A nurse is assessing a client who has fluid volume deficit. The nurse should expect which of the following findings?
Increased BUN
Increased urine ketones
Decreased urine specific gravity
Decreased Hgb
The Correct Answer is A
Choice A Reason: This is correct because BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is excreted by the kidneys. Increased BUN indicates fluid volume deficit, as the blood becomes more concentrated and the kidneys have less fluid to filter. A normal BUN level is 7 to 20 mg/dL. The nurse should monitor the client's fluid intake and output, weight, and serum electrolytes, and administer fluids as ordered.
Choice B Reason: This is incorrect because urine ketones are not related to fluid volume deficit, but to diabetic ketoacidosis, which is a complication of diabetes mellitus that occurs when the body breaks down fat for energy and produces ketones as a by-product. Increased urine ketones indicate diabetic ketoacidosis, which can cause
dehydration, acidosis, and coma. A normal urine ketone level is negative or trace. The nurse should monitor the client's blood glucose, pH, and bicarbonate levels, and administer insulin and fluids as ordered.
Choice C Reason: This is incorrect because urine specific gravity is a measure of the concentration of solutes in the urine. Decreased urine specific gravity indicates fluid volume excess, as the urine becomes more diluted and the kidneys excrete more fluid. A normal urine specific gravity range is 1.005 to 1.030. The nurse should monitor the client's fluid balance, vital signs, and edema, and administer diuretics as ordered.
Choice D Reason: This is incorrect because Hgb stands for hemoglobin, which is a protein in red blood cells that carries oxygen. Decreased Hgb indicates anemia, which is a condition that occurs when the blood has a low number of red blood cells or hemoglobin. Anemia can cause fatigue, weakness, and pallor. A normal Hgb level for adult males is 14 to 18 g/dL and for adult females is 12 to 16 g/dL. The nurse should monitor the client's oxygen saturation, iron level, and blood transfusion needs, and administer iron supplements or erythropoietin as ordered.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D","E"]
Explanation
Choice A: Furosemide (Lasix) is incorrect because it is a diuretic that increases urine output and potassium excretion. However, this medication is not effective for patients with chronic renal failure who have oliguria or anuria.
Furosemide can also cause hypokalemia, which is a low potassium level.
Choice B: Sodium polystyrene sulfonate (Kayexalate) is correct because it is a cation exchange resin that binds to potassium in the gastrointestinal tract and removes it from the body through feces. This medication can lower the serum potassium level and prevent hyperkalemia, which is a high potassium level.
Choice C: Dextrose 10% is correct because it is a hypertonic solution that raises the blood glucose level and stimulates the release of insulin. Insulin helps to move potassium from the extracellular fluid into the cells, thus lowering the serum potassium level.
Choice D: Sodium bicarbonate is correct because it is an alkalizing agent that corrects metabolic acidosis, which is a common complication of chronic renal failure. Metabolic acidosis can cause potassium to shift from the intracellular fluid to the extracellular fluid, thus raising the serum potassium level. Sodium bicarbonate can reverse this effect and lower the serum potassium level.
Choice E: Insulin is correct because it also helps to move potassium from the extracellular fluid into the cells, thus lowering the serum potassium level. Insulin can be given intravenously with dextrose 10% to prevent hypoglycemia, which is a low blood glucose level.
Correct Answer is B
Explanation
Choice A: Metabolic alkalosis is incorrect because it is characterized by a high pH and a high HCO3, not a low pH and a normal HCO3. Metabolic alkalosis occurs when there is a loss of metabolic acids or an excess of bicarbonate in the body, such as from vomiting, gastric suctioning, or diuretic therapy.
Choice B: Respiratory acidosis is correct because it is characterized by a low pH and a high PaCO2. Respiratory acidosis occurs when there is impaired gas exchange or hypoventilation, resulting in accumulation of carbon dioxide in the blood. This can be caused by conditions such as chronic obstructive pulmonary disease (COPD), pneumonia, asthma, or chest trauma.
Choice C: Metabolic acidosis is incorrect because it is characterized by a low pH and a low HCO3, not a low pH and a normal HCO3. Metabolic acidosis occurs when there is an excess of metabolic acids in the body, such as lactic acid, ketoacids, or salicylates.
Choice D: Respiratory alkalosis is incorrect because it is characterized by a high pH and a low PaCO2, not a low pH and a high PaCO2. Respiratory alkalosis occurs when there is excessive loss of carbon dioxide through hyperventilation, such as in anxiety, fever, or aspirin overdose.
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