A client is admitted with hypovolemia due to severe bleeding. Which Intravenous fluid does the nurse anticipate using to replace fluid losses?

5% dextrose in 0.25% sodium chloride (D51/4NS)

3% sodium chloride (3% NaCl)

5% dextrose in water (DSW)

0.9% sodium chloride (0.9% NaCl)

Answer and Explanation

The Correct Answer is D

D. 0.9% sodium chloride (0.9% NaCl): This solution, also known as normal saline, is isotonic and contains the same concentration of sodium as extracellular fluid. It is the most appropriate choice for initial fluid resuscitation in hypovolemia due to severe bleeding because it rapidly expands intravascular volume, replaces sodium losses, and helps restore circulating blood volume.
A. This solution contains dextrose (glucose) and a small amount of sodium chloride. It provides some glucose for energy but has a lower sodium concentration compared to isotonic solutions like normal saline. While it may be used in certain situations, such as to provide maintenance fluids or correct mild dehydration, it is not the first choice for fluid resuscitation in hypovolemia due to severe bleeding because it does not adequately replace lost volume.
B. 3% sodium chloride (3% NaCl): This solution is hypertonic and has a high sodium concentration. It is not typically used for initial fluid resuscitation in hypovolemia due to severe bleeding. Hypertonic saline solutions like 3% NaCl are more commonly used in specific situations such as severe hyponatremia or cerebral edema.
C. 5% dextrose in water (D5W): This solution contains only dextrose and water and is isotonic until the dextrose is metabolized, after which it becomes hypotonic. D5W is not suitable for fluid resuscitation in hypovolemia due to severe bleeding because it does not provide adequate sodium or volume replacement.

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Correct Answer is B

Explanation

B. Elevating the head of the bed to 30-45 degrees is the recommended position for administering enteral feeding to reduce the risk of aspiration. This semi-upright position helps promote gastric emptying and reduces the likelihood of reflux or regurgitation of the feed into the lungs. It also allows for better tolerance of the feeding and minimizes the risk of complications.
A. Positioning the client on the left side with the knees bent is not typically recommended for enteral feeding. This position may increase the risk of aspiration, especially if the client has impaired swallowing or if there are issues with gastric emptying. It may also not be the most comfortable or practical position for administering enteral feeding.
C. Positioning the client on the right side with a pillow behind the back is not a standard practice for administering enteral feeding. This position may not provide optimal access for administering the feed, and it does not offer the benefits of head elevation to reduce the risk of aspiration.

D. Elevating the head of the bed to only 15 degrees may not provide sufficient upright positioning to reduce the risk of aspiration during enteral feeding. While it is better than lying completely flat, a higher degree of elevation (30-45 degrees) is generally recommended for optimal safety and effectiveness of enteral feeding.

A. "I will not need to take medications to help with my problem." B. "These attacks could last seconds to minutes." C. "These attacks can come on suddenly even when I am alert and active." D. "Sometimes when I get angry It can trigger the attacks."

Correct Answer is A

Explanation

A. Narcolepsy is a chronic neurological disorder characterized by excessive daytime sleepiness and other symptoms such as cataplexy (sudden loss of muscle tone), sleep paralysis, and hallucinations. While lifestyle modifications and behavioral strategies may help manage symptoms, medications are often necessary to control narcolepsy symptoms effectively. Therefore, if a client with narcolepsy states that they will not need medications, further teaching is indeed needed.
B. Narcoleptic attacks, or sleep attacks, can indeed last seconds to minutes. They are characterized by sudden and uncontrollable episodes of sleepiness or sleep onset, which can occur during daytime activities.
C. Narcoleptic attacks can occur suddenly, even when the individual is alert and engaged in activities. These attacks are unpredictable and can significantly disrupt daily life.
D. Emotional triggers, such as stress, excitement, or anger, can sometimes precipitate or exacerbate narcoleptic symptoms, including sleep attacks and cataplexy. However, not all individuals with narcolepsy experience triggers in the same way, and triggers can vary among individuals. Therefore, this statement may or may not be true for the individual in question.

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A client is admitted with hypovolemia due to severe bleeding. Which Intravenous fluid does the nurse anticipate using to replace fluid losses?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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