A nurse is monitoring the ﬂuid replacement of a client who has sustained burns. The nurse should administer which of the following ﬂuids in the first 24 hr following a burn injury?

Dextrose 5% in 0.9% sodium chloride

Dextrose 5% in water

0.9% sodium chloride

Lactated Ringer's

Answer and Explanation

The Correct Answer is D

Choice A Reason: This is incorrect because dextrose 5% in 0.9% sodium chloride is a hypertonic solution that can cause ﬂuid overload and pulmonary edema in a client who has burns.

Choice B Reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause ﬂuid shifts from the intravascular space to the interstitial space, resulting in hypovolemia and hypotension in a client who has burns.

Choice C Reason: This is incorrect because 0.9% sodium chloride is an isotonic solution that can cause hypernatremia and hyperchloremia in a client who has burns, as the ﬂuid loss from burns is greater than the sodium loss.

Choice D Reason: This is correct because lactated Ringer's is an isotonic solution that contains electrolytes similar to plasma, such as sodium, potassium, calcium, and chloride. It also contains lactate, which is converted to bicarbonate in the liver and helps correct the metabolic acidosis that occurs in a client who has burns.

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Correct Answer is A

Explanation

Choice A Reason: This is correct because respiratory acidosis is characterized by a low pH and a high PaCO2, indicating that the client has impaired ventilation and excess carbon dioxide in the blood.

Choice B Reason: This is incorrect because respiratory alkalosis is characterized by a high pH and a low PaCO2, indicating that the client has increased ventilation and reduced carbon dioxide in the blood.

Choice C Reason: This is incorrect because metabolic acidosis is characterized by a low pH and a low HCO3, indicating that the client has an excess of metabolic acids or a loss of base in the blood.

Choice D Reason: This is incorrect because metabolic alkalosis is characterized by a high pH and a high HCO3, indicating that the client has an excess of base or a loss of metabolic acids in the blood.

A. Administer intravenous pain medication. B. Draw blood for a complete blood cell (CBC) count. C. Insert an indwelling urinary catheter. D. Inspect the mouth for signs of inhalation injuries.

Correct Answer is D

Explanation

Choice A Reason: This choice is incorrect because administering intravenous pain medication is not the priority action for a client who has sustained partial-thickness burns. Pain medication may be indicated for pain relief and comfort, but it does not address the potential life-threatening complications of burns such as shock, infection, or respiratory distress.

Choice B Reason: This choice is incorrect because drawing blood for a CBC count is not the priority action for a client who has sustained partial-thickness burns. A CBC count may be useful to monitor the hematological status and detect any signs of infection or anemia, but it does not address the immediate needs of the client

Choice C Reason: This choice is incorrect because inserting an indwelling urinary catheter is not the priority action for a client who has sustained partial-thickness burns. A urinary catheter may be necessary to measure the urine output and assess the renal function and ﬂuid balance, but it does not address the most urgent problem of the client.

Choice D Reason: This choice is correct because inspecting the mouth for signs of inhalation injuries is the priority action for a client who has sustained partial-thickness burns. Inhalation injuries are caused by inhaling hot air, smoke, or toxic gases that damage the airway and lungs. They can cause airway obstruction, bronchospasm, pulmonary edema, or respiratory failure. Therefore, the nurse should inspect the mouth for signs such as soot, singed nasal hairs, burns on the lips or tongue, hoarseness, stridor, or wheezes. The nurse should also monitor the oxygen saturation and arterial blood gases to assess the oxygenation and ventilation status of the client.

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A nurse is monitoring the ﬂuid replacement of a client who has sustained burns. The nurse should administer which of the following ﬂuids in the first 24 hr following a burn injury?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 is 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate which of the following acid-base imbalances?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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