A nurse is feeding a client who has heart failure. Which of the following findings indicates that the client is gaining fluid volume excess?
Creatinine 1.3 mg/dL
BNP 300 pg/mL
Potassium 3.5 mEq/L
Sodium 140 mEq/L
The Correct Answer is B
Choice A reason: Creatinine 1.3 mg/dL is slightly elevated, but it does not indicate fluid volume excess. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.
Choice B reason: BNP 300 pg/mL is high and indicates fluid volume excess. BNP stands for brain natriuretic peptide, which is a hormone released by the heart when it is stretched by increased blood volume or pressure. High BNP levels can indicate heart failure or fluid overload.
Choice C reason: Potassium 3.5 mEq/L is within the normal range (3.5-5.0), and it does not indicate fluid volume excess. Potassium is an electrolyte that helps regulate nerve and muscle function, especially the heart. Low or high potassium levels can cause cardiac arrhythmias, muscle weakness, or paralysis.
Choice D reason: Sodium 140 mEq/L is within the normal range (135-145), and it does not indicate fluid volume excess. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. Low or high sodium levels can cause confusion, seizures, or coma.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Potassium 3.5 mEq/L is not a finding that indicates fluid volume deficit because it is within the normal range, which is 3.5 to 5.0 mEq/L. Potassium is an electrolyte that regulates nerve and muscle function, acid-base balance, and fluid balance. Potassium level can be affected by various factors, such as diet, medication, kidney function, and dehydration.
Choice B reason: Sodium 145 mEq/L is not a finding that indicates fluid volume deficit because it is within the normal range, which is 136 to 145 mEq/L. Sodium is an electrolyte that regulates blood pressure, blood volume, and fluid balance. Sodium level can be affected by various factors, such as diet, medication, kidney function, and fluid loss.
Choice C reason: Hematocrit 53% is a finding that indicates fluid volume deficit because it is above the normal range, which is 38 to 50% for men and 34 to 46% for women. Hematocrit is the percentage of red blood cells in the total blood volume. Hematocrit level can increase due to dehydration, which causes hemoconcentration or increased blood viscosity.
Choice D reason: HbA1c 5% is not a finding that indicates fluid volume deficit because it is within the normal range, which is less than 5.7%. HbA1c is the percentage of hemoglobin that is attached to glucose. HbA1c level reflects the average blood glucose level over the past two to three months. HbA1c level can be affected by various factors, such as diabetes, anemia, and medication.
Correct Answer is A
Explanation
Choice A reason: Scrambled eggs are a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are soft, moist, and easy to swallow. Scrambled eggs also provide protein, iron, and vitamin B12 for the client.
Choice B reason: Tuna fish is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it may contain bones, skin, or scales that can cause discomfort or injury to the gums or mouth. Tuna fish should be avoided or checked for bones and skin before consuming.
Choice C reason: Roast beef is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it is tough, dry, and hard to chew. Roast beef can cause pain, fatigue, or choking for the client who has ill-fitting dentures. Roast beef should be avoided or cut into very small pieces and moistened with gravy or sauce before consuming.
Choice D reason: Apple slices are not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are crisp, firm, and sticky. Apple slices can dislodge or damage the dentures or cause irritation or infection to the gums or mouth. Apple slices should be avoided or cooked until soft and mashed before consuming.
Choice E reason: Dried fruit is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are chewy, sticky, and sugary. Dried fruit can adhere to the dentures or teeth and cause dental caries or gum disease. Dried fruit should be avoided or soaked in water until soft and cut into small pieces before consuming.
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