sphincter, which can lead to acid reflux1415.
Choice B rationale
Chocolate is known to trigger GERD symptoms1415. It contains caffeine and fat, which can relax the lower esophageal sphincter and cause acid reflux1415.
Choice C rationale
Oatmeal is generally not a trigger for GERD101112131415. It is a whole grain that is high in fiber, which can help control GERD symptoms1415.
Choice D rationale
Apples are generally not a trigger for GERD101112131415. They are non-citrus fruits and thus less likely to cause acid reflux1415.
Correct Answer is D
Explanation
Choice A rationale
While liver issues can be a concern with certain medications or diseases, they are not typically associated with GERD. GERD is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. Therefore, monitoring for liver issues would not be directly relevant to a patient with GERD.
Choice B rationale
Pancreatic cancer is a serious condition, but it is not directly related to GERD. GERD is primarily an issue of the esophagus and stomach, not the pancreas. While it’s always important to be vigilant about potential health issues, there is no specific reason for a patient with GERD to watch for manifestations of pancreatic cancer.
Choice C rationale
While diabetes is a significant health concern, it is not directly linked to GERD. GERD does not increase the risk for diabetes. An endocrinologist specializes in hormonal disorders, including
diabetes, but would not typically be involved in the management of GERD unless there were other co-existing endocrine issues.
Choice D rationale
This is the correct answer. Barrett’s esophagus is a condition that can develop in people who have long-term GERD. It changes the color and composition of the esophagus lining, which can increase the risk of esophageal cancer. Therefore, it is important for patients with long-term GERD symptoms to follow up with a GI specialist for recommended surveillance for Barrett’s esophagus.
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