A nurse is caring for a client who has hypernatremia. Which of the following actions should the nurse take? (Select all that apply.)
Restrict fluid intake
Monitor neurological status
Administer hypotonic IV fluids
Encourage foods high in sodium
Provide oral hygiene frequently
Correct Answer : B,C,E
Choice A reason:
Restricting fluid intake is not an action that the nurse should take for a client who has hypernatremia. Fluid restriction can worsen hypernatremia by increasing the concentration of sodium in the blood. Fluid intake should be increased or replaced with isotonic or hypotonic fluids to dilute sodium and correct hypernatremia.
Choice B reason:
Monitoring neurological status is an action that the nurse should take for a client who has hypernatremia. Hypernatremia can cause neurological symptoms such as confusion, agitation, seizures, coma, and death due to cellular dehydration and brain shrinkage. The nurse should assess the client's level of consciousness, orientation, memory, behavior, and reflexes regularly and report any changes or deterioration.
Choice C reason:
Administering hypotonic IV fluids is an action that the nurse should take for a client who has hypernatremia. Hypotonic fluids have a lower concentration of solutes than normal body fluids and can help lower serum sodium levels by moving water into the cells from the blood vessels. The nurse should administer hypotonic fluids slowly and carefully to avoid fluid overload or cerebral edema.
Choice D reason:
Encouraging foods high in sodium is not an action that the nurse should take for a client who has hypernat
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A reason:
This is a correct answer because healing of ulcers is an expected outcome of PPI therapy for PUD, as it occurs when the acid-induced damage to the mucosa is repaired and the ulcer is closed.
Choice B reason:
This is a correct answer because relief of pain is an expected outcome of PPI therapy for PUD, as it occurs when the acid-induced irritation and inflammation of the mucosa and the nerve endings are reduced.
Choice C reason:
This is an incorrect answer because eradication of H. pylori is not an expected outcome of PPI therapy for PUD, as it requires a combination of antibiotics and bismuth compounds to kill the bacteria and prevent its recurrence.
Choice D reason:
This is a correct answer because prevention of bleeding is an expected outcome of PPI therapy for PUD, as it occurs when the acid-induced erosion and perforation of the mucosa and the blood vessels are prevented.
Choice E reason:
This is a correct answer because reduction of inflammation is an expected outcome of PPI therapy for PUD, as it occurs when the acid-induced activation of inflammatory mediators and immune cells are inhibited.
Correct Answer is A
Explanation
Choice A reason:
Gram-positive cocci are bacteria that have a spherical shape and stain purple with Gram stain due to their thick peptidoglycan cell wall. Streptococcus pyogenes is an example of gram-positive cocci that can cause infections such as pharyngitis, impetigo, cellulitis, necrotizing fasciitis, or rheumatic fever.
Choice B reason:
Gram-negative cocci are bacteria that have a spherical shape and stain pink with Gram stain due to their thin peptidoglycan cell wall and outer membrane. Neisseria gonorrhoeae and Neisseria meningitidis are examples of gram-negative cocci that can cause infections such as gonorrhea, meningitis, or septicemia.
Choice C reason:
Gram-positive bacilli are bacteria that have a rod-shaped shape and stain purple with Gram stain due to their thick peptidoglycan cell wall. Bacillus anthracis and Clostridium botulinum are examples of gram-positive bacilli that can cause infections such as anthrax, botulism, or tetanus.
Choice D reason:
Gram-negative bacilli are bacteria that have a rod-shaped shape and stain pink with Gram stain due to their thin peptidoglycan cell wall and outer membrane. Escherichia coli and Pseudomonas aeruginosa are examples of gram-negative bacilli that can cause infections such as urinary tract infection, wound infection, or sepsis.
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