A nurse is collecting data from a client who is dehydrated due to fluid volume deficit. Which of the following findings should the nurse expect?

Moist skin

Distended neck veins

Increased urinary output

Thready pulses

Answer and Explanation

The Correct Answer is D

A. Moist skin: Dehydration typically causes the skin to become dry, not moist. In fluid volume deficit, the body loses water and electrolytes, leading to a lack of moisture in the skin.

B. Distended neck veins: Distended neck veins are typically a sign of fluid volume excess or overload, such as in heart failure, not fluid volume deficit. Dehydration usually leads to decreased blood volume, which results in flat veins.

C. Increased urinary output: Dehydration leads to decreased urine output as the body attempts to conserve water. Increased urinary output would be seen in conditions like diabetes insipidus, not dehydration.

D. Thready pulses: Thready pulses are a common sign of dehydration. Fluid volume deficit reduces circulating blood volume, leading to weaker and less palpable pulses, which is characteristic of dehydration.

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","B","D"]

Explanation

A. Never give KCI intramuscularly (IM) or as an IV bolus: Potassium chloride (KCl) should never be administered via IM injection or as an IV bolus. Both methods can cause severe irritation, tissue necrosis, and cardiac complications. Potassium should be given slowly and diluted to prevent these risks.

B. Always dilute potassium chloride in a large amount of IV solution: Potassium chloride must always be diluted when administered IV to prevent vein irritation and reduce the risk of hyperkalemia. It should be given in a large volume of fluid to ensure safe, slow infusion.

C. Never administer more than 40 mEq/L of IV potassium chloride (KCl) per hour: While the general recommendation is to limit the infusion rate to 10-20 mEq/hour for most patients, in certain situations, doses higher than 40 mEq/L per hour might be prescribed under close monitoring depending on the specific clinical situation.

D. Monitor the IV site frequently for early signs of infiltration, as potassium is caustic to the tissues: Potassium chloride is irritating to veins and tissues. If the IV infiltrates (leaks into the surrounding tissue), it can cause significant tissue damage, so frequent monitoring of the IV site is essential.

A. An NG tube to suction B. An indwelling urinary catheter to gravity drainage C. A chest tube to water-seal drainage D. A nephrostomy tube to a drainage bag

Correct Answer is A

Explanation

A. An NG tube to suction: Nasogastric (NG) tube suction can result in the loss of potassium through gastric secretions. Prolonged suction can cause a significant loss of electrolytes, including potassium, leading to hypokalemia. This is the client most at risk for hypokalemia.

B. An indwelling urinary catheter to gravity drainage: An indwelling urinary catheter drains urine, which does not typically cause significant potassium loss. Potassium loss through the urinary system would require excessive urination or diuretic use, not gravity drainage.

C. A chest tube to water-seal drainage: A chest tube to water-seal drainage is used to drain air or fluid from the pleural space. It does not typically result in significant electrolyte loss like potassium, so this is not a major concern for hypokalemia.

D. A nephrostomy tube to a drainage bag: A nephrostomy tube drains urine from the kidney, but it does not generally lead to significant potassium loss unless there are other underlying conditions, such as diuretic therapy. This is not as high a risk for hypokalemia as NG suction.

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 collecting data from a client who is dehydrated due to fluid volume deficit. Which of the following findings should the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When administering potassium chloride, which of following safety precautions must be observed? (Select all that apply)

Correct Answer is ["A","B","D"]

Explanation

A nurse is caring for four clients who have drainage tubes. The nurse should identify the client who has which of the following tubes as being at risk for hypokalemia?

Correct Answer is A

Explanation

Four patients arrive at the emergency department at the same time. Which patient will the nurse see first?

A licensed practical/vocational nurse (LPN/LVN) is preparing to add a new IV of 5% dextrose in water (D5W) with potassium (K) to an existing line. The LPN/LVN notices that only 25 mL of urine has been collected over the past hour. What is the most appropriate nursing intervention?

The nurse is aware that the compensating mechanism that is most likely to occur in the presence of respiratory acidosis is:

A client has been admitted with chronic obstructive pulmonary disease. Diagnostic tests have been ordered. Which of the tests will provide the most accurate indicator of the client's acid-base balance?

A nurse teaches a client who is at risk for mild hypernatremia. Which statement should the nurse include in this client's teaching?

A nurse is caring for a client who exhibits dehydration-induced confusion. Which intervention should the nurse implement first?

A client at risk for developing hyperkalemia states, "I love fruit and usually eat it every day, but now I can't because of my high potassium level." How should the nurse respond?

A patient presents to the emergency department with reports of vomiting and diarrhea for the past 48 hours. The health care provider orders isotonic intravenous (IV) therapy. Which IV will the nurse prepare?