A nurse is teaching a client who has diabetes mellitus about fluid and electrolyte balance. The nurse should instruct the client to increase fluid intake before, during, and after active exercise for which of the following reasons?

"To prevent hypernatremia and dehydration.”

"To dilute excess glucose and ketones in the blood.”

"To promote renal perfusion and urine output.”

"To replace lost electrolytes and prevent acidosis."

Answer and Explanation

The Correct Answer is A

Choice A reason:

To prevent hypernatremia and dehydration. This is the correct reason because exercise increases fluid loss through sweating and breathing, which can lead to dehydration and high sodium levels in the blood (hypernatremia) Dehydration and hypernatremia can cause symptoms such as thirst, confusion, weakness, and seizures. Therefore, increasing fluid intake before, during, and after active exercise can help maintain fluid and electrolyte balance in clients who have diabetes mellitus.

Choice B reason:

To dilute excess glucose and ketones in the blood. This is not a correct reason because increasing fluid intake does not lower blood glucose or ketone levels significantly. Clients who have diabetes mellitus should monitor their blood glucose and ketone levels regularly and adjust their insulin dosage and carbohydrate intake accordingly. Fluid intake alone is not enough to prevent hyperglycemia or ketoacidosis, which are serious complications of diabetes mellitus.

Choice C reason:

To promote renal perfusion and urine output. This is not a correct reason because increasing fluid intake does not improve kidney function or urine output in clients who have diabetes mellitus. Clients who have diabetes mellitus are at risk of developing diabetic nephropathy, which is a chronic kidney disease caused by damage to the blood vessels and glomeruli of the kidneys. Diabetic nephropathy can lead to reduced renal perfusion and urine output, as well as proteinuria, edema, hypertension, and renal failure. Therefore, increasing fluid intake does not prevent or treat diabetic nephropathy.

Choice D reason:

To replace lost electrolytes and prevent acidosis. This is not a correct reason because increasing fluid intake does not replenish electrolytes or prevent acidosis in clients who have diabetes mellitus. Clients who have diabetes mellitus are at risk of developing diabetic ketoacidosis (DKA), which is a life-threatening condition caused by insufficient insulin production or utilization, resulting in high blood glucose and ketone levels. DKA causes metabolic acidosis, which lowers the pH of the blood and body fluids. DKA also causes electrolyte imbalances, such as low potassium, sodium, chloride, and bicarbonate levels. Therefore, increasing fluid intake does not correct the metabolic acidosis or electrolyte imbalances caused by DKA.

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 C

Explanation

Choice A reason: Hyperglycemia. This is incorrect because dextrose 5% in water (D5W) is not likely to cause hyperglycemia in a dehydrated client. D5W is a hypotonic solution that provides free water and glucose to the body. The glucose is rapidly metabolized by the cells, leaving only water in the intravascular space. This water then moves into the intracellular and interstitial compartments, rehydrating the tissues. Therefore, D5W does not increase the blood glucose level significantly in a dehydrated client.

Choice B reason:

Hyperkalemia. This is incorrect because dextrose 5% in water (D5W) does not contain any potassium or other electrolytes. Hyperkalemia is a condition of high potassium level in the blood, which can be caused by renal failure, acidosis, tissue injury, or excessive intake of potassium-rich foods or supplements. D5W does not affect the potassium level in the blood.

Choice C reason:

Fluid overload. This is correct because dextrose 5% in water (D5W) can cause fluid overload in a client who has impaired fluid regulation mechanisms, such as heart failure, kidney disease, or liver disease. Fluid overload is a condition of excess fluid volume in the body, which can lead to edema, hypertension, dyspnea, crackles, jugular venous distension, and pulmonary congestion. D5W can cause fluid overload by expanding the intravascular volume and shifting water into the interstitial and intracellular spaces.

Choice D reason:

Metabolic acidosis. This is incorrect because dextrose 5% in water (D5W) does not cause metabolic acidosis in a dehydrated client. Metabolic acidosis is a condition of low pH and low bicarbonate level in the blood, which can be caused by diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, or ingestion of toxic substances. D5W does not affect the pH or bicarbonate level in the blood.

A. "This solution will help lower your blood sugar level.” B. "This solution will provide some nutrition with glucose.” C. "This solution will correct your low sodium level.” D. "This solution will increase your blood volume."

Correct Answer is C

Explanation

Choice A reason:

This is incorrect because dextrose 5% in normal saline is a hypertonic solution that will increase the blood sugar level, not lower it. Patients with Addison's crisis have low cortisol levels, which can impair glucose metabolism and cause hypoglycemia, so they need glucose supplementation.

Choice B reason:

This is partially correct because dextrose 5% in normal saline will provide some nutrition with glucose, but this is not the main reason for using this solution in Addison's crisis. Patients with Addison's crisis have low aldosterone levels, which can cause hyponatremia and hypovolemia, so they need sodium and fluid replacement.

Choice C reason:

This is correct because dextrose 5% in normal saline will correct the low sodium level caused by aldosterone deficiency in Addison's crisis. Sodium is essential for maintaining blood pressure, fluid balance, and nerve and muscle function. Dextrose 5% in normal saline will also increase the blood volume and prevent dehydration and shock.

Choice D reason:

This is partially correct because dextrose 5% in normal saline will increase the blood volume, but this is not the only solution that can do that. Other isotonic or hypertonic solutions can also expand the intravascular space. Dextrose 5% in normal saline is preferred in Addison's crisis because it also provides glucose and sodium, which are both deficient in this condition.

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 teaching a client who has diabetes mellitus about fluid and electrolyte balance. The nurse should instruct the client to increase fluid intake before, during, and after active exercise for which of the following reasons?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has dehydration and is receiving dextrose 5% in water (D5W) intravenously. The nurse should monitor the client for which of the following complications of this type of solution?

Correct Answer is C

Explanation

A client who has Addison's crisis is receiving dextrose 5% in normal saline intravenously. The client asks the nurse why this type of solution is used. Which of the following responses should the nurse give?

Correct Answer is C

Explanation

A nurse is reviewing the laboratory results of a client who has diabetic ketoacidosis (DKA) and is receiving 0.45% sodium chloride (1/2 normal saline) intravenously. Which of the following findings indicates that the therapy is effective?

A nurse is preparing to administer lactated Ringer's (LR) solution to a client who has hypovolemia due to third-space shifting. Which of the following actions should the nurse take? (Select all that apply.)

A nurse is teaching a client who has diabetes mellitus about fluid and electrolyte balance. The nurse should instruct the client to increase fluid intake before, during, and after active exercise for which of the following reasons?