Which of the following actions is inappropriate when implementing precautions in a client with hyponatremia?
Encouraging a low-sodium diet
Padding the side rails of the bed
Providing a quiet and calm environment
Having the client use the call light when toileting is needed
The Correct Answer is A
A. Encouraging a low-sodium diet is inappropriate for a client with hyponatremia. Hyponatremia is a condition of low sodium levels in the blood, and the priority in managing this condition is to restore normal sodium levels, not to restrict sodium.
B. Padding the side rails of the bed is appropriate to protect the client from injury, especially if the client is at risk for seizures due to the electrolyte imbalance.
C. Providing a quiet and calm environment is beneficial for a client with hyponatremia, as it can help reduce the risk of seizures or agitation associated with the condition.
D. Having the client use the call light when toileting is needed is a standard precaution to ensure the client’s safety, especially if they are at risk of falls or confusion due to the electrolyte imbalance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hemoglobin A1C of 7.2 is diagnostic for diabetes. An A1C of 6.5% or higher is diagnostic for diabetes, as it reflects the average blood glucose levels over the past 2-3 months.
B. Fasting plasma glucose of 98 mg/dl is within the normal range (70-99 mg/dl). A fasting plasma glucose of 126 mg/dl or higher is diagnostic for diabetes.
C. Two-hour plasma glucose of 140 mg/dl is within the normal range (less than 140 mg/dl after a glucose tolerance test). A two-hour plasma glucose of 200 mg/dl or higher is diagnostic for diabetes.
D. Random plasma glucose of 110 mg/dl is within the normal range. A random plasma glucose of 200 mg/dl or higher, along with symptoms of hyperglycemia, would be diagnostic for diabetes.
Correct Answer is B
Explanation
A. Orthostatic hypotension can be concerning, but it is not as immediately alarming as a very elevated WBC count. It could indicate dehydration or blood loss, which are common in Crohn's disease exacerbations, but it is not as critical as an infection or severe inflammation.
B. A WBC count of 83 (normal range is typically 4,000-11,000) is significantly elevated and suggests a severe infection or inflammatory response, which is a critical concern in Crohn's disease exacerbations. This could indicate a life-threatening complication such as an abscess or perforation.
C. Lack of appetite for 2 days is common during an exacerbation of Crohn's disease, though it can contribute to dehydration or malnutrition, it is not as immediately concerning as an elevated WBC count.
D. Abdominal cramping is a typical symptom of Crohn's disease and may worsen during exacerbations, but it is not the most concerning finding compared to a severely elevated WBC count.
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