A nurse is assessing a client who has a fluid volume deficit. The nurse should expect which of the following findings?
Decreased hemoglobin (Hgb)
Increased blood urea nitrogen (BUN)
Increased urine ketones
Decreased urine specific gravity
The Correct Answer is B
Choice A reason:
Decreased hemoglobin (Hgb) levels can be indicative of anemia or blood loss, but they are not typically associated with fluid volume deficit. In cases of fluid volume deficit, the Hgb concentration may actually appear elevated due to hemoconcentration as the plasma volume decreases.
Choice B reason:
Increased blood urea nitrogen (BUN) levels are expected in a fluid volume deficit because as the blood volume decreases, the concentration of solutes like urea can increase. This is often due to decreased renal perfusion and subsequent reduced renal function, leading to less urea being excreted through the kidneys.
Choice C reason:
Increased urine ketones are typically associated with diabetic ketoacidosis or starvation, not directly with fluid volume deficit. Ketones are produced when the body breaks down fats for energy, which is not a process directly related to fluid volume status.
Choice D reason:
Decreased urine specific gravity would not be expected in fluid volume deficit; in fact, one would expect the opposite. Specific gravity measures the kidney's ability to concentrate urine. In fluid volume deficit, the urine specific gravity would likely be increased as the body attempts to conserve water.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
The statement that symptoms can worsen with penile penetration during intercourse is partially correct. While sexual activity may exacerbate feelings of bulging or discomfort associated with uterine prolapse, it does not typically worsen the prolapse itself⁹. Painful intercourse, known as dyspareunia, is a common symptom of pelvic organ prolapse, which includes uterine prolapse.
Choice B reason:
Feeling a sensation of pressure in the pelvis is a classic symptom of uterine prolapse. As the uterus descends into the vaginal canal, it can create a sensation of fullness or pressure that is often noticeable and uncomfortable for the patient.
Choice C reason:
Low back pain is indeed a symptom that can be associated with uterine prolapse. The weakening of pelvic floor muscles and ligaments that leads to prolapse can also contribute to discomfort in the lower back.
Choice D reason:
The presence of feces in the vagina would not be a direct symptom of uterine prolapse. However, a related condition called rectocele, where the rectum bulges into the vagina, could cause such a symptom. This condition is different from uterine prolapse and would require separate management.
Correct Answer is D
Explanation
Choice A reason:
While the white blood cell (WBC) count is important in assessing the immune system's ability to fight infection, a WBC of 5,000/mm³ is within the normal range (4,500 to 11,000 WBCs/mm³). Therefore, it is not the most critical value for a nurse to prioritize in the care of an HIV patient.
Choice B reason:
A platelet count of 150,000/mm³ is also within the normal range (150,000 to 450,000 platelets/mm³). Although thrombocytopenia can occur in HIV, this value does not indicate an immediate concern for the nurse to prioritize.
Choice C reason:
A positive Western blot test confirms the presence of HIV antibodies, which is indicative of HIV infection. However, this is a diagnostic result rather than a laboratory value that reflects the current status of the patient's immune function or disease progression.
Choice D reason:
The CD4-T-cell count is a critical laboratory value for assessing the immune function of a patient with HIV. A count of 180 cells/mm³ is below the normal range of 500 to 1,200 cells/mm³ and indicates a significantly weakened immune system, placing the patient at risk for opportunistic infections. This value is a priority as it guides treatment decisions and the need for prophylaxis against opportunistic infections.
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