A nurse is collecting data from a patient who has dehydration. Which of the following findings should the nurse expect?
Moist skin
Dark-colored urine
High blood pressure
Distended neck veins
The Correct Answer is B
Choice A reason: Moist skin is not a sign of dehydration, but rather a sign of adequate hydration or sweating. Dehydration can cause dry skin, mucous membranes, and lips.
Choice B reason: Dark-colored urine is a sign of dehydration, as it indicates a high concentration of waste products and a low volume of water in the urine. Dehydration can cause the kidneys to conserve water and produce less urine.
Choice C reason: High blood pressure is not a sign of dehydration, but rather a sign of fluid overload or other factors such as stress, pain, or medication. Dehydration can cause low blood pressure, as it reduces the blood volume and the cardiac output.
Choice D reason: Distended neck veins are not a sign of dehydration, but rather a sign of fluid overload or right-sided heart failure. Dehydration can cause flat neck veins, as it reduces the venous return and the central venous pressure.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is incorrect because respiratory alkalosis is a condition where the blood pH is higher than the normal range of 7.35 to 7.45, due to hyperventilation, which lowers the carbon dioxide in the blood. Severe diarrhea does not cause hyperventilation, but rather dehydration and electrolyte imbalance.
Choice B reason: This is incorrect because metabolic alkalosis is a condition where the blood pH is higher than the normal range of 7.35 to 7.45, due to a loss of acids or an excess of bases in the body. Severe diarrhea does not cause a loss of acids or an excess of bases, but rather a loss of fluids and bicarbonate, which is a base that buffers the acids in the blood.
Choice C reason: This is correct because metabolic acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to an excess of acids or a loss of bases in the body. Severe diarrhea causes a loss of fluids and bicarbonate, which is a base that buffers the acids in the blood. This leads to an accumulation of acids and a decrease in pH.
Choice D reason: This is incorrect because respiratory acidosis is a condition where the blood pH is lower than the normal range of 7.35 to 7.45, due to impaired gas exchange or hypoventilation, which causes carbon dioxide to accumulate in the blood. Severe diarrhea does not affect the respiratory system directly, but rather the metabolic system.
Correct Answer is A
Explanation
Choice A reason: Renal failure can cause hyperkalemia because the kidneys are unable to excrete excess potassium from the body. This can lead to high levels of potassium in the blood, which can affect the heart and muscles.
Choice B reason: Diarrhea can cause hypokalemia, not hyperkalemia, because it can lead to loss of potassium from the gastrointestinal tract. This can result in low levels of potassium in the blood, which can also affect the heart and muscles.
Choice C reason: Blood transfusion can cause hyperkalemia if the blood is old or hemolyzed, meaning that the red blood cells have broken down and released potassium into the plasma. This can increase the potassium levels in the recipient's blood.
Choice D reason: Diaphoresis, or sweating, can cause hypokalemia, not hyperkalemia, because it can lead to loss of potassium from the skin. This can also lower the potassium levels in the blood.
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