Which intravenous fluid is classified as a hypertonic solution?

Dextrose 2.5% with water

0.9% sodium chloride

Dextrose 5% with water

3% sodium chloride

Answer and Explanation

The Correct Answer is D

Choice A reason: Dextrose 2.5% with water is considered a hypotonic solution because it has a lower osmolarity than plasma. Administering hypotonic solutions moves water into the intracellular space, which can hydrate cells but does not pull fluid from the cells into the intravascular space.

Choice B reason: 0.9% sodium chloride, also called normal saline, is an isotonic solution because its osmolarity is approximately equal to that of plasma. It maintains fluid balance between the intravascular and interstitial spaces without causing significant fluid shifts into or out of cells.

Choice C reason: Dextrose 5% in water (D5W) is considered isotonic in the bag but becomes hypotonic after metabolism of dextrose. It provides free water that distributes throughout the intracellular and extracellular compartments, and it does not function as a hypertonic solution.

Choice D reason: 3% sodium chloride is a hypertonic solution because it has a higher osmolarity than plasma. Hypertonic solutions draw water out of cells into the intravascular space, which is useful in treating severe hyponatremia or cerebral edema. Administration requires careful monitoring to prevent fluid overload, hypernatremia, and cellular dehydration.

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Correct Answer is C

Explanation

Choice A reason:
While entry-level nurses are expected to think critically, attempting to solve complex problems entirely independently can risk errors or compromise client safety. Collaboration and guidance are key components of safe nursing practice.

Choice B reason:
Understanding that not every problem can be solved reflects realistic expectations, but it is a passive approach and does not actively guide the nurse toward safe decision-making or seeking appropriate support.

Choice C reason:
Recognizing one’s own limitations and seeking support from experienced colleagues or supervisors is a core competency for newly licensed nurses. This ensures safe, effective care while promoting professional growth and accountability. It reflects appropriate judgment, teamwork, and adherence to standards of practice.

Choice D reason:
Prioritizing self-care is important for long-term career sustainability and prevention of burnout, but it does not directly address the immediate decision-making or problem-solving required for handling a specific client situation safely.

A. Crackles in the lung bases B. Hemoglobin of 19.2 g/dL C. Blood pressure of 92/64 mmHg D. Weak peripheral pulses

Correct Answer is A

Explanation

Choice A reason:
Fluid volume overload leads to excess fluid in the intravascular and interstitial spaces. When fluid accumulates in the lungs, it causes pulmonary congestion, which is auscultated as crackles, particularly in the lung bases. This is a classic and expected assessment finding in fluid volume overload.

Choice B reason:
A hemoglobin level of 19.2 g/dL indicates hemoconcentration, which is more commonly associated with fluid volume deficit rather than overload. In fluid volume overload, hemodilution typically occurs, resulting in decreased hemoglobin and hematocrit levels.

Choice C reason:
A blood pressure of 92/64 mmHg suggests hypotension, which is more consistent with hypovolemia or shock. Fluid volume overload usually leads to increased blood pressure due to expanded intravascular volume, not decreased blood pressure.

Choice D reason:
Weak peripheral pulses are commonly seen in fluid volume deficit due to decreased circulating volume. In fluid volume overload, pulses are more likely to be bounding as a result of increased intravascular volume and pressure.

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Which intravenous fluid is classified as a hypertonic solution?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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