A nurse is monitoring a client who has dehydration and is receiving IV fluid replacement.
Which of the following findings should the nurse identify as effectiveness of the treatment?

Urine output 200 mL/4 hr.

Heart rate 104/min.

Peripheral pulses +1.

Urine specific gravity 1.04. .

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The nurse should identify that an effective outcome of IV fluid replacement in a client with dehydration is an increase in urine output. Urine output of 200 mL in 4 hours indicates that the kidneys are responding to the IV fluid replacement, and the client is likely rehydrating. This suggests that the renal perfusion has improved, and the client's body is eliminating waste products properly.

Choice B rationale:

A heart rate of 104 beats per minute is not necessarily indicative of the effectiveness of IV fluid replacement. Heart rate may vary for various reasons, and it is not a specific parameter for assessing the response to hydration. Other factors, such as blood pressure, should be considered to evaluate cardiovascular status.

Choice C rationale:

Peripheral pulses of +1 are not a direct indicator of the effectiveness of IV fluid replacement. While improved hydration may lead to better peripheral perfusion, this assessment is somewhat subjective and may not accurately reflect the overall effectiveness of the treatment.

Choice D rationale:

A urine specific gravity of 1.04 is not indicative of the effectiveness of IV fluid replacement. A specific gravity of 1.004 is within the normal range (normal range: 1.005-1.030) and does not necessarily indicate hydration status. It is essential to focus on urine output and other objective parameters to assess the effectiveness of hydration therapy. .

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Correct Answer is A

Explanation

Choice A rationale:

The nurse should identify that the client needs liver function tests while taking pyrazinamide. Pyrazinamide is one of the drugs used to treat tuberculosis, and it is known to potentially cause hepatotoxicity (liver damage). Regular monitoring of liver function tests, including liver enzymes like ALT and AST, is essential to detect any liver-related issues early and ensure the client's safety during the medication therapy.

Choice B rationale:

Thyroid function studies are not typically necessary while a client is taking pyrazinamide. Pyrazinamide is not known to have a direct effect on thyroid function.

Choice C rationale:

Blood glucose levels do not need to be monitored specifically due to pyrazinamide therapy. Although some antituberculosis drugs may affect blood sugar levels, pyrazinamide is not a common culprit for such side effects.

Choice D rationale:

Gallbladder studies are not typically indicated while taking pyrazinamide. Pyrazinamide is not known to cause specific issues related to the gallbladder. Monitoring liver function is more critical due to its potential hepatotoxicity.

A. "A headache indicates tolerance to the medication.”. B. "It sounds as if you are allergic to this medication.”. C. "A headache is a common adverse effect of this medication, but it will probably occur less often over time.”. D. "Your headache is probably a result of anxiety about the chest pain.”.

Correct Answer is C

Explanation

Choice A rationale:

Tolerance to nitroglycerin is not indicated by the presence of a headache. Nitroglycerin is a vasodilator used to relieve angina, and headaches can be a common side effect.

Choice B rationale:

Allergic reactions to nitroglycerin are rare, and a headache is not a typical symptom of an allergy to this medication.

Choice C rationale:

"A headache is a common adverse effect of this medication, but it will probably occur less often over time.”. This is the correct response. Nitroglycerin commonly causes headaches due to its vasodilatory effects. Patients often experience this side effect initially, but it tends to improve or occur less frequently with continued use. The nurse should educate the client about this and reassure them that the headaches should diminish over time.

Choice D rationale:

Anxiety may exacerbate chest pain, but it is not the likely cause of the headache. It is important to address the headache as a potential side effect of the medication.

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A nurse is monitoring a client who has dehydration and is receiving IV fluid replacement.Which of the following findings should the nurse identify as effectiveness of the treatment?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has tuberculosis and is about to start taking pyrazinamide.The nurse should identify that the client needs which of the following tests while taking this medication therapy?

Correct Answer is A

Explanation

A nurse administered nitroglycerin sublingually to a client who has angina pectoris and experienced chest pain.The client states that his chest pain is relieved but now he has a headache.Which of the following responses by the nurse is appropriate?

Correct Answer is C

Explanation

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A nurse is monitoring a client who has dehydration and is receiving IV fluid replacement.
Which of the following findings should the nurse identify as effectiveness of the treatment?