A patient is severely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effects does the nurse expect this will have on the red blood cells

The blood cells will migrate to the bone marrow

the red cells will precipitate out of circulation

They will swell and eventually rupture

The cells will shrink and shrivel, decreasing their oxygen-carrying ability

Answer and Explanation

The Correct Answer is D

A) The blood cells will migrate to the bone marrow:
While the bone marrow is responsible for producing red blood cells, dehydration and hypertonicity of the blood would not cause the red blood cells to migrate to the bone marrow. Migration of blood cells typically refers to white blood cells moving toward sites of infection or inflammation, not a response to dehydration.

B) The red cells will precipitate out of circulation:
Red blood cells do not precipitate out of circulation due to dehydration or hypertonic conditions. Instead, dehydration causes a shift in water balance that leads to changes in the shape and function of the red blood cells. Precipitation of cells is not a physiological response in this context.

C) They will swell and eventually rupture:
In conditions of hypertonicity, where the concentration of solutes (such as sodium) in the blood is higher than normal, red blood cells actually shrink, not swell. When blood is hypertonic, water moves out of the red blood cells into the extracellular space to balance the osmotic pressure, leading to cell shrinkage. Cells only swell in hypotonic conditions, when water moves into the cell.

D) The cells will shrink and shrivel, decreasing their oxygen-carrying ability:
When the body becomes dehydrated, the blood becomes hypertonic (more concentrated), leading to a shift of water out of the red blood cells to try to balance the osmotic gradient. As a result, the red blood cells shrink and shrivel. This shrinkage can impair their ability to carry oxygen effectively, as the cells may become more rigid and less flexible, making it difficult for them to navigate through small blood vessels and perform gas exchange in the lungs and tissues.

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Correct Answer is D

Explanation

A) CSF proteins and an angiography: While cerebrospinal fluid (CSF) analysis is a valuable diagnostic tool in multiple sclerosis (MS), angiography is not typically used in diagnosing MS. Angiography is primarily used to assess blood vessels and would not help in diagnosing a neurological condition like MS, which involves the central nervous system's myelin sheath.
B) Serum anti-acetylcholine antibodies and x-rays: Anti-acetylcholine antibodies are more relevant for diagnosing autoimmune conditions such as myasthenia gravis, not multiple sclerosis. Additionally, x-rays are not useful for diagnosing MS, as MS is primarily a disorder of the central nervous system, and x-rays are not effective in visualizing soft tissues or brain lesions associated with MS.
C) Serum albumin and a computed tomography (CT) scan: Serum albumin levels are not relevant for diagnosing MS. A CT scan may be used in some cases to rule out other conditions, but magnetic resonance imaging (MRI) is more sensitive and specific for diagnosing MS. MRI is particularly effective in detecting the plaques or lesions in the brain and spinal cord that are characteristic of MS.
D) Cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI): This is the correct combination of diagnostic tests for multiple sclerosis. CSF analysis can show elevated levels of immunoglobulin G (IgG) and oligoclonal bands, which are common in MS. MRI is the most sensitive imaging tool for detecting the characteristic plaques or demyelinated areas in the brain and spinal cord, which are hallmarks of MS. Therefore, this combination is the gold standard for confirming the diagnosis of MS.

A. Excessive salivation B. Respiratory paralysis C. Muscle weakness D. Muscle spasms

Correct Answer is C

Explanation

A) Excessive salivation: Neostigmine (Prostigmin) is a cholinesterase inhibitor, which works by increasing the levels of acetylcholine at neuromuscular junctions. If a dose is missed, excessive salivation can be a side effect of too much acetylcholine activity, but it is not the most immediate symptom in this case. Muscle weakness is a more direct consequence of a missed dose.

B) Respiratory paralysis: While respiratory weakness or paralysis can occur in myasthenia gravis, it is usually associated with a severe form of the disease or if the patient is in a myasthenic crisis. A single missed dose of neostigmine typically does not result in respiratory failure unless the patient is already in a very fragile state.

C) Muscle weakness: Neostigmine helps to improve neuromuscular transmission by inhibiting the breakdown of acetylcholine, which is crucial for muscle contraction. A missed dose would directly lead to a reduction in acetylcholine levels, exacerbating the characteristic muscle weakness of myasthenia gravis. Muscle weakness is the most anticipated symptom when neostigmine is not administered on time.

D) Muscle spasms: Muscle spasms are typically not a symptom of missed neostigmine therapy. Instead, muscle weakness occurs due to impaired neuromuscular transmission. Spasms might occur if there is significant overstimulation of the muscles, but this is more associated with electrolyte imbalances or other neuromuscular issues

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A patient is severely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effects does the nurse expect this will have on the red blood cells

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Naxlex Comprehensive Predictor Exams

A patient has symptoms that are characteristic of multiple sclerosis (MS). Which diagnostic tests are likely to be ordered to aid in the diagnosis of this patient?

Correct Answer is D

Explanation

The nurse assumes care of a patient who has myasthenia gravis and notes that a dose of neostigmine (Prostigmin) due 1 hour prior was not given. The nurse will anticipate the patient to exhibit which symptoms?

Correct Answer is C

Explanation

A student ask the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?

A patient is severely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effects does the nurse expect this will have on the red blood cells

The nurse is preparing to care for a patient who has myasthenia gravis. The nurse will be alert to symptoms affecting which body system in this patient?

The nurse is caring for a patient with Parkinson’s disease. While writing the care plan for this patient what would be an appropriate nursing diagnosis?

After the effector cell has being stimulated by acetylcholine (ACh), what enzyme stop the stimulation and allows the effector membrane to repolarize?

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