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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Reporting ability to complete ADLs is not a specific finding that indicates that probiotic therapy is effective. Ability to complete ADLs depends on various factors, such as energy level, muscle strength, mobility, cognition, and motivation. Ability to complete ADLs may improve with parenteral nutrition, but not necessarily with probiotic therapy.
Choice B reason: Having pink mucous membranes is not a specific finding that indicates that probiotic therapy is effective. Pink mucous membranes reflect adequate hydration and oxygenation status, which are important for overall health, but not directly related to probiotic therapy.
Choice C reason: Having blood glucose level within the expected reference range is not a specific finding that indicates that probiotic therapy is effective. Blood glucose level is influenced by carbohydrate intake, insulin production, and medication use, which are related to parenteral nutrition, but not probiotic therapy.
Choice D reason: Having soft, formed bowel movements is a specific finding that indicates that probiotic therapy is effective. Probiotic therapy is the use of beneficial bacteria or yeast to restore the normal flora and function of the gastrointestinal tract, which can prevent or treat diarrhea, constipation, or infection. Having soft, formed bowel movements shows that the client has a healthy and balanced gut microbiome.
Correct Answer is C
Explanation
Choice A reason: Limiting high-calorie supplements to between meals is not a good strategy for managing anorexia while receiving radiation therapy because it can reduce the appetite and intake of regular meals, which are more nutritious and balanced. High-calorie supplements should be used as an addition to, not a replacement for, regular meals.
Choice B reason: Avoiding overeating during 'good' days is not a good strategy for managing anorexia while receiving radiation therapy because it can cause discomfort, nausea, or vomiting, which can worsen anorexia and affect the tolerance of radiation therapy. Eating should be based on hunger and satiety cues, not on good or bad days.
Choice C reason: Consuming nutrition-dense foods first is a good strategy for managing anorexia while receiving radiation therapy because it can ensure adequate intake of calories, protein, vitamins, and minerals, which are essential for healing and recovery. Nutrition-dense foods are those that provide high amounts of nutrients per serving, such as eggs, cheese, nuts, beans, and meat.
Choice D reason: Eating hot foods rather than cold foods is not a good strategy for managing anorexia while receiving radiation therapy because it can irritate the mouth and throat, which may be inflamed or sore due to radiation therapy. Cold foods are more soothing and refreshing for the mouth and throat, such as ice cream, yogurt, smoothies, and popsicles.
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