A nurse is assessing a client who has fluid overload.
Which of the following findings should the nurse expect? (Select all that apply.).
Increased heart rate.
Increased respiratory rate.
Increased temperature.
Increased hematocrit.
Increased blood pressure.
Correct Answer : A,B,E
Choice A rationale:
Increased heart rate is a compensatory mechanism to maintain cardiac output in the presence of fluid overload.
Choice B rationale:
Increased respiratory rate may occur due to pulmonary congestion caused by fluid overload.
Choice C rationale:
Increased temperature is not typically associated with fluid overload.
Choice D rationale:
Increased hematocrit would indicate dehydration, not fluid overload.
Choice E rationale:
Increased blood pressure can occur due to increased blood volume in fluid overload.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Basal cell carcinoma often appears as a raised, flesh-colored lesion with pearly, white borders. It is the most common type of skin cancer.
Choice B rationale:
Actinic keratosis is a precancerous skin condition that can lead to squamous cell carcinoma if left untreated. It typically presents as dry, scaly patches or spots.
Choice C rationale:
Squamous cell carcinoma often appears as a firm, red nodule or a flat lesion with a scaly, crusted surface.
Choice D rationale:
Malignant melanoma is a more serious type of skin cancer that can develop anywhere on the body. It often appears as a new, irregular, or changing mole.
Correct Answer is A
Explanation
Choice A rationale:
Potassium 2.3 mEq/L is below the normal range of 3.5 to 5.0 mEq/L1. Hydrochlorothiazide, a diuretic, can cause hypokalemia, which is a low level of potassium.
Choice B rationale:
Chloride 99 mEq/L is within the normal range of 96 to 106 mEq/L2, so it’s not a concern.
Choice C rationale:
Sodium 136 mEq/L is within the normal range of 135 to 145 mEq/L3, so it’s not a concern.
Choice D rationale:
Calcium 10 mg/dL is within the normal range of 8.6 to 10.2 mg/dL4, so it’s not a concern.
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