The nurse is prepping a client for a trip to the operating room. The nurse anticipates that the physician will order which IV fluid?

10% Dextrose

3% NaCl

Lactated Ringer’s

0.45% NaCl

Answer and Explanation

The Correct Answer is C

Choice A reason: 10% Dextrose is a hypertonic solution used for caloric supplementation or hypoglycemia treatment. It can cause hyperglycemia and fluid shifts, making it unsuitable for routine preoperative hydration. Surgical patients need balanced electrolyte solutions to replace fluid losses and maintain homeostasis, which 10% dextrose does not provide effectively.

Choice B reason: 3% NaCl, a hypertonic saline, is used for severe hyponatremia or cerebral edema. It risks causing hypernatremia and fluid overload if not carefully monitored. Preoperative patients typically require isotonic fluids to maintain electrolyte balance and hydration, making 3% NaCl inappropriate for standard surgical preparation.

Choice C reason: Lactated Ringer’s is an isotonic solution containing electrolytes like sodium, potassium, and calcium, closely mimicking plasma. It is ideal for preoperative hydration, as it replaces fluid losses, maintains electrolyte balance, and supports hemodynamic stability during surgery. Its balanced composition makes it the standard choice for surgical patients.

Choice D reason: 0.45% NaCl, a hypotonic solution, is used for maintenance hydration or hypernatremia correction. It provides less sodium than needed for surgical fluid replacement and may cause hyponatremia or fluid shifts. Isotonic fluids like Lactated Ringer’s are preferred preoperatively to ensure electrolyte stability and adequate hydration.

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Correct Answer is C

Explanation

Choice A reason: Supine with head elevated is used for comfort or respiratory support but not for lumbar puncture. This position does not allow access to the lumbar spine or flex the back to open intervertebral spaces, which is necessary for safe needle insertion during the procedure.

Choice B reason: Prone with legs extended is used for procedures like wound care but not lumbar puncture. This position does not flex the spine to widen intervertebral spaces, making needle insertion difficult and risky. The lateral recumbent position is standard for accessing the subarachnoid space.

Choice C reason: Lateral recumbent with knees flexed maximizes lumbar spine flexion, opening intervertebral spaces for safe needle insertion into the subarachnoid space during a lumbar puncture. This position reduces the risk of nerve damage and ensures accurate cerebrospinal fluid collection, making it the standard choice.

Choice D reason: Sitting upright with back straight may be used in some procedures but is less common for lumbar puncture. It does not provide optimal spinal flexion compared to the lateral recumbent position, which better exposes the lumbar vertebrae, reducing complications during needle insertion.

A. Rebound tenderness at McBurney’s point B. Left lower quadrant pain C. High-pitched bowel sounds D. Soft, non-tender abdomen

Correct Answer is A

Explanation

Choice A reason: Rebound tenderness at McBurney’s point (right lower quadrant) indicates peritoneal irritation, a hallmark of appendicitis. The inflamed appendix causes localized pain, exacerbated by pressure release due to peritoneal inflammation. This specific finding is highly suggestive of appendicitis, distinguishing it from other abdominal conditions.

Choice B reason: Left lower quadrant pain is not typical for appendicitis, which usually presents in the right lower quadrant due to the appendix’s anatomical location. Left-sided pain may suggest conditions like diverticulitis or colitis, but it does not align with the localized inflammation characteristic of appendicitis.

Choice C reason: High-pitched bowel sounds suggest increased peristalsis, as in early obstruction, but are not specific to appendicitis. Appendicitis may reduce bowel sounds due to peritoneal irritation. Rebound tenderness is a more direct indicator, as it reflects the localized inflammation and irritation of appendicitis.

Choice D reason: A soft, non-tender abdomen is inconsistent with appendicitis, which causes localized pain and tenderness due to inflammation. A non-tender abdomen suggests a normal or alternative condition, not appendicitis, where peritoneal irritation typically produces tenderness, especially at McBurney’s point, upon palpation or rebound.

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The nurse is prepping a client for a trip to the operating room. The nurse anticipates that the physician will order which IV fluid?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing a client for a lumbar puncture. Which position should the nurse place the client in to facilitate the procedure?

Correct Answer is C

Explanation

A nurse is evaluating a client with suspected appendicitis. Which physical assessment finding is most indicative of this condition?

Correct Answer is A

Explanation

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