A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following manifestations of dehydration?

A client who has a urine specific gravity of 1.010. (Reference Range 1.005-1.030)

A client who has a hematocrit of 42%. (Reference Range 36-46%)

A client who has a temperature of 39 °C.

A client who has a weight loss of 2.2 kg in 24 hr.

Answer and Explanation

The Correct Answer is D

Choice A reason: A client who has a urine specific gravity of 1.010 is not dehydrated. Urine specific gravity is a measure of the concentration of solutes in the urine. A normal range is 1.005-1.030, which means that the urine is neither too dilute nor too concentrated. A high urine specific gravity (>1.030) indicates dehydration, as the urine becomes more concentrated due to fluid loss. A low urine specific gravity (<1.005) indicates overhydration, as the urine becomes more dilute due to fluid excess.

Choice B reason: A client who has a hematocrit of 42% is not dehydrated. Hematocrit is the percentage of red blood cells in the blood. A normal range is 36-46% for women and 40-54% for men. A high hematocrit (>54% for men and >46% for women) indicates dehydration, as the blood becomes more viscous due to fluid loss. A low hematocrit (<40% for men and <36% for women) indicates overhydration, as the blood becomes more diluted due to fluid excess.

Choice C reason: A client who has a temperature of 39 °C may or may not be dehydrated. Temperature is a measure of the body's heat production and regulation. A normal range is 36.5-37.5 °C. A high temperature (>37.5 °C) indicates fever, which can be caused by various factors, such as infection, inflammation, or medication. Fever can also cause dehydration, as the body loses fluid through sweating and increased respiration. However, fever is not a specific sign of dehydration, as there may be other causes or contributing factors.

Choice D reason: A client who has a weight loss of 2.2 kg in 24 hr is dehydrated. Weight loss is a measure of the change in the body's mass over time. A normal range is 0.5-1 kg per week. A rapid weight loss (>1 kg per day) indicates dehydration, as the body loses fluid through various routes, such as urine, stool, sweat, or vomit. Weight loss is a sensitive and reliable sign of dehydration, as it reflects the amount of fluid loss.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Oily stools are common, especially when excessive fat is consumed, because orlistat blocks the absorption of fat in the intestines. The undigested fat is then eliminated in the stool, making it oily, greasy, or foul-smelling.

Choice B reason: Many patients note having an increase of gas and flatus, because orlistat can also interfere with the digestion of carbohydrates and proteins, causing fermentation and gas production in the colon.

Choice C reason: Constipation is not a common side effect with this medication. In fact, orlistat may cause the opposite effect of diarrhea, as the unabsorbed fat can irritate the bowel and increase the motility.

Choice D reason: Some patients report the development of fecal incontinence, because orlistat can cause unpredictable bowel movements and difficulty in controlling the passage of stool, especially if the patient consumes a high-fat diet.

Choice E reason: This medication does have side effects, even though it can be bought over the counter. Orlistat is a prescription-strength drug that can cause serious adverse reactions, such as liver damage, kidney stones, gallbladder problems, and vitamin deficiencies. The over-the-counter version is a lower dose than the prescription one, but it still requires medical supervision and lifestyle changes.

A. The client quit smoking 6 months ago. B. The client has a strong family history of obesity. C. The client drinks six to eight cans of beer daily. D. The client has poorly controlled type 2 diabetes.

Correct Answer is C

Explanation

Choice A reason: The client quitting smoking 6 months ago is not a factor that would exclude her from being an appropriate surgical candidate. In fact, smoking cessation is a requirement for bariatric surgery, as smoking increases the risk of complications such as infection, thrombosis, and poor wound healing.

Choice B reason: The client having a strong family history of obesity is not a factor that would exclude her from being an appropriate surgical candidate. Family history is one of the genetic factors that can contribute to obesity, but it does not determine the eligibility for bariatric surgery. Other factors such as BMI, comorbidities, lifestyle, and motivation are more important.

Choice C reason: The client drinking six to eight cans of beer daily is a factor that would exclude her from being an appropriate surgical candidate. Alcohol abuse is a contraindication for bariatric surgery, as it can cause liver damage, malnutrition, dehydration, and addiction transfer. The client would need to abstain from alcohol for at least 6 months before and after the surgery.

Choice D reason: The client having poorly controlled type 2 diabetes is not a factor that would exclude her from being an appropriate surgical candidate. Type 2 diabetes is one of the comorbidities that can qualify a client for bariatric surgery, as it can improve or resolve after the surgery. However, the client would need to have a good glycemic control before the surgery to reduce the risk of complications.

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A nurse is assessing four clients for fluid balance. The nurse should identify that which of the following manifestations of dehydration?

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Naxlex Comprehensive Predictor Exams

A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what side effects does this cause?" Which of the following responses by the nurse are correct? SELECT ALL THAT APPLY

Correct Answer is ["A","B","D"]

Explanation

An adult female client has a body mass index of 34.5 kg/m2 and has expressed interest in bariatric surgery. What characteristic of the client's health status may exclude her from being an appropriate surgical candidate?

Correct Answer is C

Explanation

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