A nurse is assessing a client who has experienced significant blood loss. Which of the following is a clinical sign of hypovolemia?

Bradycardia

Hypertension

Polyuria

Cool, clammy skin

Answer and Explanation

The Correct Answer is D

A. Bradycardia is not typical in hypovolemia; tachycardia is more common as the body compensates for fluid loss.
B. Hypotension, rather than hypertension, occurs due to reduced blood volume.
C. Polyuria is not a feature of hypovolemia; decreased urine output is expected.
D. Cool, clammy skin is a classic sign of hypovolemic shock as blood flow to the skin decreases in response to blood loss.

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Correct Answer is C

Explanation

A. A sonogram may help identify kidney abnormalities but is not the initial test for suspected infection.
B. A CT scan may be needed for further evaluation but is typically not the first test ordered.
C. A midstream urine culture is often the initial diagnostic test for suspected urinary tract infections or pyelonephritis, based on symptoms of chills, fever, and flank pain.
D. An intravenous pyelogram is used to detect structural abnormalities, such as renal calculi, but is not the initial test for infection symptoms.

A. Oral hypoglycemic medications B. Dextrose 5% in 0.45% sodium chloride C. Glucocorticoid medications D. 0.9% sodium chloride IV bolus

Correct Answer is D

Explanation

A. Oral hypoglycemics are not appropriate for managing DKA, as immediate and effective control of blood glucose levels is required through IV insulin.
B. Dextrose solutions are not initially indicated, as they could elevate blood glucose further. Dextrose may be considered once blood glucose reaches a safer level (around 250 mg/dL).
C. Glucocorticoids can increase blood glucose levels, so they are contraindicated in DKA management.
D. 0.9% sodium chloride IV bolus is essential to address dehydration commonly seen in DKA due to osmotic diuresis and to restore blood volume.

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A nurse is assessing a client who has experienced significant blood loss. Which of the following is a clinical sign of hypovolemia?

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