A nurse is assessing a client who reports nausea and vomiting for the past 24 hr. Which of the following findings should indicate to the nurse that the client is experiencing dehydration?

Tachycardia

Urine output of 850 mL per day

Serum sodium level of 130 mEq/L (136 to 145 mEq/L)

Distended neck veins while in a sitting position

Answer and Explanation

The Correct Answer is A

Choice A reason: Tachycardia is a classic sign of dehydration. When fluid volume decreases, cardiac output drops, and the body compensates by increasing heart rate to maintain perfusion. This makes tachycardia a reliable indicator of dehydration in a client with prolonged vomiting.

Choice B reason: A urine output of 850 mL per day is within normal limits (normal adult urine output is 800–2000 mL/day). Dehydration would typically present with oliguria, defined as less than 400 mL/day. Therefore, this finding does not indicate dehydration.

Choice C reason: A serum sodium level of 130 mEq/L indicates hyponatremia, which can occur with excessive vomiting and fluid loss. However, hyponatremia is not a direct indicator of dehydration; it reflects electrolyte imbalance. Dehydration is more directly identified by clinical signs such as tachycardia, hypotension, and dry mucous membranes.

Choice D reason: Distended neck veins suggest fluid overload, not dehydration. In dehydration, neck veins are typically flat or collapsed due to reduced circulating volume. This finding is inconsistent with dehydration.

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Correct Answer is C

Explanation

Choice A reason: Rocuronium is a non-depolarizing neuromuscular blocker used for muscle relaxation during intubation or surgery. It does not treat malignant hyperthermia, which is the likely cause of the elevated temperature after succinylcholine administration.

Choice B reason: Epinephrine is used for anaphylaxis, cardiac arrest, and severe asthma exacerbations. It does not address the underlying pathophysiology of malignant hyperthermia, which involves uncontrolled calcium release in skeletal muscle.

Choice C reason: Dantrolene is the correct medication. It directly reduces muscle contraction by inhibiting calcium release from the sarcoplasmic reticulum. This action reverses the hypermetabolic state of malignant hyperthermia, lowering body temperature and preventing further complications such as rhabdomyolysis and organ failure.

Choice D reason: Flumazenil is a benzodiazepine antagonist used to reverse sedation. It has no role in treating malignant hyperthermia or hyperthermia caused by succinylcholine.

A. Decreased blood urea nitrogen B. Decreased serum potassium C. Increased triglyceride level D. Increased calcium level

Correct Answer is C

Explanation

Choice A reason: Decreased blood urea nitrogen is not a typical finding in metabolic syndrome. Blood urea nitrogen levels are more reflective of renal function and hydration status. Metabolic syndrome is characterized by a cluster of metabolic abnormalities such as dyslipidemia, insulin resistance, hypertension, and central obesity. Therefore, a decrease in blood urea nitrogen is unrelated and not expected in this condition.

Choice B reason: Decreased serum potassium is not a hallmark of metabolic syndrome. Potassium levels are influenced by renal function, diuretic use, or gastrointestinal losses, but metabolic syndrome does not inherently cause hypokalemia. Electrolyte disturbances are not part of the diagnostic criteria for metabolic syndrome, making this finding incorrect.

Choice C reason: Increased triglyceride level is a classic finding in metabolic syndrome. Elevated triglycerides are part of the diagnostic criteria, along with increased waist circumference, elevated fasting glucose, reduced HDL cholesterol, and hypertension. Hypertriglyceridemia reflects insulin resistance and altered lipid metabolism, both central features of metabolic syndrome. This makes it the correct answer.

Choice D reason: Increased calcium level is not associated with metabolic syndrome. Calcium levels are typically influenced by parathyroid hormone regulation, vitamin D status, or bone metabolism. Metabolic syndrome does not directly alter calcium homeostasis, so this finding would not be expected.

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A nurse is assessing a client who reports nausea and vomiting for the past 24 hr. Which of the following findings should indicate to the nurse that the client is experiencing dehydration?

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