Which intervention should the nurse implement to manage a client’s fluid and electrolyte balance?

Monitor daily urine output volume

Use salt tablets after strenuous exercise

Review food labels for sodium content

Drink plenty of water whenever thirsty

Answer and Explanation

The Correct Answer is A

Choice A reason: Monitoring daily urine output assesses kidney function and fluid balance, as urine volume reflects hydration and electrolyte homeostasis. Inadequate output signals dehydration or renal issues, allowing timely intervention to maintain fluid and electrolyte balance, making it the most effective nursing action.

Choice B reason: Salt tablets after exercise replace sodium lost in sweat but are not a universal intervention for fluid and electrolyte balance. They risk hypernatremia if overused. Monitoring urine output is more comprehensive, as it directly evaluates fluid status across various clinical scenarios.

Choice C reason: Reviewing food labels for sodium content helps manage dietary intake but is indirect and patient-dependent. Urine output monitoring provides objective data on fluid and electrolyte status, enabling timely adjustments in therapy, making it a more immediate and reliable intervention.

Choice D reason: Drinking water when thirsty supports hydration but relies on subjective thirst, which may be impaired in certain conditions. Monitoring urine output objectively assesses fluid balance, detecting imbalances early, making it a more proactive and precise intervention than thirst-driven hydration.

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Correct Answer is A

Explanation

Choice A reason: Reducing dietary sodium lowers blood pressure in hypertension by decreasing vascular fluid volume and vasoconstriction. Sodium restriction (e.g., <2.3 g/day) reduces cardiac workload, preventing complications like heart failure, making it the priority lifestyle modification for effective blood pressure control.

Choice B reason: Increasing saturated fat consumption worsens hypertension by promoting atherosclerosis and vascular stiffness. Sodium reduction is critical, as it directly lowers blood volume and pressure, reducing cardiovascular risk, making it the priority over dietary fat adjustments in hypertension management.

Choice C reason: Limiting physical activity is incorrect, as exercise lowers blood pressure by improving vascular elasticity. Sodium reduction is the priority, as it directly reduces fluid retention and vasoconstriction, providing immediate blood pressure control, making it essential for hypertension management.

Choice D reason: Smoking cessation is beneficial but not the primary focus unless active smoking is confirmed. Sodium reduction directly lowers blood pressure by decreasing fluid volume, making it the priority lifestyle change, as it addresses hypertension’s core mechanism more effectively.

A. Serum creatinine B. Troponin levels C. Complete blood count D. Blood glucose

Correct Answer is B

Explanation

Choice A reason: Serum creatinine assesses kidney function, not cardiac injury. While relevant for overall health, it does not confirm myocardial infarction. Troponin is specific to cardiac muscle damage, making it the priority test to diagnose acute coronary events in the emergency setting.

Choice B reason: Troponin levels are the gold standard for diagnosing myocardial infarction, as they rise within hours of cardiac muscle injury due to ischemia. High specificity for heart tissue makes troponin critical for confirming acute coronary syndrome, guiding urgent treatment in the emergency department.

Choice C reason: Complete blood count evaluates anemia or infection but is nonspecific for myocardial infarction. While useful for overall assessment, it does not detect cardiac injury. Troponin directly indicates heart muscle damage, making it the priority test for confirming the diagnosis.

Choice D reason: Blood glucose may be elevated in stress or diabetes but is not diagnostic for myocardial infarction. Cardiac-specific markers like troponin are essential for confirming heart injury, as glucose levels lack specificity for acute coronary events, making them secondary.

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Which intervention should the nurse implement to manage a client’s fluid and electrolyte balance?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with a history of hypertension. Which lifestyle modification should the nurse emphasize?

Correct Answer is A

Explanation

A client is admitted to the emergency department with a suspected myocardial infarction. Which laboratory test should the nurse prioritize to confirm the diagnosis?

Correct Answer is B

Explanation

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