A nurse is caring for a client who is receiving IV fluid therapy. For which of the following findings should the nurse monitor as an adverse effect of the IV fluid therapy?
Bradypnea
Distended neck veins
Weight loss
Bradycardia
The Correct Answer is B
A. Bradypnea. Slow respiratory rate is not a typical sign of fluid overload. In fact, fluid volume excess may lead to tachypnea or dyspnea as fluid accumulates in the lungs and impairs gas exchange.
B. Distended neck veins. Jugular vein distention is a classic sign of fluid volume overload. It reflects increased central venous pressure and is commonly seen in clients receiving excessive IV fluids or those with heart failure.
C. Weight loss. IV fluid therapy is intended to increase intravascular volume, and adverse effects are usually related to fluid retention, not loss. Weight gain, not weight loss, would indicate fluid overload.
D. Bradycardia. An increased, not decreased, heart rate (tachycardia) is typically seen with fluid volume excess or in response to fluid shifts. Bradycardia is not a common adverse effect of IV fluid therapy.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Occupational therapist. An occupational therapist is the appropriate specialist to assess and assist with fine motor skills and daily living activities, such as eating. They can provide adaptive equipment and training to help the client maintain independence and improve quality of life.
B. Physical therapist. A physical therapist focuses primarily on gross motor skills, mobility, and physical strength, not fine motor control necessary for holding utensils. They are more involved in rehabilitation related to ambulation and transfers.
C. Dietitian. A dietitian helps develop nutritionally appropriate meal plans based on medical conditions and dietary needs. However, they do not address the client’s ability to physically manage eating tools or self-feed.
D. Social worker. A social worker provides support with emotional, financial, and community resources, but does not assist with the physical or mechanical aspects of daily tasks like feeding. They may coordinate care but not deliver direct therapy for motor challenges.
Correct Answer is D
Explanation
A. Able to unzip a zipper. This fine motor skill typically develops closer to age 2 to 3 years. At 15 months, most toddlers do not yet have the dexterity required to manipulate clothing fasteners.
B. Builds a tower of 4 cubes. A 15-month-old can usually build a tower of 2 to 3 cubes, while building a tower of 4 or more cubes is more typical around 18 to 24 months.
C. Throws a ball without falling. While some toddlers may attempt to throw a ball, doing so without falling is more characteristic of children around 18 months or older as balance improves.
D. Walks without help. This is an expected milestone by 12 to 15 months. Most toddlers at 15 months are able to walk independently, though gait may still be wide-based and unsteady.
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