A nurse is collecting data from a client who has hyperparathyroidism and is receiving 0.9% sodium chloride via IV infusion. Which of the following manifestations should the nurse identify as an adverse effect of the treatment?
New onset of hearing loss
Kussmaul respirations
Hyperthermia
Chvostek's sig
The Correct Answer is D
Rationale:
A. New onset of hearing loss: Hearing loss is not a typical adverse effect of 0.9% sodium chloride infusion. It may occur with high-dose loop diuretics like furosemide but is unrelated to isotonic fluid administration or hyperparathyroidism management.
B. Kussmaul respirations: These are deep, rapid respirations seen in metabolic acidosis, particularly diabetic ketoacidosis. They are not associated with isotonic fluid infusion or calcium disturbances in hyperparathyroidism.
C. Hyperthermia: Elevated body temperature is not linked to 0.9% sodium chloride infusion. Hyperthermia may occur with infections or neurologic injury, but not as a direct consequence of isotonic fluid therapy.
D. Chvostek's sign: Chvostek's sign is a clinical indicator of hypocalcemia, which can occur as an adverse effect of 0.9% sodium chloride infusion in clients with hyperparathyroidism. Large volumes of saline increase calcium excretion, potentially leading to low serum calcium levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. "Why have you changed your mind about the procedure?": Asking “why” can feel confrontational and may pressure the client to justify their decision rather than respecting their autonomy. It’s better to acknowledge their feelings without judgment.
B. "You have the right to refuse the procedure.": Affirming the client’s right to refuse respects their autonomy and legal rights. It opens the door for further discussion and ensures informed consent is voluntary and ongoing.
C. "Have you had any troubles with swallowing?": This question is unrelated to the client’s decision to refuse the bronchoscopy and does not address their expressed concern or right to refuse.
D. "Your doctor wants you to have this procedure.": Emphasizing the provider’s wishes may pressure the client and undermine their autonomy. The nurse’s role is to support informed decision-making, not to coerce.
Correct Answer is D
Explanation
Rationale:
A. Inform the caregiver that it is okay to use the same towels: Sharing towels can spread impetigo, which is a highly contagious bacterial skin infection. Families should be instructed to use separate towels, washcloths, and linens to reduce the risk of cross-contamination.
B. Request the provider to prescribe an antiviral medication: Impetigo is caused by bacteria such as Staphylococcus aureus or Streptococcus pyogenes, not viruses. Antibacterial agents, not antivirals, are the appropriate treatment for managing this condition.
C. Place the toddler on droplet precautions: Impetigo primarily spreads through direct contact with lesions or contaminated objects, not respiratory droplets. Standard precautions with contact isolation are typically used rather than droplet precautions.
D. Prevent the toddler from scratching their skin by using elbow restraints: Scratching can worsen impetigo lesions and lead to further bacterial spread or secondary infection. Using soft restraints like elbow splints can safely discourage scratching and promote healing while preventing the infection from spreading.
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