Which fluid replacement therapy would the nurse prepare to administer for a patient who is exhibiting clinical manifestations of hypovolemic shock?
0.459% saline.
0.9% NaCl.
5% dextrose in 0.45% saline.
Dextran.
The Correct Answer is B
Choice A rationale:
0.459% saline is a hypotonic solution with a lower concentration of salt than the normal physiological range (0.9% NaCl) Hypotonic solutions can cause red blood cells to swell and potentially burst due to the osmotic imbalance, making it inappropriate for hypovolemic shock.
Choice B rationale:
0.9% NaCl, also known as normal saline, is an isotonic solution with a salt concentration similar to the body's own fluids. Isotonic solutions are ideal for hypovolemic shock as they help to expand the intravascular volume without causing significant shifts of fluid and electrolytes within the body compartments.
Choice C rationale:
5% dextrose in 0.45% saline is a hypotonic solution with a low salt concentration. While it provides some fluid replacement, it doesn't address the electrolyte imbalance adequately, which is crucial in hypovolemic shock.
Choice D rationale:
Dextran is a plasma volume expander but is not the first-line choice for hypovolemic shock. It might be used in certain situations, but isotonic crystalloids like 0.9% NaCl are preferred for rapid volume expansion and stabilization of the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The sodium level is within the normal range, but the potassium level is slightly elevated. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice B rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Choice C rationale:
Sodium level of 135 mEq/L, potassium level of 3.6 mEq/L is the correct answer. In this option, both sodium and potassium levels are within normal ranges. Changing the IV prescription to DSNS with 20 mEq KCl/L ensures that the patient receives adequate hydration (from the dextrose and normal saline) without causing hyperkalemia.
Choice D rationale:
The sodium level is slightly elevated, and the potassium level is within the normal range. This does not support the rationale for changing the IV prescription to a lower potassium concentration.
Correct Answer is B
Explanation
Choice A rationale:
Skeletal pain is not a typical finding in stage I Hodgkin lymphoma. Hodgkin lymphoma typically presents with painless enlarged lymph nodes, which is a hallmark symptom of the disease.
Choice B rationale:
Enlarged lymph nodes are a characteristic feature of Hodgkin lymphoma. In stage I, the disease is localized to one group of lymph nodes.
Choice C rationale:
T-cell blasts in the lymph node are not specific to Hodgkin lymphoma. Hodgkin lymphoma is characterized by the presence of Reed-Sternberg cells, which are large abnormal B cells, not T-cell blasts.
Choice D rationale:
Lymphoblasts in the cerebrospinal fluid are not associated with Hodgkin lymphoma. Involvement of the central nervous system is rare in Hodgkin lymphoma and typically does not lead to the presence of lymphoblasts in the cerebrospinal fluid.
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