A nurse on a mental health unit is admitting a client.
Exhibits
Select the 3 client findings the nurse should recognize as manifestations of water intoxication.

Activity level

White blood cell count

Sodium level

Potassium level

Hallucinations

Answer and Explanation

Correct Answer : A,C,E

A. Activity level: Restlessness, pacing, and inability to remain seated are early neurological manifestations of water intoxication, stemming from cerebral edema related to hyponatremia. These signs often precede more severe symptoms like seizures.

B. White blood cell count: A count of 9,100/mm³ is within normal limits and does not indicate water intoxication. This value is unrelated to the dilutional effects of excessive fluid intake.

C. Sodium level: A sodium of 130 mEq/L indicates hyponatremia, which is a hallmark laboratory finding in water intoxication due to dilutional effects from excess fluid intake. Low sodium can cause neurological changes and altered mental status.

D. Potassium level: A potassium of 3.6 mEq/L is within the normal range and does not support a diagnosis of water intoxication. Potassium is less affected by acute overhydration compared to sodium.

E. Hallucinations: Responding to unseen stimuli can occur when hyponatremia causes cerebral swelling, disrupting normal brain function. In clients with psychotic disorders, excess water intake can exacerbate hallucinations or make them more pronounced.

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Correct Answer is C

Explanation

Rationale:

A. Current fecal impaction: While fecal impaction requires treatment, it is not related to the safety or pharmacologic effects of conjugated estrogen therapy and does not constitute a contraindication.

B. Present report of abdominal pain: Abdominal pain requires evaluation, but it is nonspecific and not an absolute contraindication to conjugated estrogen unless related to certain underlying conditions like liver disease or cancer.

C. Thrombophlebitis: Estrogen increases the risk of thromboembolic events by promoting clot formation. A history or presence of thrombophlebitis makes estrogen therapy unsafe due to the elevated risk of worsening venous thromboembolism.

D. Diverticulitis: Diverticulitis is an inflammatory bowel condition that is not directly affected by estrogen therapy. It would not typically prohibit the use of conjugated estrogen unless complications or comorbidities present additional risks.

A. Cleanse the insertion site of the drain using a circular motion toward the center. B. Irrigate the wound with a low-pressure flow of solution. C. Irrigate the wound using a 10-mL syringe. D. Cleanse the wound starting at the bottom and moving upward.

Correct Answer is B

Explanation

A. Cleanse the insertion site of the drain using a circular motion toward the center: Proper technique involves cleaning from the least contaminated area (the center) outward to the surrounding skin, not toward the center, to prevent introducing pathogens into the wound.

B. Irrigate the wound with a low-pressure flow of solution: Low-pressure irrigation helps remove debris and exudate without damaging tissue or disrupting healing. It is a safe and effective method for cleansing an abdominal incision.

C. Irrigate the wound using a 10-mL syringe: Using a small syringe can create high-pressure flow, which may traumatize tissue. Larger volume syringes (e.g., 30–60 mL) with controlled, low-pressure flow are recommended for wound irrigation.

D. Cleanse the wound starting at the bottom and moving upward: Wound cleaning should proceed from the least contaminated area (top or center of the incision) toward more contaminated areas (periphery) to reduce the risk of introducing bacteria into the wound.

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A nurse on a mental health unit is admitting a client. Exhibits Select the 3 client findings the nurse should recognize as manifestations of water intoxication.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical history of a client who asks about the use of conjugated estrogen. The nurse should identify which of the following findings as a contraindication for the administration of this medication?

Correct Answer is C

Explanation

A nurse is performing wound care for a client who has an abdominal incision. Which of the following techniques should the nurse implement?

Correct Answer is B

Explanation

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A nurse on a mental health unit is admitting a client. Exhibits Select the 3 client findings the nurse should recognize as manifestations of water intoxication.

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A nurse on a mental health unit is admitting a client.
Exhibits
Select the 3 client findings the nurse should recognize as manifestations of water intoxication.