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A client at risk for mild hypernatremia is being taught by a nurse. Which statement should the nurse include in this client's teaching?
- A. Weigh yourself every morning and every night
- B. Check your radial pulse twice a day
- C. Read food labels to determine sodium content
- D. Bake or grill the meat rather than frying it
Correct Answer: C
Rationale: The correct answer is C. Reading food labels to determine sodium content is important in managing mild hypernatremia. This allows the client to monitor and control their sodium intake, which can help prevent further elevation of sodium levels. Weighing oneself or checking the pulse does not directly address sodium intake. Choosing cooking methods like baking or grilling is more about reducing fat intake, not sodium.
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. A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation should the nurse identify as an exam
- A. Increased rate and depth of respirations
- B. ncreased urinary output
- C. Increased thirst and hunger
- D. ncreased release of acids from the kidneys
Correct Answer: A
Rationale: The correct answer is A: Increased rate and depth of respirations. In this case, the client's arterial blood gas values show a pH within normal range (7.36), PaCO2 below normal (33 mm Hg), and HCO3 below normal (18 mEq/L), indicating a metabolic acidosis. To compensate for the acidosis, the client will hyperventilate, leading to increased rate and depth of respirations to blow off excess CO2 and attempt to normalize the pH. Options B, C, and D are incorrect because increased urinary output, thirst, hunger, and release of acids from the kidneys are not direct compensatory mechanisms for metabolic acidosis.
A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults.
What factors contribute to this phenomenon? Select all that do not apply.
- A. Decreased kidney mass
- B. Decreased renal blood flow
- C. Decreased excretion of potassium
- D. Increased conservation of sodium
Correct Answer: D
Rationale: The correct answer is D: Increased conservation of sodium. Older adults tend to have an increased conservation of sodium, leading to fluid retention and decreased fluid intake, which can contribute to dehydration.
A: Decreased kidney mass is incorrect because it is a factor that can contribute to decreased kidney function but not directly linked to dehydration.
B: Decreased renal blood flow can impact kidney function but is not a direct cause of dehydration in older adults.
C: Decreased excretion of potassium is not a factor that directly contributes to dehydration in older adults.
After teaching a client who was malnourished and is being discharged, a nurse assesses the clients understanding. Which statement indicates the client correctly understood teaching to decrease risk for the development of metabolic acidosis?
- A. I will drink at least three glasses of milk each day.
- B. . I will eat three well-balanced meals and a snack daily.
- C. . I will not take pain medication and antihistamines together.
- D. I will avoid salting my food when cooking or during meals.
Correct Answer: A
Rationale: The correct answer is A: "I will drink at least three glasses of milk each day." Milk is a good source of calcium and bicarbonate, which can help buffer excess acids in the body and prevent metabolic acidosis. Calcium also plays a role in maintaining the acid-base balance.
Option B is incorrect because while eating well-balanced meals is important for overall health, it does not specifically address the prevention of metabolic acidosis. Option C is irrelevant to the prevention of metabolic acidosis. Option D is incorrect because avoiding salting food does not directly address the underlying issue of metabolic acidosis related to malnutrition.
. One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acutecare nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over
15 minutes. This intervention will achieve which of the following?
- A. Help distinguish hyponatremia from hypernatremia
- B. Help evaluate pituitary gland function
- C. Help distinguish reduced renal blood flow from decreased renal function
- D. Help provide an effective treatment for hypertension-induced oliguria
Correct Answer: C
Rationale: The correct answer is C: Help distinguish reduced renal blood flow from decreased renal function.
Rationale:
1. Oliguria is a decrease in urine output.
2. Fluid challenge with normal saline can help determine the cause of oliguria by assessing the response of the kidneys.
3. If the oliguria improves after the fluid challenge, it suggests reduced renal blood flow as the cause.
4. If oliguria persists, it indicates decreased renal function.
Summary:
A. Fluid challenge does not directly help in distinguishing between hyponatremia and hypernatremia.
B. Evaluating pituitary gland function requires specific tests, not just a fluid challenge.
D. Treating hypertension-induced oliguria may involve different interventions, not just a fluid challenge.
You are called to your patients room by a family member who voices concern about the patients status. On
assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also
find 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this patients signs and symptoms?
- A. Hypocalcemia
- B. Hyponatremia
- C. Hyperchloremia
- D. Hypophosphatemia
Correct Answer: C
Rationale: The correct answer is C: Hyperchloremia. In this scenario, the patient's symptoms point towards fluid overload, which can lead to hyperchloremia due to excessive chloride intake. 3+ pitting edema suggests fluid retention, a common symptom of hyperchloremia. Additionally, tachypnea can occur as a compensatory mechanism for metabolic acidosis seen in hyperchloremia. Lethargy, weakness, and diminished cognitive ability can be attributed to electrolyte imbalances impacting nerve and muscle function.
Choice A: Hypocalcemia is less likely as it typically presents with neuromuscular irritability, not lethargy.
Choice B: Hyponatremia usually presents with neurological symptoms like confusion and seizures, not the symptoms described.
Choice D: Hypophosphatemia typically presents with muscle weakness, not the full constellation of symptoms described.