A nurse is to administer a hypotonic solution to a patient with a critically high sodium. Which solution is hypotonic?
0.9% Sodium Chloride
Lactated Ringer's
D5W (5% Dextrose in Water)
0.45% Sodium Chloride
The Correct Answer is D
Choice A reason: This is not a correct answer because 0.9% Sodium Chloride is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.
Choice B reason: This is not a correct answer because Lactated Ringer's is an isotonic solution, which means it has the same osmolarity as the blood plasma. It does not cause any fluid shifts between the intracellular and extracellular compartments.
Choice C reason: This is not a correct answer because D5W (5% Dextrose in Water) is an isotonic solution when it is in the IV bag, but it becomes hypotonic once it enters the body, as the dextrose is rapidly metabolized and only water remains. However, it is not a preferred solution for a patient with critically high sodium, as it can cause cerebral edema and worsen the neurological status.
Choice D reason: This is a correct answer because 0.45% Sodium Chloride is a hypotonic solution, which means it has a lower osmolarity than the blood plasma. It causes fluid to shift from the extracellular to the intracellular compartment, which can help lower the sodium level and correct the fluid imbalance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: A client who has a urine specific gravity of 1.010 is not dehydrated. Urine specific gravity is a measure of the concentration of solutes in the urine. A normal range is 1.005-1.030, which means that the urine is neither too dilute nor too concentrated. A high urine specific gravity (>1.030) indicates dehydration, as the urine becomes more concentrated due to fluid loss. A low urine specific gravity (<1.005) indicates overhydration, as the urine becomes more dilute due to fluid excess.
Choice B reason: A client who has a hematocrit of 42% is not dehydrated. Hematocrit is the percentage of red blood cells in the blood. A normal range is 36-46% for women and 40-54% for men. A high hematocrit (>54% for men and >46% for women) indicates dehydration, as the blood becomes more viscous due to fluid loss. A low hematocrit (<40% for men and <36% for women) indicates overhydration, as the blood becomes more diluted due to fluid excess.
Choice C reason: A client who has a temperature of 39 °C may or may not be dehydrated. Temperature is a measure of the body's heat production and regulation. A normal range is 36.5-37.5 °C. A high temperature (>37.5 °C) indicates fever, which can be caused by various factors, such as infection, inflammation, or medication. Fever can also cause dehydration, as the body loses fluid through sweating and increased respiration. However, fever is not a specific sign of dehydration, as there may be other causes or contributing factors.
Choice D reason: A client who has a weight loss of 2.2 kg in 24 hr is dehydrated. Weight loss is a measure of the change in the body's mass over time. A normal range is 0.5-1 kg per week. A rapid weight loss (>1 kg per day) indicates dehydration, as the body loses fluid through various routes, such as urine, stool, sweat, or vomit. Weight loss is a sensitive and reliable sign of dehydration, as it reflects the amount of fluid loss.
Correct Answer is C
Explanation
Choice A reason: Ulcerative colitis is not a complication of diverticulitis. Ulcerative colitis is a chronic inflammatory bowel disease that causes ulcers and inflammation in the colon and rectum. Diverticulitis is an acute condition that occurs when small pouches called diverticula in the colon become infected or inflamed.
Choice B reason: Dysphagia is not a complication of diverticulitis. Dysphagia is a term for difficulty swallowing, which can have many causes, such as stroke, nerve damage, or esophageal cancer. Diverticulitis affects the lower part of the digestive tract, not the upper part.
Choice C reason: Peritonitis is a complication of diverticulitis. Peritonitis is an inflammation of the peritoneum, the membrane that lines the abdominal cavity. It can be caused by a perforation or rupture of a diverticulum, which allows bacteria and fecal matter to enter the peritoneal space. Peritonitis is a serious and life-threatening condition that requires immediate medical attention.
Choice D reason: Crohn's disease is not a complication of diverticulitis. Crohn's disease is a chronic inflammatory bowel disease that can affect any part of the digestive tract, causing ulcers, fistulas, and strictures. Diverticulitis is an acute condition that affects only the colon, not the entire digestive tract.
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