Nokea
The nurse is caring for a client with a burn injury covering 30% of the body. Which fluid should the nurse expect to administer?
- A. Normal saline
- B. Lactated Ringer's
- C. 5% dextrose
- D. Albumin
Correct Answer: B
Rationale: Lactated Ringer's is the preferred fluid for burn resuscitation per the Parkland formula, restoring volume and electrolytes without causing hemolysis.
You may also like to solve these questions
Which of the following clients is at greatest risk for extravasation?
- A. The client with heart failure who is receiving Ringer's lactate
- B. The client with cancer who is receiving bendamustine
- C. The client who is receiving potassium supplementation intravenously
- D. The client who is receiving total parenteral nutrition
Correct Answer: B
Rationale: Bendamustine, a chemotherapy drug, is a vesicant, posing a high risk for extravasation, which can cause severe tissue damage if it leaks into surrounding tissues.
The nurse recognizes that a client with pain disorder is improving when the client says which of the following?
- A. I need to have a good cry about all the pain I've been in and then not dwell on it.'
- B. I need to find another physician who can accurately diagnose my condition.'
- C. The pain medicine that you gave me helps me to relax.'
- D. I'm angry with all of the doctors I've seen who don't know what they're doing.'
Correct Answer: A
Rationale: Expressing a desire to process emotions and move forward indicates improved coping, a sign of progress in managing pain disorder.
Which of the following is an adverse effect to therapeutic radiation therapy?
- A. Fibrosis
- B. Alopecia
- C. Oral dryness
- D. Xerostomia
Correct Answer: D
Rationale: Xerostomia (dry mouth) is a common adverse effect of radiation therapy, particularly when the head or neck is irradiated, due to damage to salivary glands.
When educating unlicensed assistants on how to prevent the development of pressure ulcers, the nurse should emphasize that most tissue injuries related to shearing can be prevented by implementing which of the following activities?
- A. Close adherence to a turning schedule
- B. Keeping the skin clean and dry
- C. Proper positioning and moving of the client
- D. Use of skin lubricants
Correct Answer: C
Rationale: Proper positioning and moving techniques prevent shearing injuries, which occur when skin slides over a surface, damaging tissue. Turning schedules and clean skin help but are less specific to shearing.
The nurse is performing Leopold's maneuvers on a woman who is in her eighth month of pregnancy. The nurse is palpating the uterus as shown by the following maneuvers is the nurse performing?
- A. First maneuver.
- B. Second maneuver.
- C. Third maneuver.
- D. Fourth maneuver.
Correct Answer: C
Rationale: The third Leopold's maneuver involves palpating the lower uterus to determine the presenting part, typically performed in the eighth month to assess fetal position.