A nurse is planning to teach a group of newly licensed nurses about hypernatremia. Which of the following manifestations should the nurse include in the teaching?
Seizure
Elevated hematocrit
Bradypnea
Personality change
The Correct Answer is D
A. Seizure: While seizures may occur in severe cases of hypernatremia, they are more typically associated with hyponatremia, where cerebral edema is more prominent due to water shifts into brain cells.
B. Elevated hematocrit: An elevated hematocrit may be seen with dehydration, which can accompany hypernatremia, but it is not a direct or reliable indicator of sodium imbalance itself.
C. Bradypnea: Respiratory changes like bradypnea are not characteristic of hypernatremia. This condition primarily affects the neurological system, not the respiratory system.
D. Personality change: Hypernatremia causes cellular dehydration, particularly in brain cells, leading to neurological symptoms such as confusion, agitation, irritability, and personality changes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
A. Wear a dosimeter film badge to measure exposure: The dosimeter badge tracks cumulative radiation exposure to ensure the nurse stays within safe limits. It is essential personal protective equipment when caring for clients undergoing internal radiation therapy.
B. Place a caution sign on the client’s door: A radiation warning sign alerts staff and visitors about the presence of a radioactive source, ensuring they follow safety protocols to minimize unnecessary exposure.
C. Discard bed linens from the client's room at the end of each day: Linens are not contaminated by a sealed implant, as the radiation source is enclosed and does not leak into the environment. Linens should be handled per routine procedure unless visibly soiled.
D. Instruct visitors to remain 61 cm (2 feet) away from the client: Visitors should be instructed to stay at least 6 feet (approximately 183 cm) away and limit visits to 30 minutes. The 2-foot distance is insufficient to ensure safety from radiation exposure.
E. Don a lead apron when providing care: A lead apron helps shield the nurse from radiation exposure when close contact is necessary. It is a standard precaution when interacting with clients who have a sealed radiation source.
Correct Answer is C
Explanation
A. Trim the fat from red meat prior to cooking: Children with cystic fibrosis often require higher fat intake due to malabsorption, so removing fat is not recommended unless medically indicated for another reason.
B. Give the child hot foods to reduce the sense of fullness: There is no physiological basis to suggest that giving hot foods reduces a sense of fullness in children with cystic fibrosis. Large volumes or very hot/cold foods could potentially exacerbate gastrointestinal discomfort. fullness is more effectively managed with enzyme support and meal planning.
C. Provide a diet high in protein and calories: Due to increased energy needs and poor nutrient absorption, children with cystic fibrosis benefit from a high-calorie, high-protein diet to support growth and maintain weight.
D. Administer pancreatic enzymes 30 min after meals: Pancreatic enzymes should be given just before or at the start of meals to aid digestion effectively. Giving them 30 minutes after eating would not support optimal nutrient absorption.
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